Lei Li

Xuandong Zhao, Lei Li, Yu-Xiang Wang · berkeley, cmu

Large language models are shown to memorize privacy information such as social security numbers in training data. Given the sheer scale of the training corpus, it is challenging to screen and filter these privacy data, either manually or automatically. In this paper, we propose Confidentially Redacted Training (CRT), a method to train language generation models while protecting the confidential segments. We borrow ideas from differential privacy (which solves a related but distinct problem) and show that our method is able to provably prevent unintended memorization by randomizing parts of the training process. Moreover, we show that redaction with an approximately correct screening policy amplifies the confidentiality guarantee. We implement the method for both LSTM and GPT language models. Our experimental results show that the models trained by CRT obtain almost the same perplexity while preserving strong confidentiality.

Yuhao Huang, Xin Yang, Lian Liu et al.

The Segment Anything Model (SAM) is the first foundation model for general image segmentation. It has achieved impressive results on various natural image segmentation tasks. However, medical image segmentation (MIS) is more challenging because of the complex modalities, fine anatomical structures, uncertain and complex object boundaries, and wide-range object scales. To fully validate SAM's performance on medical data, we collected and sorted 53 open-source datasets and built a large medical segmentation dataset with 18 modalities, 84 objects, 125 object-modality paired targets, 1050K 2D images, and 6033K masks. We comprehensively analyzed different models and strategies on the so-called COSMOS 1050K dataset. Our findings mainly include the following: 1) SAM showed remarkable performance in some specific objects but was unstable, imperfect, or even totally failed in other situations. 2) SAM with the large ViT-H showed better overall performance than that with the small ViT-B. 3) SAM performed better with manual hints, especially box, than the Everything mode. 4) SAM could help human annotation with high labeling quality and less time. 5) SAM was sensitive to the randomness in the center point and tight box prompts, and may suffer from a serious performance drop. 6) SAM performed better than interactive methods with one or a few points, but will be outpaced as the number of points increases. 7) SAM's performance correlated to different factors, including boundary complexity, intensity differences, etc. 8) Finetuning the SAM on specific medical tasks could improve its average DICE performance by 4.39% and 6.68% for ViT-B and ViT-H, respectively. We hope that this comprehensive report can help researchers explore the potential of SAM applications in MIS, and guide how to appropriately use and develop SAM.

Gongping Chen, Lei Li, JianXun Zhang et al.

Breast tumor segmentation is one of the key steps that helps us characterize and localize tumor regions. However, variable tumor morphology, blurred boundary, and similar intensity distributions bring challenges for accurate segmentation of breast tumors. Recently, many U-net variants have been proposed and widely used for breast tumors segmentation. However, these architectures suffer from two limitations: (1) Ignoring the characterize ability of the benchmark networks, and (2) Introducing extra complex operations increases the difficulty of understanding and reproducing the network. To alleviate these challenges, this paper proposes a simple yet powerful nested U-net (NU-net) for accurate segmentation of breast tumors. The key idea is to utilize U-Nets with different depths and shared weights to achieve robust characterization of breast tumors. NU-net mainly has the following advantages: (1) Improving network adaptability and robustness to breast tumors with different scales, (2) This method is easy to reproduce and execute, and (3) The extra operations increase network parameters without significantly increasing computational cost. Extensive experimental results with twelve state-of-the-art segmentation methods on three public breast ultrasound datasets demonstrate that NU-net has more competitive segmentation performance on breast tumors. Furthermore, the robustness of NU-net is further illustrated on the segmentation of renal ultrasound images. The source code is publicly available on https://github.com/CGPzy/NU-net.

Zheyao Gao, Lei Li, Fuping Wu et al.

Distributed learning has shown great potential in medical image analysis. It allows to use multi-center training data with privacy protection. However, data distributions in local centers can vary from each other due to different imaging vendors, and annotation protocols. Such variation degrades the performance of learning-based methods. To mitigate the influence, two groups of methods have been proposed for different aims, i.e., the global methods and the personalized methods. The former are aimed to improve the performance of a single global model for all test data from unseen centers (known as generic data); while the latter target multiple models for each center (denoted as local data). However, little has been researched to achieve both goals simultaneously. In this work, we propose a new framework of distributed learning that bridges the gap between two groups, and improves the performance for both generic and local data. Specifically, our method decouples the predictions for generic data and local data, via distribution-conditioned adaptation matrices. Results on multi-center left atrial (LA) MRI segmentation showed that our method demonstrated superior performance over existing methods on both generic and local data. Our code is available at https://github.com/key1589745/decouple_predict

Quan Meng, Lei Li, Matthias Nießner et al.

