MedRG: Medical Report Grounding with Multi-modal Large Language Model

Medical Report Grounding is pivotal in identifying the most relevant regions in medical images based on a given phrase query, a critical aspect in medical image analysis and radiological diagnosis. However, prevailing visual grounding approaches necessitate the manual extraction of key phrases from medical reports, imposing substantial burdens on both system efficiency and physicians. In this paper, we introduce a novel framework, Medical Report Grounding (MedRG), an end-to-end solution for utilizing a multi-modal Large Language Model to predict key phrase by incorporating a unique token, BOX, into the vocabulary to serve as an embedding for unlocking detection capabilities. Subsequently, the vision encoder-decoder jointly decodes the hidden embedding and the input medical image, generating the corresponding grounding box. The experimental results validate the effectiveness of MedRG, surpassing the performance of the existing state-of-the-art medical phrase grounding methods. This study represents a pioneering exploration of the medical report grounding task, marking the first-ever endeavor in this domain.

Instrument-tissue Interaction Detection Framework for Surgical Video Understanding

Instrument-tissue interaction detection task, which helps understand surgical activities, is vital for constructing computer-assisted surgery systems but with many challenges. Firstly, most models represent instrument-tissue interaction in a coarse-grained way which only focuses on classification and lacks the ability to automatically detect instruments and tissues. Secondly, existing works do not fully consider relations between intra- and inter-frame of instruments and tissues. In the paper, we propose to represent instrument-tissue interaction as <instrument class, instrument bounding box, tissue class, tissue bounding box, action class> quintuple and present an Instrument-Tissue Interaction Detection Network (ITIDNet) to detect the quintuple for surgery videos understanding. Specifically, we propose a Snippet Consecutive Feature (SCF) Layer to enhance features by modeling relationships of proposals in the current frame using global context information in the video snippet. We also propose a Spatial Corresponding Attention (SCA) Layer to incorporate features of proposals between adjacent frames through spatial encoding. To reason relationships between instruments and tissues, a Temporal Graph (TG) Layer is proposed with intra-frame connections to exploit relationships between instruments and tissues in the same frame and inter-frame connections to model the temporal information for the same instance. For evaluation, we build a cataract surgery video (PhacoQ) dataset and a cholecystectomy surgery video (CholecQ) dataset. Experimental results demonstrate the promising performance of our model, which outperforms other state-of-the-art models on both datasets.

AIC-UNet: Anatomy-informed Cascaded UNet for Robust Multi-Organ Segmentation

Imposing key anatomical features, such as the number of organs, their shapes, sizes, and relative positions, is crucial for building a robust multi-organ segmentation model. Current attempts to incorporate anatomical features include broadening effective receptive fields (ERF) size with resource- and data-intensive modules such as self-attention or introducing organ-specific topology regularizers, which may not scale to multi-organ segmentation problems where inter-organ relation also plays a huge role. We introduce a new approach to impose anatomical constraints on any existing encoder-decoder segmentation model by conditioning model prediction with learnable anatomy prior. More specifically, given an abdominal scan, a part of the encoder spatially warps a learnable prior to align with the given input scan using thin plate spline (TPS) grid interpolation. The warped prior is then integrated during the decoding phase to guide the model for more anatomy-informed predictions. Code is available at \hyperlink{https://anonymous.4open.science/r/AIC-UNet-7048}{https://anonymous.4open.science/r/AIC-UNet-7048}.

Training-free image style alignment for self-adapting domain shift on handheld ultrasound devices

Handheld ultrasound devices face usage limitations due to user inexperience and cannot benefit from supervised deep learning without extensive expert annotations. Moreover, the models trained on standard ultrasound device data are constrained by training data distribution and perform poorly when directly applied to handheld device data. In this study, we propose the Training-free Image Style Alignment (TISA) framework to align the style of handheld device data to those of standard devices. The proposed TISA can directly infer handheld device images without extra training and is suited for clinical applications. We show that TISA performs better and more stably in medical detection and segmentation tasks for handheld device data. We further validate TISA as the clinical model for automatic measurements of spinal curvature and carotid intima-media thickness. The automatic measurements agree well with manual measurements made by human experts and the measurement errors remain within clinically acceptable ranges. We demonstrate the potential for TISA to facilitate automatic diagnosis on handheld ultrasound devices and expedite their eventual widespread use.

