Xipeng Pan

Yuhao Mo, Chu Han, Yu Liu et al. · pku

Ultrasonography is an important routine examination for breast cancer diagnosis, due to its non-invasive, radiation-free and low-cost properties. However, the diagnostic accuracy of breast cancer is still limited due to its inherent limitations. It would be a tremendous success if we can precisely diagnose breast cancer by breast ultrasound images (BUS). Many learning-based computer-aided diagnostic methods have been proposed to achieve breast cancer diagnosis/lesion classification. However, most of them require a pre-define ROI and then classify the lesion inside the ROI. Conventional classification backbones, such as VGG16 and ResNet50, can achieve promising classification results with no ROI requirement. But these models lack interpretability, thus restricting their use in clinical practice. In this study, we propose a novel ROI-free model for breast cancer diagnosis in ultrasound images with interpretable feature representations. We leverage the anatomical prior knowledge that malignant and benign tumors have different spatial relationships between different tissue layers, and propose a HoVer-Transformer to formulate this prior knowledge. The proposed HoVer-Trans block extracts the inter- and intra-layer spatial information horizontally and vertically. We conduct and release an open dataset GDPH&SYSUCC for breast cancer diagnosis in BUS. The proposed model is evaluated in three datasets by comparing with four CNN-based models and two vision transformer models via five-fold cross validation. It achieves state-of-the-art classification performance with the best model interpretability. In the meanwhile, our proposed model outperforms two senior sonographers on the breast cancer diagnosis when only one BUS image is given.

Wentao Liu, Tong Tian, Lemeng Wang et al.

The automated segmentation of Intracranial Arteries (IA) in Digital Subtraction Angiography (DSA) plays a crucial role in the quantification of vascular morphology, significantly contributing to computer-assisted stroke research and clinical practice. Current research primarily focuses on the segmentation of single-frame DSA using proprietary datasets. However, these methods face challenges due to the inherent limitation of single-frame DSA, which only partially displays vascular contrast, thereby hindering accurate vascular structure representation. In this work, we introduce DIAS, a dataset specifically developed for IA segmentation in DSA sequences. We establish a comprehensive benchmark for evaluating DIAS, covering full, weak, and semi-supervised segmentation methods. Specifically, we propose the vessel sequence segmentation network, in which the sequence feature extraction module effectively captures spatiotemporal representations of intravascular contrast, achieving intracranial artery segmentation in 2D+Time DSA sequences. For weakly-supervised IA segmentation, we propose a novel scribble learning-based image segmentation framework, which, under the guidance of scribble labels, employs cross pseudo-supervision and consistency regularization to improve the performance of the segmentation network. Furthermore, we introduce the random patch-based self-training framework, aimed at alleviating the performance constraints encountered in IA segmentation due to the limited availability of annotated DSA data. Our extensive experiments on the DIAS dataset demonstrate the effectiveness of these methods as potential baselines for future research and clinical applications. The dataset and code are publicly available at https://doi.org/10.5281/zenodo.11396520 and https://github.com/lseventeen/DIAS.

Wentao Liu, Tong Tian, Weijin Xu et al.

The success of Transformer in computer vision has attracted increasing attention in the medical imaging community. Especially for medical image segmentation, many excellent hybrid architectures based on convolutional neural networks (CNNs) and Transformer have been presented and achieve impressive performance. However, most of these methods, which embed modular Transformer into CNNs, struggle to reach their full potential. In this paper, we propose a novel hybrid architecture for medical image segmentation called PHTrans, which parallelly hybridizes Transformer and CNN in main building blocks to produce hierarchical representations from global and local features and adaptively aggregate them, aiming to fully exploit their strengths to obtain better segmentation performance. Specifically, PHTrans follows the U-shaped encoder-decoder design and introduces the parallel hybird module in deep stages, where convolution blocks and the modified 3D Swin Transformer learn local features and global dependencies separately, then a sequence-to-volume operation unifies the dimensions of the outputs to achieve feature aggregation. Extensive experimental results on both Multi-Atlas Labeling Beyond the Cranial Vault and Automated Cardiac Diagnosis Challeng datasets corroborate its effectiveness, consistently outperforming state-of-the-art methods. The code is available at: https://github.com/lseventeen/PHTrans.

Huadeng Wang, Hao Xu, Bingbing Li et al.

