Danny Z. Chen

Yizhe Zhang, Tao Zhou, Shuo Wang et al.

The Segment Anything Model (SAM) is a recently developed large model for general-purpose segmentation for computer vision tasks. SAM was trained using 11 million images with over 1 billion masks and can produce segmentation results for a wide range of objects in natural scene images. SAM can be viewed as a general perception model for segmentation (partitioning images into semantically meaningful regions). Thus, how to utilize such a large foundation model for medical image segmentation is an emerging research target. This paper shows that although SAM does not immediately give high-quality segmentation for medical image data, its generated masks, features, and stability scores are useful for building and training better medical image segmentation models. In particular, we demonstrate how to use SAM to augment image input for commonly-used medical image segmentation models (e.g., U-Net). Experiments on three segmentation tasks show the effectiveness of our proposed SAMAug method. The code is available at \url{https://github.com/yizhezhang2000/SAMAug}.

Yuexin Bian, Jintai Chen, Xiaojun Chen et al.

A large number of people suffer from life-threatening cardiac abnormalities, and electrocardiogram (ECG) analysis is beneficial to determining whether an individual is at risk of such abnormalities. Automatic ECG classification methods, especially the deep learning based ones, have been proposed to detect cardiac abnormalities using ECG records, showing good potential to improve clinical diagnosis and help early prevention of cardiovascular diseases. However, the predictions of the known neural networks still do not satisfactorily meet the needs of clinicians, and this phenomenon suggests that some information used in clinical diagnosis may not be well captured and utilized by these methods. In this paper, we introduce some rules into convolutional neural networks, which help present clinical knowledge to deep learning based ECG analysis, in order to improve automated ECG diagnosis performance. Specifically, we propose a Handcrafted-Rule-enhanced Neural Network (called HRNN) for ECG classification with standard 12-lead ECG input, which consists of a rule inference module and a deep learning module. Experiments on two large-scale public ECG datasets show that our new approach considerably outperforms existing state-of-the-art methods. Further, our proposed approach not only can improve the diagnosis performance, but also can assist in detecting mislabelled ECG samples. Our codes are available at https://github.com/alwaysbyx/ecg_processing.

Yizhe Zhang, Suraj Mishra, Peixian Liang et al.

We aim to quantitatively measure the practical usability of medical image segmentation models: to what extent, how often, and on which samples a model's predictions can be used/trusted. We first propose a measure, Correctness-Confidence Rank Correlation (CCRC), to capture how predictions' confidence estimates correlate with their correctness scores in rank. A model with a high value of CCRC means its prediction confidences reliably suggest which samples' predictions are more likely to be correct. Since CCRC does not capture the actual prediction correctness, it alone is insufficient to indicate whether a prediction model is both accurate and reliable to use in practice. Therefore, we further propose another method, Usable Region Estimate (URE), which simultaneously quantifies predictions' correctness and reliability of confidence assessments in one estimate. URE provides concrete information on to what extent a model's predictions are usable. In addition, the sizes of usable regions (UR) can be utilized to compare models: A model with a larger UR can be taken as a more usable and hence better model. Experiments on six datasets validate that the proposed evaluation methods perform well, providing a concrete and concise measure for the practical usability of medical image segmentation models. Code is made available at https://github.com/yizhezhang2000/ure.

Yaopeng Peng, Milan Sonka, Danny Z. Chen

In this paper, we introduce U-Net v2, a new robust and efficient U-Net variant for medical image segmentation. It aims to augment the infusion of semantic information into low-level features while simultaneously refining high-level features with finer details. For an input image, we begin by extracting multi-level features with a deep neural network encoder. Next, we enhance the feature map of each level by infusing semantic information from higher-level features and integrating finer details from lower-level features through Hadamard product. Our novel skip connections empower features of all the levels with enriched semantic characteristics and intricate details. The improved features are subsequently transmitted to the decoder for further processing and segmentation. Our method can be seamlessly integrated into any Encoder-Decoder network. We evaluate our method on several public medical image segmentation datasets for skin lesion segmentation and polyp segmentation, and the experimental results demonstrate the segmentation accuracy of our new method over state-of-the-art methods, while preserving memory and computational efficiency. Code is available at: https://github.com/yaoppeng/U-Net_v2

Yejia Zhang, Pengfei Gu, Nishchal Sapkota et al.

Modern medical image segmentation methods primarily use discrete representations in the form of rasterized masks to learn features and generate predictions. Although effective, this paradigm is spatially inflexible, scales poorly to higher-resolution images, and lacks direct understanding of object shapes. To address these limitations, some recent works utilized implicit neural representations (INRs) to learn continuous representations for segmentation. However, these methods often directly adopted components designed for 3D shape reconstruction. More importantly, these formulations were also constrained to either point-based or global contexts, lacking contextual understanding or local fine-grained details, respectively--both critical for accurate segmentation. To remedy this, we propose a novel approach, SwIPE (Segmentation with Implicit Patch Embeddings), that leverages the advantages of INRs and predicts shapes at the patch level--rather than at the point level or image level--to enable both accurate local boundary delineation and global shape coherence. Extensive evaluations on two tasks (2D polyp segmentation and 3D abdominal organ segmentation) show that SwIPE significantly improves over recent implicit approaches and outperforms state-of-the-art discrete methods with over 10x fewer parameters. Our method also demonstrates superior data efficiency and improved robustness to data shifts across image resolutions and datasets. Code is available on Github (https://github.com/charzharr/miccai23-swipe-implicit-segmentation).

Peixian Liang, Yizhe Zhang, Yifan Ding et al.

Deep learning (DL) based semantic segmentation methods have achieved excellent performance in biomedical image segmentation, producing high quality probability maps to allow extraction of rich instance information to facilitate good instance segmentation. While numerous efforts were put into developing new DL semantic segmentation models, less attention was paid to a key issue of how to effectively explore their probability maps to attain the best possible instance segmentation. We observe that probability maps by DL semantic segmentation models can be used to generate many possible instance candidates, and accurate instance segmentation can be achieved by selecting from them a set of "optimized" candidates as output instances. Further, the generated instance candidates form a well-behaved hierarchical structure (a forest), which allows selecting instances in an optimized manner. Hence, we propose a novel framework, called hierarchical earth mover's distance (H-EMD), for instance segmentation in biomedical 2D+time videos and 3D images, which judiciously incorporates consistent instance selection with semantic-segmentation-generated probability maps. H-EMD contains two main stages. (1) Instance candidate generation: capturing instance-structured information in probability maps by generating many instance candidates in a forest structure. (2) Instance candidate selection: selecting instances from the candidate set for final instance segmentation. We formulate a key instance selection problem on the instance candidate forest as an optimization problem based on the earth mover's distance (EMD), and solve it by integer linear programming. Extensive experiments on eight biomedical video or 3D datasets demonstrate that H-EMD consistently boosts DL semantic segmentation models and is highly competitive with state-of-the-art methods.

Yizhe Zhang, Tao Zhou, Shuo Wang et al.

