Alison Pouch

Hao Li, Baris Oguz, Gabriel Arenas et al.

Placenta volume measurement from 3D ultrasound images is critical for predicting pregnancy outcomes, and manual annotation is the gold standard. However, such manual annotation is expensive and time-consuming. Automated segmentation algorithms can often successfully segment the placenta, but these methods may not consistently produce robust segmentations suitable for practical use. Recently, inspired by the Segment Anything Model (SAM), deep learning-based interactive segmentation models have been widely applied in the medical imaging domain. These models produce a segmentation from visual prompts provided to indicate the target region, which may offer a feasible solution for practical use. However, none of these models are specifically designed for interactively segmenting 3D ultrasound images, which remain challenging due to the inherent noise of this modality. In this paper, we evaluate publicly available state-of-the-art 3D interactive segmentation models in contrast to a human-in-the-loop approach for the placenta segmentation task. The Dice score, normalized surface Dice, averaged symmetric surface distance, and 95-percent Hausdorff distance are used as evaluation metrics. We consider a Dice score of 0.95 a successful segmentation. Our results indicate that the human-in-the-loop segmentation model reaches this standard. Moreover, we assess the efficiency of the human-in-the-loop model as a function of the amount of prompts. Our results demonstrate that the human-in-the-loop model is both effective and efficient for interactive placenta segmentation. The code is available at \url{https://github.com/MedICL-VU/PRISM-placenta}.

Hao Li, Baris Oguz, Gabriel Arenas et al.

Placenta volume measured from 3D ultrasound (3DUS) images is an important tool for tracking the growth trajectory and is associated with pregnancy outcomes. Manual segmentation is the gold standard, but it is time-consuming and subjective. Although fully automated deep learning algorithms perform well, they do not always yield high-quality results for each case. Interactive segmentation models could address this issue. However, there is limited work on interactive segmentation models for the placenta. Despite their segmentation accuracy, these methods may not be feasible for clinical use as they require relatively large computational power which may be especially prohibitive in low-resource environments, or on mobile devices. In this paper, we propose a lightweight interactive segmentation model aiming for clinical use to interactively segment the placenta from 3DUS images in real-time. The proposed model adopts the segmentation from our fully automated model for initialization and is designed in a human-in-the-loop manner to achieve iterative improvements. The Dice score and normalized surface Dice are used as evaluation metrics. The results show that our model can achieve superior performance in segmentation compared to state-of-the-art models while using significantly fewer parameters. Additionally, the proposed model is much faster for inference and robust to poor initial masks. The code is available at https://github.com/MedICL-VU/PRISM-placenta.

Filippos Bellos, Yutong Li, Jessie N Dong et al.

Point-of-care transthoracic echocardiography (TTE) enables cardiac assessment in virtually any clinical setting, yet its diagnostic utility remains constrained by the expertise required for image acquisition and interpretation. Visual question answering (VQA) offers a promising paradigm for bridging this expertise gap through interactive clinical assistance, but existing echocardiography VQA datasets are limited in scale, restricted to high-quality images, and only cover a few views. We introduce EchoVQA, the first large-scale VQA dataset for echocardiography, comprising 14,299 images and 74,819 question-answer pairs. The dataset integrates public sources (EchoNet-Dynamic, CAMUS) with our own point-of-care acquisitions from two handheld probes (Lumify, Clarius), spanning diverse views and including both high-quality and suboptimal images. Uniquely, EchoVQA includes acquisition guidance questions to help users optimize transducer positioning toward a diagnostic apical 4-chamber view for left ventricular ejection fraction estimation -- a challenging task for novice operators in point-of-care settings. We further develop a parameter-efficient method based on multimodal learnable prompts achieving state-of-the-art performance on most benchmarks, including EchoVQA, with significantly less trainable parameters than existing state-of-the-art approaches.

Trevor J. Chan, Aarush Sahni, Yijin Fang et al.

We introduce SAM3D, a new approach to semi-automatic zero-shot segmentation of 3D images building on the existing Segment Anything Model. We achieve fast and accurate segmentations in 3D images with a four-step strategy involving: user prompting with 3D polylines, volume slicing along multiple axes, slice-wide inference with a pretrained model, and recomposition and refinement in 3D. We evaluated SAM3D performance qualitatively on an array of imaging modalities and anatomical structures and quantify performance for specific structures in abdominal pelvic CT and brain MRI. Notably, our method achieves good performance with zero model training or finetuning, making it particularly useful for tasks with a scarcity of preexisting labeled data. By enabling users to create 3D segmentations of unseen data quickly and with dramatically reduced manual input, these methods have the potential to aid surgical planning and education, diagnostic imaging, and scientific research.

Aparna Nair-Kanneganti, Trevor J. Chan, Shir Goldfinger et al.

Despite huge advances, LLMs still lack convenient and reliable methods to quantify the uncertainty in their responses, making them difficult to trust in high-stakes applications. One of the simplest approaches to eliciting more accurate answers is to select the mode of many responses, a technique known as ensembling. In this work, we expand on typical ensembling approaches by looking at ensembles with a variable voting threshold. We introduce a theoretical framework for question answering and show that, by permitting ensembles to "abstain" from providing an answer when the dominant response falls short of the threshold, it is possible to dramatically increase the trustworthiness of the remaining answers. From this framework, we derive theoretical results as well as report experimental results on two problem domains: arithmetic problem solving and clinical-note question-answering. In both domains, we observe that large gains in answer trustworthiness can be achieved using highly restrictive voting ensembles, while incurring relatively modest reductions in response yield and accuracy. Due to this quality, voting ensembles may be particularly useful in applications - such as healthcare and data annotation - that require a high degree of certainty but which may not require that every question receive an automated answer.

Xing Yao, Runxuan Yu, Dewei Hu et al.

Ultrasound (US) image stitching can expand the field-of-view (FOV) by combining multiple US images from varied probe positions. However, registering US images with only partially overlapping anatomical contents is a challenging task. In this work, we introduce SynStitch, a self-supervised framework designed for 2DUS stitching. SynStitch consists of a synthetic stitching pair generation module (SSPGM) and an image stitching module (ISM). SSPGM utilizes a patch-conditioned ControlNet to generate realistic 2DUS stitching pairs with known affine matrix from a single input image. ISM then utilizes this synthetic paired data to learn 2DUS stitching in a supervised manner. Our framework was evaluated against multiple leading methods on a kidney ultrasound dataset, demonstrating superior 2DUS stitching performance through both qualitative and quantitative analyses. The code will be made public upon acceptance of the paper.