Learning towards Synchronous Network Memorizability and Generalizability for Continual Segmentation across Multiple Sites

In clinical practice, a segmentation network is often required to continually learn on a sequential data stream from multiple sites rather than a consolidated set, due to the storage cost and privacy restriction. However, during the continual learning process, existing methods are usually restricted in either network memorizability on previous sites or generalizability on unseen sites. This paper aims to tackle the challenging problem of Synchronous Memorizability and Generalizability (SMG) and to simultaneously improve performance on both previous and unseen sites, with a novel proposed SMG-learning framework. First, we propose a Synchronous Gradient Alignment (SGA) objective, which \emph{not only} promotes the network memorizability by enforcing coordinated optimization for a small exemplar set from previous sites (called replay buffer), \emph{but also} enhances the generalizability by facilitating site-invariance under simulated domain shift. Second, to simplify the optimization of SGA objective, we design a Dual-Meta algorithm that approximates the SGA objective as dual meta-objectives for optimization without expensive computation overhead. Third, for efficient rehearsal, we configure the replay buffer comprehensively considering additional inter-site diversity to reduce redundancy. Experiments on prostate MRI data sequentially acquired from six institutes demonstrate that our method can simultaneously achieve higher memorizability and generalizability over state-of-the-art methods. Code is available at https://github.com/jingyzhang/SMG-Learning.

Eye-gaze-guided Vision Transformer for Rectifying Shortcut Learning

Learning harmful shortcuts such as spurious correlations and biases prevents deep neural networks from learning the meaningful and useful representations, thus jeopardizing the generalizability and interpretability of the learned representation. The situation becomes even more serious in medical imaging, where the clinical data (e.g., MR images with pathology) are limited and scarce while the reliability, generalizability and transparency of the learned model are highly required. To address this problem, we propose to infuse human experts' intelligence and domain knowledge into the training of deep neural networks. The core idea is that we infuse the visual attention information from expert radiologists to proactively guide the deep model to focus on regions with potential pathology and avoid being trapped in learning harmful shortcuts. To do so, we propose a novel eye-gaze-guided vision transformer (EG-ViT) for diagnosis with limited medical image data. We mask the input image patches that are out of the radiologists' interest and add an additional residual connection in the last encoder layer of EG-ViT to maintain the correlations of all patches. The experiments on two public datasets of INbreast and SIIM-ACR demonstrate our EG-ViT model can effectively learn/transfer experts' domain knowledge and achieve much better performance than baselines. Meanwhile, it successfully rectifies the harmful shortcut learning and significantly improves the EG-ViT model's interpretability. In general, EG-ViT takes the advantages of both human expert's prior knowledge and the power of deep neural networks. This work opens new avenues for advancing current artificial intelligence paradigms by infusing human intelligence.

Semi-Cycled Generative Adversarial Networks for Real-World Face Super-Resolution

Real-world face super-resolution (SR) is a highly ill-posed image restoration task. The fully-cycled Cycle-GAN architecture is widely employed to achieve promising performance on face SR, but prone to produce artifacts upon challenging cases in real-world scenarios, since joint participation in the same degradation branch will impact final performance due to huge domain gap between real-world and synthetic LR ones obtained by generators. To better exploit the powerful generative capability of GAN for real-world face SR, in this paper, we establish two independent degradation branches in the forward and backward cycle-consistent reconstruction processes, respectively, while the two processes share the same restoration branch. Our Semi-Cycled Generative Adversarial Networks (SCGAN) is able to alleviate the adverse effects of the domain gap between the real-world LR face images and the synthetic LR ones, and to achieve accurate and robust face SR performance by the shared restoration branch regularized by both the forward and backward cycle-consistent learning processes. Experiments on two synthetic and two real-world datasets demonstrate that, our SCGAN outperforms the state-of-the-art methods on recovering the face structures/details and quantitative metrics for real-world face SR. The code will be publicly released at https://github.com/HaoHou-98/SCGAN.