Mitosis detection is one of the challenging problems in computational pathology, and mitotic count is an important index of cancer grading for pathologists. However, current counts of mitotic nuclei rely on pathologists looking microscopically at the number of mitotic nuclei in hot spots, which is subjective and time-consuming. In this paper, we propose a two-stage cascaded network, named FoCasNet, for mitosis detection. In the first stage, a detection network named M_det is proposed to detect as many mitoses as possible. In the second stage, a classification network M_class is proposed to refine the results of the first stage. In addition, the attention mechanism, normalization method, and hybrid anchor branch classification subnet are introduced to improve the overall detection performance. Our method achieves the current highest F1-score of 0.888 on the public dataset ICPR 2012. We also evaluated our method on the GZMH dataset released by our research team for the first time and reached the highest F1-score of 0.563, which is also better than multiple classic detection networks widely used at present. It confirmed the effectiveness and generalization of our method. The code will be available at: https://github.com/antifen/mitosis-nuclei-detection.

Jianwei Lin, Jiatai Lin, Cheng Lu et al.

Brain tumor segmentation (BTS) in magnetic resonance image (MRI) is crucial for brain tumor diagnosis, cancer management and research purposes. With the great success of the ten-year BraTS challenges as well as the advances of CNN and Transformer algorithms, a lot of outstanding BTS models have been proposed to tackle the difficulties of BTS in different technical aspects. However, existing studies hardly consider how to fuse the multi-modality images in a reasonable manner. In this paper, we leverage the clinical knowledge of how radiologists diagnose brain tumors from multiple MRI modalities and propose a clinical knowledge-driven brain tumor segmentation model, called CKD-TransBTS. Instead of directly concatenating all the modalities, we re-organize the input modalities by separating them into two groups according to the imaging principle of MRI. A dual-branch hybrid encoder with the proposed modality-correlated cross-attention block (MCCA) is designed to extract the multi-modality image features. The proposed model inherits the strengths from both Transformer and CNN with the local feature representation ability for precise lesion boundaries and long-range feature extraction for 3D volumetric images. To bridge the gap between Transformer and CNN features, we propose a Trans&CNN Feature Calibration block (TCFC) in the decoder. We compare the proposed model with five CNN-based models and six transformer-based models on the BraTS 2021 challenge dataset. Extensive experiments demonstrate that the proposed model achieves state-of-the-art brain tumor segmentation performance compared with all the competitors.

Huadeng Wang, Zhipeng Liu, Rushi Lan et al.

Mitosis nuclei count is one of the important indicators for the pathological diagnosis of breast cancer. The manual annotation needs experienced pathologists, which is very time-consuming and inefficient. With the development of deep learning methods, some models with good performance have emerged, but the generalization ability should be further strengthened. In this paper, we propose a two-stage mitosis segmentation and classification method, named SCMitosis. Firstly, the segmentation performance with a high recall rate is achieved by the proposed depthwise separable convolution residual block and channel-spatial attention gate. Then, a classification network is cascaded to further improve the detection performance of mitosis nuclei. The proposed model is verified on the ICPR 2012 dataset, and the highest F-score value of 0.8687 is obtained compared with the current state-of-the-art algorithms. In addition, the model also achieves good performance on GZMH dataset, which is prepared by our group and will be firstly released with the publication of this paper. The code will be available at: https://github.com/antifen/mitosis-nuclei-segmentation.

Hao Wang, Jiatai Lin, Danyi Li et al.

Mitosis detection is one of the fundamental tasks in computational pathology, which is extremely challenging due to the heterogeneity of mitotic cell. Most of the current studies solve the heterogeneity in the technical aspect by increasing the model complexity. However, lacking consideration of the biological knowledge and the complex model design may lead to the overfitting problem while limited the generalizability of the detection model. In this paper, we systematically study the morphological appearances in different mitotic phases as well as the ambiguous non-mitotic cells and identify that balancing the data and feature diversity can achieve better generalizability. Based on this observation, we propose a novel generalizable framework (MitDet) for mitosis detection. The data diversity is considered by the proposed diversity-guided sample balancing (DGSB). And the feature diversity is preserved by inter- and intra- class feature diversity-preserved module (InCDP). Stain enhancement (SE) module is introduced to enhance the domain-relevant diversity of both data and features simultaneously. Extensive experiments have demonstrated that our proposed model outperforms all the SOTA approaches in several popular mitosis detection datasets in both internal and external test sets using minimal annotation efforts with point annotations only. Comprehensive ablation studies have also proven the effectiveness of the rethinking of data and feature diversity balancing. By analyzing the results quantitatively and qualitatively, we believe that our proposed model not only achieves SOTA performance but also might inspire the future studies in new perspectives. Source code is at https://github.com/Onehour0108/MitDet.