The Segment Anything Model (SAM) exhibits a capability to segment a wide array of objects in natural images, serving as a versatile perceptual tool for various downstream image segmentation tasks. In contrast, medical image segmentation tasks often rely on domain-specific knowledge (DSK). In this paper, we propose a novel method that combines the segmentation foundation model (i.e., SAM) with domain-specific knowledge for reliable utilization of unlabeled images in building a medical image segmentation model. Our new method is iterative and consists of two main stages: (1) segmentation model training; (2) expanding the labeled set by using the trained segmentation model, an unlabeled set, SAM, and domain-specific knowledge. These two stages are repeated until no more samples are added to the labeled set. A novel optimal-matching-based method is developed for combining the SAM-generated segmentation proposals and pixel-level and image-level DSK for constructing annotations of unlabeled images in the iterative stage (2). In experiments, we demonstrate the effectiveness of our proposed method for breast cancer segmentation in ultrasound images, polyp segmentation in endoscopic images, and skin lesion segmentation in dermoscopic images. Our work initiates a new direction of semi-supervised learning for medical image segmentation: the segmentation foundation model can be harnessed as a valuable tool for label-efficient segmentation learning in medical image segmentation.

Suraj Mishra, Yizhe Zhang, Li Zhang et al.

Automatic classification of pigmented, non-pigmented, and depigmented non-melanocytic skin lesions have garnered lots of attention in recent years. However, imaging variations in skin texture, lesion shape, depigmentation contrast, lighting condition, etc. hinder robust feature extraction, affecting classification accuracy. In this paper, we propose a new deep neural network that exploits input data for robust feature extraction. Specifically, we analyze the convolutional network's behavior (field-of-view) to find the location of deep supervision for improved feature extraction. To achieve this, first, we perform activation mapping to generate an object mask, highlighting the input regions most critical for classification output generation. Then the network layer whose layer-wise effective receptive field matches the approximated object shape in the object mask is selected as our focus for deep supervision. Utilizing different types of convolutional feature extractors and classifiers on three melanoma detection datasets and two vitiligo detection datasets, we verify the effectiveness of our new method.

Siyi Qian, Haochao Ying, Renjun Hu et al.

Graph Neural Networks (GNNs) have become widely-used models for semi-supervised learning. However, the robustness of GNNs in the presence of label noise remains a largely under-explored problem. In this paper, we consider an important yet challenging scenario where labels on nodes of graphs are not only noisy but also scarce. In this scenario, the performance of GNNs is prone to degrade due to label noise propagation and insufficient learning. To address these issues, we propose a novel RTGNN (Robust Training of Graph Neural Networks via Noise Governance) framework that achieves better robustness by learning to explicitly govern label noise. More specifically, we introduce self-reinforcement and consistency regularization as supplemental supervision. The self-reinforcement supervision is inspired by the memorization effects of deep neural networks and aims to correct noisy labels. Further, the consistency regularization prevents GNNs from overfitting to noisy labels via mimicry loss in both the inter-view and intra-view perspectives. To leverage such supervisions, we divide labels into clean and noisy types, rectify inaccurate labels, and further generate pseudo-labels on unlabeled nodes. Supervision for nodes with different types of labels is then chosen adaptively. This enables sufficient learning from clean labels while limiting the impact of noisy ones. We conduct extensive experiments to evaluate the effectiveness of our RTGNN framework, and the results validate its consistent superior performance over state-of-the-art methods with two types of label noises and various noise rates.

Jiahuan Yan, Jintai Chen, Yixuan Wu et al.

Recent development of deep neural networks (DNNs) for tabular learning has largely benefited from the capability of DNNs for automatic feature interaction. However, the heterogeneity nature of tabular features makes such features relatively independent, and developing effective methods to promote tabular feature interaction still remains an open problem. In this paper, we propose a novel Graph Estimator, which automatically estimates the relations among tabular features and builds graphs by assigning edges between related features. Such relation graphs organize independent tabular features into a kind of graph data such that interaction of nodes (tabular features) can be conducted in an orderly fashion. Based on our proposed Graph Estimator, we present a bespoke Transformer network tailored for tabular learning, called T2G-Former, which processes tabular data by performing tabular feature interaction guided by the relation graphs. A specific Cross-level Readout collects salient features predicted by the layers in T2G-Former across different levels, and attains global semantics for final prediction. Comprehensive experiments show that our T2G-Former achieves superior performance among DNNs and is competitive with non-deep Gradient Boosted Decision Tree models.

Jintai Chen, Kuanlun Liao, Kun Wei et al.

Electrocardiogram (ECG) is a widely used non-invasive diagnostic tool for heart diseases. Many studies have devised ECG analysis models (e.g., classifiers) to assist diagnosis. As an upstream task, researches have built generative models to synthesize ECG data, which are beneficial to providing training samples, privacy protection, and annotation reduction. However, previous generative methods for ECG often neither synthesized multi-view data, nor dealt with heart disease conditions. In this paper, we propose a novel disease-aware generative adversarial network for multi-view ECG synthesis called ME-GAN, which attains panoptic electrocardio representations conditioned on heart diseases and projects the representations onto multiple standard views to yield ECG signals. Since ECG manifestations of heart diseases are often localized in specific waveforms, we propose a new "mixup normalization" to inject disease information precisely into suitable locations. In addition, we propose a view discriminator to revert disordered ECG views into a pre-determined order, supervising the generator to obtain ECG representing correct view characteristics. Besides, a new metric, rFID, is presented to assess the quality of the synthesized ECG signals. Comprehensive experiments verify that our ME-GAN performs well on multi-view ECG signal synthesis with trusty morbid manifestations.

Yixuan Wu, Jintai Chen, Jiahuan Yan et al.

Since annotating medical images for segmentation tasks commonly incurs expensive costs, it is highly desirable to design an annotation-efficient method to alleviate the annotation burden. Recently, contrastive learning has exhibited a great potential in learning robust representations to boost downstream tasks with limited labels. In medical imaging scenarios, ready-made meta labels (i.e., specific attribute information of medical images) inherently reveal semantic relationships among images, which have been used to define positive pairs in previous work. However, the multi-perspective semantics revealed by various meta labels are usually incompatible and can incur intractable "semantic contradiction" when combining different meta labels. In this paper, we tackle the issue of "semantic contradiction" in a gradient-guided manner using our proposed Gradient Mitigator method, which systematically unifies multi-perspective meta labels to enable a pre-trained model to attain a better high-level semantic recognition ability. Moreover, we emphasize that the fine-grained discrimination ability is vital for segmentation-oriented pre-training, and develop a novel method called Gradient Filter to dynamically screen pixel pairs with the most discriminating power based on the magnitude of gradients. Comprehensive experiments on four medical image segmentation datasets verify that our new method GCL: (1) learns informative image representations and considerably boosts segmentation performance with limited labels, and (2) shows promising generalizability on out-of-distribution datasets.

Yejia Zhang, Xinrong Hu, Nishchal Sapkota et al.

