Zahi A. Fayad

Zelong Liu, Andrew Tieu, Nikhil Patel et al.

Artificial Intelligence (AI) has the potential to revolutionize diagnosis and segmentation in medical imaging. However, development and clinical implementation face multiple challenges including limited data availability, lack of generalizability, and the necessity to incorporate multi-modal data effectively. A foundation model, which is a large-scale pre-trained AI model, offers a versatile base that can be adapted to a variety of specific tasks and contexts. Here, we present VIsualization and Segmentation Masked AutoEncoder (VIS-MAE), novel model weights specifically designed for medical imaging. Specifically, VIS-MAE is trained on a dataset of 2.5 million unlabeled images from various modalities (CT, MR, PET,X-rays, and ultrasound), using self-supervised learning techniques. It is then adapted to classification and segmentation tasks using explicit labels. VIS-MAE has high label efficiency, outperforming several benchmark models in both in-domain and out-of-domain applications. In addition, VIS-MAE has improved label efficiency as it can achieve similar performance to other models with a reduced amount of labeled training data (50% or 80%) compared to other pre-trained weights. VIS-MAE represents a significant advancement in medical imaging AI, offering a generalizable and robust solution for improving segmentation and classification tasks while reducing the data annotation workload. The source code of this work is available at https://github.com/lzl199704/VIS-MAE.

Linmin Pei, Granger Sutton, Michael Rutherford et al.

The de-identification (deID) of protected health information (PHI) and personally identifiable information (PII) is a fundamental requirement for sharing medical images, particularly through public repositories, to ensure compliance with patient privacy laws. In addition, preservation of non-PHI metadata to inform and enable downstream development of imaging artificial intelligence (AI) is an important consideration in biomedical research. The goal of MIDI-B was to provide a standardized platform for benchmarking of DICOM image deID tools based on a set of rules conformant to the HIPAA Safe Harbor regulation, the DICOM Attribute Confidentiality Profiles, and best practices in preservation of research-critical metadata, as defined by The Cancer Imaging Archive (TCIA). The challenge employed a large, diverse, multi-center, and multi-modality set of real de-identified radiology images with synthetic PHI/PII inserted. The MIDI-B Challenge consisted of three phases: training, validation, and test. Eighty individuals registered for the challenge. In the training phase, we encouraged participants to tune their algorithms using their in-house or public data. The validation and test phases utilized the DICOM images containing synthetic identifiers (of 216 and 322 subjects, respectively). Ten teams successfully completed the test phase of the challenge. To measure success of a rule-based approach to image deID, scores were computed as the percentage of correct actions from the total number of required actions. The scores ranged from 97.91% to 99.93%. Participants employed a variety of open-source and proprietary tools with customized configurations, large language models, and optical character recognition (OCR). In this paper we provide a comprehensive report on the MIDI-B Challenge's design, implementation, results, and lessons learned.

Alexander Zhou, Zelong Liu, Andrew Tieu et al.

In this retrospective study, we annotated 44 structures on two datasets: an internal dataset of 1,518 MRI sequences from 843 patients at the Mount Sinai Health System, and an external dataset of 397 MRI sequences from 263 patients for benchmarking. The internal dataset trained the nnU-Net model MRAnnotator, which demonstrated strong generalizability on the external dataset. MRAnnotator outperformed existing models such as TotalSegmentator MRI and MRSegmentator on both datasets, achieving an overall average Dice score of 0.878 on the internal dataset and 0.875 on the external set. Model weights are available on GitHub, and the external test set can be shared upon request.

Hao-Chih Lee, Zelong Liu, Hamza Ahmed et al.

General-purpose vision-language models (VLMs) have emerged as promising tools in radiology, offering zero-shot capabilities that mitigate the need for large labeled datasets. However, in high-stakes domains like diagnostic radiology, these models often lack the discriminative precision required for reliable clinical use. This challenge is compounded by the scarcity and heterogeneity of publicly available volumetric CT datasets, which vary widely in annotation formats and granularity. To address these limitations, we introduce Uniferum, a volumetric VLM that unifies diverse supervision signals, encoded in classification labels and segmentation masks, into a single training framework. By harmonizing three public 3D CT datasets with distinct annotations, Uniferum achieves state-of-the-art performance, improving AUROC on the CT-RATE benchmark by 7% compared to CLIP-based and conventional multi-label convolutional models. The model demonstrates robust out-of-distribution generalization, with observed evidence of unexpected zero-shot performance on the RAD-CHEST and INSPECT datasets. Our results highlight the effectiveness of integrating heterogeneous annotations and body segmentation to enhance model performance, setting a new direction for clinically reliable, data-efficient VLMs in 3D medical imaging.

Zelong Liu, Alexander Zhou, Arnold Yang et al.

Deep learning in medical imaging often requires large-scale, high-quality data or initiation with suitably pre-trained weights. However, medical datasets are limited by data availability, domain-specific knowledge, and privacy concerns, and the creation of large and diverse radiologic databases like RadImageNet is highly resource-intensive. To address these limitations, we introduce RadImageGAN, the first multi-modal radiologic data generator, which was developed by training StyleGAN-XL on the real RadImageNet dataset of 102,774 patients. RadImageGAN can generate high-resolution synthetic medical imaging datasets across 12 anatomical regions and 130 pathological classes in 3 modalities. Furthermore, we demonstrate that RadImageGAN generators can be utilized with BigDatasetGAN to generate multi-class pixel-wise annotated paired synthetic images and masks for diverse downstream segmentation tasks with minimal manual annotation. We showed that using synthetic auto-labeled data from RadImageGAN can significantly improve performance on four diverse downstream segmentation datasets by augmenting real training data and/or developing pre-trained weights for fine-tuning. This shows that RadImageGAN combined with BigDatasetGAN can improve model performance and address data scarcity while reducing the resources needed for annotations for segmentation tasks.