Improved Esophageal Varices Assessment from Non-Contrast CT Scans

Esophageal varices (EV), a serious health concern resulting from portal hypertension, are traditionally diagnosed through invasive endoscopic procedures. Despite non-contrast computed tomography (NC-CT) imaging being a less expensive and non-invasive imaging modality, it has yet to gain full acceptance as a primary clinical diagnostic tool for EV evaluation. To overcome existing diagnostic challenges, we present the Multi-Organ-cOhesion-Network (MOON), a novel framework enhancing the analysis of critical organ features in NC-CT scans for effective assessment of EV. Drawing inspiration from the thorough assessment practices of radiologists, MOON establishes a cohesive multiorgan analysis model that unifies the imaging features of the related organs of EV, namely esophagus, liver, and spleen. This integration significantly increases the diagnostic accuracy for EV. We have compiled an extensive NC-CT dataset of 1,255 patients diagnosed with EV, spanning three grades of severity. Each case is corroborated by endoscopic diagnostic results. The efficacy of MOON has been substantiated through a validation process involving multi-fold cross-validation on 1,010 cases and an independent test on 245 cases, exhibiting superior diagnostic performance compared to methods focusing solely on the esophagus (for classifying severe grade: AUC of 0.864 versus 0.803, and for moderate to severe grades: AUC of 0.832 versus 0.793). To our knowledge, MOON is the first work to incorporate a synchronized multi-organ NC-CT analysis for EV assessment, providing a more acceptable and minimally invasive alternative for patients compared to traditional endoscopy.

LIDIA: Precise Liver Tumor Diagnosis on Multi-Phase Contrast-Enhanced CT via Iterative Fusion and Asymmetric Contrastive Learning

The early detection and precise diagnosis of liver tumors are tasks of critical clinical value, yet they pose significant challenges due to the high heterogeneity and variability of liver tumors. In this work, a precise LIver tumor DIAgnosis network on multi-phase contrast-enhance CT, named LIDIA, is proposed for real-world scenario. To fully utilize all available phases in contrast-enhanced CT, LIDIA first employs the iterative fusion module to aggregate variable numbers of image phases, thereby capturing the features of lesions at different phases for better tumor diagnosis. To effectively mitigate the high heterogeneity problem of liver tumors, LIDIA incorporates asymmetric contrastive learning to enhance the discriminability between different classes. To evaluate our method, we constructed a large-scale dataset comprising 1,921 patients and 8,138 lesions. LIDIA has achieved an average AUC of 93.6% across eight different types of lesions, demonstrating its effectiveness. Besides, LIDIA also demonstrated strong generalizability with an average AUC of 89.3% when tested on an external cohort of 828 patients.

Dual Relation Mining Network for Zero-Shot Learning

Zero-shot learning (ZSL) aims to recognize novel classes through transferring shared semantic knowledge (e.g., attributes) from seen classes to unseen classes. Recently, attention-based methods have exhibited significant progress which align visual features and attributes via a spatial attention mechanism. However, these methods only explore visual-semantic relationship in the spatial dimension, which can lead to classification ambiguity when different attributes share similar attention regions, and semantic relationship between attributes is rarely discussed. To alleviate the above problems, we propose a Dual Relation Mining Network (DRMN) to enable more effective visual-semantic interactions and learn semantic relationship among attributes for knowledge transfer. Specifically, we introduce a Dual Attention Block (DAB) for visual-semantic relationship mining, which enriches visual information by multi-level feature fusion and conducts spatial attention for visual to semantic embedding. Moreover, an attribute-guided channel attention is utilized to decouple entangled semantic features. For semantic relationship modeling, we utilize a Semantic Interaction Transformer (SIT) to enhance the generalization of attribute representations among images. Additionally, a global classification branch is introduced as a complement to human-defined semantic attributes, and we then combine the results with attribute-based classification. Extensive experiments demonstrate that the proposed DRMN leads to new state-of-the-art performances on three standard ZSL benchmarks, i.e., CUB, SUN, and AwA2.

Artificial intelligence for context-aware visual change detection in software test automation

Automated software testing is integral to the software development process, streamlining workflows and ensuring product reliability. Visual testing within this context, especially concerning user interface (UI) and user experience (UX) validation, stands as one of crucial determinants of overall software quality. Nevertheless, conventional methods like pixel-wise comparison and region-based visual change detection fall short in capturing contextual similarities, nuanced alterations, and understanding the spatial relationships between UI elements. In this paper, we introduce a novel graph-based method for visual change detection in software test automation. Leveraging a machine learning model, our method accurately identifies UI controls from software screenshots and constructs a graph representing contextual and spatial relationships between the controls. This information is then used to find correspondence between UI controls within screenshots of different versions of a software. The resulting graph encapsulates the intricate layout of the UI and underlying contextual relations, providing a holistic and context-aware model. This model is finally used to detect and highlight visual regressions in the UI. Comprehensive experiments on different datasets showed that our change detector can accurately detect visual software changes in various simple and complex test scenarios. Moreover, it outperformed pixel-wise comparison and region-based baselines by a large margin in more complex testing scenarios. This work not only contributes to the advancement of visual change detection but also holds practical implications, offering a robust solution for real-world software test automation challenges, enhancing reliability, and ensuring the seamless evolution of software interfaces.

