A Robust Ensemble Algorithm for Ischemic Stroke Lesion Segmentation: Generalizability and Clinical Utility Beyond the ISLES Challenge

Diffusion-weighted MRI (DWI) is essential for stroke diagnosis, treatment decisions, and prognosis. However, image and disease variability hinder the development of generalizable AI algorithms with clinical value. We address this gap by presenting a novel ensemble algorithm derived from the 2022 Ischemic Stroke Lesion Segmentation (ISLES) challenge. ISLES'22 provided 400 patient scans with ischemic stroke from various medical centers, facilitating the development of a wide range of cutting-edge segmentation algorithms by the research community. Through collaboration with leading teams, we combined top-performing algorithms into an ensemble model that overcomes the limitations of individual solutions. Our ensemble model achieved superior ischemic lesion detection and segmentation accuracy on our internal test set compared to individual algorithms. This accuracy generalized well across diverse image and disease variables. Furthermore, the model excelled in extracting clinical biomarkers. Notably, in a Turing-like test, neuroradiologists consistently preferred the algorithm's segmentations over manual expert efforts, highlighting increased comprehensiveness and precision. Validation using a real-world external dataset (N=1686) confirmed the model's generalizability. The algorithm's outputs also demonstrated strong correlations with clinical scores (admission NIHSS and 90-day mRS) on par with or exceeding expert-derived results, underlining its clinical relevance. This study offers two key findings. First, we present an ensemble algorithm (https://github.com/Tabrisrei/ISLES22_Ensemble) that detects and segments ischemic stroke lesions on DWI across diverse scenarios on par with expert (neuro)radiologists. Second, we show the potential for biomedical challenge outputs to extend beyond the challenge's initial objectives, demonstrating their real-world clinical applicability.

Benchmarking Segmentation Models with Mask-Preserved Attribute Editing

When deploying segmentation models in practice, it is critical to evaluate their behaviors in varied and complex scenes. Different from the previous evaluation paradigms only in consideration of global attribute variations (e.g. adverse weather), we investigate both local and global attribute variations for robustness evaluation. To achieve this, we construct a mask-preserved attribute editing pipeline to edit visual attributes of real images with precise control of structural information. Therefore, the original segmentation labels can be reused for the edited images. Using our pipeline, we construct a benchmark covering both object and image attributes (e.g. color, material, pattern, style). We evaluate a broad variety of semantic segmentation models, spanning from conventional close-set models to recent open-vocabulary large models on their robustness to different types of variations. We find that both local and global attribute variations affect segmentation performances, and the sensitivity of models diverges across different variation types. We argue that local attributes have the same importance as global attributes, and should be considered in the robustness evaluation of segmentation models. Code: https://github.com/PRIS-CV/Pascal-EA.

Vision-language Assisted Attribute Learning

Attribute labeling at large scale is typically incomplete and partial, posing significant challenges to model optimization. Existing attribute learning methods often treat the missing labels as negative or simply ignore them all during training, either of which could hamper the model performance to a great extent. To overcome these limitations, in this paper we leverage the available vision-language knowledge to explicitly disclose the missing labels for enhancing model learning. Given an image, we predict the likelihood of each missing attribute label assisted by an off-the-shelf vision-language model, and randomly select to ignore those with high scores in training. Our strategy strikes a good balance between fully ignoring and negatifying the missing labels, as these high scores are found to be informative on revealing label ambiguity. Extensive experiments show that our proposed vision-language assisted loss can achieve state-of-the-art performance on the newly cleaned VAW dataset. Qualitative evaluation demonstrates the ability of the proposed method in predicting more complete attributes.

Ariadne's Thread:Using Text Prompts to Improve Segmentation of Infected Areas from Chest X-ray images

Segmentation of the infected areas of the lung is essential for quantifying the severity of lung disease like pulmonary infections. Existing medical image segmentation methods are almost uni-modal methods based on image. However, these image-only methods tend to produce inaccurate results unless trained with large amounts of annotated data. To overcome this challenge, we propose a language-driven segmentation method that uses text prompt to improve to the segmentation result. Experiments on the QaTa-COV19 dataset indicate that our method improves the Dice score by 6.09% at least compared to the uni-modal methods. Besides, our extended study reveals the flexibility of multi-modal methods in terms of the information granularity of text and demonstrates that multi-modal methods have a significant advantage over image-only methods in terms of the size of training data required.