Simon Graham, Quoc Dang Vu, Mostafa Jahanifar et al.

Nuclear detection, segmentation and morphometric profiling are essential in helping us further understand the relationship between histology and patient outcome. To drive innovation in this area, we setup a community-wide challenge using the largest available dataset of its kind to assess nuclear segmentation and cellular composition. Our challenge, named CoNIC, stimulated the development of reproducible algorithms for cellular recognition with real-time result inspection on public leaderboards. We conducted an extensive post-challenge analysis based on the top-performing models using 1,658 whole-slide images of colon tissue. With around 700 million detected nuclei per model, associated features were used for dysplasia grading and survival analysis, where we demonstrated that the challenge's improvement over the previous state-of-the-art led to significant boosts in downstream performance. Our findings also suggest that eosinophils and neutrophils play an important role in the tumour microevironment. We release challenge models and WSI-level results to foster the development of further methods for biomarker discovery.

Chu Han, Xipeng Pan, Lixu Yan et al.

Lung cancer is the leading cause of cancer death worldwide, and adenocarcinoma (LUAD) is the most common subtype. Exploiting the potential value of the histopathology images can promote precision medicine in oncology. Tissue segmentation is the basic upstream task of histopathology image analysis. Existing deep learning models have achieved superior segmentation performance but require sufficient pixel-level annotations, which is time-consuming and expensive. To enrich the label resources of LUAD and to alleviate the annotation efforts, we organize this challenge WSSS4LUAD to call for the outstanding weakly-supervised semantic segmentation (WSSS) techniques for histopathology images of LUAD. Participants have to design the algorithm to segment tumor epithelial, tumor-associated stroma and normal tissue with only patch-level labels. This challenge includes 10,091 patch-level annotations (the training set) and over 130 million labeled pixels (the validation and test sets), from 87 WSIs (67 from GDPH, 20 from TCGA). All the labels were generated by a pathologist-in-the-loop pipeline with the help of AI models and checked by the label review board. Among 532 registrations, 28 teams submitted the results in the test phase with over 1,000 submissions. Finally, the first place team achieved mIoU of 0.8413 (tumor: 0.8389, stroma: 0.7931, normal: 0.8919). According to the technical reports of the top-tier teams, CAM is still the most popular approach in WSSS. Cutmix data augmentation has been widely adopted to generate more reliable samples. With the success of this challenge, we believe that WSSS approaches with patch-level annotations can be a complement to the traditional pixel annotations while reducing the annotation efforts. The entire dataset has been released to encourage more researches on computational pathology in LUAD and more novel WSSS techniques.

Jijun Cheng, Xipeng Pan, Feihu Hou et al.

Nuclear segmentation and classification is an essential step for computational pathology. TIA lab from Warwick University organized a nuclear segmentation and classification challenge (CoNIC) for H&E stained histopathology images in colorectal cancer with two highly correlated tasks, nuclei segmentation and classification task and cellular composition task. There are a few obstacles we have to address in this challenge, 1) limited training samples, 2) color variation, 3) imbalanced annotations, 4) similar morphological appearance among classes. To deal with these challenges, we proposed a standardized pipeline for nuclear segmentation and classification by integrating several pluggable components. First, we built a GAN-based model to automatically generate pseudo images for data augmentation. Then we trained a self-supervised stain normalization model to solve the color variation problem. Next we constructed a baseline model HoVer-Net with cost-sensitive loss to encourage the model pay more attention on the minority classes. According to the results of the leaderboard, our proposed pipeline achieves 0.40665 mPQ+ (Rank 49th) and 0.62199 r2 (Rank 10th) in the preliminary test phase.

Chu Han, Jiatai Lin, Jinhai Mai et al.

