Image and Video Processing (eess.IV)

Abstract: Medical imaging informatics is a rapidly growing field that combines the principles of medical imaging and informatics to improve the acquisition, management, and interpretation of medical images. This chapter introduces the basic concepts of medical imaging informatics, including image processing, feature engineering, and machine learning. It also discusses the recent advancements in computer vision and deep learning technologies and how they are used to develop new quantitative image markers and prediction models for disease detection, diagnosis, and prognosis prediction. By covering the basic knowledge of medical imaging informatics, this chapter provides a foundation for understanding the role of informatics in medicine and its potential impact on patient care.

Abstract: In recent years, "U-shaped" neural networks featuring encoder and decoder structures have gained popularity in the field of medical image segmentation. Various variants of this model have been developed. Nevertheless, the evaluation of these models has received less attention compared to model development. In response, we propose a comprehensive method for evaluating medical image segmentation models for multi-indicator and multi-organ (named MIMO). MIMO allows models to generate independent thresholds which are then combined with multi-indicator evaluation and confidence estimation to screen and measure each organ. As a result, MIMO offers detailed information on the segmentation of each organ in each sample, thereby aiding developers in analyzing and improving the model. Additionally, MIMO can produce concise usability and comprehensiveness scores for different models. Models with higher scores are deemed to be excellent models, which is convenient for clinical evaluation. Our research tests eight different medical image segmentation models on two abdominal multi-organ datasets and evaluates them from four perspectives: correctness, confidence estimation, Usable Region and MIMO. Furthermore, robustness experiments are tested. Experimental results demonstrate that MIMO offers novel insights into multi-indicator and multi-organ medical image evaluation and provides a specific and concise measure for the usability and comprehensiveness of the model. Code: https://github.com/SCUT-ML-GUO/MIMO

Abstract: Fully-supervised polyp segmentation has accomplished significant triumphs over the years in advancing the early diagnosis of colorectal cancer. However, label-efficient solutions from weak supervision like scribbles are rarely explored yet primarily meaningful and demanding in medical practice due to the expensiveness and scarcity of densely-annotated polyp data. Besides, various deployment issues, including data shifts and corruption, put forward further requests for model generalization and robustness. To address these concerns, we design a framework of Spatial-Spectral Dual-branch Mutual Teaching and Entropy-guided Pseudo Label Ensemble Learning (S$^2$ME). Concretely, for the first time in weakly-supervised medical image segmentation, we promote the dual-branch co-teaching framework by leveraging the intrinsic complementarity of features extracted from the spatial and spectral domains and encouraging cross-space consistency through collaborative optimization. Furthermore, to produce reliable mixed pseudo labels, which enhance the effectiveness of ensemble learning, we introduce a novel adaptive pixel-wise fusion technique based on the entropy guidance from the spatial and spectral branches. Our strategy efficiently mitigates the deleterious effects of uncertainty and noise present in pseudo labels and surpasses previous alternatives in terms of efficacy. Ultimately, we formulate a holistic optimization objective to learn from the hybrid supervision of scribbles and pseudo labels. Extensive experiments and evaluation on four public datasets demonstrate the superiority of our method regarding in-distribution accuracy, out-of-distribution generalization, and robustness, highlighting its promising clinical significance. Our code is available at https://github.com/lofrienger/S2ME.

Abstract: Structural MRI(S-MRI) is one of the most versatile imaging modality that revolutionized the anatomical study of brain in past decades. The corpus callosum (CC) is the principal white matter fibre tract, enabling all kinds of inter-hemispheric communication. Thus, subtle changes in CC might be associated with various neurological disorders. The present work proposes the potential of YOLOv5-based CC detection framework to differentiate atypical Parkinsonian disorders (PD) from healthy controls (HC). With 3 rounds of hold-out validation, mean classification accuracy of 92% is obtained using the proposed method on a proprietary dataset consisting of 20 healthy subjects and 20 cases of APDs, with an improvement of 5% over SOTA methods (CC morphometry and visual texture analysis) that used the same dataset. Subsequently, in order to incorporate the explainability of YOLO predictions, Eigen CAM based heatmap is generated for identifying the most important sub-region in CC that leads to the classification. The result of Eigen CAM showed CC mid-body as the most distinguishable sub-region in classifying APDs and HC, which is in-line with SOTA methodologies and the current prevalent understanding in medicine.

Abstract: Deep learning based automatic medical image segmentation models often suffer from domain shift, where the models trained on a source domain do not generalize well to other unseen domains. As a vision foundation model with powerful generalization capabilities, Segment Anything Model (SAM) shows potential for improving the cross-domain robustness of medical image segmentation. However, SAM and its fine-tuned models performed significantly worse in fully automatic mode compared to when given manual prompts. Upon further investigation, we discovered that the degradation in performance was related to the coupling effect of poor prompts and mask segmentation. In fully automatic mode, the presence of inevitable poor prompts (such as points outside the mask or boxes significantly larger than the mask) can significantly mislead mask generation. To address the coupling effect, we propose the decoupling SAM (DeSAM). DeSAM modifies SAM's mask decoder to decouple mask generation and prompt embeddings while leveraging pre-trained weights. We conducted experiments on publicly available prostate cross-site datasets. The results show that DeSAM improves dice score by an average of 8.96% (from 70.06% to 79.02%) compared to previous state-of-the-art domain generalization method. Moreover, DeSAM can be trained on personal devices with entry-level GPU since our approach does not rely on tuning the heavyweight image encoder. The code is publicly available at https://github.com/yifangao112/DeSAM.

