Beyond the Eye: A Relational Model for Early Dementia Detection Using Retinal OCTA Images

Early detection of dementia, such as Alzheimer's disease (AD) or mild cognitive impairment (MCI), is essential to enable timely intervention and potential treatment. Accurate detection of AD/MCI is challenging due to the high complexity, cost, and often invasive nature of current diagnostic techniques, which limit their suitability for large-scale population screening. Given the shared embryological origins and physiological characteristics of the retina and brain, retinal imaging is emerging as a potentially rapid and cost-effective alternative for the identification of individuals with or at high risk of AD. In this paper, we present a novel PolarNet+ that uses retinal optical coherence tomography angiography (OCTA) to discriminate early-onset AD (EOAD) and MCI subjects from controls. Our method first maps OCTA images from Cartesian coordinates to polar coordinates, allowing approximate sub-region calculation to implement the clinician-friendly early treatment of diabetic retinopathy study (ETDRS) grid analysis. We then introduce a multi-view module to serialize and analyze the images along three dimensions for comprehensive, clinically useful information extraction. Finally, we abstract the sequence embedding into a graph, transforming the detection task into a general graph classification problem. A regional relationship module is applied after the multi-view module to excavate the relationship between the sub-regions. Such regional relationship analyses validate known eye-brain links and reveal new discriminative patterns.

CLIP-DR: Textual Knowledge-Guided Diabetic Retinopathy Grading with Ranking-aware Prompting

Diabetic retinopathy (DR) is a complication of diabetes and usually takes decades to reach sight-threatening levels. Accurate and robust detection of DR severity is critical for the timely management and treatment of diabetes. However, most current DR grading methods suffer from insufficient robustness to data variability (\textit{e.g.} colour fundus images), posing a significant difficulty for accurate and robust grading. In this work, we propose a novel DR grading framework CLIP-DR based on three observations: 1) Recent pre-trained visual language models, such as CLIP, showcase a notable capacity for generalisation across various downstream tasks, serving as effective baseline models. 2) The grading of image-text pairs for DR often adheres to a discernible natural sequence, yet most existing DR grading methods have primarily overlooked this aspect. 3) A long-tailed distribution among DR severity levels complicates the grading process. This work proposes a novel ranking-aware prompting strategy to help the CLIP model exploit the ordinal information. Specifically, we sequentially design learnable prompts between neighbouring text-image pairs in two different ranking directions. Additionally, we introduce a Similarity Matrix Smooth module into the structure of CLIP to balance the class distribution. Finally, we perform extensive comparisons with several state-of-the-art methods on the GDRBench benchmark, demonstrating our CLIP-DR's robustness and superior performance. The implementation code is available \footnote{\url{https://github.com/Qinkaiyu/CLIP-DR}

STLLaVA-Med: Self-Training Large Language and Vision Assistant for Medical

Large Vision-Language Models (LVLMs) have shown significant potential in assisting medical diagnosis by leveraging extensive biomedical datasets. However, the advancement of medical image understanding and reasoning critically depends on building high-quality visual instruction data, which is costly and labor-intensive to obtain, particularly in the medical domain. To mitigate this data-starving issue, we introduce Self-Training Large Language and Vision Assistant for Medical (STLLaVA-Med). The proposed method is designed to train a policy model (an LVLM) capable of auto-generating medical visual instruction data to improve data efficiency, guided through Direct Preference Optimization (DPO). Specifically, a more powerful and larger LVLM (e.g., GPT-4o) is involved as a biomedical expert to oversee the DPO fine-tuning process on the auto-generated data, encouraging the policy model to align efficiently with human preferences. We validate the efficacy and data efficiency of STLLaVA-Med across three major medical Visual Question Answering (VQA) benchmarks, demonstrating competitive zero-shot performance with the utilization of only 9% of the medical data.

