MONAI Label: A framework for AI-assisted Interactive Labeling of 3D Medical ImagesAndres Diaz-Pinto, Sachidanand Alle, Vishwesh Nath et al. · microsoft-research
The lack of annotated datasets is a major bottleneck for training new task-specific supervised machine learning models, considering that manual annotation is extremely expensive and time-consuming. To address this problem, we present MONAI Label, a free and open-source framework that facilitates the development of applications based on artificial intelligence (AI) models that aim at reducing the time required to annotate radiology datasets. Through MONAI Label, researchers can develop AI annotation applications focusing on their domain of expertise. It allows researchers to readily deploy their apps as services, which can be made available to clinicians via their preferred user interface. Currently, MONAI Label readily supports locally installed (3D Slicer) and web-based (OHIF) frontends and offers two active learning strategies to facilitate and speed up the training of segmentation algorithms. MONAI Label allows researchers to make incremental improvements to their AI-based annotation application by making them available to other researchers and clinicians alike. Additionally, MONAI Label provides sample AI-based interactive and non-interactive labeling applications, that can be used directly off the shelf, as plug-and-play to any given dataset. Significant reduced annotation times using the interactive model can be observed on two public datasets.
Analysis of Image-and-Text Uncertainty Propagation in Multimodal Large Language Models with Cardiac MR-Based ApplicationsYucheng Tang, Yunguan Fu, Weixi Yi et al.
Multimodal large language models (MLLMs) can process and integrate information from multimodality sources, such as text and images. However, interrelationship among input modalities, uncertainties due to individual uni-modal data and potential clinical applications following such an uncertainty decomposition are yet fully understood in the context of large-scale MLLMs. In this work, we propose a multimodal uncertainty propagation model (MUPM) based on uncertainty propagation, to characterise the relationship among the uncertainties arising from image-only, text-only, and joint image-text variations in MLLM inputs. Using real clinical data consisting of cardiac MR scans and digital health records, we describe that MUPMs can be optimised robustly with a few samples. We then show that the fitted MUPMs are generalisable across different input data distributions and, perhaps surprisingly, across different downstream tasks. Such a transferability may be explained by the shared pretraining, comparatively light MLLM fine-tuning, along with the low-dimensional nature of the MUPMs. More importantly, this learned transferability, quantifying the relationship between these uncertainties, led to direct clinical applications in which uncertainties may be estimated and thus analysed robustly for varying data or even a novel set of cardiac disease prediction tasks. In addition, we show experimentally the efficiency in multimodal data required for estimating the overall uncertainty and its ability to identify redundant factors, both of which are considered practical yet clinically useful applications with the proposed MUPMs. Codes are available at https://github.com/yucheng722/MUPM.
18.2CVApr 9, 2025
MedSegFactory: Text-Guided Generation of Medical Image-Mask PairsJiawei Mao, Yuhan Wang, Yucheng Tang et al.
This paper presents MedSegFactory, a versatile medical synthesis framework that generates high-quality paired medical images and segmentation masks across modalities and tasks. It aims to serve as an unlimited data repository, supplying image-mask pairs to enhance existing segmentation tools. The core of MedSegFactory is a dual-stream diffusion model, where one stream synthesizes medical images and the other generates corresponding segmentation masks. To ensure precise alignment between image-mask pairs, we introduce Joint Cross-Attention (JCA), enabling a collaborative denoising paradigm by dynamic cross-conditioning between streams. This bidirectional interaction allows both representations to guide each other's generation, enhancing consistency between generated pairs. MedSegFactory unlocks on-demand generation of paired medical images and segmentation masks through user-defined prompts that specify the target labels, imaging modalities, anatomical regions, and pathological conditions, facilitating scalable and high-quality data generation. This new paradigm of medical image synthesis enables seamless integration into diverse medical imaging workflows, enhancing both efficiency and accuracy. Extensive experiments show that MedSegFactory generates data of superior quality and usability, achieving competitive or state-of-the-art performance in 2D and 3D segmentation tasks while addressing data scarcity and regulatory constraints.
8.4CVAug 16, 2025
Impact of Clinical Image Quality on Efficient Foundation Model FinetuningYucheng Tang, Pawel Rajwa, Alexander Ng et al.
Foundation models in medical imaging have shown promising label efficiency, achieving high performance on downstream tasks using only a fraction of the annotated data otherwise required. In this study, we evaluate this potential in the context of prostate multiparametric MRI using ProFound, a recently developed domain-specific vision foundation model pretrained on large-scale prostate MRI datasets. We investigate the impact of variable image quality on the label-efficient finetuning, by quantifying the generalisability of the finetuned models. We conduct a comprehensive set of experiments by systematically varying the ratios of high- and low-quality images in the finetuning and evaluation sets. Our findings indicate that image quality distribution and its finetune-and-test mismatch significantly affect model performance. In particular: a) Varying the ratio of high- to low-quality images between finetuning and test sets leads to notable differences in downstream performance; and b) The presence of sufficient high-quality images in the finetuning set is critical for maintaining strong performance, whilst the importance of matched finetuning and testing distribution varies between different downstream tasks, such as automated radiology reporting and prostate cancer detection. Importantly, experimental results also show that, although finetuning requires significantly less labeled data compared to training from scratch when the quality ratio is consistent, this label efficiency is not independent of the image quality distribution. For example, we show cases that, without sufficient high-quality images in finetuning, finetuned models may fail to outperform those without pretraining.