Tissue-level semantic segmentation is a vital step in computational pathology. Fully-supervised models have already achieved outstanding performance with dense pixel-level annotations. However, drawing such labels on the giga-pixel whole slide images is extremely expensive and time-consuming. In this paper, we use only patch-level classification labels to achieve tissue semantic segmentation on histopathology images, finally reducing the annotation efforts. We proposed a two-step model including a classification and a segmentation phases. In the classification phase, we proposed a CAM-based model to generate pseudo masks by patch-level labels. In the segmentation phase, we achieved tissue semantic segmentation by our proposed Multi-Layer Pseudo-Supervision. Several technical novelties have been proposed to reduce the information gap between pixel-level and patch-level annotations. As a part of this paper, we introduced a new weakly-supervised semantic segmentation (WSSS) dataset for lung adenocarcinoma (LUAD-HistoSeg). We conducted several experiments to evaluate our proposed model on two datasets. Our proposed model outperforms two state-of-the-art WSSS approaches. Note that we can achieve comparable quantitative and qualitative results with the fully-supervised model, with only around a 2\% gap for MIoU and FwIoU. By comparing with manual labeling, our model can greatly save the annotation time from hours to minutes. The source code is available at: \url{https://github.com/ChuHan89/WSSS-Tissue}.

Huadeng Wang, Jiejiang Yu, Bingbing Li et al.

Accurate and automated gland segmentation on pathological images can assist pathologists in diagnosing the malignancy of colorectal adenocarcinoma. However, due to various gland shapes, severe deformation of malignant glands, and overlapping adhesions between glands. Gland segmentation has always been very challenging. To address these problems, we propose a DEA model. This model consists of two branches: the backbone encoding and decoding network and the local semantic extraction network. The backbone encoding and decoding network extracts advanced Semantic features, uses the proposed feature decoder to restore feature space information, and then enhances the boundary features of the gland through boundary enhancement attention. The local semantic extraction network uses the pre-trained DeepLabv3+ as a Local semantic-guided encoder to realize the extraction of edge features. Experimental results on two public datasets, GlaS and CRAG, confirm that the performance of our method is better than other gland segmentation methods.

Wentao Liu, Bowen Liang, Weijin Xu et al.

The rigid registration of aortic Digital Subtraction Angiography (DSA) and Computed Tomography Angiography (CTA) can provide 3D anatomical details of the vasculature for the interventional surgical treatment of conditions such as aortic dissection and aortic aneurysms, holding significant value for clinical research. However, the current methods for 2D/3D image registration are dependent on manual annotations or synthetic data, as well as the extraction of landmarks, which is not suitable for cross-modal registration of aortic DSA/CTA. In this paper, we propose an unsupervised method, UDCR, for aortic DSA/CTA rigid registration based on deep reinforcement learning. Leveraging the imaging principles and characteristics of DSA and CTA, we have constructed a cross-dimensional registration environment based on spatial transformations. Specifically, we propose an overlap degree calculation reward function that measures the intensity difference between the foreground and background, aimed at assessing the accuracy of registration between segmentation maps and DSA images. This method is highly flexible, allowing for the loading of pre-trained models to perform registration directly or to seek the optimal spatial transformation parameters through online learning. We manually annotated 61 pairs of aortic DSA/CTA for algorithm evaluation. The results indicate that the proposed UDCR achieved a Mean Absolute Error (MAE) of 2.85 mm in translation and 4.35° in rotation, showing significant potential for clinical applications.

Jiatai Lin, Guoqiang Han, Xipeng Pan et al.

Histopathological tissue classification is a fundamental task in pathomics cancer research. Precisely differentiating different tissue types is a benefit for the downstream researches, like cancer diagnosis, prognosis and etc. Existing works mostly leverage the popular classification backbones in computer vision to achieve histopathological tissue classification. In this paper, we proposed a super lightweight plug-and-play module, named Pyramidal Deep-Broad Learning (PDBL), for any well-trained classification backbone to further improve the classification performance without a re-training burden. We mimic how pathologists observe pathology slides in different magnifications and construct an image pyramid for the input image in order to obtain the pyramidal contextual information. For each level in the pyramid, we extract the multi-scale deep-broad features by our proposed Deep-Broad block (DB-block). We equipped PDBL in three popular classification backbones, ShuffLeNetV2, EfficientNetb0, and ResNet50 to evaluate the effectiveness and efficiency of our proposed module on two datasets (Kather Multiclass Dataset and the LC25000 Dataset). Experimental results demonstrate the proposed PDBL can steadily improve the tissue-level classification performance for any CNN backbones, especially for the lightweight models when given a small among of training samples (less than 10%), which greatly saves the computational time and annotation efforts.