Huihui Fang

Junde Wu, Rao Fu, Huihui Fang et al.

Diffusion probabilistic model (DPM) recently becomes one of the hottest topic in computer vision. Its image generation application such as Imagen, Latent Diffusion Models and Stable Diffusion have shown impressive generation capabilities, which aroused extensive discussion in the community. Many recent studies also found it is useful in many other vision tasks, like image deblurring, super-resolution and anomaly detection. Inspired by the success of DPM, we propose the first DPM based model toward general medical image segmentation tasks, which we named MedSegDiff. In order to enhance the step-wise regional attention in DPM for the medical image segmentation, we propose dynamic conditional encoding, which establishes the state-adaptive conditions for each sampling step. We further propose Feature Frequency Parser (FF-Parser), to eliminate the negative effect of high-frequency noise component in this process. We verify MedSegDiff on three medical segmentation tasks with different image modalities, which are optic cup segmentation over fundus images, brain tumor segmentation over MRI images and thyroid nodule segmentation over ultrasound images. The experimental results show that MedSegDiff outperforms state-of-the-art (SOTA) methods with considerable performance gap, indicating the generalization and effectiveness of the proposed model. Our code is released at https://github.com/WuJunde/MedSegDiff.

Huihui Fang, Fei Li, Huazhu Fu et al.

Glaucoma causes irreversible vision loss due to damage to the optic nerve, and there is no cure for glaucoma.OCT imaging modality is an essential technique for assessing glaucomatous damage since it aids in quantifying fundus structures. To promote the research of AI technology in the field of OCT-assisted diagnosis of glaucoma, we held a Glaucoma OCT Analysis and Layer Segmentation (GOALS) Challenge in conjunction with the International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) 2022 to provide data and corresponding annotations for researchers studying layer segmentation from OCT images and the classification of glaucoma. This paper describes the released 300 circumpapillary OCT images, the baselines of the two sub-tasks, and the evaluation methodology. The GOALS Challenge is accessible at https://aistudio.baidu.com/aistudio/competition/detail/230.

Junde Wu, Huihui Fang, Fei Li et al.

GAMMA Challenge is organized to encourage the AI models to screen the glaucoma from a combination of 2D fundus image and 3D optical coherence tomography volume, like the ophthalmologists.

Junde Wu, Huihui Fang, Yehui Yang et al.

Different from the general visual classification, some classification tasks are more challenging as they need the professional categories of the images. In the paper, we call them expert-level classification. Previous fine-grained vision classification (FGVC) has made many efforts on some of its specific sub-tasks. However, they are difficult to expand to the general cases which rely on the comprehensive analysis of part-global correlation and the hierarchical features interaction. In this paper, we propose Expert Network (ExpNet) to address the unique challenges of expert-level classification through a unified network. In ExpNet, we hierarchically decouple the part and context features and individually process them using a novel attentive mechanism, called Gaze-Shift. In each stage, Gaze-Shift produces a focal-part feature for the subsequent abstraction and memorizes a context-related embedding. Then we fuse the final focal embedding with all memorized context-related embedding to make the prediction. Such an architecture realizes the dual-track processing of partial and global information and hierarchical feature interactions. We conduct the experiments over three representative expert-level classification tasks: FGVC, disease classification, and artwork attributes classification. In these experiments, superior performance of our ExpNet is observed comparing to the state-of-the-arts in a wide range of fields, indicating the effectiveness and generalization of our ExpNet. The code will be made publicly available.

Junde Wu, Huihui Fang, Hoayi Xiong et al.

On the medical images, many of the tissues/lesions may be ambiguous. That is why the medical segmentation is typically annotated by a group of clinical experts to mitigate the personal bias. However, this clinical routine also brings new challenges to the application of machine learning algorithms. Without a definite ground-truth, it will be difficult to train and evaluate the deep learning models. When the annotations are collected from different graders, a common choice is majority vote. However such a strategy ignores the difference between the grader expertness. In this paper, we consider the task of predicting the segmentation with the calibrated inter-observer uncertainty. We note that in clinical practice, the medical image segmentation is usually used to assist the disease diagnosis. Inspired by this observation, we propose diagnosis-first principle, which is to take disease diagnosis as the criterion to calibrate the inter-observer segmentation uncertainty. Following this idea, a framework named Diagnosis First segmentation Framework (DiFF) is proposed to estimate diagnosis-first segmentation from the raw images.Specifically, DiFF will first learn to fuse the multi-rater segmentation labels to a single ground-truth which could maximize the disease diagnosis performance. We dubbed the fused ground-truth as Diagnosis First Ground-truth (DF-GT).Then, we further propose Take and Give Modelto segment DF-GT from the raw image. We verify the effectiveness of DiFF on three different medical segmentation tasks: OD/OC segmentation on fundus images, thyroid nodule segmentation on ultrasound images, and skin lesion segmentation on dermoscopic images. Experimental results show that the proposed DiFF is able to significantly facilitate the corresponding disease diagnosis, which outperforms previous state-of-the-art multi-rater learning methods.

