Ting Ma

Pengcheng Shi, Jiesi Hu, Yanwu Yang et al.

Vascular segmentation in medical imaging plays a crucial role in analysing morphological and functional assessments. Traditional methods, like the centerline Dice (clDice) loss, ensure topology preservation but falter in capturing geometric details, especially under translation and deformation. The combination of clDice with traditional Dice loss can lead to diameter imbalance, favoring larger vessels. Addressing these challenges, we introduce the centerline boundary Dice (cbDice) loss function, which harmonizes topological integrity and geometric nuances, ensuring consistent segmentation across various vessel sizes. cbDice enriches the clDice approach by including boundary-aware aspects, thereby improving geometric detail recognition. It matches the performance of the boundary difference over union (B-DoU) loss through a mask-distance-based approach, enhancing traslation sensitivity. Crucially, cbDice incorporates radius information from vascular skeletons, enabling uniform adaptation to vascular diameter changes and maintaining balance in branch growth and fracture impacts. Furthermore, we conducted a theoretical analysis of clDice variants (cl-X-Dice). We validated cbDice's efficacy on three diverse vascular segmentation datasets, encompassing both 2D and 3D, and binary and multi-class segmentation. Particularly, the method integrated with cbDice demonstrated outstanding performance on the MICCAI 2023 TopCoW Challenge dataset. Our code is made publicly available at: https://github.com/PengchengShi1220/cbDice.

Jiesi Hu, Yanwu Yang, Xutao Guo et al.

Since 2019, coronavirus Disease 2019 (COVID-19) has been widely spread and posed a serious threat to public health. Chest Computed Tomography (CT) holds great potential for screening and diagnosis of this disease. The segmentation of COVID-19 CT imaging can achieves quantitative evaluation of infections and tracks disease progression. COVID-19 infections are characterized by high heterogeneity and unclear boundaries, so capturing low-level features such as texture and intensity is critical for segmentation. However, segmentation networks that emphasize low-level features are still lacking. In this work, we propose a DECOR-Net capable of capturing more decorrelated low-level features. The channel re-weighting strategy is applied to obtain plenty of low-level features and the dependencies between channels are reduced by proposed decorrelation loss. Experiments show that DECOR-Net outperforms other cutting-edge methods and surpasses the baseline by 5.1% and 4.9% in terms of Dice coefficient and intersection over union. Moreover, the proposed decorrelation loss can improve the performance constantly under different settings. The Code is available at https://github.com/jiesihu/DECOR-Net.git.

Yanwu Yang, Hairui Chen, Jiesi Hu et al.

Recent advancements in deep learning have shifted the development of brain imaging analysis. However, several challenges remain, such as heterogeneity, individual variations, and the contradiction between the high dimensionality and small size of brain imaging datasets. These issues complicate the learning process, preventing models from capturing intrinsic, meaningful patterns and potentially leading to suboptimal performance due to biases and overfitting. Curriculum learning (CL) presents a promising solution by organizing training examples from simple to complex, mimicking the human learning process, and potentially fostering the development of more robust and accurate models. Despite its potential, the inherent limitations posed by small initial training datasets present significant challenges, including overfitting and poor generalization. In this paper, we introduce the Progressive Self-Paced Distillation (PSPD) framework, employing an adaptive and progressive pacing and distillation mechanism. This allows for dynamic curriculum adjustments based on the states of both past and present models. The past model serves as a teacher, guiding the current model with gradually refined curriculum knowledge and helping prevent the loss of previously acquired knowledge. We validate PSPD's efficacy and adaptability across various convolutional neural networks using the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset, underscoring its superiority in enhancing model performance and generalization capabilities. The source code for this approach will be released at https://github.com/Hrychen7/PSPD.

Xutao Guo, Yanwu Yang, Chenfei Ye et al.