Self-supervised instance discrimination is an effective contrastive pretext task to learn feature representations and address limited medical image annotations. The idea is to make features of transformed versions of the same images similar while forcing all other augmented images' representations to contrast. However, this instance-based contrastive learning leaves performance on the table by failing to maximize feature affinity between images with similar content while counter-productively pushing their representations apart. Recent improvements on this paradigm (e.g., leveraging multi-modal data, different images in longitudinal studies, spatial correspondences) either relied on additional views or made stringent assumptions about data properties, which can sacrifice generalizability and applicability. To address this challenge, we propose a new self-supervised contrastive learning method that uses unsupervised feature clustering to better select positive and negative image samples. More specifically, we produce pseudo-classes by hierarchically clustering features obtained by an auto-encoder in an unsupervised manner, and prevent destructive interference during contrastive learning by avoiding the selection of negatives from the same pseudo-class. Experiments on 2D skin dermoscopic image segmentation and 3D multi-class whole heart CT segmentation demonstrate that our method outperforms state-of-the-art self-supervised contrastive techniques on these tasks.

Pengfei Gu, Yejia Zhang, Chaoli Wang et al.

Convolutional neural network (CNN) based methods have achieved great successes in medical image segmentation, but their capability to learn global representations is still limited due to using small effective receptive fields of convolution operations. Transformer based methods are capable of modelling long-range dependencies of information for capturing global representations, yet their ability to model local context is lacking. Integrating CNN and Transformer to learn both local and global representations while exploring multi-scale features is instrumental in further improving medical image segmentation. In this paper, we propose a hierarchical CNN and Transformer hybrid architecture, called ConvFormer, for medical image segmentation. ConvFormer is based on several simple yet effective designs. (1) A feed forward module of Deformable Transformer (DeTrans) is re-designed to introduce local information, called Enhanced DeTrans. (2) A residual-shaped hybrid stem based on a combination of convolutions and Enhanced DeTrans is developed to capture both local and global representations to enhance representation ability. (3) Our encoder utilizes the residual-shaped hybrid stem in a hierarchical manner to generate feature maps in different scales, and an additional Enhanced DeTrans encoder with residual connections is built to exploit multi-scale features with feature maps of different scales as input. Experiments on several datasets show that our ConvFormer, trained from scratch, outperforms various CNN- or Transformer-based architectures, achieving state-of-the-art performance.

Yizhe Zhang, Shuo Wang, Yejia Zhang et al.

Conformal prediction (CP) generates a set of predictions for a given test sample such that the prediction set almost always contains the true label (e.g., 99.5\% of the time). CP provides comprehensive predictions on possible labels of a given test sample, and the size of the set indicates how certain the predictions are (e.g., a set larger than one is `uncertain'). Such distinct properties of CP enable effective collaborations between human experts and medical AI models, allowing efficient intervention and quality check in clinical decision-making. In this paper, we propose a new method called Reliable-Region-Based Conformal Prediction (RR-CP), which aims to impose a stronger statistical guarantee so that the user-specified error rate (e.g., 0.5\%) can be achieved in the test time, and under this constraint, the size of the prediction set is optimized (to be small). We consider a small prediction set size an important measure only when the user-specified error rate is achieved. Experiments on five public datasets show that our RR-CP performs well: with a reasonably small-sized prediction set, it achieves the user-specified error rate (e.g., 0.5\%) significantly more frequently than exiting CP methods.

Nishchal Sapkota, Haoyan Shi, Yejia Zhang et al.

Medical image segmentation is critical for accurate diagnostics and treatment planning, but remains challenging due to complex anatomical structures and limited annotated training data. CNN-based segmentation methods excel at local feature extraction, but struggle with modeling long-range dependencies. Transformers, on the other hand, capture global context more effectively, but are inherently data-hungry and computationally expensive. In this work, we introduce UKAST, a U-Net like architecture that integrates rational-function based Kolmogorov-Arnold Networks (KANs) into Swin Transformer encoders. By leveraging rational base functions and Group Rational KANs (GR-KANs) from the Kolmogorov-Arnold Transformer (KAT), our architecture addresses the inefficiencies of vanilla spline-based KANs, yielding a more expressive and data-efficient framework with reduced FLOPs and only a very small increase in parameter count compared to SwinUNETR. UKAST achieves state-of-the-art performance on four diverse 2D and 3D medical image segmentation benchmarks, consistently surpassing both CNN- and Transformer-based baselines. Notably, it attains superior accuracy in data-scarce settings, alleviating the data-hungry limitations of standard Vision Transformers. These results show the potential of KAN-enhanced Transformers to advance data-efficient medical image segmentation. Code is available at: https://github.com/nsapkota417/UKAST

Jiahuan Yan, Jintai Chen, Qianxing Wang et al.

Tabular datasets play a crucial role in various applications. Thus, developing efficient, effective, and widely compatible prediction algorithms for tabular data is important. Currently, two prominent model types, Gradient Boosted Decision Trees (GBDTs) and Deep Neural Networks (DNNs), have demonstrated performance advantages on distinct tabular prediction tasks. However, selecting an effective model for a specific tabular dataset is challenging, often demanding time-consuming hyperparameter tuning. To address this model selection dilemma, this paper proposes a new framework that amalgamates the advantages of both GBDTs and DNNs, resulting in a DNN algorithm that is as efficient as GBDTs and is competitively effective regardless of dataset preferences for GBDTs or DNNs. Our idea is rooted in an observation that deep learning (DL) offers a larger parameter space that can represent a well-performing GBDT model, yet the current back-propagation optimizer struggles to efficiently discover such optimal functionality. On the other hand, during GBDT development, hard tree pruning, entropy-driven feature gate, and model ensemble have proved to be more adaptable to tabular data. By combining these key components, we present a Tree-hybrid simple MLP (T-MLP). In our framework, a tensorized, rapidly trained GBDT feature gate, a DNN architecture pruning approach, as well as a vanilla back-propagation optimizer collaboratively train a randomly initialized MLP model. Comprehensive experiments show that T-MLP is competitive with extensively tuned DNNs and GBDTs in their dominating tabular benchmarks (88 datasets) respectively, all achieved with compact model storage and significantly reduced training duration.

Yixuan Wu, Kaiyuan Hu, Qian Shao et al.

The advent of telemedicine represents a transformative development in leveraging technology to extend the reach of specialized medical expertise to remote surgeries, a field where the immediacy of expert guidance is paramount. However, the intricate dynamics of Operating Room (OR) scene pose unique challenges for telemedicine, particularly in achieving high-fidelity, real-time scene reconstruction and transmission amidst obstructions and bandwidth limitations. This paper introduces TeleOR, a pioneering system designed to address these challenges through real-time OR scene reconstruction for Tele-intervention. TeleOR distinguishes itself with three innovative approaches: dynamic self-calibration, which leverages inherent scene features for calibration without the need for preset markers, allowing for obstacle avoidance and real-time camera adjustment; selective OR reconstruction, focusing on dynamically changing scene segments to reduce reconstruction complexity; and viewport-adaptive transmission, optimizing data transmission based on real-time client feedback to efficiently deliver high-quality 3D reconstructions within bandwidth constraints. Comprehensive experiments on the 4D-OR surgical scene dataset demostrate the superiority and applicability of TeleOR, illuminating the potential to revolutionize tele-interventions by overcoming the spatial and technical barriers inherent in remote surgical guidance.

Yixuan Wu, Bo Zheng, Jintai Chen et al.

