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.

FRCNet Frequency and Region Consistency for Semi-supervised Medical Image Segmentation

Limited labeled data hinder the application of deep learning in medical domain. In clinical practice, there are sufficient unlabeled data that are not effectively used, and semi-supervised learning (SSL) is a promising way for leveraging these unlabeled data. However, existing SSL methods ignore frequency domain and region-level information and it is important for lesion regions located at low frequencies and with significant scale changes. In this paper, we introduce two consistency regularization strategies for semi-supervised medical image segmentation, including frequency domain consistency (FDC) to assist the feature learning in frequency domain and multi-granularity region similarity consistency (MRSC) to perform multi-scale region-level local context information feature learning. With the help of the proposed FDC and MRSC, we can leverage the powerful feature representation capability of them in an effective and efficient way. We perform comprehensive experiments on two datasets, and the results show that our method achieves large performance gains and exceeds other state-of-the-art methods.

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.

Reliable Source Approximation: Source-Free Unsupervised Domain Adaptation for Vestibular Schwannoma MRI Segmentation

Source-Free Unsupervised Domain Adaptation (SFUDA) has recently become a focus in the medical image domain adaptation, as it only utilizes the source model and does not require annotated target data. However, current SFUDA approaches cannot tackle the complex segmentation task across different MRI sequences, such as the vestibular schwannoma segmentation. To address this problem, we proposed Reliable Source Approximation (RSA), which can generate source-like and structure-preserved images from the target domain for updating model parameters and adapting domain shifts. Specifically, RSA deploys a conditional diffusion model to generate multiple source-like images under the guidance of varying edges of one target image. An uncertainty estimation module is then introduced to predict and refine reliable pseudo labels of generated images, and the prediction consistency is developed to select the most reliable generations. Subsequently, all reliable generated images and their pseudo labels are utilized to update the model. Our RSA is validated on vestibular schwannoma segmentation across multi-modality MRI. The experimental results demonstrate that RSA consistently improves domain adaptation performance over other state-of-the-art SFUDA methods. Code is available at https://github.com/zenghy96/Reliable-Source-Approximation.

Is Dataset Quality Still a Concern in Diagnosis Using Large Foundation Model?

Recent advancements in pre-trained large foundation models (LFM) have yielded significant breakthroughs across various domains, including natural language processing and computer vision. These models have been particularly impactful in the domain of medical diagnostic tasks. With abundant unlabeled data, an LFM has been developed for fundus images using the Vision Transformer (VIT) and a self-supervised learning framework. This LFM has shown promising performance in fundus disease diagnosis across multiple datasets. On the other hand, deep learning models have long been challenged by dataset quality issues, such as image quality and dataset bias. To investigate the influence of data quality on LFM, we conducted explorations in two fundus diagnosis tasks using datasets of varying quality. Specifically, we explored the following questions: Is LFM more robust to image quality? Is LFM affected by dataset bias? Can fine-tuning techniques alleviate these effects? Our investigation found that LFM exhibits greater resilience to dataset quality issues, including image quality and dataset bias, compared to typical convolutional networks. Furthermore, we discovered that overall fine-tuning is an effective adapter for LFM to mitigate the impact of dataset quality issues.

MM-Retinal: Knowledge-Enhanced Foundational Pretraining with Fundus Image-Text Expertise

Current fundus image analysis models are predominantly built for specific tasks relying on individual datasets. The learning process is usually based on data-driven paradigm without prior knowledge, resulting in poor transferability and generalizability. To address this issue, we propose MM-Retinal, a multi-modal dataset that encompasses high-quality image-text pairs collected from professional fundus diagram books. Moreover, enabled by MM-Retinal, we present a novel Knowledge-enhanced foundational pretraining model which incorporates Fundus Image-Text expertise, called KeepFIT. It is designed with image similarity-guided text revision and mixed training strategy to infuse expert knowledge. Our proposed fundus foundation model achieves state-of-the-art performance across six unseen downstream tasks and holds excellent generalization ability in zero-shot and few-shot scenarios. MM-Retinal and KeepFIT are available at https://github.com/lxirich/MM-Retinal.

Topicwise Separable Sentence Retrieval for Medical Report Generation

Automated radiology reporting holds immense clinical potential in alleviating the burdensome workload of radiologists and mitigating diagnostic bias. Recently, retrieval-based report generation methods have garnered increasing attention due to their inherent advantages in terms of the quality and consistency of generated reports. However, due to the long-tail distribution of the training data, these models tend to learn frequently occurring sentences and topics, overlooking the rare topics. Regrettably, in many cases, the descriptions of rare topics often indicate critical findings that should be mentioned in the report. To address this problem, we introduce a Topicwise Separable Sentence Retrieval (Teaser) for medical report generation. To ensure comprehensive learning of both common and rare topics, we categorize queries into common and rare types to learn differentiated topics, and then propose Topic Contrastive Loss to effectively align topics and queries in the latent space. Moreover, we integrate an Abstractor module following the extraction of visual features, which aids the topic decoder in gaining a deeper understanding of the visual observational intent. Experiments on the MIMIC-CXR and IU X-ray datasets demonstrate that Teaser surpasses state-of-the-art models, while also validating its capability to effectively represent rare topics and establish more dependable correspondences between queries and topics.

RaffeSDG: Random Frequency Filtering enabled Single-source Domain Generalization for Medical Image Segmentation

Deep learning models often encounter challenges in making accurate inferences when there are domain shifts between the source and target data. This issue is particularly pronounced in clinical settings due to the scarcity of annotated data resulting from the professional and private nature of medical data. Despite the existence of decent solutions, many of them are hindered in clinical settings due to limitations in data collection and computational complexity. To tackle domain shifts in data-scarce medical scenarios, we propose a Random frequency filtering enabled Single-source Domain Generalization algorithm (RaffeSDG), which promises robust out-of-domain inference with segmentation models trained on a single-source domain. A filter-based data augmentation strategy is first proposed to promote domain variability within a single-source domain by introducing variations in frequency space and blending homologous samples. Then Gaussian filter-based structural saliency is also leveraged to learn robust representations across augmented samples, further facilitating the training of generalizable segmentation models. To validate the effectiveness of RaffeSDG, we conducted extensive experiments involving out-of-domain inference on segmentation tasks for three human tissues imaged by four diverse modalities. Through thorough investigations and comparisons, compelling evidence was observed in these experiments, demonstrating the potential and generalizability of RaffeSDG. The code is available at https://github.com/liamheng/Non-IID_Medical_Image_Segmentation.

An Aggregation-Free Federated Learning for Tackling Data Heterogeneity

The performance of Federated Learning (FL) hinges on the effectiveness of utilizing knowledge from distributed datasets. Traditional FL methods adopt an aggregate-then-adapt framework, where clients update local models based on a global model aggregated by the server from the previous training round. This process can cause client drift, especially with significant cross-client data heterogeneity, impacting model performance and convergence of the FL algorithm. To address these challenges, we introduce FedAF, a novel aggregation-free FL algorithm. In this framework, clients collaboratively learn condensed data by leveraging peer knowledge, the server subsequently trains the global model using the condensed data and soft labels received from the clients. FedAF inherently avoids the issue of client drift, enhances the quality of condensed data amid notable data heterogeneity, and improves the global model performance. Extensive numerical studies on several popular benchmark datasets show FedAF surpasses various state-of-the-art FL algorithms in handling label-skew and feature-skew data heterogeneity, leading to superior global model accuracy and faster convergence.