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.

SamDSK: Combining Segment Anything Model with Domain-Specific Knowledge for Semi-Supervised Learning in Medical Image Segmentation

The Segment Anything Model (SAM) exhibits a capability to segment a wide array of objects in natural images, serving as a versatile perceptual tool for various downstream image segmentation tasks. In contrast, medical image segmentation tasks often rely on domain-specific knowledge (DSK). In this paper, we propose a novel method that combines the segmentation foundation model (i.e., SAM) with domain-specific knowledge for reliable utilization of unlabeled images in building a medical image segmentation model. Our new method is iterative and consists of two main stages: (1) segmentation model training; (2) expanding the labeled set by using the trained segmentation model, an unlabeled set, SAM, and domain-specific knowledge. These two stages are repeated until no more samples are added to the labeled set. A novel optimal-matching-based method is developed for combining the SAM-generated segmentation proposals and pixel-level and image-level DSK for constructing annotations of unlabeled images in the iterative stage (2). In experiments, we demonstrate the effectiveness of our proposed method for breast cancer segmentation in ultrasound images, polyp segmentation in endoscopic images, and skin lesion segmentation in dermoscopic images. Our work initiates a new direction of semi-supervised learning for medical image segmentation: the segmentation foundation model can be harnessed as a valuable tool for label-efficient segmentation learning in medical image segmentation.

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.

Graph-Free Learning in Graph-Structured Data: A More Efficient and Accurate Spatiotemporal Learning Perspective

Spatiotemporal learning, which aims at extracting spatiotemporal correlations from the collected spatiotemporal data, is a research hotspot in recent years. And considering the inherent graph structure of spatiotemporal data, recent works focus on capturing spatial dependencies by utilizing Graph Convolutional Networks (GCNs) to aggregate vertex features with the guidance of adjacency matrices. In this paper, with extensive and deep-going experiments, we comprehensively analyze existing spatiotemporal graph learning models and reveal that extracting adjacency matrices with carefully design strategies, which are viewed as the key of enhancing performance on graph learning, are largely ineffective. Meanwhile, based on these experiments, we also discover that the aggregation itself is more important than the way that how vertices are aggregated. With these preliminary, a novel efficient Graph-Free Spatial (GFS) learning module based on layer normalization for capturing spatial correlations in spatiotemporal graph learning. The proposed GFS module can be easily plugged into existing models for replacing all graph convolution components. Rigorous theoretical proof demonstrates that the time complexity of GFS is significantly better than that of graph convolution operation. Extensive experiments verify the superiority of GFS in both the perspectives of efficiency and learning effect in processing graph-structured data especially extreme large scale graph data.

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).

ConvFormer: Combining CNN and Transformer for Medical Image Segmentation

Convolutional neural network (CNN) based methods have achieved great successes in medical image segmentation, but their capability to learn global representations is still limited due to using small effective receptive fields of convolution operations. Transformer based methods are capable of modelling long-range dependencies of information for capturing global representations, yet their ability to model local context is lacking. Integrating CNN and Transformer to learn both local and global representations while exploring multi-scale features is instrumental in further improving medical image segmentation. In this paper, we propose a hierarchical CNN and Transformer hybrid architecture, called ConvFormer, for medical image segmentation. ConvFormer is based on several simple yet effective designs. (1) A feed forward module of Deformable Transformer (DeTrans) is re-designed to introduce local information, called Enhanced DeTrans. (2) A residual-shaped hybrid stem based on a combination of convolutions and Enhanced DeTrans is developed to capture both local and global representations to enhance representation ability. (3) Our encoder utilizes the residual-shaped hybrid stem in a hierarchical manner to generate feature maps in different scales, and an additional Enhanced DeTrans encoder with residual connections is built to exploit multi-scale features with feature maps of different scales as input. Experiments on several datasets show that our ConvFormer, trained from scratch, outperforms various CNN- or Transformer-based architectures, achieving state-of-the-art performance.

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.