Guang Yang

Zhaohu Xing, Liang Wan, Huazhu Fu et al.

In recent years, Denoising Diffusion Models have demonstrated remarkable success in generating semantically valuable pixel-wise representations for image generative modeling. In this study, we propose a novel end-to-end framework, called Diff-UNet, for medical volumetric segmentation. Our approach integrates the diffusion model into a standard U-shaped architecture to extract semantic information from the input volume effectively, resulting in excellent pixel-level representations for medical volumetric segmentation. To enhance the robustness of the diffusion model's prediction results, we also introduce a Step-Uncertainty based Fusion (SUF) module during inference to combine the outputs of the diffusion models at each step. We evaluate our method on three datasets, including multimodal brain tumors in MRI, liver tumors, and multi-organ CT volumes, and demonstrate that Diff-UNet outperforms other state-of-the-art methods significantly. Our experimental results also indicate the universality and effectiveness of the proposed model. The proposed framework has the potential to facilitate the accurate diagnosis and treatment of medical conditions by enabling more precise segmentation of anatomical structures. The codes of Diff-UNet are available at https://github.com/ge-xing/Diff-UNet

Qingyu Yang, Guang Yang, Jun Jiang et al.

Developing and integrating advanced image sensors with novel algorithms in camera systems are prevalent with the increasing demand for computational photography and imaging on mobile platforms. However, the lack of high-quality data for research and the rare opportunity for in-depth exchange of views from industry and academia constrain the development of mobile intelligent photography and imaging (MIPI). To bridge the gap, we introduce the first MIPI challenge, including five tracks focusing on novel image sensors and imaging algorithms. In this paper, Quad Joint Remosaic and Denoise, one of the five tracks, working on the interpolation of Quad CFA to Bayer at full resolution, is introduced. The participants were provided a new dataset, including 70 (training) and 15 (validation) scenes of high-quality Quad and Bayer pairs. In addition, for each scene, Quad of different noise levels was provided at 0dB, 24dB, and 42dB. All the data were captured using a Quad sensor in both outdoor and indoor conditions. The final results are evaluated using objective metrics, including PSNR, SSIM, LPIPS, and KLD. A detailed description of all models developed in this challenge is provided in this paper. More details of this challenge and the link to the dataset can be found at https://github.com/mipi-challenge/MIPI2022.

Qingyu Yang, Guang Yang, Jun Jiang et al.

Developing and integrating advanced image sensors with novel algorithms in camera systems are prevalent with the increasing demand for computational photography and imaging on mobile platforms. However, the lack of high-quality data for research and the rare opportunity for in-depth exchange of views from industry and academia constrain the development of mobile intelligent photography and imaging (MIPI). To bridge the gap, we introduce the first MIPI challenge, including five tracks focusing on novel image sensors and imaging algorithms. In this paper, RGBW Joint Fusion and Denoise, one of the five tracks, working on the fusion of binning-mode RGBW to Bayer, is introduced. The participants were provided with a new dataset including 70 (training) and 15 (validation) scenes of high-quality RGBW and Bayer pairs. In addition, for each scene, RGBW of different noise levels was provided at 24dB and 42dB. All the data were captured using an RGBW sensor in both outdoor and indoor conditions. The final results are evaluated using objective metrics, including PSNR, SSIM}, LPIPS, and KLD. A detailed description of all models developed in this challenge is provided in this paper. More details of this challenge and the link to the dataset can be found at https://github.com/mipi-challenge/MIPI2022.

Jiahao Huang, Angelica Aviles-Rivero, Carola-Bibiane Schönlieb et al.

Deep learning has shown the capability to substantially accelerate MRI reconstruction while acquiring fewer measurements. Recently, diffusion models have gained burgeoning interests as a novel group of deep learning-based generative methods. These methods seek to sample data points that belong to a target distribution from a Gaussian distribution, which has been successfully extended to MRI reconstruction. In this work, we proposed a Cold Diffusion-based MRI reconstruction method called CDiffMR. Different from conventional diffusion models, the degradation operation of our CDiffMR is based on \textit{k}-space undersampling instead of adding Gaussian noise, and the restoration network is trained to harness a de-aliaseing function. We also design starting point and data consistency conditioning strategies to guide and accelerate the reverse process. More intriguingly, the pre-trained CDiffMR model can be reused for reconstruction tasks with different undersampling rates. We demonstrated, through extensive numerical and visual experiments, that the proposed CDiffMR can achieve comparable or even superior reconstruction results than state-of-the-art models. Compared to the diffusion model-based counterpart, CDiffMR reaches readily competing results using only $1.6 \sim 3.4\%$ for inference time. The code is publicly available at https://github.com/ayanglab/CDiffMR.

Yang Nan, Javier Del Ser, Zeyu Tang et al.

Airway segmentation is crucial for the examination, diagnosis, and prognosis of lung diseases, while its manual delineation is unduly burdensome. To alleviate this time-consuming and potentially subjective manual procedure, researchers have proposed methods to automatically segment airways from computerized tomography (CT) images. However, some small-sized airway branches (e.g., bronchus and terminal bronchioles) significantly aggravate the difficulty of automatic segmentation by machine learning models. In particular, the variance of voxel values and the severe data imbalance in airway branches make the computational module prone to discontinuous and false-negative predictions. especially for cohorts with different lung diseases. Attention mechanism has shown the capacity to segment complex structures, while fuzzy logic can reduce the uncertainty in feature representations. Therefore, the integration of deep attention networks and fuzzy theory, given by the fuzzy attention layer, should be an escalated solution for better generalization and robustness. This paper presents an efficient method for airway segmentation, comprising a novel fuzzy attention neural network and a comprehensive loss function to enhance the spatial continuity of airway segmentation. The deep fuzzy set is formulated by a set of voxels in the feature map and a learnable Gaussian membership function. Different from the existing attention mechanism, the proposed channel-specific fuzzy attention addresses the issue of heterogeneous features in different channels. Furthermore, a novel evaluation metric is proposed to assess both the continuity and completeness of airway structures. The efficiency, generalization and robustness of the proposed method have been proved by training on normal lung disease while testing on datasets of lung cancer, COVID-19 and pulmonary fibrosis.

Jiahao Huang, Xiaodan Xing, Zhifan Gao et al.

Fast MRI aims to reconstruct a high fidelity image from partially observed measurements. Exuberant development in fast MRI using deep learning has been witnessed recently. Meanwhile, novel deep learning paradigms, e.g., Transformer based models, are fast-growing in natural language processing and promptly developed for computer vision and medical image analysis due to their prominent performance. Nevertheless, due to the complexity of the Transformer, the application of fast MRI may not be straightforward. The main obstacle is the computational cost of the self-attention layer, which is the core part of the Transformer, can be expensive for high resolution MRI inputs. In this study, we propose a new Transformer architecture for solving fast MRI that coupled Shifted Windows Transformer with U-Net to reduce the network complexity. We incorporate deformable attention to construe the explainability of our reconstruction model. We empirically demonstrate that our method achieves consistently superior performance on the fast MRI task. Besides, compared to state-of-the-art Transformer models, our method has fewer network parameters while revealing explainability. The code is publicly available at https://github.com/ayanglab/SDAUT.

