Anatomically-aware Uncertainty for Semi-supervised Image Segmentation

Semi-supervised learning relaxes the need of large pixel-wise labeled datasets for image segmentation by leveraging unlabeled data. A prominent way to exploit unlabeled data is to regularize model predictions. Since the predictions of unlabeled data can be unreliable, uncertainty-aware schemes are typically employed to gradually learn from meaningful and reliable predictions. Uncertainty estimation methods, however, rely on multiple inferences from the model predictions that must be computed for each training step, which is computationally expensive. Moreover, these uncertainty maps capture pixel-wise disparities and do not consider global information. This work proposes a novel method to estimate segmentation uncertainty by leveraging global information from the segmentation masks. More precisely, an anatomically-aware representation is first learnt to model the available segmentation masks. The learnt representation thereupon maps the prediction of a new segmentation into an anatomically-plausible segmentation. The deviation from the plausible segmentation aids in estimating the underlying pixel-level uncertainty in order to further guide the segmentation network. The proposed method consequently estimates the uncertainty using a single inference from our representation, thereby reducing the total computation. We evaluate our method on two publicly available segmentation datasets of left atria in cardiac MRIs and of multiple organs in abdominal CTs. Our anatomically-aware method improves the segmentation accuracy over the state-of-the-art semi-supervised methods in terms of two commonly used evaluation metrics.

A Foundation LAnguage-Image model of the Retina (FLAIR): Encoding expert knowledge in text supervision

Foundation vision-language models are currently transforming computer vision, and are on the rise in medical imaging fueled by their very promising generalization capabilities. However, the initial attempts to transfer this new paradigm to medical imaging have shown less impressive performances than those observed in other domains, due to the significant domain shift and the complex, expert domain knowledge inherent to medical-imaging tasks. Motivated by the need for domain-expert foundation models, we present FLAIR, a pre-trained vision-language model for universal retinal fundus image understanding. To this end, we compiled 37 open-access, mostly categorical fundus imaging datasets from various sources, with up to 97 different target conditions and 284,660 images. We integrate the expert's domain knowledge in the form of descriptive textual prompts, during both pre-training and zero-shot inference, enhancing the less-informative categorical supervision of the data. Such a textual expert's knowledge, which we compiled from the relevant clinical literature and community standards, describes the fine-grained features of the pathologies as well as the hierarchies and dependencies between them. We report comprehensive evaluations, which illustrate the benefit of integrating expert knowledge and the strong generalization capabilities of FLAIR under difficult scenarios with domain shifts or unseen categories. When adapted with a lightweight linear probe, FLAIR outperforms fully-trained, dataset-focused models, more so in the few-shot regimes. Interestingly, FLAIR outperforms by a large margin more generalist, larger-scale image-language models, which emphasizes the potential of embedding experts' domain knowledge and the limitations of generalist models in medical imaging.

MoP-CLIP: A Mixture of Prompt-Tuned CLIP Models for Domain Incremental Learning

Despite the recent progress in incremental learning, addressing catastrophic forgetting under distributional drift is still an open and important problem. Indeed, while state-of-the-art domain incremental learning (DIL) methods perform satisfactorily within known domains, their performance largely degrades in the presence of novel domains. This limitation hampers their generalizability, and restricts their scalability to more realistic settings where train and test data are drawn from different distributions. To address these limitations, we present a novel DIL approach based on a mixture of prompt-tuned CLIP models (MoP-CLIP), which generalizes the paradigm of S-Prompting to handle both in-distribution and out-of-distribution data at inference. In particular, at the training stage we model the features distribution of every class in each domain, learning individual text and visual prompts to adapt to a given domain. At inference, the learned distributions allow us to identify whether a given test sample belongs to a known domain, selecting the correct prompt for the classification task, or from an unseen domain, leveraging a mixture of the prompt-tuned CLIP models. Our empirical evaluation reveals the poor performance of existing DIL methods under domain shift, and suggests that the proposed MoP-CLIP performs competitively in the standard DIL settings while outperforming state-of-the-art methods in OOD scenarios. These results demonstrate the superiority of MoP-CLIP, offering a robust and general solution to the problem of domain incremental learning.

Prompting classes: Exploring the Power of Prompt Class Learning in Weakly Supervised Semantic Segmentation

Recently, CLIP-based approaches have exhibited remarkable performance on generalization and few-shot learning tasks, fueled by the power of contrastive language-vision pre-training. In particular, prompt tuning has emerged as an effective strategy to adapt the pre-trained language-vision models to downstream tasks by employing task-related textual tokens. Motivated by this progress, in this work we question whether other fundamental problems, such as weakly supervised semantic segmentation (WSSS), can benefit from prompt tuning. Our findings reveal two interesting observations that shed light on the impact of prompt tuning on WSSS. First, modifying only the class token of the text prompt results in a greater impact on the Class Activation Map (CAM), compared to arguably more complex strategies that optimize the context. And second, the class token associated with the image ground truth does not necessarily correspond to the category that yields the best CAM. Motivated by these observations, we introduce a novel approach based on a PrOmpt cLass lEarning (POLE) strategy. Through extensive experiments we demonstrate that our simple, yet efficient approach achieves SOTA performance in a well-known WSSS benchmark. These results highlight not only the benefits of language-vision models in WSSS but also the potential of prompt learning for this problem. The code is available at https://github.com/rB080/WSS_POLE.