As deep learning methods continue to improve medical image segmentation performance, data annotation is still a big bottleneck due to the labor-intensive and time-consuming burden on medical experts, especially for 3D images. To significantly reduce annotation efforts while attaining competitive segmentation accuracy, we propose a self-learning and one-shot learning based framework for 3D medical image segmentation by annotating only one slice of each 3D image. Our approach takes two steps: (1) self-learning of a reconstruction network to learn semantic correspondence among 2D slices within 3D images, and (2) representative selection of single slices for one-shot manual annotation and propagating the annotated data with the well-trained reconstruction network. Extensive experiments verify that our new framework achieves comparable performance with less than 1% annotated data compared with fully supervised methods and generalizes well on several out-of-distribution testing sets.

Yejia Zhang, Nishchal Sapkota, Pengfei Gu et al.

Understanding of spatial attributes is central to effective 3D radiology image analysis where crop-based learning is the de facto standard. Given an image patch, its core spatial properties (e.g., position & orientation) provide helpful priors on expected object sizes, appearances, and structures through inherent anatomical consistencies. Spatial correspondences, in particular, can effectively gauge semantic similarities between inter-image regions, while their approximate extraction requires no annotations or overbearing computational costs. However, recent 3D contrastive learning approaches either neglect correspondences or fail to maximally capitalize on them. To this end, we propose an extensible 3D contrastive framework (Spade, for Spatial Debiasing) that leverages extracted correspondences to select more effective positive & negative samples for representation learning. Our method learns both globally invariant and locally equivariant representations with downstream segmentation in mind. We also propose separate selection strategies for global & local scopes that tailor to their respective representational requirements. Compared to recent state-of-the-art approaches, Spade shows notable improvements on three downstream segmentation tasks (CT Abdominal Organ, CT Heart, MR Heart).

Yaopeng Peng, Hongxiao Wang, Milan Sonka et al.

Modern deep neural networks have achieved great successes in medical image analysis. However, the features captured by convolutional neural networks (CNNs) or Transformers tend to be optimized for pixel intensities and neglect key anatomical structures such as connected components and loops. In this paper, we propose a persistent homology guided approach (PHG-Net) that explores topological features of objects for medical image classification. For an input image, we first compute its cubical persistence diagram and extract topological features into a vector representation using a small neural network (called the PH module). The extracted topological features are then incorporated into the feature map generated by CNN or Transformer for feature fusion. The PH module is lightweight and capable of integrating topological features into any CNN or Transformer architectures in an end-to-end fashion. We evaluate our PHG-Net on three public datasets and demonstrate its considerable improvements on the target classification tasks over state-of-the-art methods.

Yizhe Zhang, Danny Z. Chen

In this paper, we propose a novel approach (called GPT4MIA) that utilizes Generative Pre-trained Transformer (GPT) as a plug-and-play transductive inference tool for medical image analysis (MIA). We provide theoretical analysis on why a large pre-trained language model such as GPT-3 can be used as a plug-and-play transductive inference model for MIA. At the methodological level, we develop several technical treatments to improve the efficiency and effectiveness of GPT4MIA, including better prompt structure design, sample selection, and prompt ordering of representative samples/features. We present two concrete use cases (with workflow) of GPT4MIA: (1) detecting prediction errors and (2) improving prediction accuracy, working in conjecture with well-established vision-based models for image classification (e.g., ResNet). Experiments validate that our proposed method is effective for these two tasks. We further discuss the opportunities and challenges in utilizing Transformer-based large language models for broader MIA applications.

Yaopeng Peng, Zhi Chen, Andreas Wahle et al.

The key manifestation of coronary artery disease (CAD) is development of fibroatheromatous plaque, the cap of which may rupture and subsequently lead to coronary artery blocking and heart attack. As such, quantitative analysis of coronary plaque, its plaque cap, and consequently the cap's likelihood to rupture are of critical importance when assessing a risk of cardiovascular events. This paper reports a new deep learning based approach, called FiAt-Net, for detecting angular extent of fibroatheroma (FA) and segmenting its cap in 3D intravascular optical coherence tomography (IVOCT) images. IVOCT 2D image frames are first associated with distinct clusters and data from each cluster are used for model training. As plaque is typically focal and thus unevenly distributed, a binary partitioning method is employed to identify FA plaque areas to focus on to mitigate the data imbalance issue. Additional image representations (called auxiliary images) are generated to capture IVOCT intensity changes to help distinguish FA and non-FA areas on the coronary wall. Information in varying scales is derived from the original IVOCT and auxiliary images, and a multi-head self-attention mechanism is employed to fuse such information. Our FiAt-Net achieved high performance on a 3D IVOCT coronary image dataset, demonstrating its effectiveness in accurately detecting FA cap in IVOCT images.

Yejia Zhang, Pengfei Gu, Nishchal Sapkota et al.

High annotation costs and limited labels for dense 3D medical imaging tasks have recently motivated an assortment of 3D self-supervised pretraining methods that improve transfer learning performance. However, these methods commonly lack spatial awareness despite its centrality in enabling effective 3D image analysis. More specifically, position, scale, and orientation are not only informative but also automatically available when generating image crops for training. Yet, to date, no work has proposed a pretext task that distills all key spatial features. To fulfill this need, we develop a new self-supervised method, VectorPOSE, which promotes better spatial understanding with two novel pretext tasks: Vector Prediction (VP) and Boundary-Focused Reconstruction (BFR). VP focuses on global spatial concepts (i.e., properties of 3D patches) while BFR addresses weaknesses of recent reconstruction methods to learn more effective local representations. We evaluate VectorPOSE on three 3D medical image segmentation tasks, showing that it often outperforms state-of-the-art methods, especially in limited annotation settings.

Yue Wang, Yuyang Xu, Renjun Hu et al.

Despite the rapid advancements of electrocardiogram (ECG) signal diagnosis and analysis methods through deep learning, two major hurdles still limit their clinical adoption: the lack of versatility in processing ECG signals with diverse configurations, and the inadequate detection of risk signals due to sample imbalances. Addressing these challenges, we introduce VersAtile and Risk-Sensitive cardiac diagnosis (VARS), an innovative approach that employs a graph-based representation to uniformly model heterogeneous ECG signals. VARS stands out by transforming ECG signals into versatile graph structures that capture critical diagnostic features, irrespective of signal diversity in the lead count, sampling frequency, and duration. This graph-centric formulation also enhances diagnostic sensitivity, enabling precise localization and identification of abnormal ECG patterns that often elude standard analysis methods. To facilitate representation transformation, our approach integrates denoising reconstruction with contrastive learning to preserve raw ECG information while highlighting pathognomonic patterns. We rigorously evaluate the efficacy of VARS on three distinct ECG datasets, encompassing a range of structural variations. The results demonstrate that VARS not only consistently surpasses existing state-of-the-art models across all these datasets but also exhibits substantial improvement in identifying risk signals. Additionally, VARS offers interpretability by pinpointing the exact waveforms that lead to specific model outputs, thereby assisting clinicians in making informed decisions. These findings suggest that our VARS will likely emerge as an invaluable tool for comprehensive cardiac health assessment.