Minghui Zhang, Yangqian Wu, Hanxiao Zhang et al. · harvard

Open international challenges are becoming the de facto standard for assessing computer vision and image analysis algorithms. In recent years, new methods have extended the reach of pulmonary airway segmentation that is closer to the limit of image resolution. Since EXACT'09 pulmonary airway segmentation, limited effort has been directed to quantitative comparison of newly emerged algorithms driven by the maturity of deep learning based approaches and clinical drive for resolving finer details of distal airways for early intervention of pulmonary diseases. Thus far, public annotated datasets are extremely limited, hindering the development of data-driven methods and detailed performance evaluation of new algorithms. To provide a benchmark for the medical imaging community, we organized the Multi-site, Multi-domain Airway Tree Modeling (ATM'22), which was held as an official challenge event during the MICCAI 2022 conference. ATM'22 provides large-scale CT scans with detailed pulmonary airway annotation, including 500 CT scans (300 for training, 50 for validation, and 150 for testing). The dataset was collected from different sites and it further included a portion of noisy COVID-19 CTs with ground-glass opacity and consolidation. Twenty-three teams participated in the entire phase of the challenge and the algorithms for the top ten teams are reviewed in this paper. Quantitative and qualitative results revealed that deep learning models embedded with the topological continuity enhancement achieved superior performance in general. ATM'22 challenge holds as an open-call design, the training data and the gold standard evaluation are available upon successful registration via its homepage.

Weixun Luo, Xiaodan Xing, Guang Yang

Featured by a bottleneck structure, autoencoder (AE) and its variants have been largely applied in various medical image analysis tasks, such as segmentation, reconstruction and de-noising. Despite of their promising performances in aforementioned tasks, in this paper, we claim that AE models are not applicable to single image super-resolution (SISR) for 3D CT data. Our hypothesis is that the bottleneck architecture that resizes feature maps in AE models degrades the details of input images, thus can sabotage the performance of super-resolution. Although U-Net proposed skip connections that merge information from different levels, we claim that the degrading impact of feature resizing operations could hardly be removed by skip connections. By conducting large-scale ablation experiments and comparing the performance between models with and without the bottleneck design on a public CT lung dataset , we have discovered that AE models, including U-Net, have failed to achieve a compatible SISR result ($p<0.05$ by Student's t-test) compared to the baseline model. Our work is the first comparative study investigating the suitability of AE architecture for 3D CT SISR tasks and brings a rationale for researchers to re-think the choice of model architectures especially for 3D CT SISR tasks. The full implementation and trained models can be found at: https://github.com/Roldbach/Autoencoder-3D-CT-SISR

Jiahao Huang, Pedro F. Ferreira, Lichao Wang et al.

In vivo cardiac diffusion tensor imaging (cDTI) is a promising Magnetic Resonance Imaging (MRI) technique for evaluating the micro-structure of myocardial tissue in the living heart, providing insights into cardiac function and enabling the development of innovative therapeutic strategies. However, the integration of cDTI into routine clinical practice is challenging due to the technical obstacles involved in the acquisition, such as low signal-to-noise ratio and long scanning times. In this paper, we investigate and implement three different types of deep learning-based MRI reconstruction models for cDTI reconstruction. We evaluate the performance of these models based on reconstruction quality assessment and diffusion tensor parameter assessment. Our results indicate that the models we discussed in this study can be applied for clinical use at an acceleration factor (AF) of $\times 2$ and $\times 4$, with the D5C5 model showing superior fidelity for reconstruction and the SwinMR model providing higher perceptual scores. There is no statistical difference with the reference for all diffusion tensor parameters at AF $\times 2$ or most DT parameters at AF $\times 4$, and the quality of most diffusion tensor parameter maps are visually acceptable. SwinMR is recommended as the optimal approach for reconstruction at AF $\times 2$ and AF $\times 4$. However, we believed the models discussed in this studies are not prepared for clinical use at a higher AF. At AF $\times 8$, the performance of all models discussed remains limited, with only half of the diffusion tensor parameters being recovered to a level with no statistical difference from the reference. Some diffusion tensor parameter maps even provide wrong and misleading information.

Wenbo Zhang, Guang Yang, He Huang et al.

Glioma is the most common and aggressive brain tumor. Magnetic resonance imaging (MRI) plays a vital role to evaluate tumors for the arrangement of tumor surgery and the treatment of subsequent procedures. However, the manual segmentation of the MRI image is strenuous, which limits its clinical application. With the development of deep learning, a large number of automatic segmentation methods have been developed, but most of them stay in 2D images, which leads to subpar performance. Moreover, the serious voxel imbalance between the brain tumor and the background as well as the different sizes and locations of the brain tumor makes the segmentation of 3D images a challenging problem. Aiming at segmenting 3D MRI, we propose a model for brain tumor segmentation with multiple encoders. The structure contains four encoders and one decoder. The four encoders correspond to the four modalities of the MRI image, perform one-to-one feature extraction, and then merge the feature maps of the four modalities into the decoder. This method reduces the difficulty of feature extraction and greatly improves model performance. We also introduced a new loss function named "Categorical Dice", and set different weights for different segmented regions at the same time, which solved the problem of voxel imbalance. We evaluated our approach using the online BraTS 2020 Challenge verification. Our proposed method can achieve promising results in the validation set compared to the state-of-the-art approaches with Dice scores of 0.70249, 0.88267, and 0.73864 for the intact tumor, tumor core, and enhanced tumor, respectively.

Hao Li, Yang Nan, Javier Del Ser et al.

Despite recent advances in the accuracy of brain tumor segmentation, the results still suffer from low reliability and robustness. Uncertainty estimation is an efficient solution to this problem, as it provides a measure of confidence in the segmentation results. The current uncertainty estimation methods based on quantile regression, Bayesian neural network, ensemble, and Monte Carlo dropout are limited by their high computational cost and inconsistency. In order to overcome these challenges, Evidential Deep Learning (EDL) was developed in recent work but primarily for natural image classification. In this paper, we proposed a region-based EDL segmentation framework that can generate reliable uncertainty maps and robust segmentation results. We used the Theory of Evidence to interpret the output of a neural network as evidence values gathered from input features. Following Subjective Logic, evidence was parameterized as a Dirichlet distribution, and predicted probabilities were treated as subjective opinions. To evaluate the performance of our model on segmentation and uncertainty estimation, we conducted quantitative and qualitative experiments on the BraTS 2020 dataset. The results demonstrated the top performance of the proposed method in quantifying segmentation uncertainty and robustly segmenting tumors. Furthermore, our proposed new framework maintained the advantages of low computational cost and easy implementation and showed the potential for clinical application.

Hao Li, Yang Nan, Javier Del Ser et al.

Automatic segmentation of multiple organs and tumors from 3D medical images such as magnetic resonance imaging (MRI) and computed tomography (CT) scans using deep learning methods can aid in diagnosing and treating cancer. However, organs often overlap and are complexly connected, characterized by extensive anatomical variation and low contrast. In addition, the diversity of tumor shape, location, and appearance, coupled with the dominance of background voxels, makes accurate 3D medical image segmentation difficult. In this paper, a novel large-kernel (LK) attention module is proposed to address these problems to achieve accurate multi-organ segmentation and tumor segmentation. The advantages of convolution and self-attention are combined in the proposed LK attention module, including local contextual information, long-range dependence, and channel adaptation. The module also decomposes the LK convolution to optimize the computational cost and can be easily incorporated into FCNs such as U-Net. Comprehensive ablation experiments demonstrated the feasibility of convolutional decomposition and explored the most efficient and effective network design. Among them, the best Mid-type LK attention-based U-Net network was evaluated on CT-ORG and BraTS 2020 datasets, achieving state-of-the-art segmentation performance. The performance improvement due to the proposed LK attention module was also statistically validated.