Based on the Denoising Diffusion Probabilistic Model (DDPM), medical image segmentation can be described as a conditional image generation task, which allows to compute pixel-wise uncertainty maps of the segmentation and allows an implicit ensemble of segmentations to boost the segmentation performance. However, DDPM requires many iterative denoising steps to generate segmentations from Gaussian noise, resulting in extremely inefficient inference. To mitigate the issue, we propose a principled acceleration strategy, called pre-segmentation diffusion sampling DDPM (PD-DDPM), which is specially used for medical image segmentation. The key idea is to obtain pre-segmentation results based on a separately trained segmentation network, and construct noise predictions (non-Gaussian distribution) according to the forward diffusion rule. We can then start with noisy predictions and use fewer reverse steps to generate segmentation results. Experiments show that PD-DDPM yields better segmentation results over representative baseline methods even if the number of reverse steps is significantly reduced. Moreover, PD-DDPM is orthogonal to existing advanced segmentation models, which can be combined to further improve the segmentation performance.

Yanwu Yang, Xutao Guo, Zhikai Chang et al.

Multi-modal neuroimaging technology has greatlly facilitated the efficiency and diagnosis accuracy, which provides complementary information in discovering objective disease biomarkers. Conventional deep learning methods, e.g. convolutional neural networks, overlook relationships between nodes and fail to capture topological properties in graphs. Graph neural networks have been proven to be of great importance in modeling brain connectome networks and relating disease-specific patterns. However, most existing graph methods explicitly require known graph structures, which are not available in the sophisticated brain system. Especially in heterogeneous multi-modal brain networks, there exists a great challenge to model interactions among brain regions in consideration of inter-modal dependencies. In this study, we propose a Multi-modal Dynamic Graph Convolution Network (MDGCN) for structural and functional brain network learning. Our method benefits from modeling inter-modal representations and relating attentive multi-model associations into dynamic graphs with a compositional correspondence matrix. Moreover, a bilateral graph convolution layer is proposed to aggregate multi-modal representations in terms of multi-modal associations. Extensive experiments on three datasets demonstrate the superiority of our proposed method in terms of disease classification, with the accuracy of 90.4%, 85.9% and 98.3% in predicting Mild Cognitive Impairment (MCI), Parkinson's disease (PD), and schizophrenia (SCHZ) respectively. Furthermore, our statistical evaluations on the correspondence matrix exhibit a high correspondence with previous evidence of biomarkers.

Xiangsen Chen, Ruilong Wu, Yanyan Lan et al.

Despite deep learning's success in chemistry, its impact is hindered by a lack of interpretability and an inability to resolve activity cliffs, where minor structural nuances trigger drastic property shifts. Current representation learning, bound by the similarity principle, often fails to capture these structural-activity discontinuities. To address this, we introduce MolEvolve, an evolutionary framework that reformulates molecular discovery as an autonomous, look-ahead planning problem. Unlike traditional methods that depend on human-engineered features or rigid prior knowledge, MolEvolve leverages a Large Language Model (LLM) to actively explore and evolve a library of executable chemical symbolic operations. By utilizing the LLM to cold start and an Monte Carlo Tree Search (MCTS) engine for test-time planning with external tools (e.g. RDKit), the system self-discovers optimal trajectories autonomously. This process evolves transparent reasoning chains that translate complex structural transformations into actionable, human-readable chemical insights. Experimental results demonstrate that MolEvolve's autonomous search not only evolves transparent, human-readable chemical insights, but also outperforms baselines in both property prediction and molecule optimization tasks.

Jiesi Hu, Yanwu Yang, Xutao Guo et al.

Source-free domain adaptation (SFDA) aims to adapt models trained on a labeled source domain to an unlabeled target domain without the access to source data. In medical imaging scenarios, the practical significance of SFDA methods has been emphasized due to privacy concerns. Recent State-of-the-art SFDA methods primarily rely on self-training based on pseudo-labels (PLs). Unfortunately, PLs suffer from accuracy deterioration caused by domain shift, and thus limit the effectiveness of the adaptation process. To address this issue, we propose a Chebyshev confidence guided SFDA framework to accurately assess the reliability of PLs and generate self-improving PLs for self-training. The Chebyshev confidence is estimated by calculating probability lower bound of the PL confidence, given the prediction and the corresponding uncertainty. Leveraging the Chebyshev confidence, we introduce two confidence-guided denoising methods: direct denoising and prototypical denoising. Additionally, we propose a novel teacher-student joint training scheme (TJTS) that incorporates a confidence weighting module to improve PLs iteratively. The TJTS, in collaboration with the denoising methods, effectively prevents the propagation of noise and enhances the accuracy of PLs. Extensive experiments in diverse domain scenarios validate the effectiveness of our proposed framework and establish its superiority over state-of-the-art SFDA methods. Our paper contributes to the field of SFDA by providing a novel approach for precisely estimating the reliability of pseudo-labels and a framework for obtaining high-quality PLs, resulting in improved adaptation performance.

