Multi-rater annotations commonly occur when medical images are independently annotated by multiple experts (raters). In this paper, we tackle two challenges arisen in multi-rater annotations for medical image segmentation (called ambiguous medical image segmentation): (1) How to train a deep learning model when a group of raters produces a set of diverse but plausible annotations, and (2) how to fine-tune the model efficiently when computation resources are not available for re-training the entire model on a different dataset domain. We propose a multi-rater prompt-based approach to address these two challenges altogether. Specifically, we introduce a series of rater-aware prompts that can be plugged into the U-Net model for uncertainty estimation to handle multi-annotation cases. During the prompt-based fine-tuning process, only 0.3% of learnable parameters are required to be updated comparing to training the entire model. Further, in order to integrate expert consensus and disagreement, we explore different multi-rater incorporation strategies and design a mix-training strategy for comprehensive insight learning. Extensive experiments verify the effectiveness of our new approach for ambiguous medical image segmentation on two public datasets while alleviating the heavy burden of model re-training.
Multimodal Large Language Models (MLLMs) such as GPT-4V and Gemini Pro face challenges in achieving human-level perception in Visual Question Answering (VQA), particularly in object-oriented perception tasks which demand fine-grained understanding of object identities, locations or attributes, as indicated by empirical findings. This is mainly due to their limited capability to effectively integrate complex visual cues with textual information and potential object hallucinations. In this paper, we present a novel approach, Joint Visual and Text Prompting (VTPrompt), that employs fine-grained visual information to enhance the capability of MLLMs in VQA, especially for object-oriented perception. VTPrompt merges visual and text prompts to extract key concepts from textual questions and employs a detection model to highlight relevant objects as visual prompts in images. The processed images alongside text prompts are subsequently fed into MLLMs to produce more accurate answers. Our experiments with GPT-4V and Gemini Pro, on three benchmarks, i.e., MME , MMB and POPE, demonstrate significant improvements. Particularly, our method led to a score improvement of up to 183.5 for GPT-4V on MME and enhanced MMB performance by 8.17\% for GPT-4V and 15.69\% for Gemini Pro.
Recently, there has been a burgeoning interest in virtual clinical trials, which simulate real-world scenarios and hold the potential to significantly enhance patient safety, expedite development, reduce costs, and contribute to the broader scientific knowledge in healthcare. Existing research often focuses on leveraging electronic health records (EHRs) to support clinical trial outcome prediction. Yet, trained with limited clinical trial outcome data, existing approaches frequently struggle to perform accurate predictions. Some research has attempted to generate EHRs to augment model development but has fallen short in personalizing the generation for individual patient profiles. Recently, the emergence of large language models has illuminated new possibilities, as their embedded comprehensive clinical knowledge has proven beneficial in addressing medical issues. In this paper, we propose a large language model-based digital twin creation approach, called TWIN-GPT. TWIN-GPT can establish cross-dataset associations of medical information given limited data, generating unique personalized digital twins for different patients, thereby preserving individual patient characteristics. Comprehensive experiments show that using digital twins created by TWIN-GPT can boost clinical trial outcome prediction, exceeding various previous prediction approaches. Besides, we also demonstrate that TWIN-GPT can generate high-fidelity trial data that closely approximate specific patients, aiding in more accurate result predictions in data-scarce situations. Moreover, our study provides practical evidence for the application of digital twins in healthcare, highlighting its potential significance.
Automatic ophthalmic disease diagnosis on fundus images is important in clinical practice. However, due to complex fundus textures and limited annotated data, developing an effective automatic method for this problem is still challenging. In this paper, we present a self-supervised method via polar transformation based progressive contrastive learning, called PoCo, for ophthalmic disease diagnosis. Specifically, we novelly inject the polar transformation into contrastive learning to 1) promote contrastive learning pre-training to be faster and more stable and 2) naturally capture task-free and rotation-related textures, which provides insights into disease recognition on fundus images. Beneficially, simple normal translation-invariant convolution on transformed images can equivalently replace the complex rotation-invariant and sector convolution on raw images. After that, we develop a progressive contrastive learning method to efficiently utilize large unannotated images and a novel progressive hard negative sampling scheme to gradually reduce the negative sample number for efficient training and performance enhancement. Extensive experiments on three public ophthalmic disease datasets show that our PoCo achieves state-of-the-art performance with good generalization ability, validating that our method can reduce annotation efforts and provide reliable diagnosis. Codes are available at \url{https://github.com/wjh892521292/PoCo}.