Guang Yang, Yin Tang, Zhijian Wu et al.

Recent mainstream masked distillation methods function by reconstructing selectively masked areas of a student network from the feature map of its teacher counterpart. In these methods, the masked regions need to be properly selected, such that reconstructed features encode sufficient discrimination and representation capability like the teacher feature. However, previous masked distillation methods only focus on spatial masking, making the resulting masked areas biased towards spatial importance without encoding informative channel clues. In this study, we devise a Dual Masked Knowledge Distillation (DMKD) framework which can capture both spatially important and channel-wise informative clues for comprehensive masked feature reconstruction. More specifically, we employ dual attention mechanism for guiding the respective masking branches, leading to reconstructed feature encoding dual significance. Furthermore, fusing the reconstructed features is achieved by self-adjustable weighting strategy for effective feature distillation. Our experiments on object detection task demonstrate that the student networks achieve performance gains of 4.1% and 4.3% with the help of our method when RetinaNet and Cascade Mask R-CNN are respectively used as the teacher networks, while outperforming the other state-of-the-art distillation methods.

Hao Li, Zeyu Tang, Yang Nan et al.

Various structures in human physiology follow a treelike morphology, which often expresses complexity at very fine scales. Examples of such structures are intrathoracic airways, retinal blood vessels, and hepatic blood vessels. Large collections of 2D and 3D images have been made available by medical imaging modalities such as magnetic resonance imaging (MRI), computed tomography (CT), Optical coherence tomography (OCT) and ultrasound in which the spatial arrangement can be observed. Segmentation of these structures in medical imaging is of great importance since the analysis of the structure provides insights into disease diagnosis, treatment planning, and prognosis. Manually labelling extensive data by radiologists is often time-consuming and error-prone. As a result, automated or semi-automated computational models have become a popular research field of medical imaging in the past two decades, and many have been developed to date. In this survey, we aim to provide a comprehensive review of currently publicly available datasets, segmentation algorithms, and evaluation metrics. In addition, current challenges and future research directions are discussed.

Xiaodan Xing, Javier Del Ser, Yinzhe Wu et al.

Synthetic digital twins based on medical data accelerate the acquisition, labelling and decision making procedure in digital healthcare. A core part of digital healthcare twins is model-based data synthesis, which permits the generation of realistic medical signals without requiring to cope with the modelling complexity of anatomical and biochemical phenomena producing them in reality. Unfortunately, algorithms for cardiac data synthesis have been so far scarcely studied in the literature. An important imaging modality in the cardiac examination is three-directional CINE multi-slice myocardial velocity mapping (3Dir MVM), which provides a quantitative assessment of cardiac motion in three orthogonal directions of the left ventricle. The long acquisition time and complex acquisition produce make it more urgent to produce synthetic digital twins of this imaging modality. In this study, we propose a hybrid deep learning (HDL) network, especially for synthetic 3Dir MVM data. Our algorithm is featured by a hybrid UNet and a Generative Adversarial Network with a foreground-background generation scheme. The experimental results show that from temporally down-sampled magnitude CINE images (six times), our proposed algorithm can still successfully synthesise high temporal resolution 3Dir MVM CMR data (PSNR=42.32) with precise left ventricle segmentation (DICE=0.92). These performance scores indicate that our proposed HDL algorithm can be implemented in real-world digital twins for myocardial velocity mapping data simulation. To the best of our knowledge, this work is the first one in the literature investigating digital twins of the 3Dir MVM CMR, which has shown great potential for improving the efficiency of clinical studies via synthesised cardiac data.

Yingying Fang, Shuang Wu, Sheng Zhang et al.

Effectively leveraging multimodal data such as various images, laboratory tests and clinical information is gaining traction in a variety of AI-based medical diagnosis and prognosis tasks. Most existing multi-modal techniques only focus on enhancing their performance by leveraging the differences or shared features from various modalities and fusing feature across different modalities. These approaches are generally not optimal for clinical settings, which pose the additional challenges of limited training data, as well as being rife with redundant data or noisy modality channels, leading to subpar performance. To address this gap, we study the robustness of existing methods to data redundancy and noise and propose a generalized dynamic multimodal information bottleneck framework for attaining a robust fused feature representation. Specifically, our information bottleneck module serves to filter out the task-irrelevant information and noises in the fused feature, and we further introduce a sufficiency loss to prevent dropping of task-relevant information, thus explicitly preserving the sufficiency of prediction information in the distilled feature. We validate our model on an in-house and a public COVID19 dataset for mortality prediction as well as two public biomedical datasets for diagnostic tasks. Extensive experiments show that our method surpasses the state-of-the-art and is significantly more robust, being the only method to remain performance when large-scale noisy channels exist. Our code is publicly available at https://github.com/ayanglab/DMIB.

Michael Yeung, Todd Watts, Sean YW Tan et al.

Stain variation is a unique challenge associated with automated analysis of digital pathology. Numerous methods have been developed to improve the robustness of machine learning methods to stain variation, but comparative studies have demonstrated limited benefits to performance. Moreover, methods to handle stain variation were largely developed for H&E stained data, with evaluation generally limited to classification tasks. Here we propose Stain Consistency Learning, a novel framework combining stain-specific augmentation with a stain consistency loss function to learn stain colour invariant features. We perform the first, extensive comparison of methods to handle stain variation for segmentation tasks, comparing ten methods on Masson's trichrome and H&E stained cell and nuclei datasets, respectively. We observed that stain normalisation methods resulted in equivalent or worse performance, while stain augmentation or stain adversarial methods demonstrated improved performance, with the best performance consistently achieved by our proposed approach. The code is available at: https://github.com/mlyg/stain_consistency_learning

Jiahao Huang, Yingying Fang, Yang Nan et al.

Research studies have shown no qualms about using data driven deep learning models for downstream tasks in medical image analysis, e.g., anatomy segmentation and lesion detection, disease diagnosis and prognosis, and treatment planning. However, deep learning models are not the sovereign remedy for medical image analysis when the upstream imaging is not being conducted properly (with artefacts). This has been manifested in MRI studies, where the scanning is typically slow, prone to motion artefacts, with a relatively low signal to noise ratio, and poor spatial and/or temporal resolution. Recent studies have witnessed substantial growth in the development of deep learning techniques for propelling fast MRI. This article aims to (1) introduce the deep learning based data driven techniques for fast MRI including convolutional neural network and generative adversarial network based methods, (2) survey the attention and transformer based models for speeding up MRI reconstruction, and (3) detail the research in coupling physics and data driven models for MRI acceleration. Finally, we will demonstrate through a few clinical applications, explain the importance of data harmonisation and explainable models for such fast MRI techniques in multicentre and multi-scanner studies, and discuss common pitfalls in current research and recommendations for future research directions.

Md. Kamrul Hasan, Md. Asif Ahamad, Choon Hwai Yap et al.