Yanwu Yang, Xutao Guo, Zhikai Chang et al.

The brain age has been proven to be a phenotype of relevance to cognitive performance and brain disease. Achieving accurate brain age prediction is an essential prerequisite for optimizing the predicted brain-age difference as a biomarker. As a comprehensive biological characteristic, the brain age is hard to be exploited accurately with models using feature engineering and local processing such as local convolution and recurrent operations that process one local neighborhood at a time. Instead, Vision Transformers learn global attentive interaction of patch tokens, introducing less inductive bias and modeling long-range dependencies. In terms of this, we proposed a novel network for learning brain age interpreting with global and local dependencies, where the corresponding representations are captured by Successive Permuted Transformer (SPT) and convolution blocks. The SPT brings computation efficiency and locates the 3D spatial information indirectly via continuously encoding 2D slices from different views. Finally, we collect a large cohort of 22645 subjects with ages ranging from 14 to 97 and our network performed the best among a series of deep learning methods, yielding a mean absolute error (MAE) of 2.855 in validation set, and 2.911 in an independent test set.

Pedro R. A. S. Bassi, Wenxuan Li, Yucheng Tang et al.

How can we test AI performance? This question seems trivial, but it isn't. Standard benchmarks often have problems such as in-distribution and small-size test sets, oversimplified metrics, unfair comparisons, and short-term outcome pressure. As a consequence, good performance on standard benchmarks does not guarantee success in real-world scenarios. To address these problems, we present Touchstone, a large-scale collaborative segmentation benchmark of 9 types of abdominal organs. This benchmark is based on 5,195 training CT scans from 76 hospitals around the world and 5,903 testing CT scans from 11 additional hospitals. This diverse test set enhances the statistical significance of benchmark results and rigorously evaluates AI algorithms across various out-of-distribution scenarios. We invited 14 inventors of 19 AI algorithms to train their algorithms, while our team, as a third party, independently evaluated these algorithms on three test sets. In addition, we also evaluated pre-existing AI frameworks--which, differing from algorithms, are more flexible and can support different algorithms--including MONAI from NVIDIA, nnU-Net from DKFZ, and numerous other open-source frameworks. We are committed to expanding this benchmark to encourage more innovation of AI algorithms for the medical domain.

Na Gao, Chenfei Ye, Yanwu Yang et al.

Accurate characterization of hippocampal substructure is crucial for detecting subtle structural changes and identifying early neurodegenerative biomarkers. However, high inter-subject variability and complex folding pattern of human hippocampus hinder consistent cross-subject and longitudinal analysis. Most existing approaches rely on subject-specific modelling and lack a stable intrinsic coordinate system to accommodate anatomical variability, which limits their ability to establish reliable inter- and intra-individual correspondence. To address this, we propose HippMetric, a skeletal representation (s-rep)-based framework for hippocampal substructural morphometry and point-wise correspondence across individuals and scans. HippMetric builds on the Axis-Referenced Morphometric Model (ARMM) and employs a deformable skeletal coordinate system aligned with hippocampal anatomy and function, providing a biologically grounded reference for correspondence. Our framework comprises two core modules: a skeletal-based coordinate system that respects the hippocampus' conserved longitudinal lamellar architecture, in which functional units (lamellae) are stacked perpendicular to the long-axis, enabling anatomically consistent localization across subjects and time; and individualized s-reps generated through surface reconstruction, deformation, and geometrically constrained spoke refinement, enforcing boundary adherence, orthogonality and non-intersection to produce mathematically valid skeletal geometry. Extensive experiments on two international cohorts demonstrate that HippMetric achieves higher accuracy, reliability, and correspondence stability compared to existing shape models.

Guoqing Cai, Kai Zeng, Shoulin Huang et al.

