DVPT: Dynamic Visual Prompt Tuning of Large Pre-trained Models for Medical Image Analysis

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.

Progressive Multi-scale Consistent Network for Multi-class Fundus Lesion Segmentation

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.