HCDG: A Hierarchical Consistency Framework for Domain Generalization on Medical Image Segmentation

Modern deep neural networks struggle to transfer knowledge and generalize across domains when deploying to real-world applications. Domain generalization (DG) aims to learn a universal representation from multiple source domains to improve the network generalization ability on unseen target domains. Previous DG methods mostly focus on the data-level consistency scheme to advance the generalization capability of deep networks, without considering the synergistic regularization of different consistency schemes. In this paper, we present a novel Hierarchical Consistency framework for Domain Generalization (HCDG) by ensembling Extrinsic Consistency and Intrinsic Consistency. Particularly, for Extrinsic Consistency, we leverage the knowledge across multiple source domains to enforce data-level consistency. Also, we design a novel Amplitude Gaussian-mixing strategy for Fourier-based data augmentation to enhance such consistency. For Intrinsic Consistency, we perform task-level consistency for the same instance under the dual-task form. We evaluate the proposed HCDG framework on two medical image segmentation tasks, i.e., optic cup/disc segmentation on fundus images and prostate MRI segmentation. Extensive experimental results manifest the effectiveness and versatility of our HCDG framework. Code will be available once accept.

SurRoL: An Open-source Reinforcement Learning Centered and dVRK Compatible Platform for Surgical Robot Learning

Autonomous surgical execution relieves tedious routines and surgeon's fatigue. Recent learning-based methods, especially reinforcement learning (RL) based methods, achieve promising performance for dexterous manipulation, which usually requires the simulation to collect data efficiently and reduce the hardware cost. The existing learning-based simulation platforms for medical robots suffer from limited scenarios and simplified physical interactions, which degrades the real-world performance of learned policies. In this work, we designed SurRoL, an RL-centered simulation platform for surgical robot learning compatible with the da Vinci Research Kit (dVRK). The designed SurRoL integrates a user-friendly RL library for algorithm development and a real-time physics engine, which is able to support more PSM/ECM scenarios and more realistic physical interactions. Ten learning-based surgical tasks are built in the platform, which are common in the real autonomous surgical execution. We evaluate SurRoL using RL algorithms in simulation, provide in-depth analysis, deploy the trained policies on the real dVRK, and show that our SurRoL achieves better transferability in the real world.

Accurate Grid Keypoint Learning for Efficient Video Prediction

Video prediction methods generally consume substantial computing resources in training and deployment, among which keypoint-based approaches show promising improvement in efficiency by simplifying dense image prediction to light keypoint prediction. However, keypoint locations are often modeled only as continuous coordinates, so noise from semantically insignificant deviations in videos easily disrupt learning stability, leading to inaccurate keypoint modeling. In this paper, we design a new grid keypoint learning framework, aiming at a robust and explainable intermediate keypoint representation for long-term efficient video prediction. We have two major technical contributions. First, we detect keypoints by jumping among candidate locations in our raised grid space and formulate a condensation loss to encourage meaningful keypoints with strong representative capability. Second, we introduce a 2D binary map to represent the detected grid keypoints and then suggest propagating keypoint locations with stochasticity by selecting entries in the discrete grid space, thus preserving the spatial structure of keypoints in the longterm horizon for better future frame generation. Extensive experiments verify that our method outperforms the state-ofthe-art stochastic video prediction methods while saves more than 98% of computing resources. We also demonstrate our method on a robotic-assisted surgery dataset with promising results. Our code is available at https://github.com/xjgaocs/Grid-Keypoint-Learning.