Dual-scale Enhanced and Cross-generative Consistency Learning for Semi-supervised Polyp Segmentation

Automatic polyp segmentation plays a crucial role in the early diagnosis and treatment of colorectal cancer (CRC). However, existing methods heavily rely on fully supervised training, which requires a large amount of labeled data with time-consuming pixel-wise annotations. Moreover, accurately segmenting polyps poses challenges due to variations in shape, size, and location. To address these issues, we propose a novel Dual-scale Enhanced and Cross-generative consistency learning framework for semi-supervised polyp Segmentation (DEC-Seg) from colonoscopy images. First, we propose a Cross-level Feature Aggregation (CFA) module that integrates cross-level adjacent layers to enhance the feature representation ability across different resolutions. To address scale variation, we present a scale-enhanced consistency constraint, which ensures consistency in the segmentation maps generated from the same input image at different scales. This constraint helps handle variations in polyp sizes and improves the robustness of the model. Additionally, we design a scale-aware perturbation consistency scheme to enhance the robustness of the mean teacher model. Furthermore, we propose a cross-generative consistency scheme, in which the original and perturbed images can be reconstructed using cross-segmentation maps. This consistency constraint allows us to mine effective feature representations and boost the segmentation performance. To produce more accurate segmentation maps, we propose a Dual-scale Complementary Fusion (DCF) module that integrates features from two scale-specific decoders operating at different scales. Extensive experimental results on five benchmark datasets demonstrate the effectiveness of our DEC-Seg against other state-of-the-art semi-supervised segmentation approaches. The implementation code will be released at https://github.com/taozh2017/DECSeg.

VSR-Net: Vessel-like Structure Rehabilitation Network with Graph Clustering

The morphologies of vessel-like structures, such as blood vessels and nerve fibres, play significant roles in disease diagnosis, e.g., Parkinson's disease. Deep network-based refinement segmentation methods have recently achieved promising vessel-like structure segmentation results. There are still two challenges: (1) existing methods have limitations in rehabilitating subsection ruptures in segmented vessel-like structures; (2) they are often overconfident in predicted segmentation results. To tackle these two challenges, this paper attempts to leverage the potential of spatial interconnection relationships among subsection ruptures from the structure rehabilitation perspective. Based on this, we propose a novel Vessel-like Structure Rehabilitation Network (VSR-Net) to rehabilitate subsection ruptures and improve the model calibration based on coarse vessel-like structure segmentation results. VSR-Net first constructs subsection rupture clusters with Curvilinear Clustering Module (CCM). Then, the well-designed Curvilinear Merging Module (CMM) is applied to rehabilitate the subsection ruptures to obtain the refined vessel-like structures. Extensive experiments on five 2D/3D medical image datasets show that VSR-Net significantly outperforms state-of-the-art (SOTA) refinement segmentation methods with lower calibration error. Additionally, we provide quantitative analysis to explain the morphological difference between the rehabilitation results of VSR-Net and ground truth (GT), which is smaller than SOTA methods and GT, demonstrating that our method better rehabilitates vessel-like structures by restoring subsection ruptures.

Enhancing and Adapting in the Clinic: Source-free Unsupervised Domain Adaptation for Medical Image Enhancement

Medical imaging provides many valuable clues involving anatomical structure and pathological characteristics. However, image degradation is a common issue in clinical practice, which can adversely impact the observation and diagnosis by physicians and algorithms. Although extensive enhancement models have been developed, these models require a well pre-training before deployment, while failing to take advantage of the potential value of inference data after deployment. In this paper, we raise an algorithm for source-free unsupervised domain adaptive medical image enhancement (SAME), which adapts and optimizes enhancement models using test data in the inference phase. A structure-preserving enhancement network is first constructed to learn a robust source model from synthesized training data. Then a teacher-student model is initialized with the source model and conducts source-free unsupervised domain adaptation (SFUDA) by knowledge distillation with the test data. Additionally, a pseudo-label picker is developed to boost the knowledge distillation of enhancement tasks. Experiments were implemented on ten datasets from three medical image modalities to validate the advantage of the proposed algorithm, and setting analysis and ablation studies were also carried out to interpret the effectiveness of SAME. The remarkable enhancement performance and benefits for downstream tasks demonstrate the potential and generalizability of SAME. The code is available at https://github.com/liamheng/Annotation-free-Medical-Image-Enhancement.

