Denoising Diffusion Models (DDMs) have become the leading generative technique for synthesizing high-quality images but are often constrained by their UNet-based architectures that impose certain limitations. In particular, the considerable size of often hundreds of millions of parameters makes them impractical when hardware resources are limited. However, even with powerful hardware, processing images in the gigapixel range is difficult. This is especially true in fields such as microscopy or satellite imaging, where such challenges arise from the limitation to a predefined generative size and the inefficient scaling to larger images. We present two variations of Neural Cellular Automata (NCA)-based DDM methods to address these challenges and jumpstart NCA-based DDMs: Diff-NCA and FourierDiff-NCA. Diff-NCA performs diffusion by using only local features of the underlying distribution, making it suitable for applications where local features are critical. To communicate global knowledge in image space, naive NCA setups require timesteps that increase with the image scale. We solve this bottleneck of current NCA architectures by introducing FourierDiff-NCA, which advances Diff-NCA by adding a Fourier-based diffusion process and combines the frequency-organized Fourier space with the image space. By initiating diffusion in the Fourier domain and finalizing it in the image space, FourierDiff-NCA accelerates global communication. We validate our techniques by using Diff-NCA (208k parameters) to generate high-resolution digital pathology scans at 576x576 resolution and FourierDiff-NCA (887k parameters) to synthesize CelebA images at 64x64, outperforming VNCA and five times bigger UNet-based DDMs. In addition, we demonstrate FourierDiff-NCA's capabilities in super-resolution, OOD image synthesis, and inpainting without additional training.
Continual learning (CL) methods designed for natural image classification often fail to reach basic quality standards for medical image segmentation. Atlas-based segmentation, a well-established approach in medical imaging, incorporates domain knowledge on the region of interest, leading to semantically coherent predictions. This is especially promising for CL, as it allows us to leverage structural information and strike an optimal balance between model rigidity and plasticity over time. When combined with privacy-preserving prototypes, this process offers the advantages of rehearsal-based CL without compromising patient privacy. We propose Atlas Replay, an atlas-based segmentation approach that uses prototypes to generate high-quality segmentation masks through image registration that maintain consistency even as the training distribution changes. We explore how our proposed method performs compared to state-of-the-art CL methods in terms of knowledge transferability across seven publicly available prostate segmentation datasets. Prostate segmentation plays a vital role in diagnosing prostate cancer, however, it poses challenges due to substantial anatomical variations, benign structural differences in older age groups, and fluctuating acquisition parameters. Our results show that Atlas Replay is both robust and generalizes well to yet-unseen domains while being able to maintain knowledge, unlike end-to-end segmentation methods. Our code base is available under https://github.com/MECLabTUDA/Atlas-Replay.
Traditional initialisation methods, e.g. He and Xavier, have been effective in avoiding the problem of vanishing or exploding gradients in neural networks. However, they only use simple pointwise distributions, which model one-dimensional variables. Moreover, they ignore most information about the architecture and disregard past training experiences. These limitations can be overcome by employing generative models for initialisation. In this paper, we introduce two groups of new initialisation methods. First, we locally initialise weight groups by employing variational autoencoders. Secondly, we globally initialise full weight sets by employing graph hypernetworks. We thoroughly evaluate the impact of the employed generative models on state-of-the-art neural networks in terms of accuracy, convergence speed and ensembling. Our results show that global initialisations result in higher accuracy and faster initial convergence speed. However, the implementation through graph hypernetworks leads to diminished ensemble performance on out of distribution data. To counteract, we propose a modification called noise graph hypernetwork, which encourages diversity in the produced ensemble members. Furthermore, our approach might be able to transfer learned knowledge to different image distributions. Our work provides insights into the potential, the trade-offs and possible modifications of these new initialisation methods.
Medical imaging plays a critical role in the diagnosis and treatment planning of various medical conditions, with radiology and pathology heavily reliant on precise image segmentation. The Segment Anything Model (SAM) has emerged as a promising framework for addressing segmentation challenges across different domains. In this white paper, we delve into SAM, breaking down its fundamental components and uncovering the intricate interactions between them. We also explore the fine-tuning of SAM and assess its profound impact on the accuracy and reliability of segmentation results, focusing on applications in radiology (specifically, brain tumor segmentation) and pathology (specifically, breast cancer segmentation). Through a series of carefully designed experiments, we analyze SAM's potential application in the field of medical imaging. We aim to bridge the gap between advanced segmentation techniques and the demanding requirements of healthcare, shedding light on SAM's transformative capabilities.
Medical image segmentation relies heavily on large-scale deep learning models, such as UNet-based architectures. However, the real-world utility of such models is limited by their high computational requirements, which makes them impractical for resource-constrained environments such as primary care facilities and conflict zones. Furthermore, shifts in the imaging domain can render these models ineffective and even compromise patient safety if such errors go undetected. To address these challenges, we propose M3D-NCA, a novel methodology that leverages Neural Cellular Automata (NCA) segmentation for 3D medical images using n-level patchification. Moreover, we exploit the variance in M3D-NCA to develop a novel quality metric which can automatically detect errors in the segmentation process of NCAs. M3D-NCA outperforms the two magnitudes larger UNet models in hippocampus and prostate segmentation by 2% Dice and can be run on a Raspberry Pi 4 Model B (2GB RAM). This highlights the potential of M3D-NCA as an effective and efficient alternative for medical image segmentation in resource-constrained environments.