Federated Semi-supervised Medical Image Classification via Inter-client Relation Matching

Federated learning (FL) has emerged with increasing popularity to collaborate distributed medical institutions for training deep networks. However, despite existing FL algorithms only allow the supervised training setting, most hospitals in realistic usually cannot afford the intricate data labeling due to absence of budget or expertise. This paper studies a practical yet challenging FL problem, named \textit{Federated Semi-supervised Learning} (FSSL), which aims to learn a federated model by jointly utilizing the data from both labeled and unlabeled clients (i.e., hospitals). We present a novel approach for this problem, which improves over traditional consistency regularization mechanism with a new inter-client relation matching scheme. The proposed learning scheme explicitly connects the learning across labeled and unlabeled clients by aligning their extracted disease relationships, thereby mitigating the deficiency of task knowledge at unlabeled clients and promoting discriminative information from unlabeled samples. We validate our method on two large-scale medical image classification datasets. The effectiveness of our method has been demonstrated with the clear improvements over state-of-the-arts as well as the thorough ablation analysis on both tasks\footnote{Code will be made available at \url{https://github.com/liuquande/FedIRM}}.

Point Cloud Upsampling via Disentangled Refinement

Point clouds produced by 3D scanning are often sparse, non-uniform, and noisy. Recent upsampling approaches aim to generate a dense point set, while achieving both distribution uniformity and proximity-to-surface, and possibly amending small holes, all in a single network. After revisiting the task, we propose to disentangle the task based on its multi-objective nature and formulate two cascaded sub-networks, a dense generator and a spatial refiner. The dense generator infers a coarse but dense output that roughly describes the underlying surface, while the spatial refiner further fine-tunes the coarse output by adjusting the location of each point. Specifically, we design a pair of local and global refinement units in the spatial refiner to evolve a coarse feature map. Also, in the spatial refiner, we regress a per-point offset vector to further adjust the coarse outputs in fine-scale. Extensive qualitative and quantitative results on both synthetic and real-scanned datasets demonstrate the superiority of our method over the state-of-the-arts.

Rethinking annotation granularity for overcoming deep shortcut learning: A retrospective study on chest radiographs

Deep learning has demonstrated radiograph screening performances that are comparable or superior to radiologists. However, recent studies show that deep models for thoracic disease classification usually show degraded performance when applied to external data. Such phenomena can be categorized into shortcut learning, where the deep models learn unintended decision rules that can fit the identically distributed training and test set but fail to generalize to other distributions. A natural way to alleviate this defect is explicitly indicating the lesions and focusing the model on learning the intended features. In this paper, we conduct extensive retrospective experiments to compare a popular thoracic disease classification model, CheXNet, and a thoracic lesion detection model, CheXDet. We first showed that the two models achieved similar image-level classification performance on the internal test set with no significant differences under many scenarios. Meanwhile, we found incorporating external training data even led to performance degradation for CheXNet. Then, we compared the models' internal performance on the lesion localization task and showed that CheXDet achieved significantly better performance than CheXNet even when given 80% less training data. By further visualizing the models' decision-making regions, we revealed that CheXNet learned patterns other than the target lesions, demonstrating its shortcut learning defect. Moreover, CheXDet achieved significantly better external performance than CheXNet on both the image-level classification task and the lesion localization task. Our findings suggest improving annotation granularity for training deep learning systems as a promising way to elevate future deep learning-based diagnosis systems for clinical usage.

Deep Semi-supervised Metric Learning with Dual Alignment for Cervical Cancer Cell Detection

With availability of huge amounts of labeled data, deep learning has achieved unprecedented success in various object detection tasks. However, large-scale annotations for medical images are extremely challenging to be acquired due to the high demand of labour and expertise. To address this difficult issue, in this paper we propose a novel semi-supervised deep metric learning method to effectively leverage both labeled and unlabeled data with application to cervical cancer cell detection. Different from previous methods, our model learns an embedding metric space and conducts dual alignment of semantic features on both the proposal and prototype levels. First, on the proposal level, we generate pseudo labels for the unlabeled data to align the proposal features with learnable class proxies derived from the labeled data. Furthermore, we align the prototypes generated from each mini-batch of labeled and unlabeled data to alleviate the influence of possibly noisy pseudo labels. Moreover, we adopt a memory bank to store the labeled prototypes and hence significantly enrich the metric learning information from larger batches. To comprehensively validate the method, we construct a large-scale dataset for semi-supervised cervical cancer cell detection for the first time, consisting of 240,860 cervical cell images in total. Extensive experiments show our proposed method outperforms other state-of-the-art semi-supervised approaches consistently, demonstrating efficacy of deep semi-supervised metric learning with dual alignment on improving cervical cancer cell detection performance.

