Xinxing Xu

Xiaofeng Lei, Shaohua Li, Xinxing Xu et al.

Localizing anatomical landmarks are important tasks in medical image analysis. However, the landmarks to be localized often lack prominent visual features. Their locations are elusive and easily confused with the background, and thus precise localization highly depends on the context formed by their surrounding areas. In addition, the required precision is usually higher than segmentation and object detection tasks. Therefore, localization has its unique challenges different from segmentation or detection. In this paper, we propose a zoom-in attentive network (ZIAN) for anatomical landmark localization in ocular images. First, a coarse-to-fine, or "zoom-in" strategy is utilized to learn the contextualized features in different scales. Then, an attentive fusion module is adopted to aggregate multi-scale features, which consists of 1) a co-attention network with a multiple regions-of-interest (ROIs) scheme that learns complementary features from the multiple ROIs, 2) an attention-based fusion module which integrates the multi-ROIs features and non-ROI features. We evaluated ZIAN on two open challenge tasks, i.e., the fovea localization in fundus images and scleral spur localization in AS-OCT images. Experiments show that ZIAN achieves promising performances and outperforms state-of-the-art localization methods. The source code and trained models of ZIAN are available at https://github.com/leixiaofeng-astar/OMIA9-ZIAN.

Meng Wang, Tian Lin, Lianyu Wang et al.

Failure to recognize samples from the classes unseen during training is a major limitation of artificial intelligence in the real-world implementation for recognition and classification of retinal anomalies. We established an uncertainty-inspired open-set (UIOS) model, which was trained with fundus images of 9 retinal conditions. Besides assessing the probability of each category, UIOS also calculated an uncertainty score to express its confidence. Our UIOS model with thresholding strategy achieved an F1 score of 99.55%, 97.01% and 91.91% for the internal testing set, external target categories (TC)-JSIEC dataset and TC-unseen testing set, respectively, compared to the F1 score of 92.20%, 80.69% and 64.74% by the standard AI model. Furthermore, UIOS correctly predicted high uncertainty scores, which would prompt the need for a manual check in the datasets of non-target categories retinal diseases, low-quality fundus images, and non-fundus images. UIOS provides a robust method for real-world screening of retinal anomalies.

Zhihao Chen, Yang Zhou, Anh Tran et al.

Medical phrase grounding (MPG) aims to locate the most relevant region in a medical image, given a phrase query describing certain medical findings, which is an important task for medical image analysis and radiological diagnosis. However, existing visual grounding methods rely on general visual features for identifying objects in natural images and are not capable of capturing the subtle and specialized features of medical findings, leading to sub-optimal performance in MPG. In this paper, we propose MedRPG, an end-to-end approach for MPG. MedRPG is built on a lightweight vision-language transformer encoder and directly predicts the box coordinates of mentioned medical findings, which can be trained with limited medical data, making it a valuable tool in medical image analysis. To enable MedRPG to locate nuanced medical findings with better region-phrase correspondences, we further propose Tri-attention Context contrastive alignment (TaCo). TaCo seeks context alignment to pull both the features and attention outputs of relevant region-phrase pairs close together while pushing those of irrelevant regions far away. This ensures that the final box prediction depends more on its finding-specific regions and phrases. Experimental results on three MPG datasets demonstrate that our MedRPG outperforms state-of-the-art visual grounding approaches by a large margin. Additionally, the proposed TaCo strategy is effective in enhancing finding localization ability and reducing spurious region-phrase correlations.

Manna Dai, Yang Jiang, Feng Yang et al.

Metasurfaces have widespread applications in fifth-generation (5G) microwave communication. Among the metasurface family, free-form metasurfaces excel in achieving intricate spectral responses compared to regular-shape counterparts. However, conventional numerical methods for free-form metasurfaces are time-consuming and demand specialized expertise. Alternatively, recent studies demonstrate that deep learning has great potential to accelerate and refine metasurface designs. Here, we present XGAN, an extended generative adversarial network (GAN) with a surrogate for high-quality free-form metasurface designs. The proposed surrogate provides a physical constraint to XGAN so that XGAN can accurately generate metasurfaces monolithically from input spectral responses. In comparative experiments involving 20000 free-form metasurface designs, XGAN achieves 0.9734 average accuracy and is 500 times faster than the conventional methodology. This method facilitates the metasurface library building for specific spectral responses and can be extended to various inverse design problems, including optical metamaterials, nanophotonic devices, and drug discovery.

Yang Zhou, Tan Li Hui Faith, Yanyu Xu et al.

Medical Vision-Language Pretraining (MedVLP) shows promise in learning generalizable and transferable visual representations from paired and unpaired medical images and reports. MedVLP can provide useful features to downstream tasks and facilitate adapting task-specific models to new setups using fewer examples. However, existing MedVLP methods often differ in terms of datasets, preprocessing, and finetuning implementations. This pose great challenges in evaluating how well a MedVLP method generalizes to various clinically-relevant tasks due to the lack of unified, standardized, and comprehensive benchmark. To fill this gap, we propose BenchX, a unified benchmark framework that enables head-to-head comparison and systematical analysis between MedVLP methods using public chest X-ray datasets. Specifically, BenchX is composed of three components: 1) Comprehensive datasets covering nine datasets and four medical tasks; 2) Benchmark suites to standardize data preprocessing, train-test splits, and parameter selection; 3) Unified finetuning protocols that accommodate heterogeneous MedVLP methods for consistent task adaptation in classification, segmentation, and report generation, respectively. Utilizing BenchX, we establish baselines for nine state-of-the-art MedVLP methods and found that the performance of some early MedVLP methods can be enhanced to surpass more recent ones, prompting a revisiting of the developments and conclusions from prior works in MedVLP. Our code are available at https://github.com/yangzhou12/BenchX.

