Along He

Along He, Kai Wang, Tao Li et al.

Effectively integrating multi-scale information is of considerable significance for the challenging multi-class segmentation of fundus lesions because different lesions vary significantly in scales and shapes. Several methods have been proposed to successfully handle the multi-scale object segmentation. However, two issues are not considered in previous studies. The first is the lack of interaction between adjacent feature levels, and this will lead to the deviation of high-level features from low-level features and the loss of detailed cues. The second is the conflict between the low-level and high-level features, this occurs because they learn different scales of features, thereby confusing the model and decreasing the accuracy of the final prediction. In this paper, we propose a progressive multi-scale consistent network (PMCNet) that integrates the proposed progressive feature fusion (PFF) block and dynamic attention block (DAB) to address the aforementioned issues. Specifically, PFF block progressively integrates multi-scale features from adjacent encoding layers, facilitating feature learning of each layer by aggregating fine-grained details and high-level semantics. As features at different scales should be consistent, DAB is designed to dynamically learn the attentive cues from the fused features at different scales, thus aiming to smooth the essential conflicts existing in multi-scale features. The two proposed PFF and DAB blocks can be integrated with the off-the-shelf backbone networks to address the two issues of multi-scale and feature inconsistency in the multi-class segmentation of fundus lesions, which will produce better feature representation in the feature space. Experimental results on three public datasets indicate that the proposed method is more effective than recent state-of-the-art methods.

Yanlin Wu, Tao Li, Zhihong Wang et al.

U-Net is currently the most widely used architecture for medical image segmentation. Benefiting from its unique encoder-decoder architecture and skip connections, it can effectively extract features from input images to segment target regions. The commonly used U-Net is typically based on convolutional operations or Transformers, modeling the dependencies between local or global information to accomplish medical image analysis tasks. However, convolutional layers, fully connected layers, and attention mechanisms used in this process introduce a significant number of parameters, often requiring the stacking of network layers to model complex nonlinear relationships, which can impact the training process. To address these issues, we propose TransUKAN. Specifically, we have improved the KAN to reduce memory usage and computational load. On this basis, we explored an effective combination of KAN, Transformer, and U-Net structures. This approach enhances the model's capability to capture nonlinear relationships by introducing only a small number of additional parameters and compensates for the Transformer structure's deficiency in local information extraction. We validated TransUKAN on multiple medical image segmentation tasks. Experimental results demonstrate that TransUKAN achieves excellent performance with significantly reduced parameters. The code will be available athttps://github.com/wuyanlin-wyl/TransUKAN.

Along He, Kai Wang, Zhihong Wang et al.

Limited labeled data makes it hard to train models from scratch in medical domain, and an important paradigm is pre-training and then fine-tuning. Large pre-trained models contain rich representations, which can be adapted to downstream medical tasks. However, existing methods either tune all the parameters or the task-specific layers of the pre-trained models, ignoring the input variations of medical images, and thus they are not efficient or effective. In this work, we aim to study parameter-efficient fine-tuning (PEFT) for medical image analysis, and propose a dynamic visual prompt tuning method, named DVPT. It can extract knowledge beneficial to downstream tasks from large models with a few trainable parameters. Firstly, the frozen features are transformed by an lightweight bottleneck layer to learn the domain-specific distribution of downstream medical tasks, and then a few learnable visual prompts are used as dynamic queries and then conduct cross-attention with the transformed features, attempting to acquire sample-specific knowledge that are suitable for each sample. Finally, the features are projected to original feature dimension and aggregated with the frozen features. This DVPT module can be shared between different Transformer layers, further reducing the trainable parameters. To validate DVPT, we conduct extensive experiments with different pre-trained models on medical classification and segmentation tasks. We find such PEFT method can not only efficiently adapt the pre-trained models to the medical domain, but also brings data efficiency with partial labeled data. For example, with 0.5\% extra trainable parameters, our method not only outperforms state-of-the-art PEFT methods, even surpasses the full fine-tuning by more than 2.20\% Kappa score on medical classification task. It can saves up to 60\% labeled data and 99\% storage cost of ViT-B/16.

Zhenhuan Zhou, Along He, Yanlin Wu et al.

In medical images, various types of lesions often manifest significant differences in their shape and texture. Accurate medical image segmentation demands deep learning models with robust capabilities in multi-scale and boundary feature learning. However, previous networks still have limitations in addressing the above issues. Firstly, previous networks simultaneously fuse multi-level features or employ deep supervision to enhance multi-scale learning. However, this may lead to feature redundancy and excessive computational overhead, which is not conducive to network training and clinical deployment. Secondly, the majority of medical image segmentation networks exclusively learn features in the spatial domain, disregarding the abundant global information in the frequency domain. This results in a bias towards low-frequency components, neglecting crucial high-frequency information. To address these problems, we introduce SF-UNet, a spatial-frequency dual-domain attention network. It comprises two main components: the Multi-scale Progressive Channel Attention (MPCA) block, which progressively extract multi-scale features across adjacent encoder layers, and the lightweight Frequency-Spatial Attention (FSA) block, with only 0.05M parameters, enabling concurrent learning of texture and boundary features from both spatial and frequency domains. We validate the effectiveness of the proposed SF-UNet on three public datasets. Experimental results show that compared to previous state-of-the-art (SOTA) medical image segmentation networks, SF-UNet achieves the best performance, and achieves up to 9.4\% and 10.78\% improvement in DSC and IOU. Codes will be released at https://github.com/nkicsl/SF-UNet.

Bo Liu, Xiangyu Zhao, Along He et al.

Medical visual question answering aims to support clinical decision-making by enabling models to answer natural language questions based on medical images. While recent advances in multi-modal learning have significantly improved performance, current methods still suffer from limited answer reliability and poor interpretability, impairing the ability of clinicians and patients to understand and trust model outputs. To address these limitations, this work first proposes a Region-Aware Multimodal Chain-of-Thought (RMCoT) dataset, in which the process of producing an answer is preceded by a sequence of intermediate reasoning steps that explicitly ground relevant visual regions of the medical image, thereby providing fine-grained explainability. Furthermore, we introduce a novel verifiable reward mechanism for reinforcement learning to guide post-training, improving the alignment between the model's reasoning process and its final answer. Remarkably, our method achieves comparable performance using only one-eighth of the training data, demonstrating the efficiency and effectiveness of the proposal. The dataset is available at https://www.med-vqa.com/GEMeX/.