The Computer-aided Diagnosis or Detection (CAD) approach for skin lesion analysis is an emerging field of research that has the potential to alleviate the burden and cost of skin cancer screening. Researchers have recently indicated increasing interest in developing such CAD systems, with the intention of providing a user-friendly tool to dermatologists to reduce the challenges encountered or associated with manual inspection. This article aims to provide a comprehensive literature survey and review of a total of 594 publications (356 for skin lesion segmentation and 238 for skin lesion classification) published between 2011 and 2022. These articles are analyzed and summarized in a number of different ways to contribute vital information regarding the methods for the development of CAD systems. These ways include relevant and essential definitions and theories, input data (dataset utilization, preprocessing, augmentations, and fixing imbalance problems), method configuration (techniques, architectures, module frameworks, and losses), training tactics (hyperparameter settings), and evaluation criteria. We intend to investigate a variety of performance-enhancing approaches, including ensemble and post-processing. We also discuss these dimensions to reveal their current trends based on utilization frequencies. In addition, we highlight the primary difficulties associated with evaluating skin lesion segmentation and classification systems using minimal datasets, as well as the potential solutions to these difficulties. Findings, recommendations, and trends are disclosed to inform future research on developing an automated and robust CAD system for skin lesion analysis.

Michael Tanzer, Pedro Ferreira, Andrew Scott et al.

Diffusion Tensor Cardiac Magnetic Resonance (DT-CMR) enables us to probe the microstructural arrangement of cardiomyocytes within the myocardium in vivo and non-invasively, which no other imaging modality allows. This innovative technology could revolutionise the ability to perform cardiac clinical diagnosis, risk stratification, prognosis and therapy follow-up. However, DT-CMR is currently inefficient with over six minutes needed to acquire a single 2D static image. Therefore, DT-CMR is currently confined to research but not used clinically. We propose to reduce the number of repetitions needed to produce DT-CMR datasets and subsequently de-noise them, decreasing the acquisition time by a linear factor while maintaining acceptable image quality. Our proposed approach, based on Generative Adversarial Networks, Vision Transformers, and Ensemble Learning, performs significantly and considerably better than previous proposed approaches, bringing single breath-hold DT-CMR closer to reality.

Zhifan Gao, Yifeng Guo, Jiajing Zhang et al.

The long acquisition time has limited the accessibility of magnetic resonance imaging (MRI) because it leads to patient discomfort and motion artifacts. Although several MRI techniques have been proposed to reduce the acquisition time, compressed sensing in magnetic resonance imaging (CS-MRI) enables fast acquisition without compromising SNR and resolution. However, existing CS-MRI methods suffer from the challenge of aliasing artifacts. This challenge results in the noise-like textures and missing the fine details, thus leading to unsatisfactory reconstruction performance. To tackle this challenge, we propose a hierarchical perception adversarial learning framework (HP-ALF). HP-ALF can perceive the image information in the hierarchical mechanism: image-level perception and patch-level perception. The former can reduce the visual perception difference in the entire image, and thus achieve aliasing artifact removal. The latter can reduce this difference in the regions of the image, and thus recover fine details. Specifically, HP-ALF achieves the hierarchical mechanism by utilizing multilevel perspective discrimination. This discrimination can provide the information from two perspectives (overall and regional) for adversarial learning. It also utilizes a global and local coherent discriminator to provide structure information to the generator during training. In addition, HP-ALF contains a context-aware learning block to effectively exploit the slice information between individual images for better reconstruction performance. The experiments validated on three datasets demonstrate the effectiveness of HP-ALF and its superiority to the comparative methods.

Michael Tanzer, Sea Hee Yook, Guang Yang et al.

As diffusion tensor imaging (DTI) gains popularity in cardiac imaging due to its unique ability to non-invasively assess the cardiac microstructure, deep learning-based Artificial Intelligence is becoming a crucial tool in mitigating some of its drawbacks, such as the long scan times. As it often happens in fast-paced research environments, a lot of emphasis has been put on showing the capability of deep learning while often not enough time has been spent investigating what input and architectural properties would benefit cardiac DTI acceleration the most. In this work, we compare the effect of several input types (magnitude images vs complex images), multiple dimensionalities (2D vs 3D operations), and multiple input types (single slice vs multi-slice) on the performance of a model trained to remove artefacts caused by a simultaneous multi-slice (SMS) acquisition. Despite our initial intuition, our experiments show that, for a fixed number of parameters, simpler 2D real-valued models outperform their more advanced 3D or complex counterparts. The best performance is although obtained by a real-valued model trained using both the magnitude and phase components of the acquired data. We believe this behaviour to be due to real-valued models making better use of the lower number of parameters, and to 3D models not being able to exploit the spatial information because of the low SMS acceleration factor used in our experiments.

Jiahao Huang, Angelica Aviles-Rivero, Carola-Bibiane Schonlieb et al.

Deep learning models have been widely applied for fast MRI. The majority of existing deep learning models, e.g., convolutional neural networks, work on data with Euclidean or regular grids structures. However, high-dimensional features extracted from MR data could be encapsulated in non-Euclidean manifolds. This disparity between the go-to assumption of existing models and data requirements limits the flexibility to capture irregular anatomical features in MR data. In this work, we introduce a novel Vision GNN type network for fast MRI called Vision GNN U-Net (ViGU). More precisely, the pixel array is first embedded into patches and then converted into a graph. Secondly, a U-shape network is developed using several graph blocks in symmetrical encoder and decoder paths. Moreover, we show that the proposed ViGU can also benefit from Generative Adversarial Networks yielding to its variant ViGU-GAN. We demonstrate, through numerical and visual experiments, that the proposed ViGU and GAN variant outperform existing CNN and GAN-based methods. Moreover, we show that the proposed network readily competes with approaches based on Transformers while requiring a fraction of the computational cost. More importantly, the graph structure of the network reveals how the network extracts features from MR images, providing intuitive explainability.

Yang Nan, Fengyi Li, Peng Tang et al.

Recognition of glomeruli lesions is the key for diagnosis and treatment planning in kidney pathology; however, the coexisting glomerular structures such as mesangial regions exacerbate the difficulties of this task. In this paper, we introduce a scheme to recognize fine-grained glomeruli lesions from whole slide images. First, a focal instance structural similarity loss is proposed to drive the model to locate all types of glomeruli precisely. Then an Uncertainty Aided Apportionment Network is designed to carry out the fine-grained visual classification without bounding-box annotations. This double branch-shaped structure extracts common features of the child class from the parent class and produces the uncertainty factor for reconstituting the training dataset. Results of slide-wise evaluation illustrate the effectiveness of the entire scheme, with an 8-22% improvement of the mean Average Precision compared with remarkable detection methods. The comprehensive results clearly demonstrate the effectiveness of the proposed method.

Zeyu Tang, Nan Yang, Simon Walsh et al.

Discontinuity in the delineation of peripheral bronchioles hinders the potential clinical application of automated airway segmentation models. Moreover, the deployment of such models is limited by the data heterogeneity across different centres, and pathological abnormalities also make achieving accurate robust segmentation in distal small airways difficult. Meanwhile, the diagnosis and prognosis of lung diseases often rely on evaluating structural changes in those anatomical regions. To address this gap, this paper presents a patch-scale adversarial-based refinement network that takes in preliminary segmentation along with original CT images and outputs a refined mask of the airway structure. The method is validated on three different datasets encompassing healthy cases, cases with cystic fibrosis and cases with COVID-19. The results are quantitatively evaluated by seven metrics and achieved more than a 15% rise in detected length ratio and detected branch ratio, showing promising performance compared to previously proposed models. The visual illustration also proves our refinement guided by a patch-scale discriminator and centreline objective functions is effective in detecting discontinuities and missing bronchioles. Furthermore, the generalizability of our refinement pipeline is tested on three previous models and improves their segmentation completeness significantly.

