Test-Time Modality Generalization for Medical Image Segmentation

Generalizable medical image segmentation is essential for ensuring consistent performance across diverse unseen clinical settings. However, existing methods often overlook the capability to generalize effectively across arbitrary unseen modalities. In this paper, we introduce a novel Test-Time Modality Generalization (TTMG) framework, which comprises two core components: Modality-Aware Style Projection (MASP) and Modality-Sensitive Instance Whitening (MSIW), designed to enhance generalization in arbitrary unseen modality datasets. The MASP estimates the likelihood of a test instance belonging to each seen modality and maps it onto a distribution using modality-specific style bases, guiding its projection effectively. Furthermore, as high feature covariance hinders generalization to unseen modalities, the MSIW is applied during training to selectively suppress modality-sensitive information while retaining modality-invariant features. By integrating MASP and MSIW, the TTMG framework demonstrates robust generalization capabilities for medical image segmentation in unseen modalities a challenge that current methods have largely neglected. We evaluated TTMG alongside other domain generalization techniques across eleven datasets spanning four modalities (colonoscopy, ultrasound, dermoscopy, and radiology), consistently achieving superior segmentation performance across various modality combinations.

VizECGNet: Visual ECG Image Network for Cardiovascular Diseases Classification with Multi-Modal Training and Knowledge Distillation

An electrocardiogram (ECG) captures the heart's electrical signal to assess various heart conditions. In practice, ECG data is stored as either digitized signals or printed images. Despite the emergence of numerous deep learning models for digitized signals, many hospitals prefer image storage due to cost considerations. Recognizing the unavailability of raw ECG signals in many clinical settings, we propose VizECGNet, which uses only printed ECG graphics to determine the prognosis of multiple cardiovascular diseases. During training, cross-modal attention modules (CMAM) are used to integrate information from two modalities - image and signal, while self-modality attention modules (SMAM) capture inherent long-range dependencies in ECG data of each modality. Additionally, we utilize knowledge distillation to improve the similarity between two distinct predictions from each modality stream. This innovative multi-modal deep learning architecture enables the utilization of only ECG images during inference. VizECGNet with image input achieves higher performance in precision, recall, and F1-Score compared to signal-based ECG classification models, with improvements of 3.50%, 8.21%, and 7.38%, respectively.

Modality-agnostic Domain Generalizable Medical Image Segmentation by Multi-Frequency in Multi-Scale Attention

Generalizability in deep neural networks plays a pivotal role in medical image segmentation. However, deep learning-based medical image analyses tend to overlook the importance of frequency variance, which is critical element for achieving a model that is both modality-agnostic and domain-generalizable. Additionally, various models fail to account for the potential information loss that can arise from multi-task learning under deep supervision, a factor that can impair the model representation ability. To address these challenges, we propose a Modality-agnostic Domain Generalizable Network (MADGNet) for medical image segmentation, which comprises two key components: a Multi-Frequency in Multi-Scale Attention (MFMSA) block and Ensemble Sub-Decoding Module (E-SDM). The MFMSA block refines the process of spatial feature extraction, particularly in capturing boundary features, by incorporating multi-frequency and multi-scale features, thereby offering informative cues for tissue outline and anatomical structures. Moreover, we propose E-SDM to mitigate information loss in multi-task learning with deep supervision, especially during substantial upsampling from low resolution. We evaluate the segmentation performance of MADGNet across six modalities and fifteen datasets. Through extensive experiments, we demonstrate that MADGNet consistently outperforms state-of-the-art models across various modalities, showcasing superior segmentation performance. This affirms MADGNet as a robust solution for medical image segmentation that excels in diverse imaging scenarios. Our MADGNet code is available in GitHub Link.

M3FPolypSegNet: Segmentation Network with Multi-frequency Feature Fusion for Polyp Localization in Colonoscopy Images

Polyp segmentation is crucial for preventing colorectal cancer a common type of cancer. Deep learning has been used to segment polyps automatically, which reduces the risk of misdiagnosis. Localizing small polyps in colonoscopy images is challenging because of its complex characteristics, such as color, occlusion, and various shapes of polyps. To address this challenge, a novel frequency-based fully convolutional neural network, Multi-Frequency Feature Fusion Polyp Segmentation Network (M3FPolypSegNet) was proposed to decompose the input image into low/high/full-frequency components to use the characteristics of each component. We used three independent multi-frequency encoders to map multiple input images into a high-dimensional feature space. In the Frequency-ASPP Scalable Attention Module (F-ASPP SAM), ASPP was applied between each frequency component to preserve scale information. Subsequently, scalable attention was applied to emphasize polyp regions in a high-dimensional feature space. Finally, we designed three multi-task learning (i.e., region, edge, and distance) in four decoder blocks to learn the structural characteristics of the region. The proposed model outperformed various segmentation models with performance gains of 6.92% and 7.52% on average for all metrics on CVC-ClinicDB and BKAI-IGH-NeoPolyp, respectively.