Hierarchical transformers have achieved significant success in medical image segmentation due to their large receptive field and capabilities of effectively leveraging global long-range contextual information. Convolutional neural networks (CNNs) can also deliver a large receptive field by using large kernels, enabling them to achieve competitive performance with fewer model parameters. However, CNNs incorporated with large convolutional kernels remain constrained in adaptively capturing multi-scale features from organs with large variations in shape and size due to the employment of fixed-sized kernels. Additionally, they are unable to utilize global contextual information efficiently. To address these limitations, we propose Dynamic Large Kernel (DLK) and Dynamic Feature Fusion (DFF) modules. The DLK module employs multiple large kernels with varying kernel sizes and dilation rates to capture multi-scale features. Subsequently, a dynamic selection mechanism is utilized to adaptively highlight the most important spatial features based on global information. Additionally, the DFF module is proposed to adaptively fuse multi-scale local feature maps based on their global information. We integrate DLK and DFF in a hierarchical transformer architecture to develop a novel architecture, termed D-Net. D-Net is able to effectively utilize a multi-scale large receptive field and adaptively harness global contextual information. Extensive experimental results demonstrate that D-Net outperforms other state-of-the-art models in the two volumetric segmentation tasks, including abdominal multi-organ segmentation and multi-modality brain tumor segmentation. Our code is available at https://github.com/sotiraslab/DLK.
Multiple Instance Learning (MIL) has been widely used in weakly supervised whole slide image (WSI) classification. Typical MIL methods include a feature embedding part that embeds the instances into features via a pre-trained feature extractor and the MIL aggregator that combines instance embeddings into predictions. The current focus has been directed toward improving these parts by refining the feature embeddings through self-supervised pre-training and modeling the correlations between instances separately. In this paper, we proposed a sparsely coded MIL (SC-MIL) that addresses those two aspects at the same time by leveraging sparse dictionary learning. The sparse dictionary learning captures the similarities of instances by expressing them as a sparse linear combination of atoms in an over-complete dictionary. In addition, imposing sparsity help enhance the instance feature embeddings by suppressing irrelevant instances while retaining the most relevant ones. To make the conventional sparse coding algorithm compatible with deep learning, we unrolled it into an SC module by leveraging deep unrolling. The proposed SC module can be incorporated into any existing MIL framework in a plug-and-play manner with an acceptable computation cost. The experimental results on multiple datasets demonstrated that the proposed SC module could substantially boost the performance of state-of-the-art MIL methods. The codes are available at \href{https://github.com/sotiraslab/SCMIL.git}{https://github.com/sotiraslab/SCMIL.git}.
Survival analysis is a statistical method employed to scrutinize the duration until a specific event of interest transpires, known as time-to-event information characterized by censorship. Recently, deep learning-based methods have dominated this field due to their representational capacity and state-of-the-art performance. However, the black-box nature of the deep neural network hinders its interpretability, which is desired in real-world survival applications but has been largely neglected by previous works. In contrast, conventional tree-based methods are advantageous with respect to interpretability, while consistently grappling with an inability to approximate the global optima due to greedy expansion. In this paper, we leverage the strengths of both neural networks and tree-based methods, capitalizing on their ability to approximate intricate functions while maintaining interpretability. To this end, we propose a Neural Survival Oblique Tree (NSOTree) for survival analysis. Specifically, the NSOTree was derived from the ReLU network and can be easily incorporated into existing survival models in a plug-and-play fashion. Evaluations on both simulated and real survival datasets demonstrated the effectiveness of the proposed method in terms of performance and interpretability.
Multiple instance learning (MIL) was a weakly supervised learning approach that sought to assign binary class labels to collections of instances known as bags. However, due to their weak supervision nature, the MIL methods were susceptible to overfitting and required assistance in developing comprehensive representations of target instances. While regularization typically effectively combated overfitting, its integration with the MIL model has been frequently overlooked in prior studies. Meanwhile, current regularization methods for MIL have shown limitations in their capacity to uncover a diverse array of representations. In this study, we delve into the realm of regularization within the MIL model, presenting a novel approach in the form of a Progressive Dropout Layer (PDL). We aim to not only address overfitting but also empower the MIL model in uncovering intricate and impactful feature representations. The proposed method was orthogonal to existing MIL methods and could be easily integrated into them to boost performance. Our extensive evaluation across a range of MIL benchmark datasets demonstrated that the incorporation of the PDL into multiple MIL methods not only elevated their classification performance but also augmented their potential for weakly-supervised feature localizations.
