Shandong Wu

Jun Luo, Matias Mendieta, Chen Chen et al.

Personalized federated learning has received an upsurge of attention due to the mediocre performance of conventional federated learning (FL) over heterogeneous data. Unlike conventional FL which trains a single global consensus model, personalized FL allows different models for different clients. However, existing personalized FL algorithms only implicitly transfer the collaborative knowledge across the federation by embedding the knowledge into the aggregated model or regularization. We observed that this implicit knowledge transfer fails to maximize the potential of each client's empirical risk toward other clients. Based on our observation, in this work, we propose Personalized Global Federated Learning (PGFed), a novel personalized FL framework that enables each client to personalize its own global objective by explicitly and adaptively aggregating the empirical risks of itself and other clients. To avoid massive (O(N^2)) communication overhead and potential privacy leakage while achieving this, each client's risk is estimated through a first-order approximation for other clients' adaptive risk aggregation. On top of PGFed, we develop a momentum upgrade, dubbed PGFedMo, to more efficiently utilize clients' empirical risks. Our extensive experiments on four datasets under different federated settings show consistent improvements of PGFed over previous state-of-the-art methods. The code is publicly available at https://github.com/ljaiverson/pgfed.

Guangyu Sun, Matias Mendieta, Jun Luo et al.

Personalized Federated Learning (PFL) represents a promising solution for decentralized learning in heterogeneous data environments. Partial model personalization has been proposed to improve the efficiency of PFL by selectively updating local model parameters instead of aggregating all of them. However, previous work on partial model personalization has mainly focused on Convolutional Neural Networks (CNNs), leaving a gap in understanding how it can be applied to other popular models such as Vision Transformers (ViTs). In this work, we investigate where and how to partially personalize a ViT model. Specifically, we empirically evaluate the sensitivity to data distribution of each type of layer. Based on the insights that the self-attention layer and the classification head are the most sensitive parts of a ViT, we propose a novel approach called FedPerfix, which leverages plugins to transfer information from the aggregated model to the local client as a personalization. Finally, we evaluate the proposed approach on CIFAR-100, OrganAMNIST, and Office-Home datasets and demonstrate its effectiveness in improving the model's performance compared to several advanced PFL methods.

Zhengbo Zhou, Jun Luo, Dooman Arefan et al.

Curriculum learning is a learning method that trains models in a meaningful order from easier to harder samples. A key here is to devise automatic and objective difficulty measures of samples. In the medical domain, previous work applied domain knowledge from human experts to qualitatively assess classification difficulty of medical images to guide curriculum learning, which requires extra annotation efforts, relies on subjective human experience, and may introduce bias. In this work, we propose a new automated curriculum learning technique using the variance of gradients (VoG) to compute an objective difficulty measure of samples and evaluated its effects on elbow fracture classification from X-ray images. Specifically, we used VoG as a metric to rank each sample in terms of the classification difficulty, where high VoG scores indicate more difficult cases for classification, to guide the curriculum training process We compared the proposed technique to a baseline (without curriculum learning), a previous method that used human annotations on classification difficulty, and anti-curriculum learning. Our experiment results showed comparable and higher performance for the binary and multi-class bone fracture classification tasks.

Saba Dadsetan, Mohsen Hejrati, Shandong Wu et al.

Developing successful artificial intelligence systems in practice depends on both robust deep learning models and large, high-quality data. However, acquiring and labeling data can be prohibitively expensive and time-consuming in many real-world applications, such as clinical disease models. Self-supervised learning has demonstrated great potential in increasing model accuracy and robustness in small data regimes. In addition, many clinical imaging and disease modeling applications rely heavily on regression of continuous quantities. However, the applicability of self-supervised learning for these medical-imaging regression tasks has not been extensively studied. In this study, we develop a cross-domain self-supervised learning approach for disease prognostic modeling as a regression problem using medical images as input. We demonstrate that self-supervised pretraining can improve the prediction of Alzheimer's Disease progression from brain MRI. We also show that pretraining on extended (but not labeled) brain MRI data outperforms pretraining on natural images. We further observe that the highest performance is achieved when both natural images and extended brain-MRI data are used for pretraining.

