Jiacheng Wang

Hao Li, Han Liu, Dewei Hu et al.

Interactive segmentation model leverages prompts from users to produce robust segmentation. This advancement is facilitated by prompt engineering, where interactive prompts serve as strong priors during test-time. However, this is an inherently subjective and hard-to-reproduce process. The variability in user expertise and inherently ambiguous boundaries in medical images can lead to inconsistent prompt selections, potentially affecting segmentation accuracy. This issue has not yet been extensively explored for medical imaging. In this paper, we assess the test-time variability for interactive medical image segmentation with diverse point prompts. For a given target region, the point is classified into three sub-regions: boundary, margin, and center. Our goal is to identify a straightforward and efficient approach for optimal prompt selection during test-time based on three considerations: (1) benefits of additional prompts, (2) effects of prompt placement, and (3) strategies for optimal prompt selection. We conduct extensive experiments on the public Medical Segmentation Decathlon dataset for challenging colon tumor segmentation task. We suggest an optimal strategy for prompt selection during test-time, supported by comprehensive results. The code is publicly available at https://github.com/MedICL-VU/variability

Jiacheng Wang, Hao Li, Dewei Hu et al.

High-resolution Optical Coherence Tomography (OCT) images are crucial for ophthalmology studies but are limited by their relatively narrow field of view (FoV). Image mosaicking is a technique for aligning multiple overlapping images to obtain a larger FoV. Current mosaicking pipelines often struggle with substantial noise and considerable displacement between the input sub-fields. In this paper, we propose a versatile pipeline for stitching multi-view OCT/OCTA \textit{en face} projection images. Our method combines the strengths of learning-based feature matching and robust pixel-based registration to align multiple images effectively. Furthermore, we advance the application of a trained foundational model, Segment Anything Model (SAM), to validate mosaicking results in an unsupervised manner. The efficacy of our pipeline is validated using an in-house dataset and a large public dataset, where our method shows superior performance in terms of both accuracy and computational efficiency. We also made our evaluation tool for image mosaicking and the corresponding pipeline publicly available at \url{https://github.com/MedICL-VU/OCT-mosaicking}.

Liansheng Wang, Jiacheng Wang, Lei Zhu et al.

Automated detecting lung infections from computed tomography (CT) data plays an important role for combating COVID-19. However, there are still some challenges for developing AI system. 1) Most current COVID-19 infection segmentation methods mainly relied on 2D CT images, which lack 3D sequential constraint. 2) Existing 3D CT segmentation methods focus on single-scale representations, which do not achieve the multiple level receptive field sizes on 3D volume. 3) The emergent breaking out of COVID-19 makes it hard to annotate sufficient CT volumes for training deep model. To address these issues, we first build a multiple dimensional-attention convolutional neural network (MDA-CNN) to aggregate multi-scale information along different dimension of input feature maps and impose supervision on multiple predictions from different CNN layers. Second, we assign this MDA-CNN as a basic network into a novel dual multi-scale mean teacher network (DM${^2}$T-Net) for semi-supervised COVID-19 lung infection segmentation on CT volumes by leveraging unlabeled data and exploring the multi-scale information. Our DM${^2}$T-Net encourages multiple predictions at different CNN layers from the student and teacher networks to be consistent for computing a multi-scale consistency loss on unlabeled data, which is then added to the supervised loss on the labeled data from multiple predictions of MDA-CNN. Third, we collect two COVID-19 segmentation datasets to evaluate our method. The experimental results show that our network consistently outperforms the compared state-of-the-art methods.

Jun Ma, Yao Zhang, Song Gu et al.

Quantitative organ assessment is an essential step in automated abdominal disease diagnosis and treatment planning. Artificial intelligence (AI) has shown great potential to automatize this process. However, most existing AI algorithms rely on many expert annotations and lack a comprehensive evaluation of accuracy and efficiency in real-world multinational settings. To overcome these limitations, we organized the FLARE 2022 Challenge, the largest abdominal organ analysis challenge to date, to benchmark fast, low-resource, accurate, annotation-efficient, and generalized AI algorithms. We constructed an intercontinental and multinational dataset from more than 50 medical groups, including Computed Tomography (CT) scans with different races, diseases, phases, and manufacturers. We independently validated that a set of AI algorithms achieved a median Dice Similarity Coefficient (DSC) of 90.0\% by using 50 labeled scans and 2000 unlabeled scans, which can significantly reduce annotation requirements. The best-performing algorithms successfully generalized to holdout external validation sets, achieving a median DSC of 89.5\%, 90.9\%, and 88.3\% on North American, European, and Asian cohorts, respectively. They also enabled automatic extraction of key organ biology features, which was labor-intensive with traditional manual measurements. This opens the potential to use unlabeled data to boost performance and alleviate annotation shortages for modern AI models.