Retinal diseases (RD) are the leading cause of severe vision loss or blindness. Deep learning-based automated tools play an indispensable role in assisting clinicians in diagnosing and monitoring RD in modern medicine. Recently, an increasing number of works in this field have taken advantage of Vision Transformer to achieve state-of-the-art performance with more parameters and higher model complexity compared to Convolutional Neural Networks (CNNs). Such sophisticated and task-specific model designs, however, are prone to be overfitting and hinder their generalizability. In this work, we argue that a channel-aware and well-calibrated CNN model may overcome these problems. To this end, we empirically studied CNN's macro and micro designs and its training strategies. Based on the investigation, we proposed a no-new-MobleNet (nn-MobileNet) developed for retinal diseases. In our experiments, our generic, simple and efficient model superseded most current state-of-the-art methods on four public datasets for multiple tasks, including diabetic retinopathy grading, fundus multi-disease detection, and diabetic macular edema classification. Our work may provide novel insights into deep learning architecture design and advance retinopathy research.
Learning rich data representations from unlabeled data is a key challenge towards applying deep learning algorithms in downstream supervised tasks. Several variants of variational autoencoders have been proposed to learn compact data representaitons by encoding high-dimensional data in a lower dimensional space. Two main classes of VAEs methods may be distinguished depending on the characteristics of the meta-priors that are enforced in the representation learning step. The first class of methods derives a continuous encoding by assuming a static prior distribution in the latent space. The second class of methods learns instead a discrete latent representation using vector quantization (VQ) along with a codebook. However, both classes of methods suffer from certain challenges, which may lead to suboptimal image reconstruction results. The first class of methods suffers from posterior collapse, whereas the second class of methods suffers from codebook collapse. To address these challenges, we introduce a new VAE variant, termed SC-VAE (sparse coding-based VAE), which integrates sparse coding within variational autoencoder framework. Instead of learning a continuous or discrete latent representation, the proposed method learns a sparse data representation that consists of a linear combination of a small number of learned atoms. The sparse coding problem is solved using a learnable version of the iterative shrinkage thresholding algorithm (ISTA). Experiments on two image datasets demonstrate that our model can achieve improved image reconstruction results compared to state-of-the-art methods. Moreover, the use of learned sparse code vectors allows us to perform downstream task like coarse image segmentation through clustering image patches.
Convolutional neural networks (CNN) have been broadly studied on images, videos, graphs, and triangular meshes. However, it has seldom been studied on tetrahedral meshes. Given the merits of using volumetric meshes in applications like brain image analysis, we introduce a novel interpretable graph CNN framework for the tetrahedral mesh structure. Inspired by ChebyNet, our model exploits the volumetric Laplace-Beltrami Operator (LBO) to define filters over commonly used graph Laplacian which lacks the Riemannian metric information of 3D manifolds. For pooling adaptation, we introduce new objective functions for localized minimum cuts in the Graclus algorithm based on the LBO. We employ a piece-wise constant approximation scheme that uses the clustering assignment matrix to estimate the LBO on sampled meshes after each pooling. Finally, adapting the Gradient-weighted Class Activation Mapping algorithm for tetrahedral meshes, we use the obtained heatmaps to visualize discovered regions-of-interest as biomarkers. We demonstrate the effectiveness of our model on cortical tetrahedral meshes from patients with Alzheimer's disease, as there is scientific evidence showing the correlation of cortical thickness to neurodegenerative disease progression. Our results show the superiority of our LBO-based convolution layer and adapted pooling over the conventionally used unitary cortical thickness, graph Laplacian, and point cloud representation.
Non-mydriatic retinal color fundus photography (CFP) is widely available due to the advantage of not requiring pupillary dilation, however, is prone to poor quality due to operators, systemic imperfections, or patient-related causes. Optimal retinal image quality is mandated for accurate medical diagnoses and automated analyses. Herein, we leveraged the Optimal Transport (OT) theory to propose an unpaired image-to-image translation scheme for mapping low-quality retinal CFPs to high-quality counterparts. Furthermore, to improve the flexibility, robustness, and applicability of our image enhancement pipeline in the clinical practice, we generalized a state-of-the-art model-based image reconstruction method, regularization by denoising, by plugging in priors learned by our OT-guided image-to-image translation network. We named it as regularization by enhancing (RE). We validated the integrated framework, OTRE, on three publicly available retinal image datasets by assessing the quality after enhancement and their performance on various downstream tasks, including diabetic retinopathy grading, vessel segmentation, and diabetic lesion segmentation. The experimental results demonstrated the superiority of our proposed framework over some state-of-the-art unsupervised competitors and a state-of-the-art supervised method.