CT-GLIP: 3D Grounded Language-Image Pretraining with CT Scans and Radiology Reports for Full-Body Scenarios

Medical Vision-Language Pretraining (Med-VLP) establishes a connection between visual content from medical images and the relevant textual descriptions. Existing Med-VLP methods primarily focus on 2D images depicting a single body part, notably chest X-rays. In this paper, we extend the scope of Med-VLP to encompass 3D images, specifically targeting full-body scenarios, by using a multimodal dataset of CT images and reports. Compared with the 2D counterpart, 3D VLP is required to effectively capture essential semantics from significantly sparser representation in 3D imaging. In this paper, we introduce CT-GLIP (Grounded Language-Image Pretraining with CT scans), a novel method that constructs organ-level image-text pairs to enhance multimodal contrastive learning, aligning grounded visual features with precise diagnostic text. Additionally, we developed an abnormality dictionary to augment contrastive learning with diverse contrastive pairs. Our method, trained on a multimodal CT dataset comprising 44,011 organ-level vision-text pairs from 17,702 patients across 104 organs, demonstrates it can identify organs and abnormalities in a zero-shot manner using natural languages. The performance of CT-GLIP is validated on a separate test set of 1,130 patients, focusing on the 16 most frequent abnormalities across 7 organs. The experimental results show our model's superior performance over the standard CLIP framework across zero-shot and fine-tuning scenarios, using both CNN and ViT architectures.

Anchor-based Robust Finetuning of Vision-Language Models

We aim at finetuning a vision-language model without hurting its out-of-distribution (OOD) generalization. We address two types of OOD generalization, i.e., i) domain shift such as natural to sketch images, and ii) zero-shot capability to recognize the category that was not contained in the finetune data. Arguably, the diminished OOD generalization after finetuning stems from the excessively simplified finetuning target, which only provides the class information, such as ``a photo of a [CLASS]''. This is distinct from the process in that CLIP was pretrained, where there is abundant text supervision with rich semantic information. Therefore, we propose to compensate for the finetune process using auxiliary supervision with rich semantic information, which acts as anchors to preserve the OOD generalization. Specifically, two types of anchors are elaborated in our method, including i) text-compensated anchor which uses the images from the finetune set but enriches the text supervision from a pretrained captioner, ii) image-text-pair anchor which is retrieved from the dataset similar to pretraining data of CLIP according to the downstream task, associating with the original CLIP text with rich semantics. Those anchors are utilized as auxiliary semantic information to maintain the original feature space of CLIP, thereby preserving the OOD generalization capabilities. Comprehensive experiments demonstrate that our method achieves in-distribution performance akin to conventional finetuning while attaining new state-of-the-art results on domain shift and zero-shot learning benchmarks.

CycleINR: Cycle Implicit Neural Representation for Arbitrary-Scale Volumetric Super-Resolution of Medical Data

In the realm of medical 3D data, such as CT and MRI images, prevalent anisotropic resolution is characterized by high intra-slice but diminished inter-slice resolution. The lowered resolution between adjacent slices poses challenges, hindering optimal viewing experiences and impeding the development of robust downstream analysis algorithms. Various volumetric super-resolution algorithms aim to surmount these challenges, enhancing inter-slice resolution and overall 3D medical imaging quality. However, existing approaches confront inherent challenges: 1) often tailored to specific upsampling factors, lacking flexibility for diverse clinical scenarios; 2) newly generated slices frequently suffer from over-smoothing, degrading fine details, and leading to inter-slice inconsistency. In response, this study presents CycleINR, a novel enhanced Implicit Neural Representation model for 3D medical data volumetric super-resolution. Leveraging the continuity of the learned implicit function, the CycleINR model can achieve results with arbitrary up-sampling rates, eliminating the need for separate training. Additionally, we enhance the grid sampling in CycleINR with a local attention mechanism and mitigate over-smoothing by integrating cycle-consistent loss. We introduce a new metric, Slice-wise Noise Level Inconsistency (SNLI), to quantitatively assess inter-slice noise level inconsistency. The effectiveness of our approach is demonstrated through image quality evaluations on an in-house dataset and a downstream task analysis on the Medical Segmentation Decathlon liver tumor dataset.

