Robust Learning via Conditional Prevalence Adjustment

Healthcare data often come from multiple sites in which the correlations between confounding variables can vary widely. If deep learning models exploit these unstable correlations, they might fail catastrophically in unseen sites. Although many methods have been proposed to tackle unstable correlations, each has its limitations. For example, adversarial training forces models to completely ignore unstable correlations, but doing so may lead to poor predictive performance. Other methods (e.g. Invariant risk minimization [4]) try to learn domain-invariant representations that rely only on stable associations by assuming a causal data-generating process (input X causes class label Y ). Thus, they may be ineffective for anti-causal tasks (Y causes X), which are common in computer vision. We propose a method called CoPA (Conditional Prevalence-Adjustment) for anti-causal tasks. CoPA assumes that (1) generation mechanism is stable, i.e. label Y and confounding variable(s) Z generate X, and (2) the unstable conditional prevalence in each site E fully accounts for the unstable correlations between X and Y . Our crucial observation is that confounding variables are routinely recorded in healthcare settings and the prevalence can be readily estimated, for example, from a set of (Y, Z) samples (no need for corresponding samples of X). CoPA can work even if there is a single training site, a scenario which is often overlooked by existing methods. Our experiments on synthetic and real data show CoPA beating competitive baselines.

Zero-shot Learning of Individualized Task Contrast Prediction from Resting-state Functional Connectomes

Given sufficient pairs of resting-state and task-evoked fMRI scans from subjects, it is possible to train ML models to predict subject-specific task-evoked activity using resting-state functional MRI (rsfMRI) scans. However, while rsfMRI scans are relatively easy to collect, obtaining sufficient task fMRI scans is much harder as it involves more complex experimental designs and procedures. Thus, the reliance on scarce paired data limits the application of current techniques to only tasks seen during training. We show that this reliance can be reduced by leveraging group-average contrasts, enabling zero-shot predictions for novel tasks. Our approach, named OPIC (short for Omni-Task Prediction of Individual Contrasts), takes as input a subject's rsfMRI-derived connectome and a group-average contrast, to produce a prediction of the subject-specific contrast. Similar to zero-shot learning in large language models using special inputs to obtain answers for novel natural language processing tasks, inputting group-average contrasts guides the OPIC model to generalize to novel tasks unseen in training. Experimental results show that OPIC's predictions for novel tasks are not only better than simple group-averages, but are also competitive with a state-of-the-art model's in-domain predictions that was trained using in-domain tasks' data.

Characterizing the Features of Mitotic Figures Using a Conditional Diffusion Probabilistic Model

Mitotic figure detection in histology images is a hard-to-define, yet clinically significant task, where labels are generated with pathologist interpretations and where there is no ``gold-standard'' independent ground-truth. However, it is well-established that these interpretation based labels are often unreliable, in part, due to differences in expertise levels and human subjectivity. In this paper, our goal is to shed light on the inherent uncertainty of mitosis labels and characterize the mitotic figure classification task in a human interpretable manner. We train a probabilistic diffusion model to synthesize patches of cell nuclei for a given mitosis label condition. Using this model, we can then generate a sequence of synthetic images that correspond to the same nucleus transitioning into the mitotic state. This allows us to identify different image features associated with mitosis, such as cytoplasm granularity, nuclear density, nuclear irregularity and high contrast between the nucleus and the cell body. Our approach offers a new tool for pathologists to interpret and communicate the features driving the decision to recognize a mitotic figure.

A Framework for Interpretability in Machine Learning for Medical Imaging

Interpretability for machine learning models in medical imaging (MLMI) is an important direction of research. However, there is a general sense of murkiness in what interpretability means. Why does the need for interpretability in MLMI arise? What goals does one actually seek to address when interpretability is needed? To answer these questions, we identify a need to formalize the goals and elements of interpretability in MLMI. By reasoning about real-world tasks and goals common in both medical image analysis and its intersection with machine learning, we identify four core elements of interpretability: localization, visual recognizability, physical attribution, and transparency. Overall, this paper formalizes interpretability needs in the context of medical imaging, and our applied perspective clarifies concrete MLMI-specific goals and considerations in order to guide method design and improve real-world usage. Our goal is to provide practical and didactic information for model designers and practitioners, inspire developers of models in the medical imaging field to reason more deeply about what interpretability is achieving, and suggest future directions of interpretability research.

Learning Invariant Representations with a Nonparametric Nadaraya-Watson Head

Machine learning models will often fail when deployed in an environment with a data distribution that is different than the training distribution. When multiple environments are available during training, many methods exist that learn representations which are invariant across the different distributions, with the hope that these representations will be transportable to unseen domains. In this work, we present a nonparametric strategy for learning invariant representations based on the recently-proposed Nadaraya-Watson (NW) head. The NW head makes a prediction by comparing the learned representations of the query to the elements of a support set that consists of labeled data. We demonstrate that by manipulating the support set, one can encode different causal assumptions. In particular, restricting the support set to a single environment encourages the model to learn invariant features that do not depend on the environment. We present a causally-motivated setup for our modeling and training strategy and validate on three challenging real-world domain generalization tasks in computer vision.