We present LT3SD, a novel latent diffusion model for large-scale 3D scene generation. Recent advances in diffusion models have shown impressive results in 3D object generation, but are limited in spatial extent and quality when extended to 3D scenes. To generate complex and diverse 3D scene structures, we introduce a latent tree representation to effectively encode both lower-frequency geometry and higher-frequency detail in a coarse-to-fine hierarchy. We can then learn a generative diffusion process in this latent 3D scene space, modeling the latent components of a scene at each resolution level. To synthesize large-scale scenes with varying sizes, we train our diffusion model on scene patches and synthesize arbitrary-sized output 3D scenes through shared diffusion generation across multiple scene patches. Through extensive experiments, we demonstrate the efficacy and benefits of LT3SD for large-scale, high-quality unconditional 3D scene generation and for probabilistic completion for partial scene observations.

Lei Li, Julia Camps, Zhinuo et al.

Cardiac digital twins (CDTs) have the potential to offer individualized evaluation of cardiac function in a non-invasive manner, making them a promising approach for personalized diagnosis and treatment planning of my-ocardial infarction (MI). The inference of accurate myocardial tissue properties is crucial in creating a reliable CDT of MI. In this work, we investigate the feasibility of inferring myocardial tissue properties from the electrocardiogram (ECG) within a CDT platform. The platform integrates multi-modal data, such as cardiac MRI and ECG, to enhance the accuracy and reliability of the inferred tissue properties. We perform a sensitivity analysis based on computer simulations, systematically exploring the effects of infarct location, size, degree of transmurality, and electrical ac-tivity alteration on the simulated QRS complex of ECG, to establish the limits of the approach. We subsequently present a novel deep computational model, comprising a dual-branch variational autoencoder and an inference model, to infer infarct location and distribution from the simulated QRS. The proposed model achieves mean Dice scores of 0.457 \pm 0.317 and 0.302 \pm 0.273 for the inference of left ventricle scars and border zone, respectively. The sensitivity analysis enhances our understanding of the complex relationship between infarct characteristics and electrophysiological features. The in silico experimental results show that the model can effectively capture the relationship for the inverse inference, with promising potential for clinical application in the future. The code will be released publicly once the manuscript is accepted for publication.

Lei Li, Hannah Smith, Yilin Lyu et al.

Cardiac digital twins (CDTs) offer personalized in-silico cardiac representations for the inference of multi-scale properties tied to cardiac mechanisms. The creation of CDTs requires precise information about the electrode position on the torso, especially for the personalized electrocardiogram (ECG) calibration. However, current studies commonly rely on additional acquisition of torso imaging and manual/semi-automatic methods for ECG electrode localization. In this study, we propose a novel and efficient topology-informed model to fully automatically extract personalized ECG standard electrode locations from 2D clinically standard cardiac MRIs. Specifically, we obtain the sparse torso contours from the cardiac MRIs and then localize the standard electrodes of 12-lead ECG from the contours. Cardiac MRIs aim at imaging of the heart instead of the torso, leading to incomplete torso geometry within the imaging. To tackle the missing topology, we incorporate the electrodes as a subset of the keypoints, which can be explicitly aligned with the 3D torso topology. The experimental results demonstrate that the proposed model outperforms the time-consuming conventional model projection-based method in terms of accuracy (Euclidean distance: $1.24 \pm 0.293$ cm vs. $1.48 \pm 0.362$ cm) and efficiency ($2$~s vs. $30$-$35$~min). We further demonstrate the effectiveness of using the detected electrodes for in-silico ECG simulation, highlighting their potential for creating accurate and efficient CDT models. The code is available at https://github.com/lileitech/12lead_ECG_electrode_localizer.

Lei Li, Julia Camps, Zhinuo et al.