Junde Wu, Huihui Fang, Yehui Yang et al.

In medical image segmentation, it is often necessary to collect opinions from multiple experts to make the final decision. This clinical routine helps to mitigate individual bias. But when data is multiply annotated, standard deep learning models are often not applicable. In this paper, we propose a novel neural network framework, called Multi-Rater Prism (MrPrism) to learn the medical image segmentation from multiple labels. Inspired by the iterative half-quadratic optimization, the proposed MrPrism will combine the multi-rater confidences assignment task and calibrated segmentation task in a recurrent manner. In this recurrent process, MrPrism can learn inter-observer variability taking into account the image semantic properties, and finally converges to a self-calibrated segmentation result reflecting the inter-observer agreement. Specifically, we propose Converging Prism (ConP) and Diverging Prism (DivP) to process the two tasks iteratively. ConP learns calibrated segmentation based on the multi-rater confidence maps estimated by DivP. DivP generates multi-rater confidence maps based on the segmentation masks estimated by ConP. The experimental results show that by recurrently running ConP and DivP, the two tasks can achieve mutual improvement. The final converged segmentation result of MrPrism outperforms state-of-the-art (SOTA) strategies on a wide range of medical image segmentation tasks.

Junde Wu, Huihui Fang, Fangxin Shang et al.

Clinically, the accurate annotation of lesions/tissues can significantly facilitate the disease diagnosis. For example, the segmentation of optic disc/cup (OD/OC) on fundus image would facilitate the glaucoma diagnosis, the segmentation of skin lesions on dermoscopic images is helpful to the melanoma diagnosis, etc. With the advancement of deep learning techniques, a wide range of methods proved the lesions/tissues segmentation can also facilitate the automated disease diagnosis models. However, existing methods are limited in the sense that they can only capture static regional correlations in the images. Inspired by the global and dynamic nature of Vision Transformer, in this paper, we propose Segmentation-Assisted diagnosis Transformer (SeATrans) to transfer the segmentation knowledge to the disease diagnosis network. Specifically, we first propose an asymmetric multi-scale interaction strategy to correlate each single low-level diagnosis feature with multi-scale segmentation features. Then, an effective strategy called SeA-block is adopted to vitalize diagnosis feature via correlated segmentation features. To model the segmentation-diagnosis interaction, SeA-block first embeds the diagnosis feature based on the segmentation information via the encoder, and then transfers the embedding back to the diagnosis feature space by a decoder. Experimental results demonstrate that SeATrans surpasses a wide range of state-of-the-art (SOTA) segmentation-assisted diagnosis methods on several disease diagnosis tasks.

Junde Wu, Huihui Fang, Fangxin Shang et al.

The segmentation of optic disc(OD) and optic cup(OC) from fundus images is an important fundamental task for glaucoma diagnosis. In the clinical practice, it is often necessary to collect opinions from multiple experts to obtain the final OD/OC annotation. This clinical routine helps to mitigate the individual bias. But when data is multiply annotated, standard deep learning models will be inapplicable. In this paper, we propose a novel neural network framework to learn OD/OC segmentation from multi-rater annotations. The segmentation results are self-calibrated through the iterative optimization of multi-rater expertness estimation and calibrated OD/OC segmentation. In this way, the proposed method can realize a mutual improvement of both tasks and finally obtain a refined segmentation result. Specifically, we propose Diverging Model(DivM) and Converging Model(ConM) to process the two tasks respectively. ConM segments the raw image based on the multi-rater expertness map provided by DivM. DivM generates multi-rater expertness map from the segmentation mask provided by ConM. The experiment results show that by recurrently running ConM and DivM, the results can be self-calibrated so as to outperform a range of state-of-the-art(SOTA) multi-rater segmentation methods.

Huihui Fang, Fei Li, Junde Wu et al.