Abstract: Purpose: We propose a novel contrastive learning latent space representation for MRI datasets with partially acquired scans. We show that this latent space can be utilized for accelerated MR image reconstruction. Theory and Methods: Our novel framework, referred to as COLADA (stands for Contrastive Learning for highly accelerated MR image reconstruction), maximizes the mutual information between differently accelerated images of an MRI scan by using self-supervised contrastive learning. In other words, it attempts to "pull" the latent representations of the same scan together and "push" the latent representations of other scans away. The generated MRI latent space is subsequently utilized for MR image reconstruction and the performance was assessed in comparison to several baseline deep learning reconstruction methods. Furthermore, the quality of the proposed latent space representation was analyzed using Alignment and Uniformity. Results: COLADA comprehensively outperformed other reconstruction methods with robustness to variations in undersampling patterns, pathological abnormalities, and noise in k-space during inference. COLADA proved the high quality of reconstruction on unseen data with minimal fine-tuning. The analysis of representation quality suggests that the contrastive features produced by COLADA are optimally distributed in latent space. Conclusion: To the best of our knowledge, this is the first attempt to utilize contrastive learning on differently accelerated images for MR image reconstruction. The proposed latent space representation has practical usage due to a large number of existing partially sampled datasets. This implies the possibility of exploring self-supervised contrastive learning further to enhance the latent space of MRI for image reconstruction.

Abstract: Histological staining of tissue biopsies, especially hematoxylin and eosin (H&E) staining, serves as the benchmark for disease diagnosis and comprehensive clinical assessment of tissue. However, the process is laborious and time-consuming, often limiting its usage in crucial applications such as surgical margin assessment. To address these challenges, we combine an emerging 3D quantitative phase imaging technology, termed quantitative oblique back illumination microscopy (qOBM), with an unsupervised generative adversarial network pipeline to map qOBM phase images of unaltered thick tissues (i.e., label- and slide-free) to virtually stained H&E-like (vH&E) images. We demonstrate that the approach achieves high-fidelity conversions to H&E with subcellular detail using fresh tissue specimens from mouse liver, rat gliosarcoma, and human gliomas. We also show that the framework directly enables additional capabilities such as H&E-like contrast for volumetric imaging. The quality and fidelity of the vH&E images are validated using both a neural network classifier trained on real H&E images and tested on virtual H&E images, and a user study with neuropathologists. Given its simple and low-cost embodiment and ability to provide real-time feedback in vivo, this deep learning-enabled qOBM approach could enable new workflows for histopathology with the potential to significantly save time, labor, and costs in cancer screening, detection, treatment guidance, and more.

Abstract: Diffusion MRI (dMRI) is a widely used imaging modality, but requires long scanning times to acquire high resolution datasets. By leveraging the unique geometry present within this domain, we present a novel approach to dMRI angular super-resolution that extends upon the parametric continuous convolution (PCConv) framework. We introduce several additions to the operation including a Fourier feature mapping, global coordinates, and domain specific context. Using this framework, we build a fully parametric continuous convolution network (PCCNN) and compare against existing models. We demonstrate the PCCNN performs competitively while using significantly less parameters. Moreover, we show that this formulation generalises well to clinically relevant downstream analyses such as fixel-based analysis, and neurite orientation dispersion and density imaging.

Abstract: AI models have shown promise in many medical imaging tasks. However, our ability to explain what signals these models have learned is severely lacking. Explanations are needed in order to increase the trust in AI-based models, and could enable novel scientific discovery by uncovering signals in the data that are not yet known to experts. In this paper, we present a method for automatic visual explanations leveraging team-based expertise by generating hypotheses of what visual signals in the images are correlated with the task. We propose the following 4 steps: (i) Train a classifier to perform a given task (ii) Train a classifier guided StyleGAN-based image generator (StylEx) (iii) Automatically detect and visualize the top visual attributes that the classifier is sensitive towards (iv) Formulate hypotheses for the underlying mechanisms, to stimulate future research. Specifically, we present the discovered attributes to an interdisciplinary panel of experts so that hypotheses can account for social and structural determinants of health. We demonstrate results on eight prediction tasks across three medical imaging modalities: retinal fundus photographs, external eye photographs, and chest radiographs. We showcase examples of attributes that capture clinically known features, confounders that arise from factors beyond physiological mechanisms, and reveal a number of physiologically plausible novel attributes. Our approach has the potential to enable researchers to better understand, improve their assessment, and extract new knowledge from AI-based models. Importantly, we highlight that attributes generated by our framework can capture phenomena beyond physiology or pathophysiology, reflecting the real world nature of healthcare delivery and socio-cultural factors. Finally, we intend to release code to enable researchers to train their own StylEx models and analyze their predictive tasks.

Abstract: The ability to dynamically extend a model to new data and classes is critical for multiple organ and tumor segmentation. However, due to privacy regulations, accessing previous data and annotations can be problematic in the medical domain. This poses a significant barrier to preserving the high segmentation accuracy of the old classes when learning from new classes because of the catastrophic forgetting problem. In this paper, we first empirically demonstrate that simply using high-quality pseudo labels can fairly mitigate this problem in the setting of organ segmentation. Furthermore, we put forward an innovative architecture designed specifically for continuous organ and tumor segmentation, which incurs minimal computational overhead. Our proposed design involves replacing the conventional output layer with a suite of lightweight, class-specific heads, thereby offering the flexibility to accommodate newly emerging classes. These heads enable independent predictions for newly introduced and previously learned classes, effectively minimizing the impact of new classes on old ones during the course of continual learning. We further propose incorporating Contrastive Language-Image Pretraining (CLIP) embeddings into the organ-specific heads. These embeddings encapsulate the semantic information of each class, informed by extensive image-text co-training. The proposed method is evaluated on both in-house and public abdominal CT datasets under organ and tumor segmentation tasks. Empirical results suggest that the proposed design improves the segmentation performance of a baseline neural network on newly-introduced and previously-learned classes along the learning trajectory.