Federated and Continual Learning have emerged as potential paradigms for the robust and privacy-aware use of Deep Learning in dynamic environments. However, Client Drift and Catastrophic Forgetting are fundamental obstacles to guaranteeing consistent performance. Existing work only addresses these problems separately, which neglects the fact that the root cause behind both forms of performance deterioration is connected. We propose a unified analysis framework for building a controlled test environment for Client Drift -- by perturbing a defined ratio of clients -- and Catastrophic Forgetting -- by shifting all clients with a particular strength. Our framework further leverages this new combined analysis by generating a 3D landscape of the combined performance impact from both. We demonstrate that the performance drop through Client Drift, caused by a certain share of shifted clients, is correlated to the drop from Catastrophic Forgetting resulting from a corresponding shift strength. Correlation tests between both problems for Computer Vision (CelebA) and Medical Imaging (PESO) support this new perspective, with an average Pearson rank correlation coefficient of over 0.94. Our framework's novel ability of combined spatio-temporal shift analysis allows us to investigate how both forms of distribution shift behave in mixed scenarios, opening a new pathway for better generalization. We show that a combination of moderate Client Drift and Catastrophic Forgetting can even improve the performance of the resulting model (causing a "Generalization Bump") compared to when only one of the shifts occurs individually. We apply a simple and commonly used method from Continual Learning in the federated setting and observe this phenomenon to be reoccurring, leveraging the ability of our framework to analyze existing and novel methods for Federated and Continual Learning.
Cataract surgery is a frequently performed procedure that demands automation and advanced assistance systems. However, gathering and annotating data for training such systems is resource intensive. The publicly available data also comprises severe imbalances inherent to the surgical process. Motivated by this, we analyse cataract surgery video data for the worst-performing phases of a pre-trained downstream tool classifier. The analysis demonstrates that imbalances deteriorate the classifier's performance on underrepresented cases. To address this challenge, we utilise a conditional generative model based on Denoising Diffusion Implicit Models (DDIM) and Classifier-Free Guidance (CFG). Our model can synthesise diverse, high-quality examples based on complex multi-class multi-label conditions, such as surgical phases and combinations of surgical tools. We affirm that the synthesised samples display tools that the classifier recognises. These samples are hard to differentiate from real images, even for clinical experts with more than five years of experience. Further, our synthetically extended data can improve the data sparsity problem for the downstream task of tool classification. The evaluations demonstrate that the model can generate valuable unseen examples, allowing the tool classifier to improve by up to 10% for rare cases. Overall, our approach can facilitate the development of automated assistance systems for cataract surgery by providing a reliable source of realistic synthetic data, which we make available for everyone.
Access to the proper infrastructure is critical when performing medical image segmentation with Deep Learning. This requirement makes it difficult to run state-of-the-art segmentation models in resource-constrained scenarios like primary care facilities in rural areas and during crises. The recently emerging field of Neural Cellular Automata (NCA) has shown that locally interacting one-cell models can achieve competitive results in tasks such as image generation or segmentations in low-resolution inputs. However, they are constrained by high VRAM requirements and the difficulty of reaching convergence for high-resolution images. To counteract these limitations we propose Med-NCA, an end-to-end NCA training pipeline for high-resolution image segmentation. Our method follows a two-step process. Global knowledge is first communicated between cells across the downscaled image. Following that, patch-based segmentation is performed. Our proposed Med-NCA outperforms the classic UNet by 2% and 3% Dice for hippocampus and prostate segmentation, respectively, while also being 500 times smaller. We also show that Med-NCA is by design invariant with respect to image scale, shape and translation, experiencing only slight performance degradation even with strong shifts; and is robust against MRI acquisition artefacts. Med-NCA enables high-resolution medical image segmentation even on a Raspberry Pi B+, arguably the smallest device able to run PyTorch and that can be powered by a standard power bank.
Automatic intracranial hemorrhage segmentation in 3D non-contrast head CT (NCCT) scans is significant in clinical practice. Existing hemorrhage segmentation methods usually ignores the anisotropic nature of the NCCT, and are evaluated on different in-house datasets with distinct metrics, making it highly challenging to improve segmentation performance and perform objective comparisons among different methods. The INSTANCE 2022 was a grand challenge held in conjunction with the 2022 International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI). It is intended to resolve the above-mentioned problems and promote the development of both intracranial hemorrhage segmentation and anisotropic data processing. The INSTANCE released a training set of 100 cases with ground-truth and a validation set with 30 cases without ground-truth labels that were available to the participants. A held-out testing set with 70 cases is utilized for the final evaluation and ranking. The methods from different participants are ranked based on four metrics, including Dice Similarity Coefficient (DSC), Hausdorff Distance (HD), Relative Volume Difference (RVD) and Normalized Surface Dice (NSD). A total of 13 teams submitted distinct solutions to resolve the challenges, making several baseline models, pre-processing strategies and anisotropic data processing techniques available to future researchers. The winner method achieved an average DSC of 0.6925, demonstrating a significant growth over our proposed baseline method. To the best of our knowledge, the proposed INSTANCE challenge releases the first intracranial hemorrhage segmentation benchmark, and is also the first challenge that intended to resolve the anisotropic problem in 3D medical image segmentation, which provides new alternatives in these research fields.