With the rapid development of artificial intelligence (AI) in medical image processing, deep learning in color fundus photography (CFP) analysis is also evolving. Although there are some open-source, labeled datasets of CFPs in the ophthalmology community, large-scale datasets for screening only have labels of disease categories, and datasets with annotations of fundus structures are usually small in size. In addition, labeling standards are not uniform across datasets, and there is no clear information on the acquisition device. Here we release a multi-annotation, multi-quality, and multi-device color fundus image dataset for glaucoma analysis on an original challenge -- Retinal Fundus Glaucoma Challenge 2nd Edition (REFUGE2). The REFUGE2 dataset contains 2000 color fundus images with annotations of glaucoma classification, optic disc/cup segmentation, as well as fovea localization. Meanwhile, the REFUGE2 challenge sets three sub-tasks of automatic glaucoma diagnosis and fundus structure analysis and provides an online evaluation framework. Based on the characteristics of multi-device and multi-quality data, some methods with strong generalizations are provided in the challenge to make the predictions more robust. This shows that REFUGE2 brings attention to the characteristics of real-world multi-domain data, bridging the gap between scientific research and clinical application.

Huihui Fang, Fei Li, Junde Wu et al.

Pathologic myopia (PM) is a common blinding retinal degeneration suffered by highly myopic population. Early screening of this condition can reduce the damage caused by the associated fundus lesions and therefore prevent vision loss. Automated diagnostic tools based on artificial intelligence methods can benefit this process by aiding clinicians to identify disease signs or to screen mass populations using color fundus photographs as inputs. This paper provides insights about PALM, our open fundus imaging dataset for pathological myopia recognition and anatomical structure annotation. Our databases comprises 1200 images with associated labels for the pathologic myopia category and manual annotations of the optic disc, the position of the fovea and delineations of lesions such as patchy retinal atrophy (including peripapillary atrophy) and retinal detachment. In addition, this paper elaborates on other details such as the labeling process used to construct the database, the quality and characteristics of the samples and provides other relevant usage notes.

Junde Wu, Huihui Fang, Fei Li et al.

Color fundus photography and Optical Coherence Tomography (OCT) are the two most cost-effective tools for glaucoma screening. Both two modalities of images have prominent biomarkers to indicate glaucoma suspected. Clinically, it is often recommended to take both of the screenings for a more accurate and reliable diagnosis. However, although numerous algorithms are proposed based on fundus images or OCT volumes in computer-aided diagnosis, there are still few methods leveraging both of the modalities for the glaucoma assessment. Inspired by the success of Retinal Fundus Glaucoma Challenge (REFUGE) we held previously, we set up the Glaucoma grAding from Multi-Modality imAges (GAMMA) Challenge to encourage the development of fundus \& OCT-based glaucoma grading. The primary task of the challenge is to grade glaucoma from both the 2D fundus images and 3D OCT scanning volumes. As part of GAMMA, we have publicly released a glaucoma annotated dataset with both 2D fundus color photography and 3D OCT volumes, which is the first multi-modality dataset for glaucoma grading. In addition, an evaluation framework is also established to evaluate the performance of the submitted methods. During the challenge, 1272 results were submitted, and finally, top-10 teams were selected to the final stage. We analysis their results and summarize their methods in the paper. Since all these teams submitted their source code in the challenge, a detailed ablation study is also conducted to verify the effectiveness of the particular modules proposed. We find many of the proposed techniques are practical for the clinical diagnosis of glaucoma. As the first in-depth study of fundus \& OCT multi-modality glaucoma grading, we believe the GAMMA Challenge will be an essential starting point for future research.

Junde Wu, Huihui Fang, Dalu Yang et al.

With the advancement of deep learning techniques, an increasing number of methods have been proposed for optic disc and cup (OD/OC) segmentation from the fundus images. Clinically, OD/OC segmentation is often annotated by multiple clinical experts to mitigate the personal bias. However, it is hard to train the automated deep learning models on multiple labels. A common practice to tackle the issue is majority vote, e.g., taking the average of multiple labels. However such a strategy ignores the different expertness of medical experts. Motivated by the observation that OD/OC segmentation is often used for the glaucoma diagnosis clinically, in this paper, we propose a novel strategy to fuse the multi-rater OD/OC segmentation labels via the glaucoma diagnosis performance. Specifically, we assess the expertness of each rater through an attentive glaucoma diagnosis network. For each rater, its contribution for the diagnosis will be reflected as an expertness map. To ensure the expertness maps are general for different glaucoma diagnosis models, we further propose an Expertness Generator (ExpG) to eliminate the high-frequency components in the optimization process. Based on the obtained expertness maps, the multi-rater labels can be fused as a single ground-truth which we dubbed as Diagnosis First Ground-truth (DiagFirstGT). Experimental results show that by using DiagFirstGT as ground-truth, OD/OC segmentation networks will predict the masks with superior glaucoma diagnosis performance.