Revisiting Data Scaling Law for Medical Segmentation

The population loss of trained deep neural networks often exhibits power law scaling with the size of the training dataset, guiding significant performance advancements in deep learning applications. In this study, we focus on the scaling relationship with data size in the context of medical anatomical segmentation, a domain that remains underexplored. We analyze scaling laws for anatomical segmentation across 15 semantic tasks and 4 imaging modalities, demonstrating that larger datasets significantly improve segmentation performance, following similar scaling trends. Motivated by the topological isomorphism in images sharing anatomical structures, we evaluate the impact of deformation-guided augmentation strategies on data scaling laws, specifically random elastic deformation and registration-guided deformation. We also propose a novel, scalable image augmentation approach that generates diffeomorphic mappings from geodesic subspace based on image registration to introduce realistic deformation. Our experimental results demonstrate that both registered and generated deformation-based augmentation considerably enhance data utilization efficiency. The proposed generated deformation method notably achieves superior performance and accelerated convergence, surpassing standard power law scaling trends without requiring additional data. Overall, this work provides insights into the understanding of segmentation scalability and topological variation impact in medical imaging, thereby leading to more efficient model development with reduced annotation and computational costs.

Ambiguity-aware Truncated Flow Matching for Ambiguous Medical Image Segmentation

A simultaneous enhancement of accuracy and diversity of predictions remains a challenge in ambiguous medical image segmentation (AMIS) due to the inherent trade-offs. While truncated diffusion probabilistic models (TDPMs) hold strong potential with a paradigm optimization, existing TDPMs suffer from entangled accuracy and diversity of predictions with insufficient fidelity and plausibility. To address the aforementioned challenges, we propose Ambiguity-aware Truncated Flow Matching (ATFM), which introduces a novel inference paradigm and dedicated model components. Firstly, we propose Data-Hierarchical Inference, a redefinition of AMIS-specific inference paradigm, which enhances accuracy and diversity at data-distribution and data-sample level, respectively, for an effective disentanglement. Secondly, Gaussian Truncation Representation (GTR) is introduced to enhance both fidelity of predictions and reliability of truncation distribution, by explicitly modeling it as a Gaussian distribution at $T_{\text{trunc}}$ instead of using sampling-based approximations.Thirdly, Segmentation Flow Matching (SFM) is proposed to enhance the plausibility of diverse predictions by extending semantic-aware flow transformation in Flow Matching (FM). Comprehensive evaluations on LIDC and ISIC3 datasets demonstrate that ATFM outperforms SOTA methods and simultaneously achieves a more efficient inference. ATFM improves GED and HM-IoU by up to $12\%$ and $7.3\%$ compared to advanced methods.

Structure and Smoothness Constrained Dual Networks for MR Bias Field Correction

MR imaging techniques are of great benefit to disease diagnosis. However, due to the limitation of MR devices, significant intensity inhomogeneity often exists in imaging results, which impedes both qualitative and quantitative medical analysis. Recently, several unsupervised deep learning-based models have been proposed for MR image improvement. However, these models merely concentrate on global appearance learning, and neglect constraints from image structures and smoothness of bias field, leading to distorted corrected results. In this paper, novel structure and smoothness constrained dual networks, named S2DNets, are proposed aiming to self-supervised bias field correction. S2DNets introduce piece-wise structural constraints and smoothness of bias field for network training to effectively remove non-uniform intensity and retain much more structural details. Extensive experiments executed on both clinical and simulated MR datasets show that the proposed model outperforms other conventional and deep learning-based models. In addition to comparison on visual metrics, downstream MR image segmentation tasks are also used to evaluate the impact of the proposed model. The source code is available at: https://github.com/LeongDong/S2DNets}{https://github.com/LeongDong/S2DNets.