Deep Riemannian networks provide a powerful framework for Electroencephalography (EEG) decoding, but their practical applications are severely constrained. Accurately decoding EEG signals requires modeling complex temporal dynamics across multiple rhythms, which results in high-dimensional Riemannian inputs and significant computational costs. To address this, we propose the Manifold Pooling Network (MPNet). MPNet uses a rhythm-adaptive convolutional frontend to extract comprehensive time-frequency representations and generate multi-view Riemannian nodes. A novel manifold node pooling layer is then proposed to aggregate these nodes into a single fusion node with a fixed size, enabling the following deep Riemannian network to process it with greatly reduced costs. Experiments on two public EEG datasets show that MPNet achieves state-of-the-art accuracy, runs up to 10 times faster than the comparable Riemannian model, and maintains robust performance under limited-data conditions. These findings highlight MPNet's practicality and efficiency for real-world EEG applications.

Jiesi Hu, Yanwu Yang, Zhiyu Ye et al.

The rise of In-Context Learning (ICL) for universal medical image segmentation has introduced an unprecedented demand for large-scale, diverse datasets for training, exacerbating the long-standing problem of data scarcity. While data synthesis offers a promising solution, existing methods often fail to simultaneously achieve both high data diversity and a domain distribution suitable for medical data. To bridge this gap, we propose \textbf{SynthICL}, a novel data synthesis framework built upon domain randomization. SynthICL ensures realism by leveraging anatomical priors from real-world datasets, generates diverse anatomical structures to cover a broad data distribution, and explicitly models inter-subject variations to create data cohorts suitable for ICL. Extensive experiments on four held-out datasets validate our framework's effectiveness, showing that models trained with our data achieve performance gains of up to 63\% in average Dice and substantially enhanced generalization to unseen anatomical domains. Our work helps mitigate the data bottleneck for ICL-based segmentation, paving the way for robust models. Our code and the generated dataset are publicly available at https://github.com/jiesihu/Neuroverse3D.

Jiesi Hu, Jianfeng Cao, Yanwu Yang et al.

In-context learning (ICL) offers a promising paradigm for universal medical image analysis, enabling models to perform diverse image processing tasks without retraining. However, current ICL models for medical imaging remain limited in two critical aspects: they cannot simultaneously achieve high-fidelity predictions and global anatomical understanding, and there is no unified model trained across diverse medical imaging tasks (e.g., segmentation and enhancement) and anatomical regions. As a result, the full potential of ICL in medical imaging remains underexplored. Thus, we present \textbf{Medverse}, a universal ICL model for 3D medical imaging, trained on 22 datasets covering diverse tasks in universal image segmentation, transformation, and enhancement across multiple organs, imaging modalities, and clinical centers. Medverse employs a next-scale autoregressive in-context learning framework that progressively refines predictions from coarse to fine, generating consistent, full-resolution volumetric outputs and enabling multi-scale anatomical awareness. We further propose a blockwise cross-attention module that facilitates long-range interactions between context and target inputs while preserving computational efficiency through spatial sparsity. Medverse is extensively evaluated on a broad collection of held-out datasets covering previously unseen clinical centers, organs, species, and imaging modalities. Results demonstrate that Medverse substantially outperforms existing ICL baselines and establishes a novel paradigm for in-context learning. Code and model weights will be made publicly available. Our model are publicly available at https://github.com/jiesihu/Medverse.

Jiesi Hu, Yanwu Yang, Zhiyu Ye et al.

Universal models for medical image segmentation, such as interactive and in-context learning (ICL) models, offer strong generalization but require extensive annotations. Interactive models need repeated user prompts for each image, while ICL relies on dense, pixel-level labels. To address this, we propose Weakly Supervised In-Context Learning (WS-ICL), a new ICL paradigm that leverages weak prompts (e.g., bounding boxes or points) instead of dense labels for context. This approach significantly reduces annotation effort by eliminating the need for fine-grained masks and repeated user prompting for all images. We evaluated the proposed WS-ICL model on three held-out benchmarks. Experimental results demonstrate that WS-ICL achieves performance comparable to regular ICL models at a significantly lower annotation cost. In addition, WS-ICL is highly competitive even under the interactive paradigm. These findings establish WS-ICL as a promising step toward more efficient and unified universal models for medical image segmentation. Our code and model are publicly available at https://github.com/jiesihu/Weak-ICL.