Yang Nan, Peng Tang, Guyue Zhang et al.

Tissue segmentation is the mainstay of pathological examination, whereas the manual delineation is unduly burdensome. To assist this time-consuming and subjective manual step, researchers have devised methods to automatically segment structures in pathological images. Recently, automated machine and deep learning based methods dominate tissue segmentation research studies. However, most machine and deep learning based approaches are supervised and developed using a large number of training samples, in which the pixelwise annotations are expensive and sometimes can be impossible to obtain. This paper introduces a novel unsupervised learning paradigm by integrating an end-to-end deep mixture model with a constrained indicator to acquire accurate semantic tissue segmentation. This constraint aims to centralise the components of deep mixture models during the calculation of the optimisation function. In so doing, the redundant or empty class issues, which are common in current unsupervised learning methods, can be greatly reduced. By validation on both public and in-house datasets, the proposed deep constrained Gaussian network achieves significantly (Wilcoxon signed-rank test) better performance (with the average Dice scores of 0.737 and 0.735, respectively) on tissue segmentation with improved stability and robustness, compared to other existing unsupervised segmentation approaches. Furthermore, the proposed method presents a similar performance (p-value > 0.05) compared to the fully supervised U-Net.

Guang Yang, Yin Tang, Jun Li et al.

As a general model compression paradigm, feature-based knowledge distillation allows the student model to learn expressive features from the teacher counterpart. In this paper, we mainly focus on designing an effective feature-distillation framework and propose a spatial-channel adaptive masked distillation (AMD) network for object detection. More specifically, in order to accurately reconstruct important feature regions, we first perform attention-guided feature masking on the feature map of the student network, such that we can identify the important features via spatially adaptive feature masking instead of random masking in the previous methods. In addition, we employ a simple and efficient module to allow the student network channel to be adaptive, improving its model capability in object perception and detection. In contrast to the previous methods, more crucial object-aware features can be reconstructed and learned from the proposed network, which is conducive to accurate object detection. The empirical experiments demonstrate the superiority of our method: with the help of our proposed distillation method, the student networks report 41.3%, 42.4%, and 42.7% mAP scores when RetinaNet, Cascade Mask-RCNN and RepPoints are respectively used as the teacher framework for object detection, which outperforms the previous state-of-the-art distillation methods including FGD and MGD.

Giorgos Papanastasiou, Nikolaos Dikaios, Jiahao Huang et al.

Medical imaging is a key component in clinical diagnosis, treatment planning and clinical trial design, accounting for almost 90% of all healthcare data. CNNs achieved performance gains in medical image analysis (MIA) over the last years. CNNs can efficiently model local pixel interactions and be trained on small-scale MI data. The main disadvantage of typical CNN models is that they ignore global pixel relationships within images, which limits their generalisation ability to understand out-of-distribution data with different 'global' information. The recent progress of Artificial Intelligence gave rise to Transformers, which can learn global relationships from data. However, full Transformer models need to be trained on large-scale data and involve tremendous computational complexity. Attention and Transformer compartments (Transf/Attention) which can well maintain properties for modelling global relationships, have been proposed as lighter alternatives of full Transformers. Recently, there is an increasing trend to co-pollinate complementary local-global properties from CNN and Transf/Attention architectures, which led to a new era of hybrid models. The past years have witnessed substantial growth in hybrid CNN-Transf/Attention models across diverse MIA problems. In this systematic review, we survey existing hybrid CNN-Transf/Attention models, review and unravel key architectural designs, analyse breakthroughs, and evaluate current and future opportunities as well as challenges. We also introduced a comprehensive analysis framework on generalisation opportunities of scientific and clinical impact, based on which new data-driven domain generalisation and adaptation methods can be stimulated.

Guang Yang, Arvind Rao, Christine Fernandez-Maloigne et al.

Artificial intelligence has become pervasive across disciplines and fields, and biomedical image and signal processing is no exception. The growing and widespread interest on the topic has triggered a vast research activity that is reflected in an exponential research effort. Through study of massive and diverse biomedical data, machine and deep learning models have revolutionized various tasks such as modeling, segmentation, registration, classification and synthesis, outperforming traditional techniques. However, the difficulty in translating the results into biologically/clinically interpretable information is preventing their full exploitation in the field. Explainable AI (XAI) attempts to fill this translational gap by providing means to make the models interpretable and providing explanations. Different solutions have been proposed so far and are gaining increasing interest from the community. This paper aims at providing an overview on XAI in biomedical data processing and points to an upcoming Special Issue on Deep Learning in Biomedical Image and Signal Processing of the IEEE Signal Processing Magazine that is going to appear in March 2022.

Shiyi Wang, Yang Nan, Sheng Zhang et al.

In pulmonary tracheal segmentation, the scarcity of annotated data is a prevalent issue in medical segmentation. Additionally, Deep Learning (DL) methods face challenges: the opacity of 'black box' models and the need for performance enhancement. Our Human-Computer Interaction (HCI) based models (RS_UNet, LC_UNet, UUNet, and WD_UNet) address these challenges by combining diverse query strategies with various DL models. We train four HCI models and repeat these steps: (1) Query Strategy: The HCI models select samples that provide the most additional representative information when labeled in each iteration and identify unlabeled samples with the greatest predictive disparity using Wasserstein Distance, Least Confidence, Entropy Sampling, and Random Sampling. (2) Central line correction: Selected samples are used for expert correction of system-generated tracheal central lines in each training round. (3) Update training dataset: Experts update the training dataset after each DL model's training epoch, enhancing the trustworthiness and performance of the models. (4) Model training: The HCI model is trained using the updated dataset and an enhanced UNet version. Experimental results confirm the effectiveness of these HCI-based approaches, showing that WD-UNet, LC-UNet, UUNet, and RS-UNet achieve comparable or superior performance to state-of-the-art DL models. Notably, WD-UNet achieves this with only 15%-35% of the training data, reducing physician annotation time by 65%-85%.

Zhan Gao, Guang Yang, Amanda Prorok

Control barrier functions (CBFs) enable guaranteed safe multi-agent navigation in the continuous domain. The resulting navigation performance, however, is highly sensitive to the underlying hyperparameters. Traditional approaches consider fixed CBFs (where parameters are tuned apriori), and hence, typically do not perform well in cluttered and highly dynamic environments: conservative parameter values can lead to inefficient agent trajectories, or even failure to reach goal positions, whereas aggressive parameter values can lead to infeasible controls. To overcome these issues, in this paper, we propose online CBFs, whereby hyperparameters are tuned in real-time, as a function of what agents perceive in their immediate neighborhood. Since the explicit relationship between CBFs and navigation performance is hard to model, we leverage reinforcement learning to learn CBF-tuning policies in a model-free manner. Because we parameterize the policies with graph neural networks (GNNs), we are able to synthesize decentralized agent controllers that adjust parameter values locally, varying the degree of conservative and aggressive behaviors across agents. Simulations as well as real-world experiments show that (i) online CBFs are capable of solving navigation scenarios that are infeasible for fixed CBFs, and (ii), that they improve navigation performance by adapting to other agents and changes in the environment.

