Yi Xiong

Yuanji Zhang, Yuhao Huang, Haoran Dou et al.

Orofacial clefts are among the most common congenital craniofacial abnormalities, yet accurate prenatal detection remains challenging due to the scarcity of experienced specialists and the relative rarity of the condition. Early and reliable diagnosis is essential to enable timely clinical intervention and reduce associated morbidity. Here we show that an artificial intelligence system, trained on over 45,139 ultrasound images from 9,215 fetuses across 22 hospitals, can diagnose fetal orofacial clefts with sensitivity and specificity exceeding 93% and 95% respectively, matching the performance of senior radiologists and substantially outperforming junior radiologists. When used as a medical copilot, the system raises junior radiologists' sensitivity by more than 6%. Beyond direct diagnostic assistance, the system also accelerates the development of clinical expertise. A pilot study involving 24 radiologists and trainees demonstrated that the model can improve the expertise development for rare conditions. This dual-purpose approach offers a scalable solution for improving both diagnostic accuracy and specialist training in settings where experienced radiologists are scarce.

Yi Xiong, Ningyuan Chen, Xuefeng Gao

When two players are engaged in a repeated game with unknown payoff matrices, they may use single-agent multi-armed bandit algorithms to choose the actions independent of each other. We show that when the players use Thompson sampling, the game dynamics converges to the Nash equilibrium under a mild assumption on the payoff matrices. Therefore, algorithmic collusion doesn't arise in this case despite the fact that the players do not intentionally deploy competitive strategies. To prove the convergence result, we find that the framework developed in stochastic approximation doesn't apply, because of the sporadic and infrequent updates of the inferior actions and the lack of Lipschitz continuity. We develop a novel sample-path-wise approach to show the convergence. However, when the payoff matrices do not satisfy the assumption, the game may converge to collusive outcomes.

Chaoyu Chen, Xin Yang, Yuhao Huang et al.

Fetal pose estimation in 3D ultrasound (US) involves identifying a set of associated fetal anatomical landmarks. Its primary objective is to provide comprehensive information about the fetus through landmark connections, thus benefiting various critical applications, such as biometric measurements, plane localization, and fetal movement monitoring. However, accurately estimating the 3D fetal pose in US volume has several challenges, including poor image quality, limited GPU memory for tackling high dimensional data, symmetrical or ambiguous anatomical structures, and considerable variations in fetal poses. In this study, we propose a novel 3D fetal pose estimation framework (called FetusMapV2) to overcome the above challenges. Our contribution is three-fold. First, we propose a heuristic scheme that explores the complementary network structure-unconstrained and activation-unreserved GPU memory management approaches, which can enlarge the input image resolution for better results under limited GPU memory. Second, we design a novel Pair Loss to mitigate confusion caused by symmetrical and similar anatomical structures. It separates the hidden classification task from the landmark localization task and thus progressively eases model learning. Last, we propose a shape priors-based self-supervised learning by selecting the relatively stable landmarks to refine the pose online. Extensive experiments and diverse applications on a large-scale fetal US dataset including 1000 volumes with 22 landmarks per volume demonstrate that our method outperforms other strong competitors.

Shuangchi He, Zehui Lin, Xin Yang et al.

Standard plane recognition plays an important role in prenatal ultrasound (US) screening. Automatically recognizing the standard plane along with the corresponding anatomical structures in US image can not only facilitate US image interpretation but also improve diagnostic efficiency. In this study, we build a novel multi-label learning (MLL) scheme to identify multiple standard planes and corresponding anatomical structures of fetus simultaneously. Our contribution is three-fold. First, we represent the class correlation by word embeddings to capture the fine-grained semantic and latent statistical concurrency. Second, we equip the MLL with a graph convolutional network to explore the inner and outer relationship among categories. Third, we propose a novel cluster relabel-based contrastive learning algorithm to encourage the divergence among ambiguous classes. Extensive validation was performed on our large in-house dataset. Our approach reports the highest accuracy as 90.25% for standard planes labeling, 85.59% for planes and structures labeling and mAP as 94.63%. The proposed MLL scheme provides a novel perspective for standard plane recognition and can be easily extended to other medical image classification tasks.

Xin Yang, Haoran Dou, Ruobing Huang et al.