Jiesi Hu, Chenfei Ye, Yanwu Yang et al.

In-context learning (ICL), a type of universal model, demonstrates exceptional generalization across a wide range of tasks without retraining by leveraging task-specific guidance from context, making it particularly effective for the intricate demands of neuroimaging. However, current ICL models, limited to 2D inputs and thus exhibiting suboptimal performance, struggle to extend to 3D inputs due to the high memory demands of ICL. In this regard, we introduce Neuroverse3D, an ICL model capable of performing multiple neuroimaging tasks in 3D (e.g., segmentation, denoising, inpainting). Neuroverse3D overcomes the large memory consumption associated with 3D inputs through adaptive parallel-sequential context processing and a U-shaped fusion strategy, allowing it to handle an unlimited number of context images. Additionally, we propose an optimized loss function to balance multi-task training and enhance focus on anatomical boundaries. Our study incorporates 43,674 3D multi-modal scans from 19 neuroimaging datasets and evaluates Neuroverse3D on 14 diverse tasks using held-out test sets. The results demonstrate that Neuroverse3D significantly outperforms existing ICL models and closely matches task-specific models, enabling flexible adaptation to medical center variations without retraining. The code and model weights are publicly available at https://github.com/jiesihu/Neuroverse3D.

Pengcheng Shi, Xutao Guo, Yanwu Yang et al.

Convolutional neural networks (CNN) and Transformer variants have emerged as the leading medical image segmentation backbones. Nonetheless, due to their limitations in either preserving global image context or efficiently processing irregular shapes in visual objects, these backbones struggle to effectively integrate information from diverse anatomical regions and reduce inter-individual variability, particularly for the vasculature. Motivated by the successful breakthroughs of graph neural networks (GNN) in capturing topological properties and non-Euclidean relationships across various fields, we propose NexToU, a novel hybrid architecture for medical image segmentation. NexToU comprises improved Pool GNN and Swin GNN modules from Vision GNN (ViG) for learning both global and local topological representations while minimizing computational costs. To address the containment and exclusion relationships among various anatomical structures, we reformulate the topological interaction (TI) module based on the nature of binary trees, rapidly encoding the topological constraints into NexToU. Extensive experiments conducted on three datasets (including distinct imaging dimensions, disease types, and imaging modalities) demonstrate that our method consistently outperforms other state-of-the-art (SOTA) architectures. All the code is publicly available at https://github.com/PengchengShi1220/NexToU.

Kaiyuan Yang, Fabio Musio, Yihui Ma et al.

The Circle of Willis (CoW) is an important network of arteries connecting major circulations of the brain. Its vascular architecture is believed to affect the risk, severity, and clinical outcome of serious neurovascular diseases. However, characterizing the highly variable CoW anatomy is still a manual and time-consuming expert task. The CoW is usually imaged by two non-invasive angiographic imaging modalities, magnetic resonance angiography (MRA) and computed tomography angiography (CTA), but there exist limited datasets with annotations on CoW anatomy, especially for CTA. Therefore, we organized the TopCoW challenge with the release of an annotated CoW dataset. The TopCoW dataset is the first public dataset with voxel-level annotations for 13 CoW vessel components, enabled by virtual reality technology. It is also the first large dataset using 200 pairs of MRA and CTA from the same patients. As part of the benchmark, we invited submissions worldwide and attracted over 250 registered participants from six continents. The submissions were evaluated on both internal and external test datasets of 226 scans from over five centers. The top performing teams achieved over 90% Dice scores at segmenting the CoW components, over 80% F1 scores at detecting key CoW components, and over 70% balanced accuracy at classifying CoW variants for nearly all test sets. The best algorithms also showed clinical potential in classifying fetal-type posterior cerebral artery and locating aneurysms with CoW anatomy. TopCoW demonstrated the utility and versatility of CoW segmentation algorithms for a wide range of downstream clinical applications with explainability. The annotated datasets and best performing algorithms have been released as public Zenodo records to foster further methodological development and clinical tool building.