Jun Luo, Chen Chen, Shandong Wu

Federated prompt learning benefits federated learning with CLIP-like Vision-Language Model's (VLM's) robust representation learning ability through prompt learning. However, current federated prompt learning methods are habitually restricted to the traditional FL paradigm, where the participating clients are generally only allowed to download a single globally aggregated model from the server. While justifiable for training full-sized models under federated settings, in this work, we argue that this paradigm is ill-suited for lightweight prompts. By facilitating the clients to download multiple pre-aggregated prompts as fixed non-local experts, we propose Personalized Federated Mixture of Adaptive Prompts (pFedMoAP), a novel FL framework that personalizes the prompt learning process through the lens of Mixture of Experts (MoE). pFedMoAP implements a local attention-based gating network that learns to generate enhanced text features for better alignment with local image data, benefiting from both local and downloaded non-local adaptive prompt experts. Extensive experiments on 9 datasets under various federated settings demonstrate the efficacy of the proposed pFedMoAP algorithm. The code is available at https://github.com/ljaiverson/pFedMoAP.

Jun Luo, Gene Kitamura, Dooman Arefan et al.

Elbow fracture diagnosis often requires patients to take both frontal and lateral views of elbow X-ray radiographs. In this paper, we propose a multiview deep learning method for an elbow fracture subtype classification task. Our strategy leverages transfer learning by first training two single-view models, one for frontal view and the other for lateral view, and then transferring the weights to the corresponding layers in the proposed multiview network architecture. Meanwhile, quantitative medical knowledge was integrated into the training process through a curriculum learning framework, which enables the model to first learn from "easier" samples and then transition to "harder" samples to reach better performance. In addition, our multiview network can work both in a dual-view setting and with a single view as input. We evaluate our method through extensive experiments on a classification task of elbow fracture with a dataset of 1,964 images. Results show that our method outperforms two related methods on bone fracture study in multiple settings, and our technique is able to boost the performance of the compared methods. The code is available at https://github.com/ljaiverson/multiview-curriculum.

Jun Luo, Shandong Wu

Conventional federated learning (FL) trains one global model for a federation of clients with decentralized data, reducing the privacy risk of centralized training. However, the distribution shift across non-IID datasets, often poses a challenge to this one-model-fits-all solution. Personalized FL aims to mitigate this issue systematically. In this work, we propose APPLE, a personalized cross-silo FL framework that adaptively learns how much each client can benefit from other clients' models. We also introduce a method to flexibly control the focus of training APPLE between global and local objectives. We empirically evaluate our method's convergence and generalization behaviors, and perform extensive experiments on two benchmark datasets and two medical imaging datasets under two non-IID settings. The results show that the proposed personalized FL framework, APPLE, achieves state-of-the-art performance compared to several other personalized FL approaches in the literature. The code is publicly available at https://github.com/ljaiverson/pFL-APPLE.

Zehui Lin, Luyi Han, Xin Wang et al.

IMPORTANCE: Modern ultrasound systems are universal diagnostic tools capable of imaging the entire body. However, current AI solutions remain fragmented into single-task tools. This critical gap between hardware versatility and software specificity limits workflow integration and clinical utility. OBJECTIVE: To evaluate the diagnostic accuracy, versatility, and efficiency of single general-purpose deep learning models for multi-organ classification and segmentation. DESIGN: The Universal UltraSound Image Challenge 2025 (UUSIC25) involved developing algorithms on 11,644 images aggregated from 12 sources (9 public, 3 private). Evaluation used an independent, multi-center private test set of 2,479 images, including data from a center completely unseen during training to assess generalization. OUTCOMES: Diagnostic performance (Dice Similarity Coefficient [DSC]; Area Under the Receiver Operating Characteristic Curve [AUC]) and computational efficiency (inference time, GPU memory). RESULTS: Of 15 valid algorithms, the top model (SMART) achieved a macro-averaged DSC of 0.854 across 5 segmentation tasks and AUC of 0.766 for binary classification. Models demonstrated high capability in anatomical segmentation (e.g., fetal head DSC: 0.942) but variability in complex diagnostic tasks subject to domain shift. Specifically, in breast cancer molecular subtyping, the top model's performance dropped from an AUC of 0.571 (internal) to 0.508 (unseen external center), highlighting the challenge of generalization. CONCLUSIONS: General-purpose AI models can achieve high accuracy and efficiency across multiple tasks using a single architecture. However, significant performance degradation on unseen data suggests domain generalization is critical for future clinical deployment.

Degan Hao, Dooman Arefan, Margarita Zuley et al.