Dual-Consistency Semi-Supervised Learning with Uncertainty Quantification for COVID-19 Lesion Segmentation from CT Images

The novel coronavirus disease 2019 (COVID-19) characterized by atypical pneumonia has caused millions of deaths worldwide. Automatically segmenting lesions from chest Computed Tomography (CT) is a promising way to assist doctors in COVID-19 screening, treatment planning, and follow-up monitoring. However, voxel-wise annotations are extremely expert-demanding and scarce, especially when it comes to novel diseases, while an abundance of unlabeled data could be available. To tackle the challenge of limited annotations, in this paper, we propose an uncertainty-guided dual-consistency learning network (UDC-Net) for semi-supervised COVID-19 lesion segmentation from CT images. Specifically, we present a dual-consistency learning scheme that simultaneously imposes image transformation equivalence and feature perturbation invariance to effectively harness the knowledge from unlabeled data. We then quantify both the epistemic uncertainty and the aleatoric uncertainty and employ them together to guide the consistency regularization for more reliable unsupervised learning. Extensive experiments showed that our proposed UDC-Net improves the fully supervised method by 6.3% in Dice and outperforms other competitive semi-supervised approaches by significant margins, demonstrating high potential in real-world clinical practice.

Temporal Memory Relation Network for Workflow Recognition from Surgical Video

Automatic surgical workflow recognition is a key component for developing context-aware computer-assisted systems in the operating theatre. Previous works either jointly modeled the spatial features with short fixed-range temporal information, or separately learned visual and long temporal cues. In this paper, we propose a novel end-to-end temporal memory relation network (TMRNet) for relating long-range and multi-scale temporal patterns to augment the present features. We establish a long-range memory bank to serve as a memory cell storing the rich supportive information. Through our designed temporal variation layer, the supportive cues are further enhanced by multi-scale temporal-only convolutions. To effectively incorporate the two types of cues without disturbing the joint learning of spatio-temporal features, we introduce a non-local bank operator to attentively relate the past to the present. In this regard, our TMRNet enables the current feature to view the long-range temporal dependency, as well as tolerate complex temporal extents. We have extensively validated our approach on two benchmark surgical video datasets, M2CAI challenge dataset and Cholec80 dataset. Experimental results demonstrate the outstanding performance of our method, consistently exceeding the state-of-the-art methods by a large margin (e.g., 67.0% v.s. 78.9% Jaccard on Cholec80 dataset).

One to Many: Adaptive Instrument Segmentation via Meta Learning and Dynamic Online Adaptation in Robotic Surgical Video

Surgical instrument segmentation in robot-assisted surgery (RAS) - especially that using learning-based models - relies on the assumption that training and testing videos are sampled from the same domain. However, it is impractical and expensive to collect and annotate sufficient data from every new domain. To greatly increase the label efficiency, we explore a new problem, i.e., adaptive instrument segmentation, which is to effectively adapt one source model to new robotic surgical videos from multiple target domains, only given the annotated instruments in the first frame. We propose MDAL, a meta-learning based dynamic online adaptive learning scheme with a two-stage framework to fast adapt the model parameters on the first frame and partial subsequent frames while predicting the results. MDAL learns the general knowledge of instruments and the fast adaptation ability through the video-specific meta-learning paradigm. The added gradient gate excludes the noisy supervision from pseudo masks for dynamic online adaptation on target videos. We demonstrate empirically that MDAL outperforms other state-of-the-art methods on two datasets (including a real-world RAS dataset). The promising performance on ex-vivo scenes also benefits the downstream tasks such as robot-assisted suturing and camera control.