Guoqing Cai, Shoulin Huang, Ting Ma

Motor Imagery (MI) Electroencephalography (EEG) signals contain two crucial and complementary types of information: state information, which captures the global context of the task, and flow information, which captures fine-grained temporal dynamics. However, existing deep decoding models typically focus on only one of these information streams, resulting in unstable learning and sub-optimal performance. To address this, we propose the State-Flow Coordinated Network (StaFlowNet), a novel architecture that explicitly separates and coordinates state and flow information. We first employ a dual-branch design to extract the global state vector and temporal flow features separately. Critically, a novel state-modulated flow module is proposed to dynamically refine the learning of flow information. This modulated mechanism effectively integrates global context with fine-grained dynamics, thereby significantly enhancing task discriminability and decoding performance. Experiments on three public MI-EEG datasets demonstrate that StaFlowNet significantly outperforms state-of-the-art methods. Ablation studies further confirm that the state-modulated mechanism plays a crucial role in enhancing feature discriminability and overall performance.

Hongwei Bran Li, Fernando Navarro, Ivan Ezhov et al.

Uncertainty in medical image segmentation tasks, especially inter-rater variability, arising from differences in interpretations and annotations by various experts, presents a significant challenge in achieving consistent and reliable image segmentation. This variability not only reflects the inherent complexity and subjective nature of medical image interpretation but also directly impacts the development and evaluation of automated segmentation algorithms. Accurately modeling and quantifying this variability is essential for enhancing the robustness and clinical applicability of these algorithms. We report the set-up and summarize the benchmark results of the Quantification of Uncertainties in Biomedical Image Quantification Challenge (QUBIQ), which was organized in conjunction with International Conferences on Medical Image Computing and Computer-Assisted Intervention (MICCAI) 2020 and 2021. The challenge focuses on the uncertainty quantification of medical image segmentation which considers the omnipresence of inter-rater variability in imaging datasets. The large collection of images with multi-rater annotations features various modalities such as MRI and CT; various organs such as the brain, prostate, kidney, and pancreas; and different image dimensions 2D-vs-3D. A total of 24 teams submitted different solutions to the problem, combining various baseline models, Bayesian neural networks, and ensemble model techniques. The obtained results indicate the importance of the ensemble models, as well as the need for further research to develop efficient 3D methods for uncertainty quantification methods in 3D segmentation tasks.

Yanwu Yang, Xutao Guo, Yiwei Pan et al.

Accurate medical image segmentation is crucial for diagnosis and analysis. However, the models without calibrated uncertainty estimates might lead to errors in downstream analysis and exhibit low levels of robustness. Estimating the uncertainty in the measurement is vital to making definite, informed conclusions. Especially, it is difficult to make accurate predictions on ambiguous areas and focus boundaries for both models and radiologists, even harder to reach a consensus with multiple annotations. In this work, the uncertainty under these areas is studied, which introduces significant information with anatomical structure and is as important as segmentation performance. We exploit the medical image segmentation uncertainty quantification by measuring segmentation performance with multiple annotations in a supervised learning manner and propose a U-Net based architecture with multiple decoders, where the image representation is encoded with the same encoder, and segmentation referring to each annotation is estimated with multiple decoders. Nevertheless, a cross-loss function is proposed for bridging the gap between different branches. The proposed architecture is trained in an end-to-end manner and able to improve predictive uncertainty estimates. The model achieves comparable performance with fewer parameters to the integrated training model that ranked the runner-up in the MICCAI-QUBIQ 2020 challenge.

Yang Yang, Jiancong Chen, Ruixuan Wang et al.

Despite tremendous efforts, it is very challenging to generate a robust model to assist in the accurate quantification assessment of COVID-19 on chest CT images. Due to the nature of blurred boundaries, the supervised segmentation methods usually suffer from annotation biases. To support unbiased lesion localisation and to minimise the labeling costs, we propose a data-driven framework supervised by only image-level labels. The framework can explicitly separate potential lesions from original images, with the help of a generative adversarial network and a lesion-specific decoder. Experiments on two COVID-19 datasets demonstrate the effectiveness of the proposed framework and its superior performance to several existing methods.