Guangyu Meng, Pengfei Gu, Peixian Liang et al.

Contrastive learning (CL) has become a powerful approach for learning representations from unlabeled images. However, existing CL methods focus predominantly on visual appearance features while neglecting topological characteristics (e.g., connectivity patterns, boundary configurations, cavity formations) that provide valuable cues for medical image analysis. To address this limitation, we propose a new topological CL framework (TopoCL) that explicitly exploits topological structures during contrastive learning for medical imaging. Specifically, we first introduce topology-aware augmentations that control topological perturbations using a relative bottleneck distance between persistence diagrams, preserving medically relevant topological properties while enabling controlled structural variations. We then design a Hierarchical Topology Encoder that captures topological features through self-attention and cross-attention mechanisms. Finally, we develop an adaptive mixture-of-experts (MoE) module to dynamically integrate visual and topological representations. TopoCL can be seamlessly integrated with existing CL methods. We evaluate TopoCL on five representative CL methods (SimCLR, MoCo-v3, BYOL, DINO, and Barlow Twins) and five diverse medical image classification datasets. The experimental results show that TopoCL achieves consistent improvements: an average gain of +3.26% in linear probe classification accuracy with strong statistical significance, verifying its effectiveness.

Yaopeng Peng, Milan Sonka, Danny Z. Chen

This paper introduces Spectral U-Net, a novel deep learning network based on spectral decomposition, by exploiting Dual Tree Complex Wavelet Transform (DTCWT) for down-sampling and inverse Dual Tree Complex Wavelet Transform (iDTCWT) for up-sampling. We devise the corresponding Wave-Block and iWave-Block, integrated into the U-Net architecture, aiming at mitigating information loss during down-sampling and enhancing detail reconstruction during up-sampling. In the encoder, we first decompose the feature map into high and low-frequency components using DTCWT, enabling down-sampling while mitigating information loss. In the decoder, we utilize iDTCWT to reconstruct higher-resolution feature maps from down-sampled features. Evaluations on the Retina Fluid, Brain Tumor, and Liver Tumor segmentation datasets with the nnU-Net framework demonstrate the superiority of the proposed Spectral U-Net.

Delin An, Pengfei Gu, Milan Sonka et al.

Deep learning (DL) methods have shown remarkable successes in medical image segmentation, often using large amounts of annotated data for model training. However, acquiring a large number of diverse labeled 3D medical image datasets is highly difficult and expensive. Recently, mask propagation DL methods were developed to reduce the annotation burden on 3D medical images. For example, Sli2Vol~\cite{yeung2021sli2vol} proposed a self-supervised framework (SSF) to learn correspondences by matching neighboring slices via slice reconstruction in the training stage; the learned correspondences were then used to propagate a labeled slice to other slices in the test stage. But, these methods are still prone to error accumulation due to the inter-slice propagation of reconstruction errors. Also, they do not handle discontinuities well, which can occur between consecutive slices in 3D images, as they emphasize exploiting object continuity. To address these challenges, in this work, we propose a new SSF, called \proposed, {for segmenting any anatomical structures in 3D medical images using only a single annotated slice per training and testing volume.} Specifically, in the training stage, we first propagate an annotated 2D slice of a training volume to the other slices, generating pseudo-labels (PLs). Then, we develop a novel Object Estimation Guided Correspondence Flow Network to learn reliable correspondences between consecutive slices and corresponding PLs in a self-supervised manner. In the test stage, such correspondences are utilized to propagate a single annotated slice to the other slices of a test volume. We demonstrate the effectiveness of our method on various medical image segmentation tasks with different datasets, showing better generalizability across different organs, modalities, and modals. Code is available at \url{https://github.com/adlsn/Sli2Volplus}

Xueyang Li, Zongren Wang, Yuliang Zhang et al.

Bladder cancer is one of the most prevalent malignancies worldwide, with a recurrence rate of up to 78%, necessitating accurate post-operative monitoring for effective patient management. Multi-sequence contrast-enhanced MRI is commonly used for recurrence detection; however, interpreting these scans remains challenging, even for experienced radiologists, due to post-surgical alterations such as scarring, swelling, and tissue remodeling. AI-assisted diagnostic tools have shown promise in improving bladder cancer recurrence prediction, yet progress in this field is hindered by the lack of dedicated multi-sequence MRI datasets for recurrence assessment study. In this work, we first introduce a curated multi-sequence, multi-modal MRI dataset specifically designed for bladder cancer recurrence prediction, establishing a valuable benchmark for future research. We then propose H-CNN-ViT, a new Hierarchical Gated Attention Multi-Branch model that enables selective weighting of features from the global (ViT) and local (CNN) paths based on contextual demands, achieving a balanced and targeted feature fusion. Our multi-branch architecture processes each modality independently, ensuring that the unique properties of each imaging channel are optimally captured and integrated. Evaluated on our dataset, H-CNN-ViT achieves an AUC of 78.6%, surpassing state-of-the-art models. Our model is publicly available at https://github.com/XLIAaron/H-CNN-ViT.

Ruiwei Feng, Yufeng Xie, Minshan Lai et al.

Accurate drug response prediction (DRP) is a crucial yet challenging task in precision medicine. This paper presents a novel Attention-Guided Multi-omics Integration (AGMI) approach for DRP, which first constructs a Multi-edge Graph (MeG) for each cell line, and then aggregates multi-omics features to predict drug response using a novel structure, called Graph edge-aware Network (GeNet). For the first time, our AGMI approach explores gene constraint based multi-omics integration for DRP with the whole-genome using GNNs. Empirical experiments on the CCLE and GDSC datasets show that our AGMI largely outperforms state-of-the-art DRP methods by 8.3%--34.2% on four metrics. Our data and code are available at https://github.com/yivan-WYYGDSG/AGMI.

Jintai Chen, Kuanlun Liao, Yao Wan et al.

Tabular data are ubiquitous in real world applications. Although many commonly-used neural components (e.g., convolution) and extensible neural networks (e.g., ResNet) have been developed by the machine learning community, few of them were effective for tabular data and few designs were adequately tailored for tabular data structures. In this paper, we propose a novel and flexible neural component for tabular data, called Abstract Layer (AbstLay), which learns to explicitly group correlative input features and generate higher-level features for semantics abstraction. Also, we design a structure re-parameterization method to compress the learned AbstLay, thus reducing the computational complexity by a clear margin in the reference phase. A special basic block is built using AbstLays, and we construct a family of Deep Abstract Networks (DANets) for tabular data classification and regression by stacking such blocks. In DANets, a special shortcut path is introduced to fetch information from raw tabular features, assisting feature interactions across different levels. Comprehensive experiments on seven real-world tabular datasets show that our AbstLay and DANets are effective for tabular data classification and regression, and the computational complexity is superior to competitive methods. Besides, we evaluate the performance gains of DANet as it goes deep, verifying the extendibility of our method. Our code is available at https://github.com/WhatAShot/DANet.

Pengfei Gu, Huimin Li, Haoteng Tang et al.

