The utilisation of Plug-and-Play (PnP) priors in inverse problems has become increasingly prominent in recent years. This preference is based on the mathematical equivalence between the general proximal operator and the regularised denoiser, facilitating the adaptation of various off-the-shelf denoiser priors to a wide range of inverse problems. However, existing PnP models predominantly rely on pre-trained denoisers using large datasets. In this work, we introduce Single-Shot PnP methods (SS-PnP), shifting the focus to solving inverse problems with minimal data. First, we integrate Single-Shot proximal denoisers into iterative methods, enabling training with single instances. Second, we propose implicit neural priors based on a novel function that preserves relevant frequencies to capture fine details while avoiding the issue of vanishing gradients. We demonstrate, through extensive numerical and visual experiments, that our method leads to better approximations.
Hospital readmission prediction is considered an essential approach to decreasing readmission rates, which is a key factor in assessing the quality and efficacy of a healthcare system. Previous studies have extensively utilized three primary modalities, namely electronic health records (EHR), medical images, and clinical notes, to predict hospital readmissions. However, the majority of these studies did not integrate information from all three modalities or utilize the spatiotemporal relationships present in the dataset. This study introduces a novel model called the Multimodal Spatiotemporal Graph-Transformer (MuST) for predicting hospital readmissions. By employing Graph Convolution Networks and temporal transformers, we can effectively capture spatial and temporal dependencies in EHR and chest radiographs. We then propose a fusion transformer to combine the spatiotemporal features from the two modalities mentioned above with the features from clinical notes extracted by a pre-trained, domain-specific transformer. We assess the effectiveness of our methods using the latest publicly available dataset, MIMIC-IV. The experimental results indicate that the inclusion of multimodal features in MuST improves its performance in comparison to unimodal methods. Furthermore, our proposed pipeline outperforms the current leading methods in the prediction of hospital readmissions.
Fetal pose estimation in 3D ultrasound (US) involves identifying a set of associated fetal anatomical landmarks. Its primary objective is to provide comprehensive information about the fetus through landmark connections, thus benefiting various critical applications, such as biometric measurements, plane localization, and fetal movement monitoring. However, accurately estimating the 3D fetal pose in US volume has several challenges, including poor image quality, limited GPU memory for tackling high dimensional data, symmetrical or ambiguous anatomical structures, and considerable variations in fetal poses. In this study, we propose a novel 3D fetal pose estimation framework (called FetusMapV2) to overcome the above challenges. Our contribution is three-fold. First, we propose a heuristic scheme that explores the complementary network structure-unconstrained and activation-unreserved GPU memory management approaches, which can enlarge the input image resolution for better results under limited GPU memory. Second, we design a novel Pair Loss to mitigate confusion caused by symmetrical and similar anatomical structures. It separates the hidden classification task from the landmark localization task and thus progressively eases model learning. Last, we propose a shape priors-based self-supervised learning by selecting the relatively stable landmarks to refine the pose online. Extensive experiments and diverse applications on a large-scale fetal US dataset including 1000 volumes with 22 landmarks per volume demonstrate that our method outperforms other strong competitors.
Uncertainty estimation aims to evaluate the confidence of a trained deep neural network. However, existing uncertainty estimation approaches rely on low-dimensional distributional assumptions and thus suffer from the high dimensionality of latent features. Existing approaches tend to focus on uncertainty on discrete classification probabilities, which leads to poor generalizability to uncertainty estimation for other tasks. Moreover, most of the literature requires seeing the out-of-distribution (OOD) data in the training for better estimation of uncertainty, which limits the uncertainty estimation performance in practice because the OOD data are typically unseen. To overcome these limitations, we propose a new framework using data-adaptive high-dimensional hypothesis testing for uncertainty estimation, which leverages the statistical properties of the feature representations. Our method directly operates on latent representations and thus does not require retraining the feature encoder under a modified objective. The test statistic relaxes the feature distribution assumptions to high dimensionality, and it is more discriminative to uncertainties in the latent representations. We demonstrate that encoding features with Bayesian neural networks can enhance testing performance and lead to more accurate uncertainty estimation. We further introduce a family-wise testing procedure to determine the optimal threshold of OOD detection, which minimizes the false discovery rate (FDR). Extensive experiments validate the satisfactory performance of our framework on uncertainty estimation and task-specific prediction over a variety of competitors. The experiments on the OOD detection task also show satisfactory performance of our method when the OOD data are unseen in the training. Codes are available at https://github.com/HKU-MedAI/bnn_uncertainty.
