Pak-Hei Yeung

Pak-Hei Yeung, Moska Aliasi, Monique Haak et al.

Two-dimensional (2D) freehand ultrasound is the mainstay in prenatal care and fetal growth monitoring. The task of matching corresponding cross-sectional planes in the 3D anatomy for a given 2D ultrasound brain scan is essential in freehand scanning, but challenging. We propose AdLocUI, a framework that Adaptively Localizes 2D Ultrasound Images in the 3D anatomical atlas without using any external tracking sensor.. We first train a convolutional neural network with 2D slices sampled from co-aligned 3D ultrasound volumes to predict their locations in the 3D anatomical atlas. Next, we fine-tune it with 2D freehand ultrasound images using a novel unsupervised cycle consistency, which utilizes the fact that the overall displacement of a sequence of images in the 3D anatomical atlas is equal to the displacement from the first image to the last in that sequence. We demonstrate that AdLocUI can adapt to three different ultrasound datasets, acquired with different machines and protocols, and achieves significantly better localization accuracy than the baselines. AdLocUI can be used for sensorless 2D freehand ultrasound guidance by the bedside. The source code is available at https://github.com/pakheiyeung/AdLocUI.

Jieyun Bai, Zihao Zhou, Yitong Tang et al.

A substantial proportion (45\%) of maternal deaths, neonatal deaths, and stillbirths occur during the intrapartum phase, with a particularly high burden in low- and middle-income countries. Intrapartum biometry plays a critical role in monitoring labor progression; however, the routine use of ultrasound in resource-limited settings is hindered by a shortage of trained sonographers. To address this challenge, the Intrapartum Ultrasound Grand Challenge (IUGC), co-hosted with MICCAI 2024, was launched. The IUGC introduces a clinically oriented multi-task automatic measurement framework that integrates standard plane classification, fetal head-pubic symphysis segmentation, and biometry, enabling algorithms to exploit complementary task information for more accurate estimation. Furthermore, the challenge releases the largest multi-center intrapartum ultrasound video dataset to date, comprising 774 videos (68,106 frames) collected from three hospitals, providing a robust foundation for model training and evaluation. In this study, we present a comprehensive overview of the challenge design, review the submissions from eight participating teams, and analyze their methods from five perspectives: preprocessing, data augmentation, learning strategy, model architecture, and post-processing. In addition, we perform a systematic analysis of the benchmark results to identify key bottlenecks, explore potential solutions, and highlight open challenges for future research. Although encouraging performance has been achieved, our findings indicate that the field remains at an early stage, and further in-depth investigation is required before large-scale clinical deployment. All benchmark solutions and the complete dataset have been publicly released to facilitate reproducible research and promote continued advances in automatic intrapartum ultrasound biometry.

Pengfei Lyu, Pak-Hei Yeung, Xiaosheng Yu et al.

This paper addresses the task of cross-modal medical image segmentation by exploring unsupervised domain adaptation (UDA) approaches. We propose a model-agnostic UDA framework, LowBridge, which builds on a simple observation that cross-modal images share some similar low-level features (e.g., edges) as they are depicting the same structures. Specifically, we first train a generative model to recover the source images from their edge features, followed by training a segmentation model on the generated source images, separately. At test time, edge features from the target images are input to the pretrained generative model to generate source-style target domain images, which are then segmented using the pretrained segmentation network. Despite its simplicity, extensive experiments on various publicly available datasets demonstrate that \proposed achieves state-of-the-art performance, outperforming eleven existing UDA approaches under different settings. Notably, further ablation studies show that \proposed is agnostic to different types of generative and segmentation models, suggesting its potential to be seamlessly plugged with the most advanced models to achieve even more outstanding results in the future. The code is available at https://github.com/JoshuaLPF/LowBridge.

Pengfei Lyu, Pak-Hei Yeung, Xiaosheng Yu et al.