Modern deep neural networks have shown remarkable performance in medical image classification. However, such networks either emphasize pixel-intensity features instead of fundamental anatomical structures (e.g., those encoded by topological invariants), or they capture only simple topological features via single-parameter persistence. In this paper, we propose a new topology-guided classification framework that extracts multi-scale and multi-filtration persistent topological features and integrates them into vision classification backbones. For an input image, we first compute cubical persistence diagrams (PDs) across multiple image resolutions/scales. We then develop a ``vineyard'' algorithm that consolidates these PDs into a single, stable diagram capturing signatures at varying granularities, from global anatomy to subtle local irregularities that may indicate early-stage disease. To further exploit richer topological representations produced by multiple filtrations, we design a cross-attention-based neural network that directly processes the consolidated final PDs. The resulting topological embeddings are fused with feature maps from CNNs or Transformers. By integrating multi-scale and multi-filtration topologies into an end-to-end architecture, our approach enhances the model's capacity to recognize complex anatomical structures. Evaluations on three public datasets show consistent, considerable improvements over strong baselines and state-of-the-art methods, demonstrating the value of our comprehensive topological perspective for robust and interpretable medical image classification.

Jiahuan Yan, Bo Zheng, Hongxia Xu et al.

The transferability of deep neural networks (DNNs) has made significant progress in image and language processing. However, due to the heterogeneity among tables, such DNN bonus is still far from being well exploited on tabular data prediction (e.g., regression or classification tasks). Condensing knowledge from diverse domains, language models (LMs) possess the capability to comprehend feature names from various tables, potentially serving as versatile learners in transferring knowledge across distinct tables and diverse prediction tasks, but their discrete text representation space is inherently incompatible with numerical feature values in tables. In this paper, we present TP-BERTa, a specifically pre-trained LM for tabular data prediction. Concretely, a novel relative magnitude tokenization converts scalar numerical feature values to finely discrete, high-dimensional tokens, and an intra-feature attention approach integrates feature values with the corresponding feature names. Comprehensive experiments demonstrate that our pre-trained TP-BERTa leads the performance among tabular DNNs and is competitive with Gradient Boosted Decision Tree models in typical tabular data regime.

Yixuan Wu, Kaiyuan Hu, Danny Z. Chen et al.

With the rapid advance of computer graphics and artificial intelligence technologies, the ways we interact with the world have undergone a transformative shift. Virtual Reality (VR) technology, aided by artificial intelligence (AI), has emerged as a dominant interaction media in multiple application areas, thanks to its advantage of providing users with immersive experiences. Among those applications, medicine is considered one of the most promising areas. In this paper, we present a comprehensive examination of the burgeoning field of AI-enhanced VR applications in medical care and services. By introducing a systematic taxonomy, we meticulously classify the pertinent techniques and applications into three well-defined categories based on different phases of medical diagnosis and treatment: Visualization Enhancement, VR-related Medical Data Processing, and VR-assisted Intervention. This categorization enables a structured exploration of the diverse roles that AI-powered VR plays in the medical domain, providing a framework for a more comprehensive understanding and evaluation of these technologies. To our best knowledge, this is the first systematic survey of AI-powered VR systems in medical settings, laying a foundation for future research in this interdisciplinary domain.

Hongxiao Wang, Yang Yang, Zhuo Zhao et al.

For predicting cancer survival outcomes, standard approaches in clinical research are often based on two main modalities: pathology images for observing cell morphology features, and genomic (e.g., bulk RNA-seq) for quantifying gene expressions. However, existing pathology-genomic multi-modal algorithms face significant challenges: (1) Valuable biological insights regarding genes and gene-gene interactions are frequently overlooked; (2) one modality often dominates the optimization process, causing inadequate training for the other modality. In this paper, we introduce a new multi-modal ``Path-GPTOmic" framework for cancer survival outcome prediction. First, to extract valuable biological insights, we regulate the embedding space of a foundation model, scGPT, initially trained on single-cell RNA-seq data, making it adaptable for bulk RNA-seq data. Second, to address the imbalance-between-modalities problem, we propose a gradient modulation mechanism tailored to the Cox partial likelihood loss for survival prediction. The contributions of the modalities are dynamically monitored and adjusted during the training process, encouraging that both modalities are sufficiently trained. Evaluated on two TCGA(The Cancer Genome Atlas) datasets, our model achieves substantially improved survival prediction accuracy.

Yizhe Zhang, Shuo Wang, Tao Zhou et al.

Segmentation quality assessment (SQA) plays a critical role in the deployment of a medical image based AI system. Users need to be informed/alerted whenever an AI system generates unreliable/incorrect predictions. With the introduction of the Segment Anything Model (SAM), a general foundation segmentation model, new research opportunities emerged in how one can utilize SAM for medical image segmentation. In this paper, we propose a novel SQA method, called SQA-SAM, which exploits SAM to enhance the accuracy of quality assessment for medical image segmentation. When a medical image segmentation model (MedSeg) produces predictions for a test image, we generate visual prompts based on the predictions, and SAM is utilized to generate segmentation maps corresponding to the visual prompts. How well MedSeg's segmentation aligns with SAM's segmentation indicates how well MedSeg's segmentation aligns with the general perception of objectness and image region partition. We develop a score measure for such alignment. In experiments, we find that the generated scores exhibit moderate to strong positive correlation (in Pearson correlation and Spearman correlation) with Dice coefficient scores reflecting the true segmentation quality.

Huayi Wang, Haochao Ying, Yuyang Xu et al.

Cancer survival analysis commonly integrates information across diverse medical modalities to make survival-time predictions. Existing methods primarily focus on extracting different decoupled features of modalities and performing fusion operations such as concatenation, attention, and MoE-based (Mixture-of-Experts) fusion. However, these methods still face two key challenges: i) Fixed fusion schemes (concatenation and attention) can lead to model over-reliance on predefined feature combinations, limiting the dynamic fusion of decoupled features; ii) in MoE-based fusion methods, each expert network handles separate decoupled features, which limits information interaction among the decoupled features. To address these challenges, we propose a novel Decoupling-Reorganization-Fusion framework (DeReF), which devises a random feature reorganization strategy between modalities decoupling and dynamic MoE fusion modules.Its advantages are: i) it increases the diversity of feature combinations and granularity, enhancing the generalization ability of the subsequent expert networks; ii) it overcomes the problem of information closure and helps expert networks better capture information among decoupled features. Additionally, we incorporate a regional cross-attention network within the modality decoupling module to improve the representation quality of decoupled features. Extensive experimental results on our in-house Liver Cancer (LC) and three widely used TCGA public datasets confirm the effectiveness of our proposed method. The code will be made publicly available.

Pengfei Gu, Haoteng Tang, Islam A. Ebeid et al.

Recent advancements in foundation models, such as the Segment Anything Model (SAM), have shown strong performance in various vision tasks, particularly image segmentation, due to their impressive zero-shot segmentation capabilities. However, effectively adapting such models for medical image classification is still a less explored topic. In this paper, we introduce a new framework to adapt SAM for medical image classification. First, we utilize the SAM image encoder as a feature extractor to capture segmentation-based features that convey important spatial and contextual details of the image, while freezing its weights to avoid unnecessary overhead during training. Next, we propose a novel Spatially Localized Channel Attention (SLCA) mechanism to compute spatially localized attention weights for the feature maps. The features extracted from SAM's image encoder are processed through SLCA to compute attention weights, which are then integrated into deep learning classification models to enhance their focus on spatially relevant or meaningful regions of the image, thus improving classification performance. Experimental results on three public medical image classification datasets demonstrate the effectiveness and data-efficiency of our approach.

