Hongxia Xu

Yifei Sun, Yuzhi He, Junhao Jia et al.

Microaneurysms (MAs), the earliest pathognomonic signs of Diabetic Retinopathy (DR), present as sub-60 $μm$ lesions in fundus images with highly variable photometric and morphological characteristics, rendering manual screening not only labor-intensive but inherently error-prone. While diffusion-based anomaly detection has emerged as a promising approach for automated MA screening, its clinical application is hindered by three fundamental limitations. First, these models often fall prey to "identity mapping", where they inadvertently replicate the input image. Second, they struggle to distinguish MAs from other anomalies, leading to high false positives. Third, their suboptimal reconstruction of normal features hampers overall performance. To address these challenges, we propose a Wavelet Diffusion Transformer framework for MA Detection (WDT-MD), which features three key innovations: a noise-encoded image conditioning mechanism to avoid "identity mapping" by perturbing image conditions during training; pseudo-normal pattern synthesis via inpainting to introduce pixel-level supervision, enabling discrimination between MAs and other anomalies; and a wavelet diffusion Transformer architecture that combines the global modeling capability of diffusion Transformers with multi-scale wavelet analysis to enhance reconstruction of normal retinal features. Comprehensive experiments on the IDRiD and e-ophtha MA datasets demonstrate that WDT-MD outperforms state-of-the-art methods in both pixel-level and image-level MA detection. This advancement holds significant promise for improving early DR screening.

Jinhong Wang, Yi Cheng, Jintai Chen et al.

Multi-rater annotations commonly occur when medical images are independently annotated by multiple experts (raters). In this paper, we tackle two challenges arisen in multi-rater annotations for medical image segmentation (called ambiguous medical image segmentation): (1) How to train a deep learning model when a group of raters produces a set of diverse but plausible annotations, and (2) how to fine-tune the model efficiently when computation resources are not available for re-training the entire model on a different dataset domain. We propose a multi-rater prompt-based approach to address these two challenges altogether. Specifically, we introduce a series of rater-aware prompts that can be plugged into the U-Net model for uncertainty estimation to handle multi-annotation cases. During the prompt-based fine-tuning process, only 0.3% of learnable parameters are required to be updated comparing to training the entire model. Further, in order to integrate expert consensus and disagreement, we explore different multi-rater incorporation strategies and design a mix-training strategy for comprehensive insight learning. Extensive experiments verify the effectiveness of our new approach for ambiguous medical image segmentation on two public datasets while alleviating the heavy burden of model re-training.

Shangde Gao, Yichao Fu, Ke Liu et al.

Recently, many foundation models for medical image analysis such as MedSAM, SwinUNETR have been released and proven to be useful in multiple tasks. However, considering the inherent heterogeneity and inhomogeneity of real-world medical data, directly applying these models to specific medical image segmentation tasks often leads to negative domain shift effects, which can severely weaken the model's segmentation capabilities. To this end, we propose an adaptive amalgamation knowledge framework that aims to train a versatile foundation model to handle the joint goals of multiple expert models, each specialized for a distinct task. Specifically, we first train an nnUNet-based expert model for each task, and reuse the pre-trained SwinUNTER as the target foundation model. Then, the input data for all challenging tasks are encoded in the foundation model and the expert models, respectively, and their backbone features are jointly projected into the adaptive amalgamation layer. Within the hidden layer, the hierarchical attention mechanisms are designed to achieve adaptive merging of the target model to the hidden layer feature knowledge of all experts, which significantly reduces the domain shift arising from the inter-task differences. Finally, the gold amalgamated features and the prompt features are fed into the mask decoder to obtain the segmentation results. Extensive experiments conducted in these challenging tasks demonstrate the effectiveness and adaptability of our foundation model for real-world medical image segmentation.

Guocong Li, Weize Liu, Yihang Wu et al.

Large language models (LLMs) exhibit excellent performance in natural language processing (NLP), but remain highly sensitive to the quality of input queries, especially when these queries contain misleading or inaccurate information. Existing methods focus on correcting the output, but they often overlook the potential of improving the ability of LLMs to detect and correct misleading content in the input itself. In this paper, we propose a novel three-stage fine-tuning method that enhances the ability of LLMs to detect and correct misleading information in the input, further improving response accuracy and reducing hallucinations. Specifically, the three stages include (1) training LLMs to identify misleading information, (2) training LLMs to correct the misleading information using built-in or external knowledge, and (3) training LLMs to generate accurate answers based on the corrected queries. To evaluate our method, we conducted experiments on three datasets for the hallucination detection task and the question answering~(QA) task, as well as two datasets containing misleading information that we constructed. The experimental results demonstrate that our method significantly improves the accuracy and factuality of LLM responses, while also enhancing the ability to detect hallucinations and reducing the generation of hallucinations in the output, particularly when the query contains misleading information.

Jintai Chen, Yaojun Hu, Mingchen Cai et al.

Clinical trials are pivotal for developing new medical treatments but typically carry risks such as patient mortality and enrollment failure that waste immense efforts spanning over a decade. Applying artificial intelligence (AI) to predict key events in clinical trials holds great potential for providing insights to guide trial designs. However, complex data collection and question definition requiring medical expertise have hindered the involvement of AI thus far. This paper tackles these challenges by presenting a comprehensive suite of 23 meticulously curated AI-ready datasets covering multi-modal input features and 8 crucial prediction challenges in clinical trial design, encompassing prediction of trial duration, patient dropout rate, serious adverse event, mortality rate, trial approval outcome, trial failure reason, drug dose finding, design of eligibility criteria. Furthermore, we provide basic validation methods for each task to ensure the datasets' usability and reliability. We anticipate that the availability of such open-access datasets will catalyze the development of advanced AI approaches for clinical trial design, ultimately advancing clinical trial research and accelerating medical solution development.