Accurate standard plane (SP) localization is the fundamental step for prenatal ultrasound (US) diagnosis. Typically, dozens of US SPs are collected to determine the clinical diagnosis. 2D US has to perform scanning for each SP, which is time-consuming and operator-dependent. While 3D US containing multiple SPs in one shot has the inherent advantages of less user-dependency and more efficiency. Automatically locating SP in 3D US is very challenging due to the huge search space and large fetal posture variations. Our previous study proposed a deep reinforcement learning (RL) framework with an alignment module and active termination to localize SPs in 3D US automatically. However, termination of agent search in RL is important and affects the practical deployment. In this study, we enhance our previous RL framework with a newly designed adaptive dynamic termination to enable an early stop for the agent searching, saving at most 67% inference time, thus boosting the accuracy and efficiency of the RL framework at the same time. Besides, we validate the effectiveness and generalizability of our algorithm extensively on our in-house multi-organ datasets containing 433 fetal brain volumes, 519 fetal abdomen volumes, and 683 uterus volumes. Our approach achieves localization error of 2.52mm/10.26 degrees, 2.48mm/10.39 degrees, 2.02mm/10.48 degrees, 2.00mm/14.57 degrees, 2.61mm/9.71 degrees, 3.09mm/9.58 degrees, 1.49mm/7.54 degrees for the transcerebellar, transventricular, transthalamic planes in fetal brain, abdominal plane in fetal abdomen, and mid-sagittal, transverse and coronal planes in uterus, respectively. Experimental results show that our method is general and has the potential to improve the efficiency and standardization of US scanning.

Zhendong Liu, Xiaoqiong Huang, Xin Yang et al.

Deep segmentation models that generalize to images with unknown appearance are important for real-world medical image analysis. Retraining models leads to high latency and complex pipelines, which are impractical in clinical settings. The situation becomes more severe for ultrasound image analysis because of their large appearance shifts. In this paper, we propose a novel method for robust segmentation under unknown appearance shifts. Our contribution is three-fold. First, we advance a one-stage plug-and-play solution by embedding hierarchical style transfer units into a segmentation architecture. Our solution can remove appearance shifts and perform segmentation simultaneously. Second, we adopt Dynamic Instance Normalization to conduct precise and dynamic style transfer in a learnable manner, rather than previously fixed style normalization. Third, our solution is fast and lightweight for routine clinical adoption. Given 400*400 image input, our solution only needs an additional 0.2ms and 1.92M FLOPs to handle appearance shifts compared to the baseline pipeline. Extensive experiments are conducted on a large dataset from three vendors demonstrate our proposed method enhances the robustness of deep segmentation models.

Yuhao Huang, Xin Yang, Rui Li et al.

3D ultrasound (US) is widely used due to its rich diagnostic information, portability and low cost. Automated standard plane (SP) localization in US volume not only improves efficiency and reduces user-dependence, but also boosts 3D US interpretation. In this study, we propose a novel Multi-Agent Reinforcement Learning (MARL) framework to localize multiple uterine SPs in 3D US simultaneously. Our contribution is two-fold. First, we equip the MARL with a one-shot neural architecture search (NAS) module to obtain the optimal agent for each plane. Specifically, Gradient-based search using Differentiable Architecture Sampler (GDAS) is employed to accelerate and stabilize the training process. Second, we propose a novel collaborative strategy to strengthen agents' communication. Our strategy uses recurrent neural network (RNN) to learn the spatial relationship among SPs effectively. Extensively validated on a large dataset, our approach achieves the accuracy of 7.05 degree/2.21mm, 8.62 degree/2.36mm and 5.93 degree/0.89mm for the mid-sagittal, transverse and coronal plane localization, respectively. The proposed MARL framework can significantly increase the plane localization accuracy and reduce the computational cost and model size.

Zhendong Liu, Xin Yang, Rui Gao et al.

Deep Neural Networks (DNNs) suffer from the performance degradation when image appearance shift occurs, especially in ultrasound (US) image segmentation. In this paper, we propose a novel and intuitive framework to remove the appearance shift, and hence improve the generalization ability of DNNs. Our work has three highlights. First, we follow the spirit of universal style transfer to remove appearance shifts, which was not explored before for US images. Without sacrificing image structure details, it enables the arbitrary style-content transfer. Second, accelerated with Adaptive Instance Normalization block, our framework achieved real-time speed required in the clinical US scanning. Third, an efficient and effective style image selection strategy is proposed to ensure the target-style US image and testing content US image properly match each other. Experiments on two large US datasets demonstrate that our methods are superior to state-of-the-art methods on making DNNs robust against various appearance shifts.

Haoran Dou, Xin Yang, Jikuan Qian et al.

Standard plane localization is crucial for ultrasound (US) diagnosis. In prenatal US, dozens of standard planes are manually acquired with a 2D probe. It is time-consuming and operator-dependent. In comparison, 3D US containing multiple standard planes in one shot has the inherent advantages of less user-dependency and more efficiency. However, manual plane localization in US volume is challenging due to the huge search space and large fetal posture variation. In this study, we propose a novel reinforcement learning (RL) framework to automatically localize fetal brain standard planes in 3D US. Our contribution is two-fold. First, we equip the RL framework with a landmark-aware alignment module to provide warm start and strong spatial bounds for the agent actions, thus ensuring its effectiveness. Second, instead of passively and empirically terminating the agent inference, we propose a recurrent neural network based strategy for active termination of the agent's interaction procedure. This improves both the accuracy and efficiency of the localization system. Extensively validated on our in-house large dataset, our approach achieves the accuracy of 3.4mm/9.6° and 2.7mm/9.1° for the transcerebellar and transthalamic plane localization, respectively. Ourproposed RL framework is general and has the potential to improve the efficiency and standardization of US scanning.