Jinhong Wang, Jintai Chen, Jian Liu et al.

Ordinal regression refers to classifying object instances into ordinal categories. Ordinal regression is crucial for applications in various areas like facial age estimation, image aesthetics assessment, and even cancer staging, due to its capability to utilize ordered information effectively. More importantly, it also enhances model interpretation by considering category order, aiding the understanding of data trends and causal relationships. Despite significant recent progress, challenges remain, and further investigation of ordinal regression techniques and applications is essential to guide future research. In this survey, we present a comprehensive examination of advances and applications of ordinal regression. By introducing a systematic taxonomy, we meticulously classify the pertinent techniques and applications into three well-defined categories based on different strategies and objectives: Continuous Space Discretization, Distribution Ordering Learning, and Ambiguous Instance Delving. This categorization enables a structured exploration of diverse insights in ordinal regression problems, providing a framework for a more comprehensive understanding and evaluation of this field and its related applications. To our best knowledge, this is the first systematic survey of ordinal regression, which lays a foundation for future research in this fundamental and generic domain.

Nishchal Sapkota, Yejia Zhang, Zihao Zhao et al.

Osteochondrodysplasia, affecting 2-3% of newborns globally, is a group of bone and cartilage disorders that often result in head malformations, contributing to childhood morbidity and reduced quality of life. Current research on this disease using mouse models faces challenges since it involves accurately segmenting the developing cartilage in 3D micro-CT images of embryonic mice. Tackling this segmentation task with deep learning (DL) methods is laborious due to the big burden of manual image annotation, expensive due to the high acquisition costs of 3D micro-CT images, and difficult due to embryonic cartilage's complex and rapidly changing shapes. While DL approaches have been proposed to automate cartilage segmentation, most such models have limited accuracy and generalizability, especially across data from different embryonic age groups. To address these limitations, we propose novel DL methods that can be adopted by any DL architectures -- including CNNs, Transformers, or hybrid models -- which effectively leverage age and spatial information to enhance model performance. Specifically, we propose two new mechanisms, one conditioned on discrete age categories and the other on continuous image crop locations, to enable an accurate representation of cartilage shape changes across ages and local shape details throughout the cranial region. Extensive experiments on multi-age cartilage segmentation datasets show significant and consistent performance improvements when integrating our conditional modules into popular DL segmentation architectures. On average, we achieve a 1.7% Dice score increase with minimal computational overhead and a 7.5% improvement on unseen data. These results highlight the potential of our approach for developing robust, universal models capable of handling diverse datasets with limited annotated data, a key challenge in DL-based medical image analysis.

Pengfei Gu, Zihan Zhao, Hongxiao Wang et al.

The Segment Anything Model (SAM) exhibits impressive capabilities in zero-shot segmentation for natural images. Recently, SAM has gained a great deal of attention for its applications in medical image segmentation. However, to our best knowledge, no studies have shown how to harness the power of SAM for medical image classification. To fill this gap and make SAM a true ``foundation model'' for medical image analysis, it is highly desirable to customize SAM specifically for medical image classification. In this paper, we introduce SAMAug-C, an innovative augmentation method based on SAM for augmenting classification datasets by generating variants of the original images. The augmented datasets can be used to train a deep learning classification model, thereby boosting the classification performance. Furthermore, we propose a novel framework that simultaneously processes raw and SAMAug-C augmented image input, capitalizing on the complementary information that is offered by both. Experiments on three public datasets validate the effectiveness of our new approach.

Pengfei Gu, Huimin Li, Yejia Zhang et al.

Masked Autoencoders (MAEs) have been shown to be effective in pre-training Vision Transformers (ViTs) for natural and medical image analysis problems. By reconstructing missing pixel/voxel information in visible patches, a ViT encoder can aggregate contextual information for downstream tasks. But, existing MAE pre-training methods, which were specifically developed with the ViT architecture, lack the ability to capture geometric shape and spatial information, which is critical for medical image segmentation tasks. In this paper, we propose a novel extension of known MAEs for self pre-training (i.e., models pre-trained on the same target dataset) for 3D medical image segmentation. (1) We propose a new topological loss to preserve geometric shape information by computing topological signatures of both the input and reconstructed volumes, learning geometric shape information. (2) We introduce a pre-text task that predicts the positions of the centers and eight corners of 3D crops, enabling the MAE to aggregate spatial information. (3) We extend the MAE pre-training strategy to a hybrid state-of-the-art (SOTA) medical image segmentation architecture and co-pretrain it alongside the ViT. (4) We develop a fine-tuned model for downstream segmentation tasks by complementing the pre-trained ViT encoder with our pre-trained SOTA model. Extensive experiments on five public 3D segmentation datasets show the effectiveness of our new approach.

Suraj Mishra, Danny Z. Chen

Medical image segmentation using deep neural networks has been highly successful. However, the effectiveness of these networks is often limited by inadequate dense prediction and inability to extract robust features. To achieve refined dense prediction, we propose densely decoded networks (ddn), by selectively introducing 'crutch' network connections. Such 'crutch' connections in each upsampling stage of the network decoder (1) enhance target localization by incorporating high resolution features from the encoder, and (2) improve segmentation by facilitating multi-stage contextual information flow. Further, we present a training strategy based on adaptive deep supervision (ads), which exploits and adapts specific attributes of input dataset, for robust feature extraction. In particular, ads strategically locates and deploys auxiliary supervision, by matching the average input object size with the layer-wise effective receptive fields (lerf) of a network, resulting in a class of ddns. Such inclusion of 'companion objective' from a specific hidden layer, helps the model pay close attention to some distinct input-dependent features, which the network might otherwise 'ignore' during training. Our new networks and training strategy are validated on 4 diverse datasets of different modalities, demonstrating their effectiveness.

Yejia Zhang, Jingjing Zhang, Xiaomin Zha et al.

With rising male infertility, sperm head morphology classification becomes critical for accurate and timely clinical diagnosis. Recent deep learning (DL) morphology analysis methods achieve promising benchmark results, but leave performance and robustness on the table by relying on limited and possibly noisy class labels. To address this, we introduce a new DL training framework that leverages anatomical and image priors from human sperm microscopy crops to extract useful features without additional labeling cost. Our core idea is to distill sperm head information with reliably-generated pseudo-masks and unsupervised spatial prediction tasks. The predicted foreground masks from this distillation step are then leveraged to regularize and reduce image and label noise in the tuning stage. We evaluate our new approach on two public sperm datasets and achieve state-of-the-art performances (e.g. 65.9% SCIAN accuracy and 96.5% HuSHeM accuracy).

Yixuan Wu, Kuanlun Liao, Jintai Chen et al.