Finding Local Diffusion Schrödinger Bridge using Kolmogorov-Arnold Network

In image generation, Schr\"odinger Bridge (SB)-based methods theoretically enhance the efficiency and quality compared to the diffusion models by finding the least costly path between two distributions. However, they are computationally expensive and time-consuming when applied to complex image data. The reason is that they focus on fitting globally optimal paths in high-dimensional spaces, directly generating images as next step on the path using complex networks through self-supervised training, which typically results in a gap with the global optimum. Meanwhile, most diffusion models are in the same path subspace generated by weights $f_A(t)$ and $f_B(t)$, as they follow the paradigm ($x_t = f_A(t)x_{Img} + f_B(t)\epsilon$). To address the limitations of SB-based methods, this paper proposes for the first time to find local Diffusion Schr\"odinger Bridges (LDSB) in the diffusion path subspace, which strengthens the connection between the SB problem and diffusion models. Specifically, our method optimizes the diffusion paths using Kolmogorov-Arnold Network (KAN), which has the advantage of resistance to forgetting and continuous output. The experiment shows that our LDSB significantly improves the quality and efficiency of image generation using the same pre-trained denoising network and the KAN for optimising is only less than 0.1MB. The FID metric is reduced by \textbf{more than 15\%}, especially with a reduction of 48.50\% when NFE of DDIM is $5$ for the CelebA dataset. Code is available at https://github.com/Qiu-XY/LDSB.

Tumor Detection, Segmentation and Classification Challenge on Automated 3D Breast Ultrasound: The TDSC-ABUS Challenge

Breast cancer is one of the most common causes of death among women worldwide. Early detection helps in reducing the number of deaths. Automated 3D Breast Ultrasound (ABUS) is a newer approach for breast screening, which has many advantages over handheld mammography such as safety, speed, and higher detection rate of breast cancer. Tumor detection, segmentation, and classification are key components in the analysis of medical images, especially challenging in the context of 3D ABUS due to the significant variability in tumor size and shape, unclear tumor boundaries, and a low signal-to-noise ratio. The lack of publicly accessible, well-labeled ABUS datasets further hinders the advancement of systems for breast tumor analysis. Addressing this gap, we have organized the inaugural Tumor Detection, Segmentation, and Classification Challenge on Automated 3D Breast Ultrasound 2023 (TDSC-ABUS2023). This initiative aims to spearhead research in this field and create a definitive benchmark for tasks associated with 3D ABUS image analysis. In this paper, we summarize the top-performing algorithms from the challenge and provide critical analysis for ABUS image examination. We offer the TDSC-ABUS challenge as an open-access platform at https://tdsc-abus2023.grand-challenge.org/ to benchmark and inspire future developments in algorithmic research.

MedFILIP: Medical Fine-grained Language-Image Pre-training

Medical vision-language pretraining (VLP) that leverages naturally-paired medical image-report data is crucial for medical image analysis. However, existing methods struggle to accurately characterize associations between images and diseases, leading to inaccurate or incomplete diagnostic results. In this work, we propose MedFILIP, a fine-grained VLP model, introduces medical image-specific knowledge through contrastive learning, specifically: 1) An information extractor based on a large language model is proposed to decouple comprehensive disease details from reports, which excels in extracting disease deals through flexible prompt engineering, thereby effectively reducing text complexity while retaining rich information at a tiny cost. 2) A knowledge injector is proposed to construct relationships between categories and visual attributes, which help the model to make judgments based on image features, and fosters knowledge extrapolation to unfamiliar disease categories. 3) A semantic similarity matrix based on fine-grained annotations is proposed, providing smoother, information-richer labels, thus allowing fine-grained image-text alignment. 4) We validate MedFILIP on numerous datasets, e.g., RSNA-Pneumonia, NIH ChestX-ray14, VinBigData, and COVID-19. For single-label, multi-label, and fine-grained classification, our model achieves state-of-the-art performance, the classification accuracy has increased by a maximum of 6.69\%. The code is available in https://github.com/PerceptionComputingLab/MedFILIP.

Efficient MedSAMs: Segment Anything in Medical Images on Laptop

Promptable segmentation foundation models have emerged as a transformative approach to addressing the diverse needs in medical images, but most existing models require expensive computing, posing a big barrier to their adoption in clinical practice. In this work, we organized the first international competition dedicated to promptable medical image segmentation, featuring a large-scale dataset spanning nine common imaging modalities from over 20 different institutions. The top teams developed lightweight segmentation foundation models and implemented an efficient inference pipeline that substantially reduced computational requirements while maintaining state-of-the-art segmentation accuracy. Moreover, the post-challenge phase advanced the algorithms through the design of performance booster and reproducibility tasks, resulting in improved algorithms and validated reproducibility of the winning solution. Furthermore, the best-performing algorithms have been incorporated into the open-source software with a user-friendly interface to facilitate clinical adoption. The data and code are publicly available to foster the further development of medical image segmentation foundation models and pave the way for impactful real-world applications.

