Democratizing Artificial Intelligence in Healthcare: A Study of Model Development Across Two Institutions Incorporating Transfer Learning

The training of deep learning models typically requires extensive data, which are not readily available as large well-curated medical-image datasets for development of artificial intelligence (AI) models applied in Radiology. Recognizing the potential for transfer learning (TL) to allow a fully trained model from one institution to be fine-tuned by another institution using a much small local dataset, this report describes the challenges, methodology, and benefits of TL within the context of developing an AI model for a basic use-case, segmentation of Left Ventricular Myocardium (LVM) on images from 4-dimensional coronary computed tomography angiography. Ultimately, our results from comparisons of LVM segmentation predicted by a model locally trained using random initialization, versus one training-enhanced by TL, showed that a use-case model initiated by TL can be developed with sparse labels with acceptable performance. This process reduces the time required to build a new model in the clinical environment at a different institution.

Going to Extremes: Weakly Supervised Medical Image Segmentation

Medical image annotation is a major hurdle for developing precise and robust machine learning models. Annotation is expensive, time-consuming, and often requires expert knowledge, particularly in the medical field. Here, we suggest using minimal user interaction in the form of extreme point clicks to train a segmentation model which, in effect, can be used to speed up medical image annotation. An initial segmentation is generated based on the extreme points utilizing the random walker algorithm. This initial segmentation is then used as a noisy supervision signal to train a fully convolutional network that can segment the organ of interest, based on the provided user clicks. Through experimentation on several medical imaging datasets, we show that the predictions of the network can be refined using several rounds of training with the prediction from the same weakly annotated data. Further improvements are shown utilizing the clicked points within a custom-designed loss and attention mechanism. Our approach has the potential to speed up the process of generating new training datasets for the development of new machine learning and deep learning-based models for, but not exclusively, medical image analysis.

Learning Image Labels On-the-fly for Training Robust Classification Models

Current deep learning paradigms largely benefit from the tremendous amount of annotated data. However, the quality of the annotations often varies among labelers. Multi-observer studies have been conducted to study these annotation variances (by labeling the same data for multiple times) and its effects on critical applications like medical image analysis. This process indeed adds an extra burden to the already tedious annotation work that usually requires professional training and expertise in the specific domains. On the other hand, automated annotation methods based on NLP algorithms have recently shown promise as a reasonable alternative, relying on the existing diagnostic reports of those images that are widely available in the clinical system. Compared to human labelers, different algorithms provide labels with varying qualities that are even noisier. In this paper, we show how noisy annotations (e.g., from different algorithm-based labelers) can be utilized together and mutually benefit the learning of classification tasks. Specifically, the concept of attention-on-label is introduced to sample better label sets on-the-fly as the training data. A meta-training based label-sampling module is designed to attend the labels that benefit the model learning the most through additional back-propagation processes. We apply the attention-on-label scheme on the classification task of a synthetic noisy CIFAR-10 dataset to prove the concept, and then demonstrate superior results (3-5% increase on average in multiple disease classification AUCs) on the chest x-ray images from a hospital-scale dataset (MIMIC-CXR) and hand-labeled dataset (OpenI) in comparison to regular training paradigms.

Enhanced MRI Reconstruction Network using Neural Architecture Search

The accurate reconstruction of under-sampled magnetic resonance imaging (MRI) data using modern deep learning technology, requires significant effort to design the necessary complex neural network architectures. The cascaded network architecture for MRI reconstruction has been widely used, while it suffers from the "vanishing gradient" problem when the network becomes deep. In addition, homogeneous architecture degrades the representation capacity of the network. In this work, we present an enhanced MRI reconstruction network using a residual in residual basic block. For each cell in the basic block, we use the differentiable neural architecture search (NAS) technique to automatically choose the optimal operation among eight variants of the dense block. This new heterogeneous network is evaluated on two publicly available datasets and outperforms all current state-of-the-art methods, which demonstrates the effectiveness of our proposed method.

PC-U Net: Learning to Jointly Reconstruct and Segment the Cardiac Walls in 3D from CT Data

The 3D volumetric shape of the heart's left ventricle (LV) myocardium (MYO) wall provides important information for diagnosis of cardiac disease and invasive procedure navigation. Many cardiac image segmentation methods have relied on detection of region-of-interest as a pre-requisite for shape segmentation and modeling. With segmentation results, a 3D surface mesh and a corresponding point cloud of the segmented cardiac volume can be reconstructed for further analyses. Although state-of-the-art methods (e.g., U-Net) have achieved decent performance on cardiac image segmentation in terms of accuracy, these segmentation results can still suffer from imaging artifacts and noise, which will lead to inaccurate shape modeling results. In this paper, we propose a PC-U net that jointly reconstructs the point cloud of the LV MYO wall directly from volumes of 2D CT slices and generates its segmentation masks from the predicted 3D point cloud. Extensive experimental results show that by incorporating a shape prior from the point cloud, the segmentation masks are more accurate than the state-of-the-art U-Net results in terms of Dice's coefficient and Hausdorff distance.The proposed joint learning framework of our PC-U net is beneficial for automatic cardiac image analysis tasks because it can obtain simultaneously the 3D shape and segmentation of the LV MYO walls.