Two-Stream Graph Convolutional Network for Intra-oral Scanner Image Segmentation

Precise segmentation of teeth from intra-oral scanner images is an essential task in computer-aided orthodontic surgical planning. The state-of-the-art deep learning-based methods often simply concatenate the raw geometric attributes (i.e., coordinates and normal vectors) of mesh cells to train a single-stream network for automatic intra-oral scanner image segmentation. However, since different raw attributes reveal completely different geometric information, the naive concatenation of different raw attributes at the (low-level) input stage may bring unnecessary confusion in describing and differentiating between mesh cells, thus hampering the learning of high-level geometric representations for the segmentation task. To address this issue, we design a two-stream graph convolutional network (i.e., TSGCN), which can effectively handle inter-view confusion between different raw attributes to more effectively fuse their complementary information and learn discriminative multi-view geometric representations. Specifically, our TSGCN adopts two input-specific graph-learning streams to extract complementary high-level geometric representations from coordinates and normal vectors, respectively. Then, these single-view representations are further fused by a self-attention module to adaptively balance the contributions of different views in learning more discriminative multi-view representations for accurate and fully automatic tooth segmentation. We have evaluated our TSGCN on a real-patient dataset of dental (mesh) models acquired by 3D intraoral scanners. Experimental results show that our TSGCN significantly outperforms state-of-the-art methods in 3D tooth (surface) segmentation. Github: https://github.com/ZhangLingMing1/TSGCNet.

A Long Short-term Memory Based Recurrent Neural Network for Interventional MRI Reconstruction

Interventional magnetic resonance imaging (i-MRI) for surgical guidance could help visualize the interventional process such as deep brain stimulation (DBS), improving the surgery performance and patient outcome. Different from retrospective reconstruction in conventional dynamic imaging, i-MRI for DBS has to acquire and reconstruct the interventional images sequentially online. Here we proposed a convolutional long short-term memory (Conv-LSTM) based recurrent neural network (RNN), or ConvLR, to reconstruct interventional images with golden-angle radial sampling. By using an initializer and Conv-LSTM blocks, the priors from the pre-operative reference image and intra-operative frames were exploited for reconstructing the current frame. Data consistency for radial sampling was implemented by a soft-projection method. To improve the reconstruction accuracy, an adversarial learning strategy was adopted. A set of interventional images based on the pre-operative and post-operative MR images were simulated for algorithm validation. Results showed with only 10 radial spokes, ConvLR provided the best performance compared with state-of-the-art methods, giving an acceleration up to 40 folds. The proposed algorithm has the potential to achieve real-time i-MRI for DBS and can be used for general purpose MR-guided intervention.

Follow My Eye: Using Gaze to Supervise Computer-Aided Diagnosis

When deep neural network (DNN) was first introduced to the medical image analysis community, researchers were impressed by its performance. However, it is evident now that a large number of manually labeled data is often a must to train a properly functioning DNN. This demand for supervision data and labels is a major bottleneck in current medical image analysis, since collecting a large number of annotations from experienced experts can be time-consuming and expensive. In this paper, we demonstrate that the eye movement of radiologists reading medical images can be a new form of supervision to train the DNN-based computer-aided diagnosis (CAD) system. Particularly, we record the tracks of the radiologists' gaze when they are reading images. The gaze information is processed and then used to supervise the DNN's attention via an Attention Consistency module. To the best of our knowledge, the above pipeline is among the earliest efforts to leverage expert eye movement for deep-learning-based CAD. We have conducted extensive experiments on knee X-ray images for osteoarthritis assessment. The results show that our method can achieve considerable improvement in diagnosis performance, with the help of gaze supervision.

