Boosting Medical Image Classification with Segmentation Foundation Model

The Segment Anything Model (SAM) exhibits impressive capabilities in zero-shot segmentation for natural images. Recently, SAM has gained a great deal of attention for its applications in medical image segmentation. However, to our best knowledge, no studies have shown how to harness the power of SAM for medical image classification. To fill this gap and make SAM a true ``foundation model'' for medical image analysis, it is highly desirable to customize SAM specifically for medical image classification. In this paper, we introduce SAMAug-C, an innovative augmentation method based on SAM for augmenting classification datasets by generating variants of the original images. The augmented datasets can be used to train a deep learning classification model, thereby boosting the classification performance. Furthermore, we propose a novel framework that simultaneously processes raw and SAMAug-C augmented image input, capitalizing on the complementary information that is offered by both. Experiments on three public datasets validate the effectiveness of our new approach.

Path-GPTOmic: A Balanced Multi-modal Learning Framework for Survival Outcome Prediction

For predicting cancer survival outcomes, standard approaches in clinical research are often based on two main modalities: pathology images for observing cell morphology features, and genomic (e.g., bulk RNA-seq) for quantifying gene expressions. However, existing pathology-genomic multi-modal algorithms face significant challenges: (1) Valuable biological insights regarding genes and gene-gene interactions are frequently overlooked; (2) one modality often dominates the optimization process, causing inadequate training for the other modality. In this paper, we introduce a new multi-modal ``Path-GPTOmic" framework for cancer survival outcome prediction. First, to extract valuable biological insights, we regulate the embedding space of a foundation model, scGPT, initially trained on single-cell RNA-seq data, making it adaptable for bulk RNA-seq data. Second, to address the imbalance-between-modalities problem, we propose a gradient modulation mechanism tailored to the Cox partial likelihood loss for survival prediction. The contributions of the modalities are dynamically monitored and adjusted during the training process, encouraging that both modalities are sufficiently trained. Evaluated on two TCGA(The Cancer Genome Atlas) datasets, our model achieves substantially improved survival prediction accuracy.

SHMC-Net: A Mask-guided Feature Fusion Network for Sperm Head Morphology Classification

Male infertility accounts for about one-third of global infertility cases. Manual assessment of sperm abnormalities through head morphology analysis encounters issues of observer variability and diagnostic discrepancies among experts. Its alternative, Computer-Assisted Semen Analysis (CASA), suffers from low-quality sperm images, small datasets, and noisy class labels. We propose a new approach for sperm head morphology classification, called SHMC-Net, which uses segmentation masks of sperm heads to guide the morphology classification of sperm images. SHMC-Net generates reliable segmentation masks using image priors, refines object boundaries with an efficient graph-based method, and trains an image network with sperm head crops and a mask network with the corresponding masks. In the intermediate stages of the networks, image and mask features are fused with a fusion scheme to better learn morphological features. To handle noisy class labels and regularize training on small datasets, SHMC-Net applies Soft Mixup to combine mixup augmentation and a loss function. We achieve state-of-the-art results on SCIAN and HuSHeM datasets, outperforming methods that use additional pre-training or costly ensembling techniques.

ConUNETR: A Conditional Transformer Network for 3D Micro-CT Embryonic Cartilage Segmentation

Studying the morphological development of cartilaginous and osseous structures is critical to the early detection of life-threatening skeletal dysmorphology. Embryonic cartilage undergoes rapid structural changes within hours, introducing biological variations and morphological shifts that limit the generalization of deep learning-based segmentation models that infer across multiple embryonic age groups. Obtaining individual models for each age group is expensive and less effective, while direct transfer (predicting an age unseen during training) suffers a potential performance drop due to morphological shifts. We propose a novel Transformer-based segmentation model with improved biological priors that better distills morphologically diverse information through conditional mechanisms. This enables a single model to accurately predict cartilage across multiple age groups. Experiments on the mice cartilage dataset show the superiority of our new model compared to other competitive segmentation models. Additional studies on a separate mice cartilage dataset with a distinct mutation show that our model generalizes well and effectively captures age-based cartilage morphology patterns.