Autonomous aerial vehicle (AAV)-based bi-modal salient object detection (BSOD) aims to segment salient objects in a scene utilizing complementary cues in unaligned RGB and thermal image pairs. However, the high computational expense of existing AAV-based BSOD models limits their applicability to real-world AAV devices. To address this problem, we propose an efficient Fourier filter network with contrastive learning that achieves both real-time and accurate performance. Specifically, we first design a semantic contrastive alignment loss to align the two modalities at the semantic level, which facilitates mutual refinement in a parameter-free way. Second, inspired by the fast Fourier transform that obtains global relevance in linear complexity, we propose synchronized alignment fusion, which aligns and fuses bi-modal features in the channel and spatial dimensions by a hierarchical filtering mechanism. Our proposed model, AlignSal, reduces the number of parameters by 70.0%, decreases the floating point operations by 49.4%, and increases the inference speed by 152.5% compared to the cutting-edge BSOD model (i.e., MROS). Extensive experiments on the AAV RGB-T 2400 and seven bi-modal dense prediction datasets demonstrate that AlignSal achieves both real-time inference speed and better performance and generalizability compared to nineteen state-of-the-art models across most evaluation metrics. In addition, our ablation studies further verify AlignSal's potential in boosting the performance of existing aligned BSOD models on AAV-based unaligned data. The code is available at: https://github.com/JoshuaLPF/AlignSal.

Pak-Hei Yeung, Jayroop Ramesh, Pengfei Lyu et al.

This paper explores the transfer of knowledge from general vision models pretrained on 2D natural images to improve 3D medical image segmentation. We focus on the semi-supervised setting, where only a few labeled 3D medical images are available, along with a large set of unlabeled images. To tackle this, we propose a model-agnostic framework that progressively distills knowledge from a 2D pretrained model to a 3D segmentation model trained from scratch. Our approach, M&N, involves iterative co-training of the two models using pseudo-masks generated by each other, along with our proposed learning rate guided sampling that adaptively adjusts the proportion of labeled and unlabeled data in each training batch to align with the models' prediction accuracy and stability, minimizing the adverse effect caused by inaccurate pseudo-masks. Extensive experiments on multiple publicly available datasets demonstrate that M&N achieves state-of-the-art performance, outperforming thirteen existing semi-supervised segmentation approaches under all different settings. Importantly, ablation studies show that M&N remains model-agnostic, allowing seamless integration with different architectures. This ensures its adaptability as more advanced models emerge. The code is available at https://github.com/pakheiyeung/M-N.

Augustine X. W. Lee, Pak-Hei Yeung, Jagath C. Rajapakse

Subcortical segmentation in neuroimages plays an important role in understanding brain anatomy and facilitating computer-aided diagnosis of traumatic brain injuries and neurodegenerative disorders. However, training accurate automatic models requires large amounts of labelled data. Despite the availability of publicly available subcortical segmentation datasets for Magnetic Resonance Imaging (MRI), a significant gap exists for Computed Tomography (CT). This paper proposes an automatic ensemble framework to generate high-quality subcortical segmentation labels for CT scans by leveraging existing MRI-based models. We introduce a robust ensembling pipeline to integrate them and apply it to unannotated paired MRI-CT data, resulting in a comprehensive CT subcortical segmentation dataset. Extensive experiments on multiple public datasets demonstrate the superior performance of our proposed framework. Furthermore, using our generated CT dataset, we train segmentation models that achieve improved performance on related segmentation tasks. To facilitate future research, we make our source code, generated dataset, and trained models publicly available at https://github.com/SCSE-Biomedical-Computing-Group/CT-Subcortical-Segmentation, marking the first open-source release for CT subcortical segmentation to the best of our knowledge.

Pengfei Lyu, Xiaosheng Yu, Pak-Hei Yeung et al.

The rapid development of deep learning has significantly improved salient object detection (SOD) combining both RGB and thermal (RGB-T) images. However, existing Transformer-based RGB-T SOD models with quadratic complexity are memory-intensive, limiting their application in high-resolution bimodal feature fusion. To overcome this limitation, we propose a purely Fourier Transform-based model, namely Deep Fourier-embedded Network (FreqSal), for accurate RGB-T SOD. Specifically, we leverage the efficiency of Fast Fourier Transform with linear complexity to design three key components: (1) To fuse RGB and thermal modalities, we propose Modal-coordinated Perception Attention, which aligns and enhances bimodal Fourier representation in multiple dimensions; (2) To clarify object edges and suppress noise, we design Frequency-decomposed Edge-aware Block, which deeply decomposes and filters Fourier components of low-level features; (3) To accurately decode features, we propose Fourier Residual Channel Attention Block, which prioritizes high-frequency information while aligning channel-wise global relationships. Additionally, even when converged, existing deep learning-based SOD models' predictions still exhibit frequency gaps relative to ground-truth. To address this problem, we propose Co-focus Frequency Loss, which dynamically weights hard frequencies during edge frequency reconstruction by cross-referencing bimodal edge information in the Fourier domain. Extensive experiments on ten bimodal SOD benchmark datasets demonstrate that FreqSal outperforms twenty-nine existing state-of-the-art bimodal SOD models. Comprehensive ablation studies further validate the value and effectiveness of our newly proposed components. The code is available at https://github.com/JoshuaLPF/FreqSal.