Co-occurrent visual patterns suggest that pixel relation modeling facilitates dense prediction tasks, which inspires the development of numerous context modeling paradigms, \emph{e.g.}, multi-scale-driven and similarity-driven context schemes. Despite the impressive results, these existing paradigms often suffer from inadequate or ineffective contextual information aggregation due to reliance on large amounts of predetermined priors. To alleviate the issues, we propose a novel \textbf{I}ntervention-\textbf{D}riven \textbf{R}elation \textbf{Net}work (\textbf{IDRNet}), which leverages a deletion diagnostics procedure to guide the modeling of contextual relations among different pixels. Specifically, we first group pixel-level representations into semantic-level representations with the guidance of pseudo labels and further improve the distinguishability of the grouped representations with a feature enhancement module. Next, a deletion diagnostics procedure is conducted to model relations of these semantic-level representations via perceiving the network outputs and the extracted relations are utilized to guide the semantic-level representations to interact with each other. Finally, the interacted representations are utilized to augment original pixel-level representations for final predictions. Extensive experiments are conducted to validate the effectiveness of IDRNet quantitatively and qualitatively. Notably, our intervention-driven context scheme brings consistent performance improvements to state-of-the-art segmentation frameworks and achieves competitive results on popular benchmark datasets, including ADE20K, COCO-Stuff, PASCAL-Context, LIP, and Cityscapes. Code is available at \url{https://github.com/SegmentationBLWX/sssegmentation}.
In computation pathology, the pyramid structure of gigapixel Whole Slide Images (WSIs) has recently been studied for capturing various information from individual cell interactions to tissue microenvironments. This hierarchical structure is believed to be beneficial for cancer diagnosis and prognosis tasks. However, most previous hierarchical WSI analysis works (1) only characterize local or global correlations within the WSI pyramids and (2) use only unidirectional interaction between different resolutions, leading to an incomplete picture of WSI pyramids. To this end, this paper presents a novel Hierarchical Interaction Graph-Transformer (i.e., HIGT) for WSI analysis. With Graph Neural Network and Transformer as the building commons, HIGT can learn both short-range local information and long-range global representation of the WSI pyramids. Considering that the information from different resolutions is complementary and can benefit each other during the learning process, we further design a novel Bidirectional Interaction block to establish communication between different levels within the WSI pyramids. Finally, we aggregate both coarse-grained and fine-grained features learned from different levels together for slide-level prediction. We evaluate our methods on two public WSI datasets from TCGA projects, i.e., kidney carcinoma (KICA) and esophageal carcinoma (ESCA). Experimental results show that our HIGT outperforms both hierarchical and non-hierarchical state-of-the-art methods on both tumor subtyping and staging tasks.
The Segment Anything Model (SAM) has demonstrated remarkable capabilities of scaled-up segmentation models, enabling zero-shot generalization across a variety of domains. By leveraging large-scale foundational models as pre-trained models, it is a natural progression to fine-tune SAM for specific domains to further enhance performances. However, the adoption of foundational models in the medical domain presents a challenge due to the difficulty and expense of labeling sufficient data for adaptation within hospital systems. In this paper, we introduce an efficient and practical approach for fine-tuning SAM using a limited number of exemplars, making it suitable for such scenarios. Our approach combines two established techniques from the literature: an exemplar-guided synthesis module and the widely recognized Low-Rank Adaptation (LoRA) fine-tuning strategy, serving as data-level and model-level attempts respectively. Interestingly, our empirical findings suggest that SAM can be effectively aligned within the medical domain even with few labeled data. We validate our approach through experiments on brain tumor segmentation (BraTS) and multi-organ CT segmentation (Synapse). The comprehensive results underscore the feasibility and effectiveness of such an approach, paving the way for the practical application of SAM in the medical domain.