Effective Lymph Nodes Detection in CT Scans Using Location Debiased Query Selection and Contrastive Query Representation in Transformer

Lymph node (LN) assessment is a critical, indispensable yet very challenging task in the routine clinical workflow of radiology and oncology. Accurate LN analysis is essential for cancer diagnosis, staging, and treatment planning. Finding scatteredly distributed, low-contrast clinically relevant LNs in 3D CT is difficult even for experienced physicians under high inter-observer variations. Previous automatic LN detection works typically yield limited recall and high false positives (FPs) due to adjacent anatomies with similar image intensities, shapes, or textures (vessels, muscles, esophagus, etc). In this work, we propose a new LN DEtection TRansformer, named LN-DETR, to achieve more accurate performance. By enhancing the 2D backbone with a multi-scale 2.5D feature fusion to incorporate 3D context explicitly, more importantly, we make two main contributions to improve the representation quality of LN queries. 1) Considering that LN boundaries are often unclear, an IoU prediction head and a location debiased query selection are proposed to select LN queries of higher localization accuracy as the decoder query's initialization. 2) To reduce FPs, query contrastive learning is employed to explicitly reinforce LN queries towards their best-matched ground-truth queries over unmatched query predictions. Trained and tested on 3D CT scans of 1067 patients (with 10,000+ labeled LNs) via combining seven LN datasets from different body parts (neck, chest, and abdomen) and pathologies/cancers, our method significantly improves the performance of previous leading methods by > 4-5% average recall at the same FP rates in both internal and external testing. We further evaluate on the universal lesion detection task using NIH DeepLesion benchmark, and our method achieves the top performance of 88.46% averaged recall across 0.5 to 4 FPs per image, compared with other leading reported results.

LaRE^2: Latent Reconstruction Error Based Method for Diffusion-Generated Image Detection

The evolution of Diffusion Models has dramatically improved image generation quality, making it increasingly difficult to differentiate between real and generated images. This development, while impressive, also raises significant privacy and security concerns. In response to this, we propose a novel Latent REconstruction error guided feature REfinement method (LaRE^2) for detecting the diffusion-generated images. We come up with the Latent Reconstruction Error (LaRE), the first reconstruction-error based feature in the latent space for generated image detection. LaRE surpasses existing methods in terms of feature extraction efficiency while preserving crucial cues required to differentiate between the real and the fake. To exploit LaRE, we propose an Error-Guided feature REfinement module (EGRE), which can refine the image feature guided by LaRE to enhance the discriminativeness of the feature. Our EGRE utilizes an align-then-refine mechanism, which effectively refines the image feature for generated-image detection from both spatial and channel perspectives. Extensive experiments on the large-scale GenImage benchmark demonstrate the superiority of our LaRE^2, which surpasses the best SoTA method by up to 11.9%/12.1% average ACC/AP across 8 different image generators. LaRE also surpasses existing methods in terms of feature extraction cost, delivering an impressive speed enhancement of 8 times.

Towards a Comprehensive, Efficient and Promptable Anatomic Structure Segmentation Model using 3D Whole-body CT Scans

Segment anything model (SAM) demonstrates strong generalization ability on natural image segmentation. However, its direct adaption in medical image segmentation tasks shows significant performance drops with inferior accuracy and unstable results. It may also requires an excessive number of prompt points to obtain a reasonable accuracy. For segmenting 3D radiological CT or MRI scans, a 2D SAM model has to separately handle hundreds of 2D slices. Although quite a few studies explore adapting SAM into medical image volumes, the efficiency of 2D adaption methods is unsatisfactory and 3D adaptation methods only capable of segmenting specific organs/tumors. In this work, we propose a comprehensive and scalable 3D SAM model for whole-body CT segmentation, named CT-SAM3D. Instead of adapting SAM, we propose a 3D promptable segmentation model using a (nearly) fully labeled CT dataset. To train CT-SAM3D effectively, ensuring the model's accurate responses to higher-dimensional spatial prompts is crucial, and 3D patch-wise training is required due to GPU memory constraints. For this purpose, we propose two key technical developments: 1) a progressively and spatially aligned prompt encoding method to effectively encode click prompts in local 3D space; and 2) a cross-patch prompt learning scheme to capture more 3D spatial context, which is beneficial for reducing the editing workloads when interactively prompting on large organs. CT-SAM3D is trained and validated using a curated dataset of 1204 CT scans containing 107 whole-body anatomies, reporting significantly better quantitative performance against all previous SAM-derived models by a large margin with much fewer click prompts. Our model can handle segmenting unseen organ as well. Code, data, and our 3D interactive segmentation tool with quasi-real-time responses will be made publicly available.