Unsupervised Polychromatic Neural Representation for CT Metal Artifact Reduction

Emerging neural reconstruction techniques based on tomography (e.g., NeRF, NeAT, and NeRP) have started showing unique capabilities in medical imaging. In this work, we present a novel Polychromatic neural representation (Polyner) to tackle the challenging problem of CT imaging when metallic implants exist within the human body. The artifacts arise from the drastic variation of metal's attenuation coefficients at various energy levels of the X-ray spectrum, leading to a nonlinear metal effect in CT measurements. Reconstructing CT images from metal-affected measurements hence poses a complicated nonlinear inverse problem where empirical models adopted in previous metal artifact reduction (MAR) approaches lead to signal loss and strongly aliased reconstructions. Polyner instead models the MAR problem from a nonlinear inverse problem perspective. Specifically, we first derive a polychromatic forward model to accurately simulate the nonlinear CT acquisition process. Then, we incorporate our forward model into the implicit neural representation to accomplish reconstruction. Lastly, we adopt a regularizer to preserve the physical properties of the CT images across different energy levels while effectively constraining the solution space. Our Polyner is an unsupervised method and does not require any external training data. Experimenting with multiple datasets shows that our Polyner achieves comparable or better performance than supervised methods on in-domain datasets while demonstrating significant performance improvements on out-of-domain datasets. To the best of our knowledge, our Polyner is the first unsupervised MAR method that outperforms its supervised counterparts.

RetinexFlow for CT metal artifact reduction

Metal artifacts is a major challenge in computed tomography (CT) imaging, significantly degrading image quality and making accurate diagnosis difficult. However, previous methods either require prior knowledge of the location of metal implants, or have modeling deviations with the mechanism of artifact formation, which limits the ability to obtain high-quality CT images. In this work, we formulate metal artifacts reduction problem as a combination of decomposition and completion tasks. And we propose RetinexFlow, which is a novel end-to-end image domain model based on Retinex theory and conditional normalizing flow, to solve it. Specifically, we first design a feature decomposition encoder for decomposing the metal implant component and inherent component, and extracting the inherent feature. Then, it uses a feature-to-image flow module to complete the metal artifact-free CT image step by step through a series of invertible transformations. These designs are incorporated in our model with a coarse-to-fine strategy, enabling it to achieve superior performance. The experimental results on on simulation and clinical datasets show our method achieves better quantitative and qualitative results, exhibiting better visual performance in artifact removal and image fidelity

Visual-Linguistic Causal Intervention for Radiology Report Generation

Automatic radiology report generation is essential for computer-aided diagnosis and medication guidance. Importantly, automatic radiology report generation (RRG) can relieve the heavy burden of radiologists by generating medical reports automatically from visual-linguistic data relations. However, due to the spurious correlations within image-text data induced by visual and linguistic biases, it is challenging to generate accurate reports that reliably describe abnormalities. Besides, the cross-modal confounder is usually unobservable and difficult to be eliminated explicitly. In this paper, we mitigate the cross-modal data bias for RRG from a new perspective, i.e., visual-linguistic causal intervention, and propose a novel Visual-Linguistic Causal Intervention (VLCI) framework for RRG, which consists of a visual deconfounding module (VDM) and a linguistic deconfounding module (LDM), to implicitly deconfound the visual-linguistic confounder by causal front-door intervention. Specifically, the VDM explores and disentangles the visual confounder from the patch-based local and global features without object detection due to the absence of universal clinic semantic extraction. Simultaneously, the LDM eliminates the linguistic confounder caused by salient visual features and high-frequency context without constructing specific dictionaries. Extensive experiments on IU-Xray and MIMIC-CXR datasets show that our VLCI outperforms the state-of-the-art RRG methods significantly. Source code and models are available at https://github.com/WissingChen/VLCI.

Active CT Reconstruction with a Learned Sampling Policy

Computed tomography (CT) is a widely-used imaging technology that assists clinical decision-making with high-quality human body representations. To reduce the radiation dose posed by CT, sparse-view and limited-angle CT are developed with preserved image quality. However, these methods are still stuck with a fixed or uniform sampling strategy, which inhibits the possibility of acquiring a better image with an even reduced dose. In this paper, we explore this possibility via learning an active sampling policy that optimizes the sampling positions for patient-specific, high-quality reconstruction. To this end, we design an \textit{intelligent agent} for active recommendation of sampling positions based on on-the-fly reconstruction with obtained sinograms in a progressive fashion. With such a design, we achieve better performances on the NIH-AAPM dataset over popular uniform sampling, especially when the number of views is small. Finally, such a design also enables RoI-aware reconstruction with improved reconstruction quality within regions of interest (RoI's) that are clinically important. Experiments on the VerSe dataset demonstrate this ability of our sampling policy, which is difficult to achieve based on uniform sampling.