The interplay between structural and electrical changes in the heart after myocardial infarction (MI) plays a key role in the initiation and maintenance of arrhythmia. The anatomical and electrophysiological properties of scar, border zone, and normal myocardium modify the electrocardiographic morphology, which is routinely analysed in clinical settings. However, the influence of various MI properties on the QRS is not intuitively predictable.In this work, we have systematically investigated the effects of 17 post-MI scenarios, varying the location, size, transmural extent, and conductive level of scarring and border zone area, on the forward-calculated QRS. Additionally, we have compared the contributions of different QRS score criteria for quantifying post-MI pathophysiology.The propagation of electrical activity in the ventricles is simulated via a Eikonal model on a unified coordinate system.The analysis has been performed on 49 subjects, and the results imply that the QRS is capable of identifying MI, suggesting the feasibility of inversely reconstructing infarct regions from QRS.There exist sensitivity variations of different QRS criteria for identifying 17 MI scenarios, which is informative for solving the inverse problem.

Lei Li

Natural scene analysis and remote sensing imagery offer immense potential for advancements in large-scale language-guided context-aware data utilization. This potential is particularly significant for enhancing performance in downstream tasks such as object detection and segmentation with designed language prompting. In light of this, we introduce the CPSeg, Chain-of-Thought Language Prompting for Finer-grained Semantic Segmentation), an innovative framework designed to augment image segmentation performance by integrating a novel "Chain-of-Thought" process that harnesses textual information associated with images. This groundbreaking approach has been applied to a flood disaster scenario. CPSeg encodes prompt texts derived from various sentences to formulate a coherent chain-of-thought. We propose a new vision-language dataset, FloodPrompt, which includes images, semantic masks, and corresponding text information. This not only strengthens the semantic understanding of the scenario but also aids in the key task of semantic segmentation through an interplay of pixel and text matching maps. Our qualitative and quantitative analyses validate the effectiveness of CPSeg.

Kai-Ni Wang, Xin Yang, Juzheng Miao et al.

Multi-sequence cardiac magnetic resonance (CMR) provides essential pathology information (scar and edema) to diagnose myocardial infarction. However, automatic pathology segmentation can be challenging due to the difficulty of effectively exploring the underlying information from the multi-sequence CMR data. This paper aims to tackle the scar and edema segmentation from multi-sequence CMR with a novel auto-weighted supervision framework, where the interactions among different supervised layers are explored under a task-specific objective using reinforcement learning. Furthermore, we design a coarse-to-fine framework to boost the small myocardial pathology region segmentation with shape prior knowledge. The coarse segmentation model identifies the left ventricle myocardial structure as a shape prior, while the fine segmentation model integrates a pixel-wise attention strategy with an auto-weighted supervision model to learn and extract salient pathological structures from the multi-sequence CMR data. Extensive experimental results on a publicly available dataset from Myocardial pathology segmentation combining multi-sequence CMR (MyoPS 2020) demonstrate our method can achieve promising performance compared with other state-of-the-art methods. Our method is promising in advancing the myocardial pathology assessment on multi-sequence CMR data. To motivate the community, we have made our code publicly available via https://github.com/soleilssss/AWSnet/tree/master.

Lei Li, Wangbin Ding, Liqun Huang et al.

Right ventricular (RV) segmentation from magnetic resonance imaging (MRI) is a crucial step for cardiac morphology and function analysis. However, automatic RV segmentation from MRI is still challenging, mainly due to the heterogeneous intensity, the complex variable shapes, and the unclear RV boundary. Moreover, current methods for the RV segmentation tend to suffer from performance degradation at the basal and apical slices of MRI. In this work, we propose an automatic RV segmentation framework, where the information from long-axis (LA) views is utilized to assist the segmentation of short-axis (SA) views via information transition. Specifically, we employed the transformed segmentation from LA views as a prior information, to extract the ROI from SA views for better segmentation. The information transition aims to remove the surrounding ambiguous regions in the SA views. %, such as the tricuspid valve regions. We tested our model on a public dataset with 360 multi-center, multi-vendor and multi-disease subjects that consist of both LA and SA MRIs. Our experimental results show that including LA views can be effective to improve the accuracy of the SA segmentation. Our model is publicly available at https://github.com/NanYoMy/MMs-2.

Wangbin Ding, Lei Li, Xiahai Zhuang et al.

