Yun Gu

Ziyan Huang, Haoyu Wang, Zhongying Deng et al.

Large-scale models pre-trained on large-scale datasets have profoundly advanced the development of deep learning. However, the state-of-the-art models for medical image segmentation are still small-scale, with their parameters only in the tens of millions. Further scaling them up to higher orders of magnitude is rarely explored. An overarching goal of exploring large-scale models is to train them on large-scale medical segmentation datasets for better transfer capacities. In this work, we design a series of Scalable and Transferable U-Net (STU-Net) models, with parameter sizes ranging from 14 million to 1.4 billion. Notably, the 1.4B STU-Net is the largest medical image segmentation model to date. Our STU-Net is based on nnU-Net framework due to its popularity and impressive performance. We first refine the default convolutional blocks in nnU-Net to make them scalable. Then, we empirically evaluate different scaling combinations of network depth and width, discovering that it is optimal to scale model depth and width together. We train our scalable STU-Net models on a large-scale TotalSegmentator dataset and find that increasing model size brings a stronger performance gain. This observation reveals that a large model is promising in medical image segmentation. Furthermore, we evaluate the transferability of our model on 14 downstream datasets for direct inference and 3 datasets for further fine-tuning, covering various modalities and segmentation targets. We observe good performance of our pre-trained model in both direct inference and fine-tuning. The code and pre-trained models are available at https://github.com/Ziyan-Huang/STU-Net.

Xin You, Junjun He, Jie Yang et al.

Medical image segmentation is a fundamental task for medical image analysis and surgical planning. In recent years, UNet-based networks have prevailed in the field of medical image segmentation. However, convolution-neural networks (CNNs) suffer from limited receptive fields, which fail to model the long-range dependency of organs or tumors. Besides, these models are heavily dependent on the training of the final segmentation head. And existing methods can not well address these two limitations at the same time. Hence, in our work, we proposed a novel shape prior module (SPM), which can explicitly introduce shape priors to promote the segmentation performance of UNet-based models. The explicit shape priors consist of global and local shape priors. The former with coarse shape representations provides networks with capabilities to model global contexts. The latter with finer shape information serves as additional guidance to boost the segmentation performance, which relieves the heavy dependence on the learnable prototype in the segmentation head. To evaluate the effectiveness of SPM, we conduct experiments on three challenging public datasets. And our proposed model achieves state-of-the-art performance. Furthermore, SPM shows an outstanding generalization ability on classic CNNs and recent Transformer-based backbones, which can serve as a plug-and-play structure for the segmentation task of different datasets. Source codes are available at https://github.com/AlexYouXin/Explicit-Shape-Priors

Hanxiao Zhang, Xiao Gu, Minghui Zhang et al. · oxford

The LIDC-IDRI database is the most popular benchmark for lung cancer prediction. However, with subjective assessment from radiologists, nodules in LIDC may have entirely different malignancy annotations from the pathological ground truth, introducing label assignment errors and subsequent supervision bias during training. The LIDC database thus requires more objective labels for learning-based cancer prediction. Based on an extra small dataset containing 180 nodules diagnosed by pathological examination, we propose to re-label LIDC data to mitigate the effect of original annotation bias verified on this robust benchmark. We demonstrate in this paper that providing new labels by similar nodule retrieval based on metric learning would be an effective re-labeling strategy. Training on these re-labeled LIDC nodules leads to improved model performance, which is enhanced when new labels of uncertain nodules are added. We further infer that re-labeling LIDC is current an expedient way for robust lung cancer prediction while building a large pathological-proven nodule database provides the long-term solution.

Puyang Wang, Dazhou Guo, Dandan Zheng et al.

Intrathoracic airway segmentation in computed tomography (CT) is a prerequisite for various respiratory disease analyses such as chronic obstructive pulmonary disease (COPD), asthma and lung cancer. Unlike other organs with simpler shapes or topology, the airway's complex tree structure imposes an unbearable burden to generate the "ground truth" label (up to 7 or 3 hours of manual or semi-automatic annotation on each case). Most of the existing airway datasets are incompletely labeled/annotated, thus limiting the completeness of computer-segmented airway. In this paper, we propose a new anatomy-aware multi-class airway segmentation method enhanced by topology-guided iterative self-learning. Based on the natural airway anatomy, we formulate a simple yet highly effective anatomy-aware multi-class segmentation task to intuitively handle the severe intra-class imbalance of the airway. To solve the incomplete labeling issue, we propose a tailored self-iterative learning scheme to segment toward the complete airway tree. For generating pseudo-labels to achieve higher sensitivity , we introduce a novel breakage attention map and design a topology-guided pseudo-label refinement method by iteratively connecting breaking branches commonly existed from initial pseudo-labels. Extensive experiments have been conducted on four datasets including two public challenges. The proposed method ranked 1st in both EXACT'09 challenge using average score and ATM'22 challenge on weighted average score. In a public BAS dataset and a private lung cancer dataset, our method significantly improves previous leading approaches by extracting at least (absolute) 7.5% more detected tree length and 4.0% more tree branches, while maintaining similar precision.

Minghui Zhang, Guang-Zhong Yang, Yun Gu

Detailed pulmonary airway segmentation is a clinically important task for endobronchial intervention and treatment of peripheral located lung cancer lesions. Convolutional Neural Networks (CNNs) are promising tools for medical image analysis but have been performing poorly for cases when existing a significant imbalanced feature distribution, which is true for the airway data as the trachea and principal bronchi dominate most of the voxels whereas the lobar bronchi and distal segmental bronchi occupy a small proportion. In this paper, we propose a Differentiable Topology-Preserved Distance Transform (DTPDT) framework to improve the performance of airway segmentation. A Topology-Preserved Surrogate (TPS) learning strategy is first proposed to balance the training progress within-class distribution. Furthermore, a Convolutional Distance Transform (CDT) is designed to identify the breakage phenomenon with superior sensitivity and minimize the variation of the distance map between the predictionand ground-truth. The proposed method is validated with the publically available reference airway segmentation datasets. The detected rate of branch and length on public EXACT'09 and BAS datasets are 82.1%/79.6% and 96.5%/91.5% respectively, demonstrating the reliability and efficiency of the method in terms of improving the topology completeness of the segmentation performance while maintaining the overall topology accuracy.

Hanxiao Zhang, Liang Chen, Xiao Gu et al.

Recent evolution in deep learning has proven its value for CT-based lung nodule classification. Most current techniques are intrinsically black-box systems, suffering from two generalizability issues in clinical practice. First, benign-malignant discrimination is often assessed by human observers without pathologic diagnoses at the nodule level. We termed these data as "unsure data". Second, a classifier does not necessarily acquire reliable nodule features for stable learning and robust prediction with patch-level labels during learning. In this study, we construct a sure dataset with pathologically-confirmed labels and propose a collaborative learning framework to facilitate sure nodule classification by integrating unsure data knowledge through nodule segmentation and malignancy score regression. A loss function is designed to learn reliable features by introducing interpretability constraints regulated with nodule segmentation maps. Furthermore, based on model inference results that reflect the understanding from both machine and experts, we explore a new nodule analysis method for similar historical nodule retrieval and interpretable diagnosis. Detailed experimental results demonstrate that our approach is beneficial for achieving improved performance coupled with faithful model reasoning for lung cancer prediction. Extensive cross-evaluation results further illustrate the effect of unsure data for deep-learning-based methods in lung nodule classification.