Han Yuan, Chuan Hong, Nguyen Tuan Anh Tran et al.

Pneumothorax is a medical emergency caused by abnormal accumulation of air in the pleural space - the potential space between the lungs and chest wall. On 2D chest radiographs, pneumothorax occurs within the thoracic cavity and outside of the mediastinum and we refer to this area as "lung+ space". While deep learning (DL) has increasingly been utilized to segment pneumothorax lesions in chest radiographs, many existing DL models employ an end-to-end approach. These models directly map chest radiographs to clinician-annotated lesion areas, often neglecting the vital domain knowledge that pneumothorax is inherently location-sensitive. We propose a novel approach that incorporates the lung+ space as a constraint during DL model training for pneumothorax segmentation on 2D chest radiographs. To circumvent the need for additional annotations and to prevent potential label leakage on the target task, our method utilizes external datasets and an auxiliary task of lung segmentation. This approach generates a specific constraint of lung+ space for each chest radiograph. Furthermore, we have incorporated a discriminator to eliminate unreliable constraints caused by the domain shift between the auxiliary and target datasets. Our results demonstrated significant improvements, with average performance gains of 4.6%, 3.6%, and 3.3% regarding Intersection over Union (IoU), Dice Similarity Coefficient (DSC), and Hausdorff Distance (HD). Our research underscores the significance of incorporating medical domain knowledge about the location-specific nature of pneumothorax to enhance DL-based lesion segmentation.

Xiuchao Sui, Shaohua Li, Xue Geng et al.

Optical flow estimation aims to find the 2D motion field by identifying corresponding pixels between two images. Despite the tremendous progress of deep learning-based optical flow methods, it remains a challenge to accurately estimate large displacements with motion blur. This is mainly because the correlation volume, the basis of pixel matching, is computed as the dot product of the convolutional features of the two images. The locality of convolutional features makes the computed correlations susceptible to various noises. On large displacements with motion blur, noisy correlations could cause severe errors in the estimated flow. To overcome this challenge, we propose a new architecture "CRoss-Attentional Flow Transformer" (CRAFT), aiming to revitalize the correlation volume computation. In CRAFT, a Semantic Smoothing Transformer layer transforms the features of one frame, making them more global and semantically stable. In addition, the dot-product correlations are replaced with transformer Cross-Frame Attention. This layer filters out feature noises through the Query and Key projections, and computes more accurate correlations. On Sintel (Final) and KITTI (foreground) benchmarks, CRAFT has achieved new state-of-the-art performance. Moreover, to test the robustness of different models on large motions, we designed an image shifting attack that shifts input images to generate large artificial motions. Under this attack, CRAFT performs much more robustly than two representative methods, RAFT and GMA. The code of CRAFT is is available at https://github.com/askerlee/craft.

Huihui Fang, Fei Li, Junde Wu et al.

With the rapid development of artificial intelligence (AI) in medical image processing, deep learning in color fundus photography (CFP) analysis is also evolving. Although there are some open-source, labeled datasets of CFPs in the ophthalmology community, large-scale datasets for screening only have labels of disease categories, and datasets with annotations of fundus structures are usually small in size. In addition, labeling standards are not uniform across datasets, and there is no clear information on the acquisition device. Here we release a multi-annotation, multi-quality, and multi-device color fundus image dataset for glaucoma analysis on an original challenge -- Retinal Fundus Glaucoma Challenge 2nd Edition (REFUGE2). The REFUGE2 dataset contains 2000 color fundus images with annotations of glaucoma classification, optic disc/cup segmentation, as well as fovea localization. Meanwhile, the REFUGE2 challenge sets three sub-tasks of automatic glaucoma diagnosis and fundus structure analysis and provides an online evaluation framework. Based on the characteristics of multi-device and multi-quality data, some methods with strong generalizations are provided in the challenge to make the predictions more robust. This shows that REFUGE2 brings attention to the characteristics of real-world multi-domain data, bridging the gap between scientific research and clinical application.

Yufei He, Juncheng Liu, Yue Liu et al.

A fundamental limitation of current AI agents is their inability to learn complex skills on the fly at test time, often behaving like "clever but clueless interns" in novel environments. This severely limits their practical utility. To systematically measure and drive progress on this challenge, we first introduce the Jericho Test-Time Learning (J-TTL) benchmark. J-TTL is a new evaluation setup where an agent must play the same game for several consecutive episodes, attempting to improve its performance from one episode to the next. On J-TTL, we find that existing adaptation methods like reflection, memory, or reinforcement learning struggle. To address the challenges posed by our benchmark, we present EvoTest, an evolutionary test-time learning framework that improves an agent without any fine-tuning or gradients-by evolving the entire agentic system after every episode. EvoTest has two roles: the Actor Agent, which plays the game, and the Evolver Agent, which analyzes the episode transcript to propose a revised configuration for the next run. This configuration rewrites the prompt, updates memory by logging effective state-action choices, tunes hyperparameters, and learns the tool-use routines. On our J-TTL benchmark, EvoTest consistently increases performance, outperforming not only reflection and memory-only baselines but also more complex online fine-tuning methods. Notably, our method is the only one capable of winning two games (Detective and Library), while all baselines fail to win any.