Multi-modality medical images can provide relevant or complementary information for a target (organ, tumor or tissue). Registering multi-modality images to a common space can fuse these comprehensive information, and bring convenience for clinical application. Recently, neural networks have been widely investigated to boost registration methods. However, it is still challenging to develop a multi-modality registration network due to the lack of robust criteria for network training. In this work, we propose a multi-modality registration network (MMRegNet), which can perform registration between multi-modality images. Meanwhile, we present spatially encoded gradient information to train MMRegNet in an unsupervised manner. The proposed network was evaluated on MM-WHS 2017. Results show that MMRegNet can achieve promising performance for left ventricle cardiac registration tasks. Meanwhile, to demonstrate the versatility of MMRegNet, we further evaluate the method with a liver dataset from CHAOS 2019. Source code will be released publicly\footnote{https://github.com/NanYoMy/mmregnet} once the manuscript is accepted.

Xinlong Wang, Rufeng Zhang, Chunhua Shen et al.

To date, most existing self-supervised learning methods are designed and optimized for image classification. These pre-trained models can be sub-optimal for dense prediction tasks due to the discrepancy between image-level prediction and pixel-level prediction. To fill this gap, we aim to design an effective, dense self-supervised learning method that directly works at the level of pixels (or local features) by taking into account the correspondence between local features. We present dense contrastive learning, which implements self-supervised learning by optimizing a pairwise contrastive (dis)similarity loss at the pixel level between two views of input images. Compared to the baseline method MoCo-v2, our method introduces negligible computation overhead (only <1% slower), but demonstrates consistently superior performance when transferring to downstream dense prediction tasks including object detection, semantic segmentation and instance segmentation; and outperforms the state-of-the-art methods by a large margin. Specifically, over the strong MoCo-v2 baseline, our method achieves significant improvements of 2.0% AP on PASCAL VOC object detection, 1.1% AP on COCO object detection, 0.9% AP on COCO instance segmentation, 3.0% mIoU on PASCAL VOC semantic segmentation and 1.8% mIoU on Cityscapes semantic segmentation. Code is available at: https://git.io/AdelaiDet

Xinlong Wang, Rufeng Zhang, Tao Kong et al.

In this work, we aim at building a simple, direct, and fast instance segmentation framework with strong performance. We follow the principle of the SOLO method of Wang et al. "SOLO: segmenting objects by locations". Importantly, we take one step further by dynamically learning the mask head of the object segmenter such that the mask head is conditioned on the location. Specifically, the mask branch is decoupled into a mask kernel branch and mask feature branch, which are responsible for learning the convolution kernel and the convolved features respectively. Moreover, we propose Matrix NMS (non maximum suppression) to significantly reduce the inference time overhead due to NMS of masks. Our Matrix NMS performs NMS with parallel matrix operations in one shot, and yields better results. We demonstrate a simple direct instance segmentation system, outperforming a few state-of-the-art methods in both speed and accuracy. A light-weight version of SOLOv2 executes at 31.3 FPS and yields 37.1% AP. Moreover, our state-of-the-art results in object detection (from our mask byproduct) and panoptic segmentation show the potential to serve as a new strong baseline for many instance-level recognition tasks besides instance segmentation. Code is available at: https://git.io/AdelaiDet

Lei Li, Julia Camps, Blanca Rodriguez et al.

Cardiac digital twins (CDTs) are personalized virtual representations used to understand complex cardiac mechanisms. A critical component of CDT development is solving the ECG inverse problem, which enables the reconstruction of cardiac sources and the estimation of patient-specific electrophysiology (EP) parameters from surface ECG data. Despite challenges from complex cardiac anatomy, noisy ECG data, and the ill-posed nature of the inverse problem, recent advances in computational methods have greatly improved the accuracy and efficiency of ECG inverse inference, strengthening the fidelity of CDTs. This paper aims to provide a comprehensive review of the methods of solving ECG inverse problem, the validation strategies, the clinical applications, and future perspectives. For the methodologies, we broadly classify state-of-the-art approaches into two categories: deterministic and probabilistic methods, including both conventional and deep learning-based techniques. Integrating physics laws with deep learning models holds promise, but challenges such as capturing dynamic electrophysiology accurately, accessing accurate domain knowledge, and quantifying prediction uncertainty persist. Integrating models into clinical workflows while ensuring interpretability and usability for healthcare professionals is essential. Overcoming these challenges will drive further research in CDTs.

