DataCook: Crafting Anti-Adversarial Examples for Healthcare Data Copyright Protection

In the realm of healthcare, the challenges of copyright protection and unauthorized third-party misuse are increasingly significant. Traditional methods for data copyright protection are applied prior to data distribution, implying that models trained on these data become uncontrollable. This paper introduces a novel approach, named DataCook, designed to safeguard the copyright of healthcare data during the deployment phase. DataCook operates by "cooking" the raw data before distribution, enabling the development of models that perform normally on this processed data. However, during the deployment phase, the original test data must be also "cooked" through DataCook to ensure normal model performance. This process grants copyright holders control over authorization during the deployment phase. The mechanism behind DataCook is by crafting anti-adversarial examples (AntiAdv), which are designed to enhance model confidence, as opposed to standard adversarial examples (Adv) that aim to confuse models. Similar to Adv, AntiAdv introduces imperceptible perturbations, ensuring that the data processed by DataCook remains easily understandable. We conducted extensive experiments on MedMNIST datasets, encompassing both 2D/3D data and the high-resolution variants. The outcomes indicate that DataCook effectively meets its objectives, preventing models trained on AntiAdv from analyzing unauthorized data effectively, without compromising the validity and accuracy of the data in legitimate scenarios. Code and data are available at https://github.com/MedMNIST/DataCook.

LeFusion: Synthesizing Myocardial Pathology on Cardiac MRI via Lesion-Focus Diffusion Models

Data generated in clinical practice often exhibits biases, such as long-tail imbalance and algorithmic unfairness. This study aims to mitigate these challenges through data synthesis. Previous efforts in medical imaging synthesis have struggled with separating lesion information from background context, leading to difficulties in generating high-quality backgrounds and limited control over the synthetic output. Inspired by diffusion-based image inpainting, we propose LeFusion, lesion-focused diffusion models. By redesigning the diffusion learning objectives to concentrate on lesion areas, it simplifies the model learning process and enhance the controllability of the synthetic output, while preserving background by integrating forward-diffused background contexts into the reverse diffusion process. Furthermore, we generalize it to jointly handle multi-class lesions, and further introduce a generative model for lesion masks to increase synthesis diversity. Validated on the DE-MRI cardiac lesion segmentation dataset (Emidec), our methodology employs the popular nnUNet to demonstrate that the synthetic data make it possible to effectively enhance a state-of-the-art model. Code and model are available at https://github.com/M3DV/LeFusion.

Deep Rib Fracture Instance Segmentation and Classification from CT on the RibFrac Challenge

Rib fractures are a common and potentially severe injury that can be challenging and labor-intensive to detect in CT scans. While there have been efforts to address this field, the lack of large-scale annotated datasets and evaluation benchmarks has hindered the development and validation of deep learning algorithms. To address this issue, the RibFrac Challenge was introduced, providing a benchmark dataset of over 5,000 rib fractures from 660 CT scans, with voxel-level instance mask annotations and diagnosis labels for four clinical categories (buckle, nondisplaced, displaced, or segmental). The challenge includes two tracks: a detection (instance segmentation) track evaluated by an FROC-style metric and a classification track evaluated by an F1-style metric. During the MICCAI 2020 challenge period, 243 results were evaluated, and seven teams were invited to participate in the challenge summary. The analysis revealed that several top rib fracture detection solutions achieved performance comparable or even better than human experts. Nevertheless, the current rib fracture classification solutions are hardly clinically applicable, which can be an interesting area in the future. As an active benchmark and research resource, the data and online evaluation of the RibFrac Challenge are available at the challenge website. As an independent contribution, we have also extended our previous internal baseline by incorporating recent advancements in large-scale pretrained networks and point-based rib segmentation techniques. The resulting FracNet+ demonstrates competitive performance in rib fracture detection, which lays a foundation for further research and development in AI-assisted rib fracture detection and diagnosis.

Efficient Anatomical Labeling of Pulmonary Tree Structures via Implicit Point-Graph Networks

Pulmonary diseases rank prominently among the principal causes of death worldwide. Curing them will require, among other things, a better understanding of the many complex 3D tree-shaped structures within the pulmonary system, such as airways, arteries, and veins. In theory, they can be modeled using high-resolution image stacks. Unfortunately, standard CNN approaches operating on dense voxel grids are prohibitively expensive. To remedy this, we introduce a point-based approach that preserves graph connectivity of tree skeleton and incorporates an implicit surface representation. It delivers SOTA accuracy at a low computational cost and the resulting models have usable surfaces. Due to the scarcity of publicly accessible data, we have also curated an extensive dataset to evaluate our approach and will make it public.