Improving Representation of High-frequency Components for Medical Foundation Models

Foundation models have recently attracted significant attention for their impressive generalizability across diverse downstream tasks. However, these models are demonstrated to exhibit great limitations in representing high-frequency components and fine-grained details. In many medical imaging tasks, the precise representation of such information is crucial due to the inherently intricate anatomical structures, sub-visual features, and complex boundaries involved. Consequently, the limited representation of prevalent foundation models can result in significant performance degradation or even failure in these tasks. To address these challenges, we propose a novel pretraining strategy, named Frequency-advanced Representation Autoencoder (Frepa). Through high-frequency masking and low-frequency perturbation combined with adversarial learning, Frepa encourages the encoder to effectively represent and preserve high-frequency components in the image embeddings. Additionally, we introduce an innovative histogram-equalized image masking strategy, extending the Masked Autoencoder approach beyond ViT to other architectures such as Swin Transformer and convolutional networks. We develop Frepa across nine medical modalities and validate it on 32 downstream tasks for both 2D images and 3D volume data. Without fine-tuning, Frepa can outperform other self-supervised pretraining methods and, in some cases, even surpasses task-specific trained models. This improvement is particularly significant for tasks involving fine-grained details, such as achieving up to a +15% increase in DSC for retina vessel segmentation and a +7% increase in IoU for lung nodule detection. Further experiments quantitatively reveal that Frepa enables superior high-frequency representations and preservation in the embeddings, underscoring its potential for developing more generalized and universal medical image foundation models.

Deep learning-driven pulmonary arteries and veins segmentation reveals demography-associated pulmonary vasculature anatomy

Pulmonary artery-vein segmentation is crucial for diagnosing pulmonary diseases and surgical planning, and is traditionally achieved by Computed Tomography Pulmonary Angiography (CTPA). However, concerns regarding adverse health effects from contrast agents used in CTPA have constrained its clinical utility. In contrast, identifying arteries and veins using non-contrast CT, a conventional and low-cost clinical examination routine, has long been considered impossible. Here we propose a High-abundant Pulmonary Artery-vein Segmentation (HiPaS) framework achieving accurate artery-vein segmentation on both non-contrast CT and CTPA across various spatial resolutions. HiPaS first performs spatial normalization on raw CT scans via a super-resolution module, and then iteratively achieves segmentation results at different branch levels by utilizing the low-level vessel segmentation as a prior for high-level vessel segmentation. We trained and validated HiPaS on our established multi-centric dataset comprising 1,073 CT volumes with meticulous manual annotation. Both quantitative experiments and clinical evaluation demonstrated the superior performance of HiPaS, achieving a dice score of 91.8% and a sensitivity of 98.0%. Further experiments demonstrated the non-inferiority of HiPaS segmentation on non-contrast CT compared to segmentation on CTPA. Employing HiPaS, we have conducted an anatomical study of pulmonary vasculature on 10,613 participants in China (five sites), discovering a new association between pulmonary vessel abundance and sex and age: vessel abundance is significantly higher in females than in males, and slightly decreases with age, under the controlling of lung volumes (p < 0.0001). HiPaS realizing accurate artery-vein segmentation delineates a promising avenue for clinical diagnosis and understanding pulmonary physiology in a non-invasive manner.

Unsupervised Decomposition Networks for Bias Field Correction in MR Image

Bias field, which is caused by imperfect MR devices or imaged objects, introduces intensity inhomogeneity into MR images and degrades the performance of MR image analysis methods. Many retrospective algorithms were developed to facilitate the bias correction, to which the deep learning-based methods outperformed. However, in the training phase, the supervised deep learning-based methods heavily rely on the synthesized bias field. As the formation of the bias field is extremely complex, it is difficult to mimic the true physical property of MR images by synthesized data. While bias field correction and image segmentation are strongly related, the segmentation map is precisely obtained by decoupling the bias field from the original MR image, and the bias value is indicated by the segmentation map in reverse. Thus, we proposed novel unsupervised decomposition networks that are trained only with biased data to obtain the bias-free MR images. Networks are made up of: a segmentation part to predict the probability of every pixel belonging to each class, and an estimation part to calculate the bias field, which are optimized alternately. Furthermore, loss functions based on the combination of fuzzy clustering and the multiplicative bias field are also devised. The proposed loss functions introduce the smoothness of bias field and construct the soft relationships among different classes under intra-consistency constraints. Extensive experiments demonstrate that the proposed method can accurately estimate bias fields and produce better bias correction results. The code is available on the link: https://github.com/LeongDong/Bias-Decomposition-Networks.