Lei Li, Fuping Wu, Sihan Wang et al.

Assessment of myocardial viability is essential in diagnosis and treatment management of patients suffering from myocardial infarction, and classification of pathology on myocardium is the key to this assessment. This work defines a new task of medical image analysis, i.e., to perform myocardial pathology segmentation (MyoPS) combining three-sequence cardiac magnetic resonance (CMR) images, which was first proposed in the MyoPS challenge, in conjunction with MICCAI 2020. The challenge provided 45 paired and pre-aligned CMR images, allowing algorithms to combine the complementary information from the three CMR sequences for pathology segmentation. In this article, we provide details of the challenge, survey the works from fifteen participants and interpret their methods according to five aspects, i.e., preprocessing, data augmentation, learning strategy, model architecture and post-processing. In addition, we analyze the results with respect to different factors, in order to examine the key obstacles and explore potential of solutions, as well as to provide a benchmark for future research. We conclude that while promising results have been reported, the research is still in the early stage, and more in-depth exploration is needed before a successful application to the clinics. Note that MyoPS data and evaluation tool continue to be publicly available upon registration via its homepage (www.sdspeople.fudan.edu.cn/zhuangxiahai/0/myops20/).

Lei Li, Fuping Wu, Sihang Wang et al.

Accurate cardiac computing, analysis and modeling from multi-modality images are important for the diagnosis and treatment of cardiac disease. Late gadolinium enhancement magnetic resonance imaging (LGE MRI) is a promising technique to visualize and quantify myocardial infarction (MI) and atrial scars. Automating quantification of MI and atrial scars can be challenging due to the low image quality and complex enhancement patterns of LGE MRI. Moreover, compared with the other sequences LGE MRIs with gold standard labels are particularly limited, which represents another obstacle for developing novel algorithms for automatic segmentation and quantification of LGE MRIs. This chapter aims to summarize the state-of-the-art and our recent advanced contributions on deep learning based multi-modality cardiac image analysis. Firstly, we introduce two benchmark works for multi-sequence cardiac MRI based myocardial and pathology segmentation. Secondly, two novel frameworks for left atrial scar segmentation and quantification from LGE MRI were presented. Thirdly, we present three unsupervised domain adaptation techniques for cross-modality cardiac image segmentation.

Lei Li, Veronika A. Zimmer, Julia A. Schnabel et al.

Late gadolinium enhancement magnetic resonance imaging (LGE MRI) is commonly used to visualize and quantify left atrial (LA) scars. The position and extent of scars provide important information of the pathophysiology and progression of atrial fibrillation (AF). Hence, LA scar segmentation and quantification from LGE MRI can be useful in computer-assisted diagnosis and treatment stratification of AF patients. Since manual delineation can be time-consuming and subject to intra- and inter-expert variability, automating this computing is highly desired, which nevertheless is still challenging and under-researched. This paper aims to provide a systematic review on computing methods for LA cavity, wall, scar and ablation gap segmentation and quantification from LGE MRI, and the related literature for AF studies. Specifically, we first summarize AF-related imaging techniques, particularly LGE MRI. Then, we review the methodologies of the four computing tasks in detail, and summarize the validation strategies applied in each task. Finally, the possible future developments are outlined, with a brief survey on the potential clinical applications of the aforementioned methods. The review shows that the research into this topic is still in early stages. Although several methods have been proposed, especially for LA segmentation, there is still large scope for further algorithmic developments due to performance issues related to the high variability of enhancement appearance and differences in image acquisition.

Lei Li, Veronika A. Zimmer, Julia A. Schnabel et al.

Left atrial (LA) segmentation from late gadolinium enhanced magnetic resonance imaging (LGE MRI) is a crucial step needed for planning the treatment of atrial fibrillation. However, automatic LA segmentation from LGE MRI is still challenging, due to the poor image quality, high variability in LA shapes, and unclear LA boundary. Though deep learning-based methods can provide promising LA segmentation results, they often generalize poorly to unseen domains, such as data from different scanners and/or sites. In this work, we collect 210 LGE MRIs from different centers with different levels of image quality. To evaluate the domain generalization ability of models on the LA segmentation task, we employ four commonly used semantic segmentation networks for the LA segmentation from multi-center LGE MRIs. Besides, we investigate three domain generalization strategies, i.e., histogram matching, mutual information based disentangled representation, and random style transfer, where a simple histogram matching is proved to be most effective.