Pak-Hei Yeung, Ana I. L. Namburete, Weidi Xie

The objective of this work is to segment any arbitrary structures of interest (SOI) in 3D volumes by only annotating a single slice, (i.e. semi-automatic 3D segmentation). We show that high accuracy can be achieved by simply propagating the 2D slice segmentation with an affinity matrix between consecutive slices, which can be learnt in a self-supervised manner, namely slice reconstruction. Specifically, we compare the proposed framework, termed as Sli2Vol, with supervised approaches and two other unsupervised/ self-supervised slice registration approaches, on 8 public datasets (both CT and MRI scans), spanning 9 different SOIs. Without any parameter-tuning, the same model achieves superior performance with Dice scores (0-100 scale) of over 80 for most of the benchmarks, including the ones that are unseen during training. Our results show generalizability of the proposed approach across data from different machines and with different SOIs: a major use case of semi-automatic segmentation methods where fully supervised approaches would normally struggle. The source code will be made publicly available at https://github.com/pakheiyeung/Sli2Vol.

Mark C. Eid, Pak-Hei Yeung, Madeleine K. Wyburd et al.

Two-dimensional (2D) freehand ultrasonography is one of the most commonly used medical imaging modalities, particularly in obstetrics and gynaecology. However, it only captures 2D cross-sectional views of inherently 3D anatomies, losing valuable contextual information. As an alternative to requiring costly and complex 3D ultrasound scanners, 3D volumes can be constructed from 2D scans using machine learning. However this usually requires long computational time. Here, we propose RapidVol: a neural representation framework to speed up slice-to-volume ultrasound reconstruction. We use tensor-rank decomposition, to decompose the typical 3D volume into sets of tri-planes, and store those instead, as well as a small neural network. A set of 2D ultrasound scans, with their ground truth (or estimated) 3D position and orientation (pose) is all that is required to form a complete 3D reconstruction. Reconstructions are formed from real fetal brain scans, and then evaluated by requesting novel cross-sectional views. When compared to prior approaches based on fully implicit representation (e.g. neural radiance fields), our method is over 3x quicker, 46% more accurate, and if given inaccurate poses is more robust. Further speed-up is also possible by reconstructing from a structural prior rather than from scratch.

Jayroop Ramesh, Nicola K Dinsdale, the INTERGROWTH-21st Consortium et al.

Accurately localizing two-dimensional (2D) ultrasound (US) fetal brain images in the 3D brain, using minimal computational resources, is an important task for automated US analysis of fetal growth and development. We propose an uncertainty-aware deep learning model for automated 3D plane localization in 2D fetal brain images. Specifically, a multi-head network is trained to jointly regress 3D plane pose from 2D images in terms of different geometric transformations. The model explicitly learns to predict uncertainty to allocate higher weight to inputs with low variances across different transformations to improve performance. Our proposed method, QAERTS, demonstrates superior pose estimation accuracy than the state-of-the-art and most of the uncertainty-based approaches, leading to 9% improvement on plane angle (PA) for localization accuracy, and 8% on normalized cross-correlation (NCC) for sampled image quality. QAERTS also demonstrates efficiency, containing 5$\times$ fewer parameters than ensemble-based approach, making it advantageous in resource-constrained settings. In addition, QAERTS proves to be more robust to noise effects observed in freehand US scanning by leveraging rotational discontinuities and explicit output uncertainties.

Yubin Zheng, Pak-Hei Yeung, Jing Xia et al.

Federated learning (FL) enables multiple clients to collaboratively train machine learning models without exposing local data, balancing performance and privacy. However, domain shift and label heterogeneity across clients often hinder the generalization of the aggregated global model. Recently, large-scale vision-language models like CLIP have shown strong zero-shot classification capabilities, raising the question of how to effectively fine-tune CLIP across domains in a federated setting. In this work, we propose an adaptive federated prompt tuning framework, FedDEAP, to enhance CLIP's generalization in multi-domain scenarios. Our method includes the following three key components: (1) To mitigate the loss of domain-specific information caused by label-supervised tuning, we disentangle semantic and domain-specific features in images by using semantic and domain transformation networks with unbiased mappings; (2) To preserve domain-specific knowledge during global prompt aggregation, we introduce a dual-prompt design with a global semantic prompt and a local domain prompt to balance shared and personalized information; (3) To maximize the inclusion of semantic and domain information from images in the generated text features, we align textual and visual representations under the two learned transformations to preserve semantic and domain consistency. Theoretical analysis and extensive experiments on four datasets demonstrate the effectiveness of our method in enhancing the generalization of CLIP for federated image recognition across multiple domains.