Transforming medical imaging with Transformers? A comparative review of key properties, current progresses, and future perspectives

Transformer, the latest technological advance of deep learning, has gained prevalence in natural language processing or computer vision. Since medical imaging bear some resemblance to computer vision, it is natural to inquire about the status quo of Transformers in medical imaging and ask the question: can the Transformer models transform medical imaging? In this paper, we attempt to make a response to the inquiry. After a brief introduction of the fundamentals of Transformers, especially in comparison with convolutional neural networks (CNNs), and highlighting key defining properties that characterize the Transformers, we offer a comprehensive review of the state-of-the-art Transformer-based approaches for medical imaging and exhibit current research progresses made in the areas of medical image segmentation, recognition, detection, registration, reconstruction, enhancement, etc. In particular, what distinguishes our review lies in its organization based on the Transformer's key defining properties, which are mostly derived from comparing the Transformer and CNN, and its type of architecture, which specifies the manner in which the Transformer and CNN are combined, all helping the readers to best understand the rationale behind the reviewed approaches. We conclude with discussions of future perspectives.

3D endoscopic depth estimation using 3D surface-aware constraints

Robotic-assisted surgery allows surgeons to conduct precise surgical operations with stereo vision and flexible motor control. However, the lack of 3D spatial perception limits situational awareness during procedures and hinders mastering surgical skills in the narrow abdominal space. Depth estimation, as a representative perception task, is typically defined as an image reconstruction problem. In this work, we show that depth estimation can be reformed from a 3D surface perspective. We propose a loss function for depth estimation that integrates the surface-aware constraints, leading to a faster and better convergence with the valid information from spatial information. In addition, camera parameters are incorporated into the training pipeline to increase the control and transparency of the depth estimation. We also integrate a specularity removal module to recover more buried image information. Quantitative experimental results on endoscopic datasets and user studies with medical professionals demonstrate the effectiveness of our method.

Universal Segmentation of 33 Anatomies

In the paper, we present an approach for learning a single model that universally segments 33 anatomical structures, including vertebrae, pelvic bones, and abdominal organs. Our model building has to address the following challenges. Firstly, while it is ideal to learn such a model from a large-scale, fully-annotated dataset, it is practically hard to curate such a dataset. Thus, we resort to learn from a union of multiple datasets, with each dataset containing the images that are partially labeled. Secondly, along the line of partial labelling, we contribute an open-source, large-scale vertebra segmentation dataset for the benefit of spine analysis community, CTSpine1K, boasting over 1,000 3D volumes and over 11K annotated vertebrae. Thirdly, in a 3D medical image segmentation task, due to the limitation of GPU memory, we always train a model using cropped patches as inputs instead a whole 3D volume, which limits the amount of contextual information to be learned. To this, we propose a cross-patch transformer module to fuse more information in adjacent patches, which enlarges the aggregated receptive field for improved segmentation performance. This is especially important for segmenting, say, the elongated spine. Based on 7 partially labeled datasets that collectively contain about 2,800 3D volumes, we successfully learn such a universal model. Finally, we evaluate the universal model on multiple open-source datasets, proving that our model has a good generalization performance and can potentially serve as a solid foundation for downstream tasks.

DuDoTrans: Dual-Domain Transformer Provides More Attention for Sinogram Restoration in Sparse-View CT Reconstruction

While Computed Tomography (CT) reconstruction from X-ray sinograms is necessary for clinical diagnosis, iodine radiation in the imaging process induces irreversible injury, thereby driving researchers to study sparse-view CT reconstruction, that is, recovering a high-quality CT image from a sparse set of sinogram views. Iterative models are proposed to alleviate the appeared artifacts in sparse-view CT images, but the computation cost is too expensive. Then deep-learning-based methods have gained prevalence due to the excellent performances and lower computation. However, these methods ignore the mismatch between the CNN's \textbf{local} feature extraction capability and the sinogram's \textbf{global} characteristics. To overcome the problem, we propose \textbf{Du}al-\textbf{Do}main \textbf{Trans}former (\textbf{DuDoTrans}) to simultaneously restore informative sinograms via the long-range dependency modeling capability of Transformer and reconstruct CT image with both the enhanced and raw sinograms. With such a novel design, reconstruction performance on the NIH-AAPM dataset and COVID-19 dataset experimentally confirms the effectiveness and generalizability of DuDoTrans with fewer involved parameters. Extensive experiments also demonstrate its robustness with different noise-level scenarios for sparse-view CT reconstruction. The code and models are publicly available at https://github.com/DuDoTrans/CODE

CTSpine1K: A Large-Scale Dataset for Spinal Vertebrae Segmentation in Computed Tomography

Spine-related diseases have high morbidity and cause a huge burden of social cost. Spine imaging is an essential tool for noninvasively visualizing and assessing spinal pathology. Segmenting vertebrae in computed tomography (CT) images is the basis of quantitative medical image analysis for clinical diagnosis and surgery planning of spine diseases. Current publicly available annotated datasets on spinal vertebrae are small in size. Due to the lack of a large-scale annotated spine image dataset, the mainstream deep learning-based segmentation methods, which are data-driven, are heavily restricted. In this paper, we introduce a large-scale spine CT dataset, called CTSpine1K, curated from multiple sources for vertebra segmentation, which contains 1,005 CT volumes with over 11,100 labeled vertebrae belonging to different spinal conditions. Based on this dataset, we conduct several spinal vertebrae segmentation experiments to set the first benchmark. We believe that this large-scale dataset will facilitate further research in many spine-related image analysis tasks, including but not limited to vertebrae segmentation, labeling, 3D spine reconstruction from biplanar radiographs, image super-resolution, and enhancement.