Lei Li, Ke Gao, Juan Cao et al.

Single domain generalization is a challenging case of model generalization, where the models are trained on a single domain and tested on other unseen domains. A promising solution is to learn cross-domain invariant representations by expanding the coverage of the training domain. These methods have limited generalization performance gains in practical applications due to the lack of appropriate safety and effectiveness constraints. In this paper, we propose a novel learning framework called progressive domain expansion network (PDEN) for single domain generalization. The domain expansion subnetwork and representation learning subnetwork in PDEN mutually benefit from each other by joint learning. For the domain expansion subnetwork, multiple domains are progressively generated in order to simulate various photometric and geometric transforms in unseen domains. A series of strategies are introduced to guarantee the safety and effectiveness of the expanded domains. For the domain invariant representation learning subnetwork, contrastive learning is introduced to learn the domain invariant representation in which each class is well clustered so that a better decision boundary can be learned to improve it's generalization. Extensive experiments on classification and segmentation have shown that PDEN can achieve up to 15.28% improvement compared with the state-of-the-art single-domain generalization methods.

Chenyu Liu, Wangbin Ding, Lei Li et al.

Delineating the brain tumor from magnetic resonance (MR) images is critical for the treatment of gliomas. However, automatic delineation is challenging due to the complex appearance and ambiguous outlines of tumors. Considering that multi-modal MR images can reflect different tumor biological properties, we develop a novel multi-modal tumor segmentation network (MMTSN) to robustly segment brain tumors based on multi-modal MR images. The MMTSN is composed of three sub-branches and a main branch. Specifically, the sub-branches are used to capture different tumor features from multi-modal images, while in the main branch, we design a spatial-channel fusion block (SCFB) to effectively aggregate multi-modal features. Additionally, inspired by the fact that the spatial relationship between sub-regions of tumor is relatively fixed, e.g., the enhancing tumor is always in the tumor core, we propose a spatial loss to constrain the relationship between different sub-regions of tumor. We evaluate our method on the test set of multi-modal brain tumor segmentation challenge 2020 (BraTs2020). The method achieves 0.8764, 0.8243 and 0.773 dice score for whole tumor, tumor core and enhancing tumor, respectively.

Lei Li, Veronika A. Zimmer, Wangbin Ding et al.

Deep learning (DL)-based models have demonstrated good performance in medical image segmentation. However, the models trained on a known dataset often fail when performed on an unseen dataset collected from different centers, vendors and disease populations. In this work, we present a random style transfer network to tackle the domain generalization problem for multi-vendor and center cardiac image segmentation. Style transfer is used to generate training data with a wider distribution/ heterogeneity, namely domain augmentation. As the target domain could be unknown, we randomly generate a modality vector for the target modality in the style transfer stage, to simulate the domain shift for unknown domains. The model can be trained in a semi-supervised manner by simultaneously optimizing a supervised segmentation and an unsupervised style translation objective. Besides, the framework incorporates the spatial information and shape prior of the target by introducing two regularization terms. We evaluated the proposed framework on 40 subjects from the M\&Ms challenge2020, and obtained promising performance in the segmentation for data from unknown vendors and centers.

Lei Li, Veronika A. Zimmer, Julia A. Schnabel et al.

Left atrial (LA) and atrial scar segmentation from late gadolinium enhanced magnetic resonance imaging (LGE MRI) is an important task in clinical practice. %, to guide ablation therapy and predict treatment results for atrial fibrillation (AF) patients. The automatic segmentation is however still challenging, due to the poor image quality, the various LA shapes, the thin wall, and the surrounding enhanced regions. Previous methods normally solved the two tasks independently and ignored the intrinsic spatial relationship between LA and scars. In this work, we develop a new framework, namely AtrialJSQnet, where LA segmentation, scar projection onto the LA surface, and scar quantification are performed simultaneously in an end-to-end style. We propose a mechanism of shape attention (SA) via an explicit surface projection, to utilize the inherent correlation between LA and LA scars. In specific, the SA scheme is embedded into a multi-task architecture to perform joint LA segmentation and scar quantification. Besides, a spatial encoding (SE) loss is introduced to incorporate continuous spatial information of the target, in order to reduce noisy patches in the predicted segmentation. We evaluated the proposed framework on 60 LGE MRIs from the MICCAI2018 LA challenge. Extensive experiments on a public dataset demonstrated the effect of the proposed AtrialJSQnet, which achieved competitive performance over the state-of-the-art. The relatedness between LA segmentation and scar quantification was explicitly explored and has shown significant performance improvements for both tasks. The code and results will be released publicly once the manuscript is accepted for publication via https://zmiclab.github.io/projects.html.