Empirical Analysis of a Segmentation Foundation Model in Prostate Imaging

Most state-of-the-art techniques for medical image segmentation rely on deep-learning models. These models, however, are often trained on narrowly-defined tasks in a supervised fashion, which requires expensive labeled datasets. Recent advances in several machine learning domains, such as natural language generation have demonstrated the feasibility and utility of building foundation models that can be customized for various downstream tasks with little to no labeled data. This likely represents a paradigm shift for medical imaging, where we expect that foundation models may shape the future of the field. In this paper, we consider a recently developed foundation model for medical image segmentation, UniverSeg. We conduct an empirical evaluation study in the context of prostate imaging and compare it against the conventional approach of training a task-specific segmentation model. Our results and discussion highlight several important factors that will likely be important in the development and adoption of foundation models for medical image segmentation.

Patchwork Learning: A Paradigm Towards Integrative Analysis across Diverse Biomedical Data Sources

Machine learning (ML) in healthcare presents numerous opportunities for enhancing patient care, population health, and healthcare providers' workflows. However, the real-world clinical and cost benefits remain limited due to challenges in data privacy, heterogeneous data sources, and the inability to fully leverage multiple data modalities. In this perspective paper, we introduce "patchwork learning" (PL), a novel paradigm that addresses these limitations by integrating information from disparate datasets composed of different data modalities (e.g., clinical free-text, medical images, omics) and distributed across separate and secure sites. PL allows the simultaneous utilization of complementary data sources while preserving data privacy, enabling the development of more holistic and generalizable ML models. We present the concept of patchwork learning and its current implementations in healthcare, exploring the potential opportunities and applicable data sources for addressing various healthcare challenges. PL leverages bridging modalities or overlapping feature spaces across sites to facilitate information sharing and impute missing data, thereby addressing related prediction tasks. We discuss the challenges associated with PL, many of which are shared by federated and multimodal learning, and provide recommendations for future research in this field. By offering a more comprehensive approach to healthcare data integration, patchwork learning has the potential to revolutionize the clinical applicability of ML models. This paradigm promises to strike a balance between personalization and generalizability, ultimately enhancing patient experiences, improving population health, and optimizing healthcare providers' workflows.

A robust and interpretable deep learning framework for multi-modal registration via keypoints

We present KeyMorph, a deep learning-based image registration framework that relies on automatically detecting corresponding keypoints. State-of-the-art deep learning methods for registration often are not robust to large misalignments, are not interpretable, and do not incorporate the symmetries of the problem. In addition, most models produce only a single prediction at test-time. Our core insight which addresses these shortcomings is that corresponding keypoints between images can be used to obtain the optimal transformation via a differentiable closed-form expression. We use this observation to drive the end-to-end learning of keypoints tailored for the registration task, and without knowledge of ground-truth keypoints. This framework not only leads to substantially more robust registration but also yields better interpretability, since the keypoints reveal which parts of the image are driving the final alignment. Moreover, KeyMorph can be designed to be equivariant under image translations and/or symmetric with respect to the input image ordering. Finally, we show how multiple deformation fields can be computed efficiently and in closed-form at test time corresponding to different transformation variants. We demonstrate the proposed framework in solving 3D affine and spline-based registration of multi-modal brain MRI scans. In particular, we show registration accuracy that surpasses current state-of-the-art methods, especially in the context of large displacements. Our code is available at https://github.com/evanmy/keymorph.

Learning to Compare Longitudinal Images

Longitudinal studies, where a series of images from the same set of individuals are acquired at different time-points, represent a popular technique for studying and characterizing temporal dynamics in biomedical applications. The classical approach for longitudinal comparison involves normalizing for nuisance variations, such as image orientation or contrast differences, via pre-processing. Statistical analysis is, in turn, conducted to detect changes of interest, either at the individual or population level. This classical approach can suffer from pre-processing issues and limitations of the statistical modeling. For example, normalizing for nuisance variation might be hard in settings where there are a lot of idiosyncratic changes. In this paper, we present a simple machine learning-based approach that can alleviate these issues. In our approach, we train a deep learning model (called PaIRNet, for Pairwise Image Ranking Network) to compare pairs of longitudinal images, with or without supervision. In the self-supervised setup, for instance, the model is trained to temporally order the images, which requires learning to recognize time-irreversible changes. Our results from four datasets demonstrate that PaIRNet can be very effective in localizing and quantifying meaningful longitudinal changes while discounting nuisance variation. Our code is available at \url{https://github.com/heejong-kim/learning-to-compare-longitudinal-images.git}

UniverSeg: Universal Medical Image Segmentation

While deep learning models have become the predominant method for medical image segmentation, they are typically not capable of generalizing to unseen segmentation tasks involving new anatomies, image modalities, or labels. Given a new segmentation task, researchers generally have to train or fine-tune models, which is time-consuming and poses a substantial barrier for clinical researchers, who often lack the resources and expertise to train neural networks. We present UniverSeg, a method for solving unseen medical segmentation tasks without additional training. Given a query image and example set of image-label pairs that define a new segmentation task, UniverSeg employs a new Cross-Block mechanism to produce accurate segmentation maps without the need for additional training. To achieve generalization to new tasks, we have gathered and standardized a collection of 53 open-access medical segmentation datasets with over 22,000 scans, which we refer to as MegaMedical. We used this collection to train UniverSeg on a diverse set of anatomies and imaging modalities. We demonstrate that UniverSeg substantially outperforms several related methods on unseen tasks, and thoroughly analyze and draw insights about important aspects of the proposed system. The UniverSeg source code and model weights are freely available at https://universeg.csail.mit.edu