Mixup-Privacy: A simple yet effective approach for privacy-preserving segmentation

Privacy protection in medical data is a legitimate obstacle for centralized machine learning applications. Here, we propose a client-server image segmentation system which allows for the analysis of multi-centric medical images while preserving patient privacy. In this approach, the client protects the to-be-segmented patient image by mixing it to a reference image. As shown in our work, it is challenging to separate the image mixture to exact original content, thus making the data unworkable and unrecognizable for an unauthorized person. This proxy image is sent to a server for processing. The server then returns the mixture of segmentation maps, which the client can revert to a correct target segmentation. Our system has two components: 1) a segmentation network on the server side which processes the image mixture, and 2) a segmentation unmixing network which recovers the correct segmentation map from the segmentation mixture. Furthermore, the whole system is trained end-to-end. The proposed method is validated on the task of MRI brain segmentation using images from two different datasets. Results show that the segmentation accuracy of our method is comparable to a system trained on raw images, and outperforms other privacy-preserving methods with little computational overhead.

Transductive few-shot adapters for medical image segmentation

With the recent raise of foundation models in computer vision and NLP, the pretrain-and-adapt strategy, where a large-scale model is fine-tuned on downstream tasks, is gaining popularity. However, traditional fine-tuning approaches may still require significant resources and yield sub-optimal results when the labeled data of the target task is scarce. This is especially the case in clinical settings. To address this challenge, we formalize few-shot efficient fine-tuning (FSEFT), a novel and realistic setting for medical image segmentation. Furthermore, we introduce a novel parameter-efficient fine-tuning strategy tailored to medical image segmentation, with (a) spatial adapter modules that are more appropriate for dense prediction tasks; and (b) a constrained transductive inference, which leverages task-specific prior knowledge. Our comprehensive experiments on a collection of public CT datasets for organ segmentation reveal the limitations of standard fine-tuning methods in few-shot scenarios, point to the potential of vision adapters and transductive inference, and confirm the suitability of foundation models.

Trust your neighbours: Penalty-based constraints for model calibration

Ensuring reliable confidence scores from deep networks is of pivotal importance in critical decision-making systems, notably in the medical domain. While recent literature on calibrating deep segmentation networks has led to significant progress, their uncertainty is usually modeled by leveraging the information of individual pixels, which disregards the local structure of the object of interest. In particular, only the recent Spatially Varying Label Smoothing (SVLS) approach addresses this issue by softening the pixel label assignments with a discrete spatial Gaussian kernel. In this work, we first present a constrained optimization perspective of SVLS and demonstrate that it enforces an implicit constraint on soft class proportions of surrounding pixels. Furthermore, our analysis shows that SVLS lacks a mechanism to balance the contribution of the constraint with the primary objective, potentially hindering the optimization process. Based on these observations, we propose a principled and simple solution based on equality constraints on the logit values, which enables to control explicitly both the enforced constraint and the weight of the penalty, offering more flexibility. Comprehensive experiments on a variety of well-known segmentation benchmarks demonstrate the superior performance of the proposed approach.

Harmonizing Flows: Unsupervised MR harmonization based on normalizing flows

In this paper, we propose an unsupervised framework based on normalizing flows that harmonizes MR images to mimic the distribution of the source domain. The proposed framework consists of three steps. First, a shallow harmonizer network is trained to recover images of the source domain from their augmented versions. A normalizing flow network is then trained to learn the distribution of the source domain. Finally, at test time, a harmonizer network is modified so that the output images match the source domain's distribution learned by the normalizing flow model. Our unsupervised, source-free and task-independent approach is evaluated on cross-domain brain MRI segmentation using data from four different sites. Results demonstrate its superior performance compared to existing methods.

Mutual Information-based Generalized Category Discovery

We introduce an information-maximization approach for the Generalized Category Discovery (GCD) problem. Specifically, we explore a parametric family of loss functions evaluating the mutual information between the features and the labels, and find automatically the one that maximizes the predictive performances. Furthermore, we introduce the Elbow Maximum Centroid-Shift (EMaCS) technique, which estimates the number of classes in the unlabeled set. We report comprehensive experiments, which show that our mutual information-based approach (MIB) is both versatile and highly competitive under various GCD scenarios. The gap between the proposed approach and the existing methods is significant, more so when dealing with fine-grained classification problems. Our code: \url{https://github.com/fchiaroni/Mutual-Information-Based-GCD}.