Lei Li, Xin Weng, Julia A. Schnabel et al.

We propose an end-to-end deep neural network (DNN) which can simultaneously segment the left atrial (LA) cavity and quantify LA scars. The framework incorporates the continuous spatial information of the target by introducing a spatially encoded (SE) loss based on the distance transform map. Compared to conventional binary label based loss, the proposed SE loss can reduce noisy patches in the resulting segmentation, which is commonly seen for deep learning-based methods. To fully utilize the inherent spatial relationship between LA and LA scars, we further propose a shape attention (SA) mechanism through an explicit surface projection to build an end-to-end-trainable model. Specifically, the SA scheme is embedded into a two-task network to perform the joint LA segmentation and scar quantification. Moreover, the proposed method can alleviate the severe class-imbalance problem when detecting small and discrete targets like scars. We evaluated the proposed framework on 60 LGE MRI data from the MICCAI2018 LA challenge. For LA segmentation, the proposed method reduced the mean Hausdorff distance from 36.4 mm to 20.0 mm compared to the 3D basic U-Net using the binary cross-entropy loss. For scar quantification, the method was compared with the results or algorithms reported in the literature and demonstrated better performance.

Xiahai Zhuang, Jiahang Xu, Xinzhe Luo et al.

Accurate computing, analysis and modeling of the ventricles and myocardium from medical images are important, especially in the diagnosis and treatment management for patients suffering from myocardial infarction (MI). Late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) provides an important protocol to visualize MI. However, automated segmentation of LGE CMR is still challenging, due to the indistinguishable boundaries, heterogeneous intensity distribution and complex enhancement patterns of pathological myocardium from LGE CMR. Furthermore, compared with the other sequences LGE CMR images with gold standard labels are particularly limited, which represents another obstacle for developing novel algorithms for automatic segmentation of LGE CMR. This paper presents the selective results from the Multi-Sequence Cardiac MR (MS-CMR) Segmentation challenge, in conjunction with MICCAI 2019. The challenge offered a data set of paired MS-CMR images, including auxiliary CMR sequences as well as LGE CMR, from 45 patients who underwent cardiomyopathy. It was aimed to develop new algorithms, as well as benchmark existing ones for LGE CMR segmentation and compare them objectively. In addition, the paired MS-CMR images could enable algorithms to combine the complementary information from the other sequences for the segmentation of LGE CMR. Nine representative works were selected for evaluation and comparisons, among which three methods are unsupervised methods and the other six are supervised. The results showed that the average performance of the nine methods was comparable to the inter-observer variations. The success of these methods was mainly attributed to the inclusion of the auxiliary sequences from the MS-CMR images, which provide important label information for the training of deep neural networks.

Dongyu Ru, Jiangtao Feng, Lin Qiu et al.

Active learning for sentence understanding aims at discovering informative unlabeled data for annotation and therefore reducing the demand for labeled data. We argue that the typical uncertainty sampling method for active learning is time-consuming and can hardly work in real-time, which may lead to ineffective sample selection. We propose adversarial uncertainty sampling in discrete space (AUSDS) to retrieve informative unlabeled samples more efficiently. AUSDS maps sentences into latent space generated by the popular pre-trained language models, and discover informative unlabeled text samples for annotation via adversarial attack. The proposed approach is extremely efficient compared with traditional uncertainty sampling with more than 10x speedup. Experimental results on five datasets show that AUSDS outperforms strong baselines on effectiveness.

Lei Li, Fuping Wu, Guang Yang et al.