Enhancing Diagnostic Reliability of Foundation Model with Uncertainty Estimation in OCT Images

Inability to express the confidence level and detect unseen classes has limited the clinical implementation of artificial intelligence in the real-world. We developed a foundation model with uncertainty estimation (FMUE) to detect 11 retinal conditions on optical coherence tomography (OCT). In the internal test set, FMUE achieved a higher F1 score of 96.76% than two state-of-the-art algorithms, RETFound and UIOS, and got further improvement with thresholding strategy to 98.44%. In the external test sets obtained from other OCT devices, FMUE achieved an accuracy of 88.75% and 92.73% before and after thresholding. Our model is superior to two ophthalmologists with a higher F1 score (95.17% vs. 61.93% &71.72%). Besides, our model correctly predicts high uncertainty scores for samples with ambiguous features, of non-target-category diseases, or with low-quality to prompt manual checks and prevent misdiagnosis. FMUE provides a trustworthy method for automatic retinal anomalies detection in the real-world clinical open set environment.

ViDSOD-100: A New Dataset and a Baseline Model for RGB-D Video Salient Object Detection

With the rapid development of depth sensor, more and more RGB-D videos could be obtained. Identifying the foreground in RGB-D videos is a fundamental and important task. However, the existing salient object detection (SOD) works only focus on either static RGB-D images or RGB videos, ignoring the collaborating of RGB-D and video information. In this paper, we first collect a new annotated RGB-D video SOD (ViDSOD-100) dataset, which contains 100 videos within a total of 9,362 frames, acquired from diverse natural scenes. All the frames in each video are manually annotated to a high-quality saliency annotation. Moreover, we propose a new baseline model, named attentive triple-fusion network (ATF-Net), for RGB-D video salient object detection. Our method aggregates the appearance information from an input RGB image, spatio-temporal information from an estimated motion map, and the geometry information from the depth map by devising three modality-specific branches and a multi-modality integration branch. The modality-specific branches extract the representation of different inputs, while the multi-modality integration branch combines the multi-level modality-specific features by introducing the encoder feature aggregation (MEA) modules and decoder feature aggregation (MDA) modules. The experimental findings conducted on both our newly introduced ViDSOD-100 dataset and the well-established DAVSOD dataset highlight the superior performance of the proposed ATF-Net. This performance enhancement is demonstrated both quantitatively and qualitatively, surpassing the capabilities of current state-of-the-art techniques across various domains, including RGB-D saliency detection, video saliency detection, and video object segmentation. Our data and our code are available at github.com/jhl-Det/RGBD_Video_SOD.

Common and Rare Fundus Diseases Identification Using Vision-Language Foundation Model with Knowledge of Over 400 Diseases

The current retinal artificial intelligence models were trained using data with a limited category of diseases and limited knowledge. In this paper, we present a retinal vision-language foundation model (RetiZero) with knowledge of over 400 fundus diseases. Specifically, we collected 341,896 fundus images paired with text descriptions from 29 publicly available datasets, 180 ophthalmic books, and online resources, encompassing over 400 fundus diseases across multiple countries and ethnicities. RetiZero achieved outstanding performance across various downstream tasks, including zero-shot retinal disease recognition, image-to-image retrieval, internal domain and cross-domain retinal disease classification, and few-shot fine-tuning. Specially, in the zero-shot scenario, RetiZero achieved a Top5 score of 0.8430 and 0.7561 on 15 and 52 fundus diseases respectively. In the image-retrieval task, RetiZero achieved a Top5 score of 0.9500 and 0.8860 on 15 and 52 retinal diseases respectively. Furthermore, clinical evaluations by ophthalmology experts from different countries demonstrate that RetiZero can achieve performance comparable to experienced ophthalmologists using zero-shot and image retrieval methods without requiring model retraining. These capabilities of retinal disease identification strengthen our RetiZero foundation model in clinical implementation.

Towards Federated Domain Unlearning: Verification Methodologies and Challenges

Federated Learning (FL) has evolved as a powerful tool for collaborative model training across multiple entities, ensuring data privacy in sensitive sectors such as healthcare and finance. However, the introduction of the Right to Be Forgotten (RTBF) poses new challenges, necessitating federated unlearning to delete data without full model retraining. Traditional FL unlearning methods, not originally designed with domain specificity in mind, inadequately address the complexities of multi-domain scenarios, often affecting the accuracy of models in non-targeted domains or leading to uniform forgetting across all domains. Our work presents the first comprehensive empirical study on Federated Domain Unlearning, analyzing the characteristics and challenges of current techniques in multi-domain contexts. We uncover that these methods falter, particularly because they neglect the nuanced influences of domain-specific data, which can lead to significant performance degradation and inaccurate model behavior. Our findings reveal that unlearning disproportionately affects the model's deeper layers, erasing critical representational subspaces acquired during earlier training phases. In response, we propose novel evaluation methodologies tailored for Federated Domain Unlearning, aiming to accurately assess and verify domain-specific data erasure without compromising the model's overall integrity and performance. This investigation not only highlights the urgent need for domain-centric unlearning strategies in FL but also sets a new precedent for evaluating and implementing these techniques effectively.