Adversarial data can lead to malfunction of deep learning applications. It is essential to develop deep learning models that are robust to adversarial data while accurate on standard, clean data. In this study, we proposed a novel adversarially robust feature learning (ARFL) method for a real-world application of breast cancer diagnosis. ARFL facilitates adversarial training using both standard data and adversarial data, where a feature correlation measure is incorporated as an objective function to encourage learning of robust features and restrain spurious features. To show the effects of ARFL in breast cancer diagnosis, we built and evaluated diagnosis models using two independent clinically collected breast imaging datasets, comprising a total of 9,548 mammogram images. We performed extensive experiments showing that our method outperformed several state-of-the-art methods and that our method can enhance safer breast cancer diagnosis against adversarial attacks in clinical settings.

Zhengbo Zhou, Dooman Arefan, Margarita Zuley et al.

Longitudinal analysis of sequential radiological images is hampered by a fundamental data challenge: how to effectively model a sequence of high-resolution images captured at irregular time intervals. This data structure contains indispensable spatial and temporal cues that current methods fail to fully exploit. Models often compromise by either collapsing spatial information into vectors or applying spatio-temporal models that are computationally inefficient and incompatible with non-uniform time steps. We address this challenge with Time-Aware $Δ$t-Mamba3D, a novel state-space architecture adapted for longitudinal medical imaging. Our model simultaneously encodes irregular inter-visit intervals and rich spatio-temporal context while remaining computationally efficient. Its core innovation is a continuous-time selective scanning mechanism that explicitly integrates the true time difference between exams into its state transitions. This is complemented by a multi-scale 3D neighborhood fusion module that robustly captures spatio-temporal relationships. In a comprehensive breast cancer risk prediction benchmark using sequential screening mammogram exams, our model shows superior performance, improving the validation c-index by 2-5 percentage points and achieving higher 1-5 year AUC scores compared to established variants of recurrent, transformer, and state-space models. Thanks to its linear complexity, the model can efficiently process long and complex patient screening histories of mammograms, forming a new framework for longitudinal image analysis.

Zhengbo Zhou, Dooman Arefan, Margarita Zuley et al.

Predicting the risk of developing breast cancer is an important clinical tool to guide early intervention and tailoring personalized screening strategies. Early risk models have limited performance and recently machine learning-based analysis of mammogram images showed encouraging risk prediction effects. These models however are limited to the use of a single exam or tend to overlook nuanced breast tissue evolvement in spatial and temporal details of longitudinal imaging exams that are indicative of breast cancer risk. In this paper, we propose STA-Risk (Spatial and Temporal Asymmetry-based Risk Prediction), a novel Transformer-based model that captures fine-grained mammographic imaging evolution simultaneously from bilateral and longitudinal asymmetries for breast cancer risk prediction. STA-Risk is innovative by the side encoding and temporal encoding to learn spatial-temporal asymmetries, regulated by a customized asymmetry loss. We performed extensive experiments with two independent mammogram datasets and achieved superior performance than four representative SOTA models for 1- to 5-year future risk prediction. Source codes will be released upon publishing of the paper.

Zhengbo Zhou, Degan Hao, Dooman Arefan et al.

In breast cancer detection and diagnosis, the longitudinal analysis of mammogram images is crucial. Contemporary models excel in detecting temporal imaging feature changes, thus enhancing the learning process over sequential imaging exams. Yet, the resilience of these longitudinal models against adversarial attacks remains underexplored. In this study, we proposed a novel attack method that capitalizes on the feature-level relationship between two sequential mammogram exams of a longitudinal model, guided by both cross-entropy loss and distance metric learning, to achieve significant attack efficacy, as implemented using attack transferring in a black-box attacking manner. We performed experiments on a cohort of 590 breast cancer patients (each has two sequential mammogram exams) in a case-control setting. Results showed that our proposed method surpassed several state-of-the-art adversarial attacks in fooling the diagnosis models to give opposite outputs. Our method remained effective even if the model was trained with the common defending method of adversarial training.

Long Gao, Chang Liu, Dooman Arefan et al.

Deep learning models have gained remarkable performance on a variety of image classification tasks. However, many models suffer from limited performance in clinical or medical settings when data are imbalanced. To address this challenge, we propose a medical-knowledge-guided one-class classification approach that leverages domain-specific knowledge of classification tasks to boost the model's performance. The rationale behind our approach is that some existing prior medical knowledge can be incorporated into data-driven deep learning to facilitate model learning. We design a deep learning-based one-class classification pipeline for imbalanced image classification, and demonstrate in three use cases how we take advantage of medical knowledge of each specific classification task by generating additional middle classes to achieve higher classification performances. We evaluate our approach on three different clinical image classification tasks (a total of 8459 images) and show superior model performance when compared to six state-of-the-art methods. All codes of this work will be publicly available upon acceptance of the paper.