Late gadolinium enhancement magnetic resonance imaging (LGE MRI) appears to be a promising alternative for scar assessment in patients with atrial fibrillation (AF). Automating the quantification and analysis of atrial scars can be challenging due to the low image quality. In this work, we propose a fully automated method based on the graph-cuts framework, where the potentials of the graph are learned on a surface mesh of the left atrium (LA) using a multi-scale convolutional neural network (MS-CNN). For validation, we have employed fifty-eight images with manual delineations. MS-CNN, which can efficiently incorporate both the local and global texture information of the images, has been shown to evidently improve the segmentation accuracy of the proposed graph-cuts based method. The segmentation could be further improved when the contribution between the t-link and n-link weights of the graph is balanced. The proposed method achieves a mean accuracy of 0.856 +- 0.033 and mean Dice score of 0.702 +- 0.071 for LA scar quantification. Compared with the conventional methods, which are based on the manual delineation of LA for initialization, our method is fully automatic and has demonstrated significantly better Dice score and accuracy (p < 0.01). The method is promising and can be useful in diagnosis and prognosis of AF.

Lei Li, Fuping Wu, Guang Yang et al.

Late Gadolinium Enhancement Magnetic Resonance Imaging (LGE MRI) emerged as a routine scan for patients with atrial fibrillation (AF). However, due to the low image quality automating the quantification and analysis of the atrial scars is challenging. In this study, we pro-posed a fully automated method based on the graph-cuts framework, where the potential of the graph is learned on a surface mesh of the left atrium (LA) using an equidistant projection and a Deep Neural Network (DNN). For validation, we employed 100 datasets with manual delineation. The results showed that the performance of the proposed method improved and converged with respect to the increased size of training patches, which provide important features of the structural and texture information learned by the DNN. The segmentation could be further improved when the contribution from the t-link and n-link is balanced, thanks to inter-relationship learned by the DNN for the graph-cuts algorithm. Compared with the published methods which mostly acquired manual delineation of the LA or LA wall, our method is fully automatic and demonstrated evidently better results with statistical significance. Finally, the accuracy of quantifying the scars assessed by the Dice score was 0.570. The results are promising and the method can be useful in diagnosis and prognosis of AF.

Fuping Wu, Lei Li, Guang Yang et al.

We present a fully-automated segmentation and quantification of the left atrial (LA) fibrosis and scars combining two cardiac MRIs, one is the target late gadolinium-enhanced (LGE) image, and the other is an anatomical MRI from the same acquisition session. We formulate the joint distribution of images using a multivariate mixture model (MvMM), and employ the maximum likelihood estimator (MLE) for texture classification of the images simultaneously. The MvMM can also embed transformations assigned to the images to correct the misregistration. The iterated conditional mode algorithm is adopted for optimization. This method first extracts the anatomical shape of the LA, and then estimates a prior probability map. It projects the resulting segmentation onto the LA surface, for quantification and analysis of scarring. We applied the proposed method to 36 clinical data sets and obtained promising results (Accuracy: $0.809\pm .150$, Dice: $0.556\pm.187$). We compared the method with the conventional algorithms and showed an evidently and statistically better performance ($p<0.03$).

Guang Yang, Xiahai Zhuang, Habib Khan et al.

Purpose: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is correlated with increased morbidity and mortality. It is associated with atrial fibrosis, which may be assessed non-invasively using late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI) where scar tissue is visualised as a region of signal enhancement. In this study, we proposed a novel fully automatic pipeline to achieve an accurate and objective atrial scarring segmentation and assessment of LGE MRI scans for the AF patients. Methods: Our fully automatic pipeline uniquely combined: (1) a multi-atlas based whole heart segmentation (MA-WHS) to determine the cardiac anatomy from an MRI Roadmap acquisition which is then mapped to LGE MRI, and (2) a super-pixel and supervised learning based approach to delineate the distribution and extent of atrial scarring in LGE MRI. Results: Both our MA-WHS and atrial scarring segmentation showed accurate delineations of cardiac anatomy (mean Dice = 89%) and atrial scarring (mean Dice =79%) respectively compared to the established ground truth from manual segmentation. Compared with previously studied methods with manual interventions, our innovative pipeline demonstrated comparable results, but was computed fully automatically. Conclusion: The proposed segmentation methods allow LGE MRI to be used as an objective assessment tool for localisation, visualisation and quantification of atrial scarring.