Jiacheng Wang, Fei Chen, Yuxi Ma et al.

Skin lesion segmentation from dermoscopy images is of great significance in the quantitative analysis of skin cancers, which is yet challenging even for dermatologists due to the inherent issues, i.e., considerable size, shape and color variation, and ambiguous boundaries. Recent vision transformers have shown promising performance in handling the variation through global context modeling. Still, they have not thoroughly solved the problem of ambiguous boundaries as they ignore the complementary usage of the boundary knowledge and global contexts. In this paper, we propose a novel cross-scale boundary-aware transformer, \textbf{XBound-Former}, to simultaneously address the variation and boundary problems of skin lesion segmentation. XBound-Former is a purely attention-based network and catches boundary knowledge via three specially designed learners. We evaluate the model on two skin lesion datasets, ISIC-2016\&PH$^2$ and ISIC-2018, where our model consistently outperforms other convolution- and transformer-based models, especially on the boundary-wise metrics. We extensively verify the generalization ability of polyp lesion segmentation that has similar characteristics, and our model can also yield significant improvement compared to the latest models.

Hao Li, Dewei Hu, Han Liu et al.

Recently, deep learning methods have achieved state-of-the-art performance in many medical image segmentation tasks. Many of these are based on convolutional neural networks (CNNs). For such methods, the encoder is the key part for global and local information extraction from input images; the extracted features are then passed to the decoder for predicting the segmentations. In contrast, several recent works show a superior performance with the use of transformers, which can better model long-range spatial dependencies and capture low-level details. However, transformer as sole encoder underperforms for some tasks where it cannot efficiently replace the convolution based encoder. In this paper, we propose a model with double encoders for 3D biomedical image segmentation. Our model is a U-shaped CNN augmented with an independent transformer encoder. We fuse the information from the convolutional encoder and the transformer, and pass it to the decoder to obtain the results. We evaluate our methods on three public datasets from three different challenges: BTCV, MoDA and Decathlon. Compared to the state-of-the-art models with and without transformers on each task, our proposed method obtains higher Dice scores across the board.

Dewei Hu, Xing Yao, Jiacheng Wang et al.

Among the research efforts to segment the retinal vasculature from fundus images, deep learning models consistently achieve superior performance. However, this data-driven approach is very sensitive to domain shifts. For fundus images, such data distribution changes can easily be caused by variations in illumination conditions as well as the presence of disease-related features such as hemorrhages and drusen. Since the source domain may not include all possible types of pathological cases, a model that can robustly recognize vessels on unseen domains is desirable but remains elusive, despite many proposed segmentation networks of ever-increasing complexity. In this work, we propose a contrastive variational auto-encoder that can filter out irrelevant features and synthesize a latent image, named deep angiogram, representing only the retinal vessels. Then segmentation can be readily accomplished by thresholding the deep angiogram. The generalizability of the synthetic network is improved by the contrastive loss that makes the model less sensitive to variations of image contrast and noisy features. Compared to baseline deep segmentation networks, our model achieves higher segmentation performance via simple thresholding. Our experiments show that the model can generate stable angiograms on different target domains, providing excellent visualization of vessels and a non-invasive, safe alternative to fluorescein angiography.

Jiacheng Wang, Kathleen E. Larson, Ipek Oguz

Accuracy validation of cortical thickness measurement is a difficult problem due to the lack of ground truth data. To address this need, many methods have been developed to synthetically induce gray matter (GM) atrophy in an MRI via deformable registration, creating a set of images with known changes in cortical thickness. However, these methods often cause blurring in atrophied regions, and cannot simulate realistic atrophy within deep sulci where cerebrospinal fluid (CSF) is obscured or absent. In this paper, we present a solution using a self-supervised inpainting model to generate CSF in these regions and create images with more plausible GM/CSF boundaries. Specifically, we introduce a novel, 3D GAN model that incorporates patch-based dropout training, edge map priors, and sinusoidal positional encoding, all of which are established methods previously limited to 2D domains. We show that our framework significantly improves the quality of the resulting synthetic images and is adaptable to unseen data with fine-tuning. We also demonstrate that our resulting dataset can be employed for accuracy validation of cortical segmentation and thickness measurement.

Dewei Hu, Hao Li, Han Liu et al.

