Binod Bhattarai

Sandesh Pokhrel, Sanjay Bhandari, Eduard Vazquez et al.

Deep learning has significantly advanced the field of gastrointestinal vision, enhancing disease diagnosis capabilities. One major challenge in automating diagnosis within gastrointestinal settings is the detection of abnormal cases in endoscopic images. Due to the sparsity of data, this process of distinguishing normal from abnormal cases has faced significant challenges, particularly with rare and unseen conditions. To address this issue, we frame abnormality detection as an out-of-distribution (OOD) detection problem. In this setup, a model trained on In-Distribution (ID) data, which represents a healthy GI tract, can accurately identify healthy cases, while abnormalities are detected as OOD, regardless of their class. We introduce a test-time augmentation segment into the OOD detection pipeline, which enhances the distinction between ID and OOD examples, thereby improving the effectiveness of existing OOD methods with the same model. This augmentation shifts the pixel space, which translates into a more distinct semantic representation for OOD examples compared to ID examples. We evaluated our method against existing state-of-the-art OOD scores, showing improvements with test-time augmentation over the baseline approach.

Sandesh Pokhrel, Sanjay Bhandari, Sharib Ali et al.

The integration of deep learning tools in gastrointestinal vision holds the potential for significant advancements in diagnosis, treatment, and overall patient care. A major challenge, however, is these tools' tendency to make overconfident predictions, even when encountering unseen or newly emerging disease patterns, undermining their reliability. We address this critical issue of reliability by framing it as an out-of-distribution (OOD) detection problem, where previously unseen and emerging diseases are identified as OOD examples. However, gastrointestinal images pose a unique challenge due to the overlapping feature representations between in- Distribution (ID) and OOD examples. Existing approaches often overlook this characteristic, as they are primarily developed for natural image datasets, where feature distinctions are more apparent. Despite the overlap, we hypothesize that the features of an in-distribution example will cluster closer to the centroids of their ground truth class, resulting in a shorter distance to the nearest centroid. In contrast, OOD examples maintain an equal distance from all class centroids. Based on this observation, we propose a novel nearest-centroid distance deficit (NCCD) score in the feature space for gastrointestinal OOD detection. Evaluations across multiple deep learning architectures and two publicly available benchmarks, Kvasir2 and Gastrovision, demonstrate the effectiveness of our approach compared to several state-of-the-art methods. The code and implementation details are publicly available at: https://github.com/bhattarailab/NCDD

Bidur Khanal, Sandesh Pokhrel, Sanjay Bhandari et al.

Vision-Language Models (VLMs) are becoming increasingly popular in the medical domain, bridging the gap between medical images and clinical language. Existing VLMs demonstrate an impressive ability to comprehend medical images and text queries to generate detailed, descriptive diagnostic medical reports. However, hallucination--the tendency to generate descriptions that are inconsistent with the visual content--remains a significant issue in VLMs, with particularly severe implications in the medical field. To facilitate VLM research on gastrointestinal (GI) image analysis and study hallucination, we curate a multimodal image-text GI dataset: Gut-VLM. This dataset is created using a two-stage pipeline: first, descriptive medical reports of Kvasir-v2 images are generated using ChatGPT, which introduces some hallucinated or incorrect texts. In the second stage, medical experts systematically review these reports, and identify and correct potential inaccuracies to ensure high-quality, clinically reliable annotations. Unlike traditional datasets that contain only descriptive texts, our dataset also features tags identifying hallucinated sentences and their corresponding corrections. A common approach to reducing hallucination in VLM is to finetune the model on a small-scale, problem-specific dataset. However, we take a different strategy using our dataset. Instead of finetuning the VLM solely for generating textual reports, we finetune it to detect and correct hallucinations, an approach we call hallucination-aware finetuning. Our results show that this approach is better than simply finetuning for descriptive report generation. Additionally, we conduct an extensive evaluation of state-of-the-art VLMs across several metrics, establishing a benchmark. GitHub Repo: https://github.com/bhattarailab/Hallucination-Aware-VLM.

Krit Duangprom, Tryphon Lambrou, Binod Bhattarai

This paper presents a novel pipeline for 2D keypoint estima- tion of surgical tools by leveraging Vision Language Models (VLMs) fine- tuned using a low rank adjusting (LoRA) technique. Unlike traditional Convolutional Neural Network (CNN) or Transformer-based approaches, which often suffer from overfitting in small-scale medical datasets, our method harnesses the generalization capabilities of pre-trained VLMs. We carefully design prompts to create an instruction-tuning dataset and use them to align visual features with semantic keypoint descriptions. Experimental results show that with only two epochs of fine tuning, the adapted VLM outperforms the baseline models, demonstrating the ef- fectiveness of LoRA in low-resource scenarios. This approach not only improves keypoint detection performance, but also paves the way for future work in 3D surgical hands and tools pose estimation.

Anju Chhetri, Jari Korhonen, Prashnna Gyawali et al.

Ensuring reliability is paramount in deep learning, particularly within the domain of medical imaging, where diagnostic decisions often hinge on model outputs. The capacity to separate out-of-distribution (OOD) samples has proven to be a valuable indicator of a model's reliability in research. In medical imaging, this is especially critical, as identifying OOD inputs can help flag potential anomalies that might otherwise go undetected. While many OOD detection methods rely on feature or logit space representations, recent works suggest these approaches may not fully capture OOD diversity. To address this, we propose a novel OOD scoring mechanism, called NERO, that leverages neuron-level relevance at the feature layer. Specifically, we cluster neuron-level relevance for each in-distribution (ID) class to form representative centroids and introduce a relevance distance metric to quantify a new sample's deviation from these centroids, enhancing OOD separability. Additionally, we refine performance by incorporating scaled relevance in the bias term and combining feature norms. Our framework also enables explainable OOD detection. We validate its effectiveness across multiple deep learning architectures on the gastrointestinal imaging benchmarks Kvasir and GastroVision, achieving improvements over state-of-the-art OOD detection methods.