Super-Resolution Information Enhancement For Crowd Counting

Crowd counting is a challenging task due to the heavy occlusions, scales, and density variations. Existing methods handle these challenges effectively while ignoring low-resolution (LR) circumstances. The LR circumstances weaken the counting performance deeply for two crucial reasons: 1) limited detail information; 2) overlapping head regions accumulate in density maps and result in extreme ground-truth values. An intuitive solution is to employ super-resolution (SR) pre-processes for the input LR images. However, it complicates the inference steps and thus limits application potentials when requiring real-time. We propose a more elegant method termed Multi-Scale Super-Resolution Module (MSSRM). It guides the network to estimate the lost de tails and enhances the detailed information in the feature space. Noteworthy that the MSSRM is plug-in plug-out and deals with the LR problems with no inference cost. As the proposed method requires SR labels, we further propose a Super-Resolution Crowd Counting dataset (SR-Crowd). Extensive experiments on three datasets demonstrate the superiority of our method. The code will be available at https://github.com/PRIS-CV/MSSRM.git.

Graph Convolution Based Cross-Network Multi-Scale Feature Fusion for Deep Vessel Segmentation

Vessel segmentation is widely used to help with vascular disease diagnosis. Vessels reconstructed using existing methods are often not sufficiently accurate to meet clinical use standards. This is because 3D vessel structures are highly complicated and exhibit unique characteristics, including sparsity and anisotropy. In this paper, we propose a novel hybrid deep neural network for vessel segmentation. Our network consists of two cascaded subnetworks performing initial and refined segmentation respectively. The second subnetwork further has two tightly coupled components, a traditional CNN-based U-Net and a graph U-Net. Cross-network multi-scale feature fusion is performed between these two U-shaped networks to effectively support high-quality vessel segmentation. The entire cascaded network can be trained from end to end. The graph in the second subnetwork is constructed according to a vessel probability map as well as appearance and semantic similarities in the original CT volume. To tackle the challenges caused by the sparsity and anisotropy of vessels, a higher percentage of graph nodes are distributed in areas that potentially contain vessels while a higher percentage of edges follow the orientation of potential nearbyvessels. Extensive experiments demonstrate our deep network achieves state-of-the-art 3D vessel segmentation performance on multiple public and in-house datasets.

Multi-head Uncertainty Inference for Adversarial Attack Detection

Deep neural networks (DNNs) are sensitive and susceptible to tiny perturbation by adversarial attacks which causes erroneous predictions. Various methods, including adversarial defense and uncertainty inference (UI), have been developed in recent years to overcome the adversarial attacks. In this paper, we propose a multi-head uncertainty inference (MH-UI) framework for detecting adversarial attack examples. We adopt a multi-head architecture with multiple prediction heads (i.e., classifiers) to obtain predictions from different depths in the DNNs and introduce shallow information for the UI. Using independent heads at different depths, the normalized predictions are assumed to follow the same Dirichlet distribution, and we estimate distribution parameter of it by moment matching. Cognitive uncertainty brought by the adversarial attacks will be reflected and amplified on the distribution. Experimental results show that the proposed MH-UI framework can outperform all the referred UI methods in the adversarial attack detection task with different settings.

Learning Invariant Visual Representations for Compositional Zero-Shot Learning

Compositional Zero-Shot Learning (CZSL) aims to recognize novel compositions using knowledge learned from seen attribute-object compositions in the training set. Previous works mainly project an image and a composition into a common embedding space to measure their compatibility score. However, both attributes and objects share the visual representations learned above, leading the model to exploit spurious correlations and bias towards seen pairs. Instead, we reconsider CZSL as an out-of-distribution generalization problem. If an object is treated as a domain, we can learn object-invariant features to recognize the attributes attached to any object reliably. Similarly, attribute-invariant features can also be learned when recognizing the objects with attributes as domains. Specifically, we propose an invariant feature learning framework to align different domains at the representation and gradient levels to capture the intrinsic characteristics associated with the tasks. Experiments on two CZSL benchmarks demonstrate that the proposed method significantly outperforms the previous state-of-the-art.