Efficient Anatomical labeling of Pulmonary Tree Structures via Implicit Point-Graph Networks

Pulmonary diseases rank prominently among the principal causes of death worldwide. Curing them will require, among other things, a better understanding of the many complex 3D tree-shaped structures within the pulmonary system, such as airways, arteries, and veins. In theory, they can be modeled using high-resolution image stacks. Unfortunately, standard CNN approaches operating on dense voxel grids are prohibitively expensive. To remedy this, we introduce a point-based approach that preserves graph connectivity of tree skeleton and incorporates an implicit surface representation. It delivers SOTA accuracy at a low computational cost and the resulting models have usable surfaces. Due to the scarcity of publicly accessible data, we have also curated an extensive dataset to evaluate our approach and will make it public.

Scale-aware Test-time Click Adaptation for Pulmonary Nodule and Mass Segmentation

Pulmonary nodules and masses are crucial imaging features in lung cancer screening that require careful management in clinical diagnosis. Despite the success of deep learning-based medical image segmentation, the robust performance on various sizes of lesions of nodule and mass is still challenging. In this paper, we propose a multi-scale neural network with scale-aware test-time adaptation to address this challenge. Specifically, we introduce an adaptive Scale-aware Test-time Click Adaptation method based on effortlessly obtainable lesion clicks as test-time cues to enhance segmentation performance, particularly for large lesions. The proposed method can be seamlessly integrated into existing networks. Extensive experiments on both open-source and in-house datasets consistently demonstrate the effectiveness of the proposed method over some CNN and Transformer-based segmentation methods. Our code is available at https://github.com/SplinterLi/SaTTCA

Enforcing Topological Interaction between Implicit Surfaces via Uniform Sampling

Objects interact with each other in various ways, including containment, contact, or maintaining fixed distances. Ensuring these topological interactions is crucial for accurate modeling in many scenarios. In this paper, we propose a novel method to refine 3D object representations, ensuring that their surfaces adhere to a topological prior. Our key observation is that the object interaction can be observed via a stochastic approximation method: the statistic of signed distances between a large number of random points to the object surfaces reflect the interaction between them. Thus, the object interaction can be indirectly manipulated by using choosing a set of points as anchors to refine the object surfaces. In particular, we show that our method can be used to enforce two objects to have a specific contact ratio while having no surface intersection. The conducted experiments show that our proposed method enables accurate 3D reconstruction of human hearts, ensuring proper topological connectivity between components. Further, we show that our proposed method can be used to simulate various ways a hand can interact with an arbitrary object.

Topology Repairing of Disconnected Pulmonary Airways and Vessels: Baselines and a Dataset

Accurate segmentation of pulmonary airways and vessels is crucial for the diagnosis and treatment of pulmonary diseases. However, current deep learning approaches suffer from disconnectivity issues that hinder their clinical usefulness. To address this challenge, we propose a post-processing approach that leverages a data-driven method to repair the topology of disconnected pulmonary tubular structures. Our approach formulates the problem as a keypoint detection task, where a neural network is trained to predict keypoints that can bridge disconnected components. We use a training data synthesis pipeline that generates disconnected data from complete pulmonary structures. Moreover, the new Pulmonary Tree Repairing (PTR) dataset is publicly available, which comprises 800 complete 3D models of pulmonary airways, arteries, and veins, as well as the synthetic disconnected data. Our code and data are available at https://github.com/M3DV/pulmonary-tree-repairing.

The Impact of ChatGPT and LLMs on Medical Imaging Stakeholders: Perspectives and Use Cases

This study investigates the transformative potential of Large Language Models (LLMs), such as OpenAI ChatGPT, in medical imaging. With the aid of public data, these models, which possess remarkable language understanding and generation capabilities, are augmenting the interpretive skills of radiologists, enhancing patient-physician communication, and streamlining clinical workflows. The paper introduces an analytic framework for presenting the complex interactions between LLMs and the broader ecosystem of medical imaging stakeholders, including businesses, insurance entities, governments, research institutions, and hospitals (nicknamed BIGR-H). Through detailed analyses, illustrative use cases, and discussions on the broader implications and future directions, this perspective seeks to raise discussion in strategic planning and decision-making in the era of AI-enabled healthcare.