Segment Anything Model-guided Collaborative Learning Network for Scribble-supervised Polyp Segmentation

Polyp segmentation plays a vital role in accurately locating polyps at an early stage, which holds significant clinical importance for the prevention of colorectal cancer. Various polyp segmentation methods have been developed using fully-supervised deep learning techniques. However, pixel-wise annotation for polyp images by physicians during the diagnosis is both time-consuming and expensive. Moreover, visual foundation models such as the Segment Anything Model (SAM) have shown remarkable performance. Nevertheless, directly applying SAM to medical segmentation may not produce satisfactory results due to the inherent absence of medical knowledge. In this paper, we propose a novel SAM-guided Collaborative Learning Network (SAM-CLNet) for scribble-supervised polyp segmentation, enabling a collaborative learning process between our segmentation network and SAM to boost the model performance. Specifically, we first propose a Cross-level Enhancement and Aggregation Network (CEA-Net) for weakly-supervised polyp segmentation. Within CEA-Net, we propose a Cross-level Enhancement Module (CEM) that integrates the adjacent features to enhance the representation capabilities of different resolution features. Additionally, a Feature Aggregation Module (FAM) is employed to capture richer features across multiple levels. Moreover, we present a box-augmentation strategy that combines the segmentation maps generated by CEA-Net with scribble annotations to create more precise prompts. These prompts are then fed into SAM, generating segmentation SAM-guided masks, which can provide additional supervision to train CEA-Net effectively. Furthermore, we present an Image-level Filtering Mechanism to filter out unreliable SAM-guided masks. Extensive experimental results show that our SAM-CLNet outperforms state-of-the-art weakly-supervised segmentation methods.

A Survey on Deep Learning for Polyp Segmentation: Techniques, Challenges and Future Trends

Early detection and assessment of polyps play a crucial role in the prevention and treatment of colorectal cancer (CRC). Polyp segmentation provides an effective solution to assist clinicians in accurately locating and segmenting polyp regions. In the past, people often relied on manually extracted lower-level features such as color, texture, and shape, which often had issues capturing global context and lacked robustness to complex scenarios. With the advent of deep learning, more and more outstanding medical image segmentation algorithms based on deep learning networks have emerged, making significant progress in this field. This paper provides a comprehensive review of polyp segmentation algorithms. We first review some traditional algorithms based on manually extracted features and deep segmentation algorithms, then detail benchmark datasets related to the topic. Specifically, we carry out a comprehensive evaluation of recent deep learning models and results based on polyp sizes, considering the pain points of research topics and differences in network structures. Finally, we discuss the challenges of polyp segmentation and future trends in this field. The models, benchmark datasets, and source code links we collected are all published at https://github.com/taozh2017/Awesome-Polyp-Segmentation.

A Survey of Emerging Applications of Diffusion Probabilistic Models in MRI

Diffusion probabilistic models (DPMs) which employ explicit likelihood characterization and a gradual sampling process to synthesize data, have gained increasing research interest. Despite their huge computational burdens due to the large number of steps involved during sampling, DPMs are widely appreciated in various medical imaging tasks for their high-quality and diversity of generation. Magnetic resonance imaging (MRI) is an important medical imaging modality with excellent soft tissue contrast and superb spatial resolution, which possesses unique opportunities for diffusion models. Although there is a recent surge of studies exploring DPMs in MRI, a survey paper of DPMs specifically designed for MRI applications is still lacking. This review article aims to help researchers in the MRI community to grasp the advances of DPMs in different applications. We first introduce the theory of two dominant kinds of DPMs, categorized according to whether the diffusion time step is discrete or continuous, and then provide a comprehensive review of emerging DPMs in MRI, including reconstruction, image generation, image translation, segmentation, anomaly detection, and further research topics. Finally, we discuss the general limitations as well as limitations specific to the MRI tasks of DPMs and point out potential areas that are worth further exploration.