Time-aware Graph Embedding: A temporal smoothness and task-oriented approach

Knowledge graph embedding, which aims to learn the low-dimensional representations of entities and relationships, has attracted considerable research efforts recently. However, most knowledge graph embedding methods focus on the structural relationships in fixed triples while ignoring the temporal information. Currently, existing time-aware graph embedding methods only focus on the factual plausibility, while ignoring the temporal smoothness which models the interactions between a fact and its contexts, and thus can capture fine-granularity temporal relationships. This leads to the limited performance of embedding related applications. To solve this problem, this paper presents a Robustly Time-aware Graph Embedding (RTGE) method by incorporating temporal smoothness. Two major innovations of our paper are presented here. At first, RTGE integrates a measure of temporal smoothness in the learning process of the time-aware graph embedding. Via the proposed additional smoothing factor, RTGE can preserve both structural information and evolutionary patterns of a given graph. Secondly, RTGE provides a general task-oriented negative sampling strategy associated with temporally-aware information, which further improves the adaptive ability of the proposed algorithm and plays an essential role in obtaining superior performance in various tasks. Extensive experiments conducted on multiple benchmark tasks show that RTGE can increase performance in entity/relationship/temporal scoping prediction tasks.

Uncertainty-aware multi-view co-training for semi-supervised medical image segmentation and domain adaptation

Although having achieved great success in medical image segmentation, deep learning-based approaches usually require large amounts of well-annotated data, which can be extremely expensive in the field of medical image analysis. Unlabeled data, on the other hand, is much easier to acquire. Semi-supervised learning and unsupervised domain adaptation both take the advantage of unlabeled data, and they are closely related to each other. In this paper, we propose uncertainty-aware multi-view co-training (UMCT), a unified framework that addresses these two tasks for volumetric medical image segmentation. Our framework is capable of efficiently utilizing unlabeled data for better performance. We firstly rotate and permute the 3D volumes into multiple views and train a 3D deep network on each view. We then apply co-training by enforcing multi-view consistency on unlabeled data, where an uncertainty estimation of each view is utilized to achieve accurate labeling. Experiments on the NIH pancreas segmentation dataset and a multi-organ segmentation dataset show state-of-the-art performance of the proposed framework on semi-supervised medical image segmentation. Under unsupervised domain adaptation settings, we validate the effectiveness of this work by adapting our multi-organ segmentation model to two pathological organs from the Medical Segmentation Decathlon Datasets. Additionally, we show that our UMCT-DA model can even effectively handle the challenging situation where labeled source data is inaccessible, demonstrating strong potentials for real-world applications.

Searching Learning Strategy with Reinforcement Learning for 3D Medical Image Segmentation

Deep neural network (DNN) based approaches have been widely investigated and deployed in medical image analysis. For example, fully convolutional neural networks (FCN) achieve the state-of-the-art performance in several applications of 2D/3D medical image segmentation. Even the baseline neural network models (U-Net, V-Net, etc.) have been proven to be very effective and efficient when the training process is set up properly. Nevertheless, to fully exploit the potentials of neural networks, we propose an automated searching approach for the optimal training strategy with reinforcement learning. The proposed approach can be utilized for tuning hyper-parameters, and selecting necessary data augmentation with certain probabilities. The proposed approach is validated on several tasks of 3D medical image segmentation. The performance of the baseline model is boosted after searching, and it can achieve comparable accuracy to other manually-tuned state-of-the-art segmentation approaches.

Enhancing Foreground Boundaries for Medical Image Segmentation

Object segmentation plays an important role in the modern medical image analysis, which benefits clinical study, disease diagnosis, and surgery planning. Given the various modalities of medical images, the automated or semi-automated segmentation approaches have been used to identify and parse organs, bones, tumors, and other regions-of-interest (ROI). However, these contemporary segmentation approaches tend to fail to predict the boundary areas of ROI, because of the fuzzy appearance contrast caused during the imaging procedure. To further improve the segmentation quality of boundary areas, we propose a boundary enhancement loss to enforce additional constraints on optimizing machine learning models. The proposed loss function is light-weighted and easy to implement without any pre- or post-processing. Our experimental results validate that our loss function are better than, or at least comparable to, other state-of-the-art loss functions in terms of segmentation accuracy.

Centrality Graph Convolutional Networks for Skeleton-based Action Recognition

The topological structure of skeleton data plays a significant role in human action recognition. Combining the topological structure with graph convolutional networks has achieved remarkable performance. In existing methods, modeling the topological structure of skeleton data only considered the connections between the joints and bones, and directly use physical information. However, there exists an unknown problem to investigate the key joints, bones and body parts in every human action. In this paper, we propose the centrality graph convolutional networks to uncover the overlooked topological information, and best take advantage of the information to distinguish key joints, bones, and body parts. A novel centrality graph convolutional network firstly highlights the effects of the key joints and bones to bring a definite improvement. Besides, the topological information of the skeleton sequence is explored and combined to further enhance the performance in a four-channel framework. Moreover, the reconstructed graph is implemented by the adaptive methods on the training process, which further yields improvements. Our model is validated by two large-scale datasets, NTU-RGB+D and Kinetics, and outperforms the state-of-the-art methods.