Transformers in Medical Image Analysis: A Review

Transformers have dominated the field of natural language processing, and recently impacted the computer vision area. In the field of medical image analysis, Transformers have also been successfully applied to full-stack clinical applications, including image synthesis/reconstruction, registration, segmentation, detection, and diagnosis. Our paper presents both a position paper and a primer, promoting awareness and application of Transformers in the field of medical image analysis. Specifically, we first overview the core concepts of the attention mechanism built into Transformers and other basic components. Second, we give a new taxonomy of various Transformer architectures tailored for medical image applications and discuss their limitations. Within this review, we investigate key challenges revolving around the use of Transformers in different learning paradigms, improving the model efficiency, and their coupling with other techniques. We hope this review can give a comprehensive picture of Transformers to the readers in the field of medical image analysis.

Knee Cartilage Defect Assessment by Graph Representation and Surface Convolution

Knee osteoarthritis (OA) is the most common osteoarthritis and a leading cause of disability. Cartilage defects are regarded as major manifestations of knee OA, which are visible by magnetic resonance imaging (MRI). Thus early detection and assessment for knee cartilage defects are important for protecting patients from knee OA. In this way, many attempts have been made on knee cartilage defect assessment by applying convolutional neural networks (CNNs) to knee MRI. However, the physiologic characteristics of the cartilage may hinder such efforts: the cartilage is a thin curved layer, implying that only a small portion of voxels in knee MRI can contribute to the cartilage defect assessment; heterogeneous scanning protocols further challenge the feasibility of the CNNs in clinical practice; the CNN-based knee cartilage evaluation results lack interpretability. To address these challenges, we model the cartilages structure and appearance from knee MRI into a graph representation, which is capable of handling highly diverse clinical data. Then, guided by the cartilage graph representation, we design a non-Euclidean deep learning network with the self-attention mechanism, to extract cartilage features in the local and global, and to derive the final assessment with a visualized result. Our comprehensive experiments show that the proposed method yields superior performance in knee cartilage defect assessment, plus its convenient 3D visualization for interpretability.

Domain Generalization for Mammography Detection via Multi-style and Multi-view Contrastive Learning

Lesion detection is a fundamental problem in the computer-aided diagnosis scheme for mammography. The advance of deep learning techniques have made a remarkable progress for this task, provided that the training data are large and sufficiently diverse in terms of image style and quality. In particular, the diversity of image style may be majorly attributed to the vendor factor. However, the collection of mammograms from vendors as many as possible is very expensive and sometimes impractical for laboratory-scale studies. Accordingly, to further augment the generalization capability of deep learning model to various vendors with limited resources, a new contrastive learning scheme is developed. Specifically, the backbone network is firstly trained with a multi-style and multi-view unsupervised self-learning scheme for the embedding of invariant features to various vendor-styles. Afterward, the backbone network is then recalibrated to the downstream task of lesion detection with the specific supervised learning. The proposed method is evaluated with mammograms from four vendors and one unseen public dataset. The experimental results suggest that our approach can effectively improve detection performance on both seen and unseen domains, and outperforms many state-of-the-art (SOTA) generalization methods.

Fast T2w/FLAIR MRI Acquisition by Optimal Sampling of Information Complementary to Pre-acquired T1w MRI

Recent studies on T1-assisted MRI reconstruction for under-sampled images of other modalities have demonstrated the potential of further accelerating MRI acquisition of other modalities. Most of the state-of-the-art approaches have achieved improvement through the development of network architectures for fixed under-sampling patterns, without fully exploiting the complementary information between modalities. Although existing under-sampling pattern learning algorithms can be simply modified to allow the fully-sampled T1-weighted MR image to assist the pattern learning, no significant improvement on the reconstruction task can be achieved. To this end, we propose an iterative framework to optimize the under-sampling pattern for MRI acquisition of another modality that can complement the fully-sampled T1-weighted MR image at different under-sampling factors, while jointly optimizing the T1-assisted MRI reconstruction model. Specifically, our proposed method exploits the difference of latent information between the two modalities for determining the sampling patterns that can maximize the assistance power of T1-weighted MR image in improving the MRI reconstruction. We have demonstrated superior performance of our learned under-sampling patterns on a public dataset, compared to commonly used under-sampling patterns and state-of-the-art methods that can jointly optimize both the reconstruction network and the under-sampling pattern, up to 8-fold under-sampling factor.