Long Gao, Chang Liu, Dooman Arefan et al.

Medical image data are usually imbalanced across different classes. One-class classification has attracted increasing attention to address the data imbalance problem by distinguishing the samples of the minority class from the majority class. Previous methods generally aim to either learn a new feature space to map training samples together or to fit training samples by autoencoder-like models. These methods mainly focus on capturing either compact or descriptive features, where the information of the samples of a given one class is not sufficiently utilized. In this paper, we propose a novel deep learning-based method to learn compact features by adding constraints on the bottleneck features, and to preserve descriptive features by training an autoencoder at the same time. Through jointly optimizing the constraining loss and the autoencoder's reconstruction loss, our method can learn more relevant features associated with the given class, making the majority and minority samples more distinguishable. Experimental results on three clinical datasets (including the MRI breast images, FFDM breast images and chest X-ray images) obtains state-of-art performance compared to previous methods.

Jun Luo, Dooman Arefan, Margarita Zuley et al.

Mammography is used as a standard screening procedure for the potential patients of breast cancer. Over the past decade, it has been shown that deep learning techniques have succeeded in reaching near-human performance in a number of tasks, and its application in mammography is one of the topics that medical researchers most concentrate on. In this work, we propose an end-to-end Curriculum Learning (CL) strategy in task space for classifying the three categories of Full-Field Digital Mammography (FFDM), namely Malignant, Negative, and False recall. Specifically, our method treats this three-class classification as a "harder" task in terms of CL, and create an "easier" sub-task of classifying False recall against the combined group of Negative and Malignant. We introduce a loss scheduler to dynamically weight the contribution of the losses from the two tasks throughout the entire training process. We conduct experiments on an FFDM datasets of 1,709 images using 5-fold cross validation. The results show that our curriculum learning strategy can boost the performance for classifying the three categories of FFDM compared to the baseline strategies for model training.

Jun Luo, Gene Kitamura, Emine Doganay et al.

Elbow fractures are one of the most common fracture types. Diagnoses on elbow fractures often need the help of radiographic imaging to be read and analyzed by a specialized radiologist with years of training. Thanks to the recent advances of deep learning, a model that can classify and detect different types of bone fractures needs only hours of training and has shown promising results. However, most existing deep learning models are purely data-driven, lacking incorporation of known domain knowledge from human experts. In this work, we propose a novel deep learning method to diagnose elbow fracture from elbow X-ray images by integrating domain-specific medical knowledge into a curriculum learning framework. In our method, the training data are permutated by sampling without replacement at the beginning of each training epoch. The sampling probability of each training sample is guided by a scoring criterion constructed based on clinically known knowledge from human experts, where the scoring indicates the diagnosis difficultness of different elbow fracture subtypes. We also propose an algorithm that updates the sampling probabilities at each epoch, which is applicable to other sampling-based curriculum learning frameworks. We design an experiment with 1865 elbow X-ray images for a fracture/normal binary classification task and compare our proposed method to a baseline method and a previous method using multiple metrics. Our results show that the proposed method achieves the highest classification performance. Also, our proposed probability update algorithm boosts the performance of the previous method.

Jun Luo, Shandong Wu

Machine learning in medical research, by nature, needs careful attention on obeying the regulations of data privacy, making it difficult to train a machine learning model over gathered data from different medical centers. Failure of leveraging data of the same kind may result in poor generalizability for the trained model. Federated learning (FL) enables collaboratively training a joint model while keeping the data decentralized for multiple medical centers. However, federated optimizations often suffer from the heterogeneity of the data distribution across medical centers. In this work, we propose Federated Learning with Shared Label Distribution (FedSLD) for classification tasks, a method that assumes knowledge of the label distributions for all the participating clients in the federation. FedSLD adjusts the contribution of each data sample to the local objective during optimization given knowledge of the distribution, mitigating the instability brought by data heterogeneity across all clients. We conduct extensive experiments on four publicly available image datasets with different types of non-IID data distributions. Our results show that FedSLD achieves better convergence performance than the compared leading FL optimization algorithms, increasing the test accuracy by up to 5.50 percentage points.