Chengjia Wang, Guang Yang, Giorgos Papanastasiou

Magnetic Resonance Imaging (MRI) typically recruits multiple sequences (defined here as "modalities"). As each modality is designed to offer different anatomical and functional clinical information, there are evident disparities in the imaging content across modalities. Inter- and intra-modality affine and non-rigid image registration is an essential medical image analysis process in clinical imaging, as for example before imaging biomarkers need to be derived and clinically evaluated across different MRI modalities, time phases and slices. Although commonly needed in real clinical scenarios, affine and non-rigid image registration is not extensively investigated using a single unsupervised model architecture. In our work, we present an un-supervised deep learning registration methodology which can accurately model affine and non-rigid trans-formations, simultaneously. Moreover, inverse-consistency is a fundamental inter-modality registration property that is not considered in deep learning registration algorithms. To address inverse-consistency, our methodology performs bi-directional cross-modality image synthesis to learn modality-invariant latent rep-resentations, while involves two factorised transformation networks and an inverse-consistency loss to learn topology-preserving anatomical transformations. Overall, our model (named "FIRE") shows improved performances against the reference standard baseline method on multi-modality brain 2D and 3D MRI and intra-modality cardiac 4D MRI data experiments.

Chenglong Wang, Yun Liu, Fen Wang et al.

Lung cancer has the highest mortality rate of deadly cancers in the world. Early detection is essential to treatment of lung cancer. However, detection and accurate diagnosis of pulmonary nodules depend heavily on the experiences of radiologists and can be a heavy workload for them. Computer-aided diagnosis (CAD) systems have been developed to assist radiologists in nodule detection and diagnosis, greatly easing the workload while increasing diagnosis accuracy. Recent development of deep learning, greatly improved the performance of CAD systems. However, lack of model reliability and interpretability remains a major obstacle for its large-scale clinical application. In this work, we proposed a multi-task explainable deep-learning model for pulmonary nodule diagnosis. Our neural model can not only predict lesion malignancy but also identify relevant manifestations. Further, the location of each manifestation can also be visualized for visual interpretability. Our proposed neural model achieved a test AUC of 0.992 on LIDC public dataset and a test AUC of 0.923 on our in-house dataset. Moreover, our experimental results proved that by incorporating manifestation identification tasks into the multi-task model, the accuracy of the malignancy classification can also be improved. This multi-task explainable model may provide a scheme for better interaction with the radiologists in a clinical environment.

Shiyi Wang, Guang Yang

Medical image classification and segmentation based on deep learning (DL) are emergency research topics for diagnosing variant viruses of the current COVID-19 situation. In COVID-19 computed tomography (CT) images of the lungs, ground glass turbidity is the most common finding that requires specialist diagnosis. Based on this situation, some researchers propose the relevant DL models which can replace professional diagnostic specialists in clinics when lacking expertise. However, although DL methods have a stunning performance in medical image processing, the limited datasets can be a challenge in developing the accuracy of diagnosis at the human level. In addition, deep learning algorithms face the challenge of classifying and segmenting medical images in three or even multiple dimensions and maintaining high accuracy rates. Consequently, with a guaranteed high level of accuracy, our model can classify the patients' CT images into three types: Normal, Pneumonia and COVID. Subsequently, two datasets are used for segmentation, one of the datasets even has only a limited amount of data (20 cases). Our system combined the classification model and the segmentation model together, a fully integrated diagnostic model was built on the basis of ResNet50 and 3D U-Net algorithm. By feeding with different datasets, the COVID image segmentation of the infected area will be carried out according to classification results. Our model achieves 94.52% accuracy in the classification of lung lesions by 3 types: COVID, Pneumonia and Normal. For future medical use, embedding the model into the medical facilities might be an efficient way of assisting or substituting doctors with diagnoses, therefore, a broader range of the problem of variant viruses in the COVID-19 situation may also be successfully solved.

Guang Yang, Wu Liu, Xinchen Liu et al.

Human motion transfer refers to synthesizing photo-realistic and temporally coherent videos that enable one person to imitate the motion of others. However, current synthetic videos suffer from the temporal inconsistency in sequential frames that significantly degrades the video quality, yet is far from solved by existing methods in the pixel domain. Recently, some works on DeepFake detection try to distinguish the natural and synthetic images in the frequency domain because of the frequency insufficiency of image synthesizing methods. Nonetheless, there is no work to study the temporal inconsistency of synthetic videos from the aspects of the frequency-domain gap between natural and synthetic videos. In this paper, we propose to delve into the frequency space for temporally consistent human motion transfer. First of all, we make the first comprehensive analysis of natural and synthetic videos in the frequency domain to reveal the frequency gap in both the spatial dimension of individual frames and the temporal dimension of the video. To close the frequency gap between the natural and synthetic videos, we propose a novel Frequency-based human MOtion TRansfer framework, named FreMOTR, which can effectively mitigate the spatial artifacts and the temporal inconsistency of the synthesized videos. FreMOTR explores two novel frequency-based regularization modules: 1) the Frequency-domain Appearance Regularization (FAR) to improve the appearance of the person in individual frames and 2) Temporal Frequency Regularization (TFR) to guarantee the temporal consistency between adjacent frames. Finally, comprehensive experiments demonstrate that the FreMOTR not only yields superior performance in temporal consistency metrics but also improves the frame-level visual quality of synthetic videos. In particular, the temporal consistency metrics are improved by nearly 30% than the state-of-the-art model.

Xiaodan Xing, Huanjun Wu, Lichao Wang et al.

Data quality is the key factor for the development of trustworthy AI in healthcare. A large volume of curated datasets with controlled confounding factors can help improve the accuracy, robustness and privacy of downstream AI algorithms. However, access to good quality datasets is limited by the technical difficulty of data acquisition and large-scale sharing of healthcare data is hindered by strict ethical restrictions. Data synthesis algorithms, which generate data with a similar distribution as real clinical data, can serve as a potential solution to address the scarcity of good quality data during the development of trustworthy AI. However, state-of-the-art data synthesis algorithms, especially deep learning algorithms, focus more on imaging data while neglecting the synthesis of non-imaging healthcare data, including clinical measurements, medical signals and waveforms, and electronic healthcare records (EHRs). Thus, in this paper, we will review the synthesis algorithms, particularly for non-imaging medical data, with the aim of providing trustworthy AI in this domain. This tutorial-styled review paper will provide comprehensive descriptions of non-imaging medical data synthesis on aspects including algorithms, evaluations, limitations and future research directions.

Xiaodan Xing, Giorgos Papanastasiou, Simon Walsh et al.

As a pragmatic data augmentation tool, data synthesis has generally returned dividends in performance for deep learning based medical image analysis. However, generating corresponding segmentation masks for synthetic medical images is laborious and subjective. To obtain paired synthetic medical images and segmentations, conditional generative models that use segmentation masks as synthesis conditions were proposed. However, these segmentation mask-conditioned generative models still relied on large, varied, and labeled training datasets, and they could only provide limited constraints on human anatomical structures, leading to unrealistic image features. Moreover, the invariant pixel-level conditions could reduce the variety of synthetic lesions and thus reduce the efficacy of data augmentation. To address these issues, in this work, we propose a novel strategy for medical image synthesis, namely Unsupervised Mask (UM)-guided synthesis, to obtain both synthetic images and segmentations using limited manual segmentation labels. We first develop a superpixel based algorithm to generate unsupervised structural guidance and then design a conditional generative model to synthesize images and annotations simultaneously from those unsupervised masks in a semi-supervised multi-task setting. In addition, we devise a multi-scale multi-task Fréchet Inception Distance (MM-FID) and multi-scale multi-task standard deviation (MM-STD) to harness both fidelity and variety evaluations of synthetic CT images. With multiple analyses on different scales, we could produce stable image quality measurements with high reproducibility. Compared with the segmentation mask guided synthesis, our UM-guided synthesis provided high-quality synthetic images with significantly higher fidelity, variety, and utility ($p<0.05$ by Wilcoxon Signed Ranked test).