Confidence-Based Task Prediction in Continual Disease Classification Using Probability Distribution

Deep learning models are widely recognized for their effectiveness in identifying medical image findings in disease classification. However, their limitations become apparent in the dynamic and ever-changing clinical environment, characterized by the continuous influx of newly annotated medical data from diverse sources. In this context, the need for continual learning becomes particularly paramount, not only to adapt to evolving medical scenarios but also to ensure the privacy of healthcare data. In our research, we emphasize the utilization of a network comprising expert classifiers, where a new expert classifier is added each time a new task is introduced. We present CTP, a task-id predictor that utilizes confidence scores, leveraging the probability distribution (logits) of the classifier to accurately determine the task-id at inference time. Logits are adjusted to ensure that classifiers yield a high-entropy distribution for data associated with tasks other than their own. By defining a noise region in the distribution and computing confidence scores, CTP achieves superior performance when compared to other relevant continual learning methods. Additionally, the performance of CTP can be further improved by providing it with a continuum of data at the time of inference.

Confidence-aware multi-modality learning for eye disease screening

Multi-modal ophthalmic image classification plays a key role in diagnosing eye diseases, as it integrates information from different sources to complement their respective performances. However, recent improvements have mainly focused on accuracy, often neglecting the importance of confidence and robustness in predictions for diverse modalities. In this study, we propose a novel multi-modality evidential fusion pipeline for eye disease screening. It provides a measure of confidence for each modality and elegantly integrates the multi-modality information using a multi-distribution fusion perspective. Specifically, our method first utilizes normal inverse gamma prior distributions over pre-trained models to learn both aleatoric and epistemic uncertainty for uni-modality. Then, the normal inverse gamma distribution is analyzed as the Student's t distribution. Furthermore, within a confidence-aware fusion framework, we propose a mixture of Student's t distributions to effectively integrate different modalities, imparting the model with heavy-tailed properties and enhancing its robustness and reliability. More importantly, the confidence-aware multi-modality ranking regularization term induces the model to more reasonably rank the noisy single-modal and fused-modal confidence, leading to improved reliability and accuracy. Experimental results on both public and internal datasets demonstrate that our model excels in robustness, particularly in challenging scenarios involving Gaussian noise and modality missing conditions. Moreover, our model exhibits strong generalization capabilities to out-of-distribution data, underscoring its potential as a promising solution for multimodal eye disease screening.

Memory-efficient High-resolution OCT Volume Synthesis with Cascaded Amortized Latent Diffusion Models

Optical coherence tomography (OCT) image analysis plays an important role in the field of ophthalmology. Current successful analysis models rely on available large datasets, which can be challenging to be obtained for certain tasks. The use of deep generative models to create realistic data emerges as a promising approach. However, due to limitations in hardware resources, it is still difficulty to synthesize high-resolution OCT volumes. In this paper, we introduce a cascaded amortized latent diffusion model (CA-LDM) that can synthesis high-resolution OCT volumes in a memory-efficient way. First, we propose non-holistic autoencoders to efficiently build a bidirectional mapping between high-resolution volume space and low-resolution latent space. In tandem with autoencoders, we propose cascaded diffusion processes to synthesize high-resolution OCT volumes with a global-to-local refinement process, amortizing the memory and computational demands. Experiments on a public high-resolution OCT dataset show that our synthetic data have realistic high-resolution and global features, surpassing the capabilities of existing methods. Moreover, performance gains on two down-stream fine-grained segmentation tasks demonstrate the benefit of the proposed method in training deep learning models for medical imaging tasks. The code is public available at: https://github.com/nicetomeetu21/CA-LDM.