SwIPE: Efficient and Robust Medical Image Segmentation with Implicit Patch Embeddings

Modern medical image segmentation methods primarily use discrete representations in the form of rasterized masks to learn features and generate predictions. Although effective, this paradigm is spatially inflexible, scales poorly to higher-resolution images, and lacks direct understanding of object shapes. To address these limitations, some recent works utilized implicit neural representations (INRs) to learn continuous representations for segmentation. However, these methods often directly adopted components designed for 3D shape reconstruction. More importantly, these formulations were also constrained to either point-based or global contexts, lacking contextual understanding or local fine-grained details, respectively--both critical for accurate segmentation. To remedy this, we propose a novel approach, SwIPE (Segmentation with Implicit Patch Embeddings), that leverages the advantages of INRs and predicts shapes at the patch level--rather than at the point level or image level--to enable both accurate local boundary delineation and global shape coherence. Extensive evaluations on two tasks (2D polyp segmentation and 3D abdominal organ segmentation) show that SwIPE significantly improves over recent implicit approaches and outperforms state-of-the-art discrete methods with over 10x fewer parameters. Our method also demonstrates superior data efficiency and improved robustness to data shifts across image resolutions and datasets. Code is available on Github.

Keep Your Friends Close & Enemies Farther: Debiasing Contrastive Learning with Spatial Priors in 3D Radiology Images

Understanding of spatial attributes is central to effective 3D radiology image analysis where crop-based learning is the de facto standard. Given an image patch, its core spatial properties (e.g., position & orientation) provide helpful priors on expected object sizes, appearances, and structures through inherent anatomical consistencies. Spatial correspondences, in particular, can effectively gauge semantic similarities between inter-image regions, while their approximate extraction requires no annotations or overbearing computational costs. However, recent 3D contrastive learning approaches either neglect correspondences or fail to maximally capitalize on them. To this end, we propose an extensible 3D contrastive framework (Spade, for Spatial Debiasing) that leverages extracted correspondences to select more effective positive & negative samples for representation learning. Our method learns both globally invariant and locally equivariant representations with downstream segmentation in mind. We also propose separate selection strategies for global & local scopes that tailor to their respective representational requirements. Compared to recent state-of-the-art approaches, Spade shows notable improvements on three downstream segmentation tasks (CT Abdominal Organ, CT Heart, MR Heart).

A Point in the Right Direction: Vector Prediction for Spatially-aware Self-supervised Volumetric Representation Learning

High annotation costs and limited labels for dense 3D medical imaging tasks have recently motivated an assortment of 3D self-supervised pretraining methods that improve transfer learning performance. However, these methods commonly lack spatial awareness despite its centrality in enabling effective 3D image analysis. More specifically, position, scale, and orientation are not only informative but also automatically available when generating image crops for training. Yet, to date, no work has proposed a pretext task that distills all key spatial features. To fulfill this need, we develop a new self-supervised method, VectorPOSE, which promotes better spatial understanding with two novel pretext tasks: Vector Prediction (VP) and Boundary-Focused Reconstruction (BFR). VP focuses on global spatial concepts (i.e., properties of 3D patches) while BFR addresses weaknesses of recent reconstruction methods to learn more effective local representations. We evaluate VectorPOSE on three 3D medical image segmentation tasks, showing that it often outperforms state-of-the-art methods, especially in limited annotation settings.

Unsupervised Feature Clustering Improves Contrastive Representation Learning for Medical Image Segmentation

Self-supervised instance discrimination is an effective contrastive pretext task to learn feature representations and address limited medical image annotations. The idea is to make features of transformed versions of the same images similar while forcing all other augmented images' representations to contrast. However, this instance-based contrastive learning leaves performance on the table by failing to maximize feature affinity between images with similar content while counter-productively pushing their representations apart. Recent improvements on this paradigm (e.g., leveraging multi-modal data, different images in longitudinal studies, spatial correspondences) either relied on additional views or made stringent assumptions about data properties, which can sacrifice generalizability and applicability. To address this challenge, we propose a new self-supervised contrastive learning method that uses unsupervised feature clustering to better select positive and negative image samples. More specifically, we produce pseudo-classes by hierarchically clustering features obtained by an auto-encoder in an unsupervised manner, and prevent destructive interference during contrastive learning by avoiding the selection of negatives from the same pseudo-class. Experiments on 2D skin dermoscopic image segmentation and 3D multi-class whole heart CT segmentation demonstrate that our method outperforms state-of-the-art self-supervised contrastive techniques on these tasks.