We present DetToolChain, a novel prompting paradigm, to unleash the zero-shot object detection ability of multimodal large language models (MLLMs), such as GPT-4V and Gemini. Our approach consists of a detection prompting toolkit inspired by high-precision detection priors and a new Chain-of-Thought to implement these prompts. Specifically, the prompts in the toolkit are designed to guide the MLLM to focus on regional information (e.g., zooming in), read coordinates according to measure standards (e.g., overlaying rulers and compasses), and infer from the contextual information (e.g., overlaying scene graphs). Building upon these tools, the new detection chain-of-thought can automatically decompose the task into simple subtasks, diagnose the predictions, and plan for progressive box refinements. The effectiveness of our framework is demonstrated across a spectrum of detection tasks, especially hard cases. Compared to existing state-of-the-art methods, GPT-4V with our DetToolChain improves state-of-the-art object detectors by +21.5% AP50 on MS COCO Novel class set for open-vocabulary detection, +24.23% Acc on RefCOCO val set for zero-shot referring expression comprehension, +14.5% AP on D-cube describe object detection FULL setting.
The transferability of deep neural networks (DNNs) has made significant progress in image and language processing. However, due to the heterogeneity among tables, such DNN bonus is still far from being well exploited on tabular data prediction (e.g., regression or classification tasks). Condensing knowledge from diverse domains, language models (LMs) possess the capability to comprehend feature names from various tables, potentially serving as versatile learners in transferring knowledge across distinct tables and diverse prediction tasks, but their discrete text representation space is inherently incompatible with numerical feature values in tables. In this paper, we present TP-BERTa, a specifically pre-trained LM for tabular data prediction. Concretely, a novel relative magnitude tokenization converts scalar numerical feature values to finely discrete, high-dimensional tokens, and an intra-feature attention approach integrates feature values with the corresponding feature names. Comprehensive experiments demonstrate that our pre-trained TP-BERTa leads the performance among tabular DNNs and is competitive with Gradient Boosted Decision Tree models in typical tabular data regime.
In clinical practice, medical image segmentation provides useful information on the contours and dimensions of target organs or tissues, facilitating improved diagnosis, analysis, and treatment. In the past few years, convolutional neural networks (CNNs) and Transformers have dominated this area, but they still suffer from either limited receptive fields or costly long-range modeling. Mamba, a State Space Sequence Model (SSM), recently emerged as a promising paradigm for long-range dependency modeling with linear complexity. In this paper, we introduce a Large Window-based Mamba U}-shape Network, or LMa-UNet, for 2D and 3D medical image segmentation. A distinguishing feature of our LMa-UNet is its utilization of large windows, excelling in locally spatial modeling compared to small kernel-based CNNs and small window-based Transformers, while maintaining superior efficiency in global modeling compared to self-attention with quadratic complexity. Additionally, we design a novel hierarchical and bidirectional Mamba block to further enhance the global and neighborhood spatial modeling capability of Mamba. Comprehensive experiments demonstrate the effectiveness and efficiency of our method and the feasibility of using large window size to achieve large receptive fields. Codes are available at https://github.com/wjh892521292/LMa-UNet.
Medical generative models, acknowledged for their high-quality sample generation ability, have accelerated the fast growth of medical applications. However, recent works concentrate on separate medical generation models for distinct medical tasks and are restricted to inadequate medical multi-modal knowledge, constraining medical comprehensive diagnosis. In this paper, we propose MedM2G, a Medical Multi-Modal Generative framework, with the key innovation to align, extract, and generate medical multi-modal within a unified model. Extending beyond single or two medical modalities, we efficiently align medical multi-modal through the central alignment approach in the unified space. Significantly, our framework extracts valuable clinical knowledge by preserving the medical visual invariant of each imaging modal, thereby enhancing specific medical information for multi-modal generation. By conditioning the adaptive cross-guided parameters into the multi-flow diffusion framework, our model promotes flexible interactions among medical multi-modal for generation. MedM2G is the first medical generative model that unifies medical generation tasks of text-to-image, image-to-text, and unified generation of medical modalities (CT, MRI, X-ray). It performs 5 medical generation tasks across 10 datasets, consistently outperforming various state-of-the-art works.
Large Language Models (LLMs) have achieved impressive results in Machine Translation (MT). However, careful evaluations by human reveal that the translations produced by LLMs still contain multiple errors. Importantly, feeding back such error information into the LLMs can lead to self-correction and result in improved translation performance. Motivated by these insights, we introduce a systematic LLM-based self-correcting translation framework, named TER, which stands for Translate, Estimate, and Refine, marking a significant step forward in this direction. Our findings demonstrate that 1) our self-correction framework successfully assists LLMs in improving their translation quality across a wide range of languages, whether it's from high-resource languages to low-resource ones or whether it's English-centric or centered around other languages; 2) TER exhibits superior systematicity and interpretability compared to previous methods; 3) different estimation strategies yield varied impacts on AI feedback, directly affecting the effectiveness of the final corrections. We further compare different LLMs and conduct various experiments involving self-correction and cross-model correction to investigate the potential relationship between the translation and evaluation capabilities of LLMs. Our code and data are available at https://github.com/fzp0424/self_correct_mt