Hoda Kalabizadeh, Ludovica Griffanti, Pak-Hei Yeung et al.

Deep learning models for medical image segmentation often struggle when deployed across different datasets due to domain shifts - variations in both image appearance, known as style, and population-dependent anatomical characteristics, referred to as content. This paper presents a novel unsupervised domain adaptation framework that directly addresses domain shifts encountered in cross-domain hippocampus segmentation from MRI, with specific emphasis on content variations. Our approach combines efficient style harmonisation through z-normalisation with a bidirectional deformable image registration (DIR) strategy. The DIR network is jointly trained with segmentation and discriminator networks to guide the registration with respect to a region of interest and generate anatomically plausible transformations that align source images to the target domain. We validate our approach through comprehensive evaluations on both a synthetic dataset using Morpho-MNIST (for controlled validation of core principles) and three MRI hippocampus datasets representing populations with varying degrees of atrophy. Across all experiments, our method outperforms existing baselines. For hippocampus segmentation, when transferring from young, healthy populations to clinical dementia patients, our framework achieves up to 15% relative improvement in Dice score compared to standard augmentation methods, with the largest gains observed in scenarios with substantial content shift. These results highlight the efficacy of our approach for accurate hippocampus segmentation across diverse populations.

Jayroop Ramesh, Valentin Bacher, Mark C. Eid et al.

The International Society of Ultrasound advocates Intrapartum Ultrasound (US) Imaging in Obstetrics and Gynecology (ISUOG) to monitor labour progression through changes in fetal head position. Two reliable ultrasound-derived parameters that are used to predict outcomes of instrumental vaginal delivery are the angle of progression (AoP) and head-symphysis distance (HSD). In this work, as part of the Intrapartum Ultrasounds Grand Challenge (IUGC) 2024, we propose an automated fetal biometry measurement pipeline to reduce intra- and inter-observer variability and improve measurement reliability. Our pipeline consists of three key tasks: (i) classification of standard planes (SP) from US videos, (ii) segmentation of fetal head and pubic symphysis from the detected SPs, and (iii) computation of the AoP and HSD from the segmented regions. We perform sparse sampling to mitigate class imbalances and reduce spurious correlations in task (i), and utilize ensemble-based deep learning methods for task (i) and (ii) to enhance generalizability under different US acquisition settings. Finally, to promote robustness in task iii) with respect to the structural fidelity of measurements, we retain the largest connected components and apply ellipse fitting to the segmentations. Our solution achieved ACC: 0.9452, F1: 0.9225, AUC: 0.983, MCC: 0.8361, DSC: 0.918, HD: 19.73, ASD: 5.71, $Δ_{AoP}$: 8.90 and $Δ_{HSD}$: 14.35 across an unseen hold-out set of 4 patients and 224 US frames. The results from the proposed automated pipeline can improve the understanding of labour arrest causes and guide the development of clinical risk stratification tools for efficient and effective prenatal care.

Pak-Hei Yeung, Linde Hesse, Moska Aliasi et al.

The objective of this work is to achieve sensorless reconstruction of a 3D volume from a set of 2D freehand ultrasound images with deep implicit representation. In contrast to the conventional way that represents a 3D volume as a discrete voxel grid, we do so by parameterizing it as the zero level-set of a continuous function, i.e. implicitly representing the 3D volume as a mapping from the spatial coordinates to the corresponding intensity values. Our proposed model, termed as ImplicitVol, takes a set of 2D scans and their estimated locations in 3D as input, jointly refining the estimated 3D locations and learning a full reconstruction of the 3D volume. When testing on real 2D ultrasound images, novel cross-sectional views that are sampled from ImplicitVol show significantly better visual quality than those sampled from existing reconstruction approaches, outperforming them by over 30% (NCC and SSIM), between the output and ground-truth on the 3D volume testing data. The code will be made publicly available.