Due to the absence of a single standardized imaging protocol, domain shift between data acquired from different sites is an inherent property of medical images and has become a major obstacle for large-scale deployment of learning-based algorithms. For retinal vessel images, domain shift usually presents as the variation of intensity, contrast and resolution, while the basic tubular shape of vessels remains unaffected. Thus, taking advantage of such domain-invariant morphological features can greatly improve the generalizability of deep models. In this study, we propose a method named VesselMorph which generalizes the 2D retinal vessel segmentation task by synthesizing a shape-aware representation. Inspired by the traditional Frangi filter and the diffusion tensor imaging literature, we introduce a Hessian-based bipolar tensor field to depict the morphology of the vessels so that the shape information is taken into account. We map the intensity image and the tensor field to a latent space for feature extraction. Then we fuse the two latent representations via a weight-balancing trick and feed the result to a segmentation network. We evaluate on six public datasets of fundus and OCT angiography images from diverse patient populations. VesselMorph achieves superior generalization performance compared with competing methods in different domain shift scenarios.

Dewei Hu, Hao Li, Han Liu et al.

Deep models suffer from limited generalization capability to unseen domains, which has severely hindered their clinical applicability. Specifically for the retinal vessel segmentation task, although the model is supposed to learn the anatomy of the target, it can be distracted by confounding factors like intensity and contrast. We propose Meta learning on Anatomy-consistent Pseudo-modalities (MAP), a method that improves model generalizability by learning structural features. We first leverage a feature extraction network to generate three distinct pseudo-modalities that share the vessel structure of the original image. Next, we use the episodic learning paradigm by selecting one of the pseudo-modalities as the meta-train dataset, and perform meta-testing on a continuous augmented image space generated through Dirichlet mixup of the remaining pseudo-modalities. Further, we introduce two loss functions that facilitate the model's focus on shape information by clustering the latent vectors obtained from images featuring identical vasculature. We evaluate our model on seven public datasets of various retinal imaging modalities and we conclude that MAP has substantially better generalizability. Our code is publically available at https://github.com/DeweiHu/MAP.

Xinyi Tan, Jiacheng Wang, Liansheng Wang

Employing self-supervised learning (SSL) methodologies assumes par-amount significance in handling unlabeled polyp datasets when building deep learning-based automatic polyp segmentation models. However, the intricate privacy dynamics surrounding medical data often preclude seamless data sharing among disparate medical centers. Federated learning (FL) emerges as a formidable solution to this privacy conundrum, yet within the realm of FL, optimizing model generalization stands as a pressing imperative. Robust generalization capabilities are imperative to ensure the model's efficacy across diverse geographical domains post-training on localized client datasets. In this paper, a Federated self-supervised Domain Generalization method is proposed to enhance the generalization capacity of federated and Label-efficient intestinal polyp segmentation, named LFDG. Based on a classical SSL method, DropPos, LFDG proposes an adversarial learning-based data augmentation method (SSADA) to enhance the data diversity. LFDG further proposes a relaxation module based on Source-reconstruction and Augmentation-masking (SRAM) to maintain stability in feature learning. We have validated LFDG on polyp images from six medical centers. The performance of our method achieves 3.80% and 3.92% better than the baseline and other recent FL methods and SSL methods, respectively.

Jiacheng Wang, Yueming Jin, Shuntian Cai et al.

We propose a novel shape-aware relation network for accurate and real-time landmark detection in endoscopic submucosal dissection (ESD) surgery. This task is of great clinical significance but extremely challenging due to bleeding, lighting reflection, and motion blur in the complicated surgical environment. Compared with existing solutions, which either neglect geometric relationships among targeting objects or capture the relationships by using complicated aggregation schemes, the proposed network is capable of achieving satisfactory accuracy while maintaining real-time performance by taking full advantage of the spatial relations among landmarks. We first devise an algorithm to automatically generate relation keypoint heatmaps, which are able to intuitively represent the prior knowledge of spatial relations among landmarks without using any extra manual annotation efforts. We then develop two complementary regularization schemes to progressively incorporate the prior knowledge into the training process. While one scheme introduces pixel-level regularization by multi-task learning, the other integrates global-level regularization by harnessing a newly designed grouped consistency evaluator, which adds relation constraints to the proposed network in an adversarial manner. Both schemes are beneficial to the model in training, and can be readily unloaded in inference to achieve real-time detection. We establish a large in-house dataset of ESD surgery for esophageal cancer to validate the effectiveness of our proposed method. Extensive experimental results demonstrate that our approach outperforms state-of-the-art methods in terms of accuracy and efficiency, achieving better detection results faster. Promising results on two downstream applications further corroborate the great potential of our method in ESD clinical practice.