Ming Li, Pengcheng Xu, Junjie Hu et al.

Federated learning holds great potential for enabling large-scale healthcare research and collaboration across multiple centres while ensuring data privacy and security are not compromised. Although numerous recent studies suggest or utilize federated learning based methods in healthcare, it remains unclear which ones have potential clinical utility. This review paper considers and analyzes the most recent studies up to May 2024 that describe federated learning based methods in healthcare. After a thorough review, we find that the vast majority are not appropriate for clinical use due to their methodological flaws and/or underlying biases which include but are not limited to privacy concerns, generalization issues, and communication costs. As a result, the effectiveness of federated learning in healthcare is significantly compromised. To overcome these challenges, we provide recommendations and promising opportunities that might be implemented to resolve these problems and improve the quality of model development in federated learning with healthcare.

Xiaodan Xing, Jiahao Huang, Yang Nan et al.

The destitution of image data and corresponding expert annotations limit the training capacities of AI diagnostic models and potentially inhibit their performance. To address such a problem of data and label scarcity, generative models have been developed to augment the training datasets. Previously proposed generative models usually require manually adjusted annotations (e.g., segmentation masks) or need pre-labeling. However, studies have found that these pre-labeling based methods can induce hallucinating artifacts, which might mislead the downstream clinical tasks, while manual adjustment could be onerous and subjective. To avoid manual adjustment and pre-labeling, we propose a novel controllable and simultaneous synthesizer (dubbed CS$^2$) in this study to generate both realistic images and corresponding annotations at the same time. Our CS$^2$ model is trained and validated using high resolution CT (HRCT) data collected from COVID-19 patients to realize an efficient infections segmentation with minimal human intervention. Our contributions include 1) a conditional image synthesis network that receives both style information from reference CT images and structural information from unsupervised segmentation masks, and 2) a corresponding segmentation mask synthesis network to automatically segment these synthesized images simultaneously. Our experimental studies on HRCT scans collected from COVID-19 patients demonstrate that our CS$^2$ model can lead to realistic synthesized datasets and promising segmentation results of COVID infections compared to the state-of-the-art nnUNet trained and fine-tuned in a fully supervised manner.

Yinzhe Wu, Jiahao Huang, Fanwen Wang et al.

Diffusion Tensor Cardiac Magnetic Resonance (DT-CMR) is the only in vivo method to non-invasively examine the microstructure of the human heart. Current research in DT-CMR aims to improve the understanding of how the cardiac microstructure relates to the macroscopic function of the healthy heart as well as how microstructural dysfunction contributes to disease. To get the final DT-CMR metrics, we need to acquire diffusion weighted images of at least 6 directions. However, due to DWI's low signal-to-noise ratio, the standard voxel size is quite big on the scale for microstructures. In this study, we explored the potential of deep-learning-based methods in improving the image quality volumetrically (x4 in all dimensions). This study proposed a novel framework to enable volumetric super-resolution, with an additional model input of high-resolution b0 DWI. We demonstrated that the additional input could offer higher super-resolved image quality. Going beyond, the model is also able to super-resolve DWIs of unseen b-values, proving the model framework's generalizability for cardiac DWI superresolution. In conclusion, we would then recommend giving the model a high-resolution reference image as an additional input to the low-resolution image for training and inference to guide all super-resolution frameworks for parametric imaging where a reference image is available.

Yuchen Mao, Hongwei Li, Wei Pang et al.

The persistent challenge of medical image synthesis posed by the scarcity of annotated data and the need to synthesize `missing modalities' for multi-modal analysis, underscored the imperative development of effective synthesis methods. Recently, the combination of Low-Rank Adaptation (LoRA) with latent diffusion models (LDMs) has emerged as a viable approach for efficiently adapting pre-trained large language models, in the medical field. However, the direct application of LoRA assumes uniform ranking across all linear layers, overlooking the significance of different weight matrices, and leading to sub-optimal outcomes. Prior works on LoRA prioritize the reduction of trainable parameters, and there exists an opportunity to further tailor this adaptation process to the intricate demands of medical image synthesis. In response, we present SeLoRA, a Self-Expanding Low-Rank Adaptation Module, that dynamically expands its ranking across layers during training, strategically placing additional ranks on crucial layers, to allow the model to elevate synthesis quality where it matters most. The proposed method not only enables LDMs to fine-tune on medical data efficiently but also empowers the model to achieve improved image quality with minimal ranking. The code of our SeLoRA method is publicly available on https://anonymous.4open.science/r/SeLoRA-980D .

Jin Zhu, Guang Yang, Pietro Lio

Super-resolution plays an essential role in medical imaging because it provides an alternative way to achieve high spatial resolutions and image quality with no extra acquisition costs. In the past few decades, the rapid development of deep neural networks has promoted super-resolution performance with novel network architectures, loss functions and evaluation metrics. Specifically, vision transformers dominate a broad range of computer vision tasks, but challenges still exist when applying them to low-level medical image processing tasks. This paper proposes an efficient vision transformer with residual dense connections and local feature fusion to achieve efficient single-image super-resolution (SISR) of medical modalities. Moreover, we implement a general-purpose perceptual loss with manual control for image quality improvements of desired aspects by incorporating prior knowledge of medical image segmentation. Compared with state-of-the-art methods on four public medical image datasets, the proposed method achieves the best PSNR scores of 6 modalities among seven modalities. It leads to an average improvement of $+0.09$ dB PSNR with only 38\% parameters of SwinIR. On the other hand, the segmentation-based perceptual loss increases $+0.14$ dB PSNR on average for SOTA methods, including CNNs and vision transformers. Additionally, we conduct comprehensive ablation studies to discuss potential factors for the superior performance of vision transformers over CNNs and the impacts of network and loss function components. The code will be released on GitHub with the paper published.

Jiahao Huang, Liutao Yang, Fanwen Wang et al.

The recent Mamba model has shown remarkable adaptability for visual representation learning, including in medical imaging tasks. This study introduces MambaMIR, a Mamba-based model for medical image reconstruction, as well as its Generative Adversarial Network-based variant, MambaMIR-GAN. Our proposed MambaMIR inherits several advantages, such as linear complexity, global receptive fields, and dynamic weights, from the original Mamba model. The innovated arbitrary-mask mechanism effectively adapt Mamba to our image reconstruction task, providing randomness for subsequent Monte Carlo-based uncertainty estimation. Experiments conducted on various medical image reconstruction tasks, including fast MRI and SVCT, which cover anatomical regions such as the knee, chest, and abdomen, have demonstrated that MambaMIR and MambaMIR-GAN achieve comparable or superior reconstruction results relative to state-of-the-art methods. Additionally, the estimated uncertainty maps offer further insights into the reliability of the reconstruction quality. The code is publicly available at https://github.com/ayanglab/MambaMIR.