Computer-aided medical image segmentation has been applied widely in diagnosis and treatment to obtain clinically useful information of shapes and volumes of target organs and tissues. In the past several years, convolutional neural network (CNN) based methods (e.g., U-Net) have dominated this area, but still suffered from inadequate long-range information capturing. Hence, recent work presented computer vision Transformer variants for medical image segmentation tasks and obtained promising performances. Such Transformers model long-range dependency by computing pair-wise patch relations. However, they incur prohibitive computational costs, especially on 3D medical images (e.g., CT and MRI). In this paper, we propose a new method called Dilated Transformer, which conducts self-attention for pair-wise patch relations captured alternately in local and global scopes. Inspired by dilated convolution kernels, we conduct the global self-attention in a dilated manner, enlarging receptive fields without increasing the patches involved and thus reducing computational costs. Based on this design of Dilated Transformer, we construct a U-shaped encoder-decoder hierarchical architecture called D-Former for 3D medical image segmentation. Experiments on the Synapse and ACDC datasets show that our D-Former model, trained from scratch, outperforms various competitive CNN-based or Transformer-based segmentation models at a low computational cost without time-consuming per-training process.

Hao Zheng, Jun Han, Hongxiao Wang et al.

A large labeled dataset is a key to the success of supervised deep learning, but for medical image segmentation, it is highly challenging to obtain sufficient annotated images for model training. In many scenarios, unannotated images are abundant and easy to acquire. Self-supervised learning (SSL) has shown great potentials in exploiting raw data information and representation learning. In this paper, we propose Hierarchical Self-Supervised Learning (HSSL), a new self-supervised framework that boosts medical image segmentation by making good use of unannotated data. Unlike the current literature on task-specific self-supervised pretraining followed by supervised fine-tuning, we utilize SSL to learn task-agnostic knowledge from heterogeneous data for various medical image segmentation tasks. Specifically, we first aggregate a dataset from several medical challenges, then pre-train the network in a self-supervised manner, and finally fine-tune on labeled data. We develop a new loss function by combining contrastive loss and classification loss and pretrain an encoder-decoder architecture for segmentation tasks. Our extensive experiments show that multi-domain joint pre-training benefits downstream segmentation tasks and outperforms single-domain pre-training significantly. Compared to learning from scratch, our new method yields better performance on various tasks (e.g., +0.69% to +18.60% in Dice scores with 5% of annotated data). With limited amounts of training data, our method can substantially bridge the performance gap w.r.t. denser annotations (e.g., 10% vs.~100% of annotated data).

Suraj Mishra, Danny Z. Chen, X. Sharon Hu

Compression is a standard procedure for making convolutional neural networks (CNNs) adhere to some specific computing resource constraints. However, searching for a compressed architecture typically involves a series of time-consuming training/validation experiments to determine a good compromise between network size and performance accuracy. To address this, we propose an image complexity-guided network compression technique for biomedical image segmentation. Given any resource constraints, our framework utilizes data complexity and network architecture to quickly estimate a compressed model which does not require network training. Specifically, we map the dataset complexity to the target network accuracy degradation caused by compression. Such mapping enables us to predict the final accuracy for different network sizes, based on the computed dataset complexity. Thus, one may choose a solution that meets both the network size and segmentation accuracy requirements. Finally, the mapping is used to determine the convolutional layer-wise multiplicative factor for generating a compressed network. We conduct experiments using 5 datasets, employing 3 commonly-used CNN architectures for biomedical image segmentation as representative networks. Our proposed framework is shown to be effective for generating compressed segmentation networks, retaining up to $\approx 95\%$ of the full-sized network segmentation accuracy, and at the same time, utilizing $\approx 32x$ fewer network trainable weights (average reduction) of the full-sized networks.

Suraj Mishra, Danny Z. Chen, X. Sharon Hu

From diagnosing neovascular diseases to detecting white matter lesions, accurate tiny vessel segmentation in fundus images is critical. Promising results for accurate vessel segmentation have been known. However, their effectiveness in segmenting tiny vessels is still limited. In this paper, we study retinal vessel segmentation by incorporating tiny vessel segmentation into our framework for the overall accurate vessel segmentation. To achieve this, we propose a new deep convolutional neural network (CNN) which divides vessel segmentation into two separate objectives. Specifically, we consider the overall accurate vessel segmentation and tiny vessel segmentation as two individual objectives. Then, by exploiting the objective-dependent (homoscedastic) uncertainty, we enable the network to learn both objectives simultaneously. Further, to improve the individual objectives, we propose: (a) a vessel weight map based auxiliary loss for enhancing tiny vessel connectivity (i.e., improving tiny vessel segmentation), and (b) an enhanced encoder-decoder architecture for improved localization (i.e., for accurate vessel segmentation). Using 3 public retinal vessel segmentation datasets (CHASE_DB1, DRIVE, and STARE), we verify the superiority of our proposed framework in segmenting tiny vessels (8.3% average improvement in sensitivity) while achieving better area under the receiver operating characteristic curve (AUC) compared to state-of-the-art methods.

Jintai Chen, Bohan Yu, Biwen Lei et al.

Bone age assessment is challenging in clinical practice due to the complicated bone age assessment process. Current automatic bone age assessment methods were designed with rare consideration of the diagnostic logistics and thus may yield certain uninterpretable hidden states and outputs. Consequently, doctors can find it hard to cooperate with such models harmoniously because it is difficult to check the correctness of the model predictions. In this work, we propose a new graph-based deep learning framework for bone age assessment with hand radiographs, called Doctor Imitator (DI). The architecture of DI is designed to learn the diagnostic logistics of doctors using the scoring methods (e.g., the Tanner-Whitehouse method) for bone age assessment. Specifically, the convolutions of DI capture the local features of the anatomical regions of interest (ROIs) on hand radiographs and predict the ROI scores by our proposed Anatomy-based Group Convolution, summing up for bone age prediction. Besides, we develop a novel Dual Graph-based Attention module to compute patient-specific attention for ROI features and context attention for ROI scores. As far as we know, DI is the first automatic bone age assessment framework following the scoring methods without fully supervised hand radiographs. Experiments on hand radiographs with only bone age supervision verify that DI can achieve excellent performance with sparse parameters and provide more interpretability.

Jintai Chen, Hongyun Yu, Ruiwei Feng et al.

In clinical practice, medical image interpretation often involves multi-labeled classification, since the affected parts of a patient tend to present multiple symptoms or comorbidities. Recently, deep learning based frameworks have attained expert-level performance on medical image interpretation, which can be attributed partially to large amounts of accurate annotations. However, manually annotating massive amounts of medical images is impractical, while automatic annotation is fast but imprecise (possibly introducing corrupted labels). In this work, we propose a new regularization approach, called Flow-Mixup, for multi-labeled medical image classification with corrupted labels. Flow-Mixup guides the models to capture robust features for each abnormality, thus helping handle corrupted labels effectively and making it possible to apply automatic annotation. Specifically, Flow-Mixup decouples the extracted features by adding constraints to the hidden states of the models. Also, Flow-Mixup is more stable and effective comparing to other known regularization methods, as shown by theoretical and empirical analyses. Experiments on two electrocardiogram datasets and a chest X-ray dataset containing corrupted labels verify that Flow-Mixup is effective and insensitive to corrupted labels.