Whole slide image (WSI) analysis has become increasingly important in the medical imaging community, enabling automated and objective diagnosis, prognosis, and therapeutic-response prediction. However, in clinical practice, the ever-evolving environment hamper the utility of WSI analysis models. In this paper, we propose the FIRST continual learning framework for WSI analysis, named ConSlide, to tackle the challenges of enormous image size, utilization of hierarchical structure, and catastrophic forgetting by progressive model updating on multiple sequential datasets. Our framework contains three key components. The Hierarchical Interaction Transformer (HIT) is proposed to model and utilize the hierarchical structural knowledge of WSI. The Breakup-Reorganize (BuRo) rehearsal method is developed for WSI data replay with efficient region storing buffer and WSI reorganizing operation. The asynchronous updating mechanism is devised to encourage the network to learn generic and specific knowledge respectively during the replay stage, based on a nested cross-scale similarity learning (CSSL) module. We evaluated the proposed ConSlide on four public WSI datasets from TCGA projects. It performs best over other state-of-the-art methods with a fair WSI-based continual learning setting and achieves a better trade-off of the overall performance and forgetting on previous task
Medical imaging has witnessed remarkable progress but usually requires a large amount of high-quality annotated data which is time-consuming and costly to obtain. To alleviate this burden, semi-supervised learning has garnered attention as a potential solution. In this paper, we present Meta-Learning for Bootstrapping Medical Image Segmentation (MLB-Seg), a novel method for tackling the challenge of semi-supervised medical image segmentation. Specifically, our approach first involves training a segmentation model on a small set of clean labeled images to generate initial labels for unlabeled data. To further optimize this bootstrapping process, we introduce a per-pixel weight mapping system that dynamically assigns weights to both the initialized labels and the model's own predictions. These weights are determined using a meta-process that prioritizes pixels with loss gradient directions closer to those of clean data, which is based on a small set of precisely annotated images. To facilitate the meta-learning process, we additionally introduce a consistency-based Pseudo Label Enhancement (PLE) scheme that improves the quality of the model's own predictions by ensembling predictions from various augmented versions of the same input. In order to improve the quality of the weight maps obtained through multiple augmentations of a single input, we introduce a mean teacher into the PLE scheme. This method helps to reduce noise in the weight maps and stabilize its generation process. Our extensive experimental results on public atrial and prostate segmentation datasets demonstrate that our proposed method achieves state-of-the-art results under semi-supervision. Our code is available at https://github.com/aijinrjinr/MLB-Seg.
Cross-modality medical image synthesis is a critical topic and has the potential to facilitate numerous applications in the medical imaging field. Despite recent successes in deep-learning-based generative models, most current medical image synthesis methods rely on generative adversarial networks and suffer from notorious mode collapse and unstable training. Moreover, the 2D backbone-driven approaches would easily result in volumetric inconsistency, while 3D backbones are challenging and impractical due to the tremendous memory cost and training difficulty. In this paper, we introduce a new paradigm for volumetric medical data synthesis by leveraging 2D backbones and present a diffusion-based framework, Make-A-Volume, for cross-modality 3D medical image synthesis. To learn the cross-modality slice-wise mapping, we employ a latent diffusion model and learn a low-dimensional latent space, resulting in high computational efficiency. To enable the 3D image synthesis and mitigate volumetric inconsistency, we further insert a series of volumetric layers in the 2D slice-mapping model and fine-tune them with paired 3D data. This paradigm extends the 2D image diffusion model to a volumetric version with a slightly increasing number of parameters and computation, offering a principled solution for generic cross-modality 3D medical image synthesis. We showcase the effectiveness of our Make-A-Volume framework on an in-house SWI-MRA brain MRI dataset and a public T1-T2 brain MRI dataset. Experimental results demonstrate that our framework achieves superior synthesis results with volumetric consistency.