Ming Li, Guang Yang

In medical image analysis, Federated Learning (FL) stands out as a key technology that enables privacy-preserved, decentralized data processing, crucial for handling sensitive medical data. Currently, most FL models employ random initialization, which has been proven effective in various instances. However, given the unique challenges posed by non-IID (independently and identically distributed) data in FL, we propose a novel perspective: exploring the impact of using the foundation model with enormous pre-trained knowledge, such as the Segment Anything Model (SAM), as an instructive teacher for FL model initialization in medical image segmentation task. This work for the first time attempts to utilize the foundation model as an instructive teacher for initialization in FL, assessing its impact on the performance of FL models, especially in non-IID data scenarios. Our empirical evaluation on chest x-ray lung segmentation showcases that FL with foundation model instructed initialization not only achieves faster convergence but also improves performance in complex data contexts. These findings offer a new perspective for model initialization in FL.

Caiwen Jiang, Xiaodan Xing, Zaixin Ou et al.

The progression of Idiopathic Pulmonary Fibrosis (IPF) significantly correlates with higher patient mortality rates. Early detection of IPF progression is critical for initiating timely treatment, which can effectively slow down the advancement of the disease. However, the current clinical criteria define disease progression requiring two CT scans with a one-year interval, presenting a dilemma: a disease progression is identified only after the disease has already progressed. To this end, in this paper, we develop a novel diffusion model to accurately predict the progression of IPF by generating patient's follow-up CT scan from the initial CT scan. Specifically, from the clinical prior knowledge, we tailor improvements to the traditional diffusion model and propose a Clinically-Informed Residual Diffusion model, called CIResDiff. The key innovations of CIResDiff include 1) performing the target region pre-registration to align the lung regions of two CT scans at different time points for reducing the generation difficulty, 2) adopting the residual diffusion instead of traditional diffusion to enable the model focus more on differences (i.e., lesions) between the two CT scans rather than the largely identical anatomical content, and 3) designing the clinically-informed process based on CLIP technology to integrate lung function information which is highly relevant to diagnosis into the reverse process for assisting generation. Extensive experiments on clinical data demonstrate that our approach can outperform state-of-the-art methods and effectively predict the progression of IPF.

Xiaodan Xing, Chunling Tang, Yunzhe Guo et al.

Organoids are self-organized 3D cell clusters that closely mimic the architecture and function of in vivo tissues and organs. Quantification of organoid morphology helps in studying organ development, drug discovery, and toxicity assessment. Recent microscopy techniques provide a potent tool to acquire organoid morphology features, but manual image analysis remains a labor and time-intensive process. Thus, this paper proposes a comprehensive pipeline for microscopy analysis that leverages the SegmentAnything to precisely demarcate individual organoids. Additionally, we introduce a set of morphological properties, including perimeter, area, radius, non-smoothness, and non-circularity, allowing researchers to analyze the organoid structures quantitatively and automatically. To validate the effectiveness of our approach, we conducted tests on bright-field images of human induced pluripotent stem cells (iPSCs) derived neural-epithelial (NE) organoids. The results obtained from our automatic pipeline closely align with manual organoid detection and measurement, showcasing the capability of our proposed method in accelerating organoids morphology analysis.

Shiyi Wang, Yang Nan, Simon Walsh et al.

We propose a novel Deep Active Learning (DeepAL) model-3D Wasserstein Discriminative UNet (WD-UNet) for reducing the annotation effort of medical 3D Computed Tomography (CT) segmentation. The proposed WD-UNet learns in a semi-supervised way and accelerates learning convergence to meet or exceed the prediction metrics of supervised learning models. Our method can be embedded with different Active Learning (AL) strategies and different network structures. The model is evaluated on 3D lung airway CT scans for medical segmentation and show that the use of uncertainty metric, which is parametrized as an input of query strategy, leads to more accurate prediction results than some state-of-the-art Deep Learning (DL) supervised models, e.g.,3DUNet and 3D CEUNet. Compared to the above supervised DL methods, our WD-UNet not only saves the cost of annotation for radiologists but also saves computational resources. WD-UNet uses a limited amount of annotated data (35% of the total) to achieve better predictive metrics with a more efficient deep learning model algorithm.

Zejian Li, Chenye Meng, Yize Li et al.

Recent advances in text-to-image (T2I) generation have shown remarkable success in producing high-quality images from text. However, existing T2I models show decayed performance in compositional image generation involving multiple objects and intricate relationships. We attribute this problem to limitations in existing datasets of image-text pairs, which lack precise inter-object relationship annotations with prompts only. To address this problem, we construct LAION-SG, a large-scale dataset with high-quality structural annotations of scene graphs (SG), which precisely describe attributes and relationships of multiple objects, effectively representing the semantic structure in complex scenes. Based on LAION-SG, we train a new foundation model SDXL-SG to incorporate structural annotation information into the generation process. Extensive experiments show advanced models trained on our LAION-SG boast significant performance improvements in complex scene generation over models on existing datasets. We also introduce CompSG-Bench, a benchmark that evaluates models on compositional image generation, establishing a new standard for this domain. Our annotations with the associated processing code, the foundation model and the benchmark protocol are publicly available at https://github.com/mengcye/LAION-SG.

Caiwen Jiang, Tianyu Wang, Xiaodan Xing et al.

Ischemic stroke is a severe condition caused by the blockage of brain blood vessels, and can lead to the death of brain tissue due to oxygen deprivation. Thrombectomy has become a common treatment choice for ischemic stroke due to its immediate effectiveness. But, it carries the risk of postoperative cerebral hemorrhage. Clinically, multiple CT scans within 0-72 hours post-surgery are used to monitor for hemorrhage. However, this approach exposes radiation dose to patients, and may delay the detection of cerebral hemorrhage. To address this dilemma, we propose a novel prediction framework for measuring postoperative cerebral hemorrhage using only the patient's initial CT scan. Specifically, we introduce a dual-task mutual learning framework to takes the initial CT scan as input and simultaneously estimates both the follow-up CT scan and prognostic label to predict the occurrence of postoperative cerebral hemorrhage. Our proposed framework incorporates two attention mechanisms, i.e., self-attention and interactive attention. Specifically, the self-attention mechanism allows the model to focus more on high-density areas in the image, which are critical for diagnosis (i.e., potential hemorrhage areas). The interactive attention mechanism further models the dependencies between the interrelated generation and classification tasks, enabling both tasks to perform better than the case when conducted individually. Validated on clinical data, our method can generate follow-up CT scans better than state-of-the-art methods, and achieves an accuracy of 86.37% in predicting follow-up prognostic labels. Thus, our work thus contributes to the timely screening of post-thrombectomy cerebral hemorrhage, and could significantly reform the clinical process of thrombectomy and other similar operations related to stroke.

Yingying Fang, Shuang Wu, Zihao Jin et al.

In the field of medical imaging, particularly in tasks related to early disease detection and prognosis, understanding the reasoning behind AI model predictions is imperative for assessing their reliability. Conventional explanation methods encounter challenges in identifying decisive features in medical image classifications, especially when discriminative features are subtle or not immediately evident. To address this limitation, we propose an agent model capable of generating counterfactual images that prompt different decisions when plugged into a black box model. By employing this agent model, we can uncover influential image patterns that impact the black model's final predictions. Through our methodology, we efficiently identify features that influence decisions of the deep black box. We validated our approach in the rigorous domain of medical prognosis tasks, showcasing its efficacy and potential to enhance the reliability of deep learning models in medical image classification compared to existing interpretation methods. The code will be publicly available at https://github.com/ayanglab/DiffExplainer.