Advancing UWF-SLO Vessel Segmentation with Source-Free Active Domain Adaptation and a Novel Multi-Center Dataset

Accurate vessel segmentation in Ultra-Wide-Field Scanning Laser Ophthalmoscopy (UWF-SLO) images is crucial for diagnosing retinal diseases. Although recent techniques have shown encouraging outcomes in vessel segmentation, models trained on one medical dataset often underperform on others due to domain shifts. Meanwhile, manually labeling high-resolution UWF-SLO images is an extremely challenging, time-consuming and expensive task. In response, this study introduces a pioneering framework that leverages a patch-based active domain adaptation approach. By actively recommending a few valuable image patches by the devised Cascade Uncertainty-Predominance (CUP) selection strategy for labeling and model-finetuning, our method significantly improves the accuracy of UWF-SLO vessel segmentation across diverse medical centers. In addition, we annotate and construct the first Multi-center UWF-SLO Vessel Segmentation (MU-VS) dataset to promote this topic research, comprising data from multiple institutions. This dataset serves as a valuable resource for cross-center evaluation, verifying the effectiveness and robustness of our approach. Experimental results demonstrate that our approach surpasses existing domain adaptation and active learning methods, considerably reducing the gap between the Upper and Lower bounds with minimal annotations, highlighting our method's practical clinical value. We will release our dataset and code to facilitate relevant research: https://github.com/whq-xxh/SFADA-UWF-SLO.

Ultrasound Report Generation with Cross-Modality Feature Alignment via Unsupervised Guidance

Automatic report generation has arisen as a significant research area in computer-aided diagnosis, aiming to alleviate the burden on clinicians by generating reports automatically based on medical images. In this work, we propose a novel framework for automatic ultrasound report generation, leveraging a combination of unsupervised and supervised learning methods to aid the report generation process. Our framework incorporates unsupervised learning methods to extract potential knowledge from ultrasound text reports, serving as the prior information to guide the model in aligning visual and textual features, thereby addressing the challenge of feature discrepancy. Additionally, we design a global semantic comparison mechanism to enhance the performance of generating more comprehensive and accurate medical reports. To enable the implementation of ultrasound report generation, we constructed three large-scale ultrasound image-text datasets from different organs for training and validation purposes. Extensive evaluations with other state-of-the-art approaches exhibit its superior performance across all three datasets. Code and dataset are valuable at this link.

MiM: Mask in Mask Self-Supervised Pre-Training for 3D Medical Image Analysis

The Vision Transformer (ViT) has demonstrated remarkable performance in Self-Supervised Learning (SSL) for 3D medical image analysis. Mask AutoEncoder (MAE) for feature pre-training can further unleash the potential of ViT on various medical vision tasks. However, due to large spatial sizes with much higher dimensions of 3D medical images, the lack of hierarchical design for MAE may hinder the performance of downstream tasks. In this paper, we propose a novel \textit{Mask in Mask (MiM)} pre-training framework for 3D medical images, which aims to advance MAE by learning discriminative representation from hierarchical visual tokens across varying scales. We introduce multiple levels of granularity for masked inputs from the volume, which are then reconstructed simultaneously ranging at both fine and coarse levels. Additionally, a cross-level alignment mechanism is applied to adjacent level volumes to enforce anatomical similarity hierarchically. Furthermore, we adopt a hybrid backbone to enhance the hierarchical representation learning efficiently during the pre-training. MiM was pre-trained on a large scale of available 3D volumetric images, \textit{i.e.,} Computed Tomography (CT) images containing various body parts. Extensive experiments on thirteen public datasets demonstrate the superiority of MiM over other SSL methods in organ/lesion/tumor segmentation and disease classification. We further scale up the MiM to large pre-training datasets with more than 10k volumes, showing that large-scale pre-training can further enhance the performance of downstream tasks. The improvement also concluded that the research community should pay more attention to the scale of the pre-training dataset towards the healthcare foundation model for 3D medical images.

Design as Desired: Utilizing Visual Question Answering for Multimodal Pre-training

Multimodal pre-training demonstrates its potential in the medical domain, which learns medical visual representations from paired medical reports. However, many pre-training tasks require extra annotations from clinicians, and most of them fail to explicitly guide the model to learn the desired features of different pathologies. To the best of our knowledge, we are the first to utilize Visual Question Answering (VQA) for multimodal pre-training to guide the framework focusing on targeted pathological features. In this work, we leverage descriptions in medical reports to design multi-granular question-answer pairs associated with different diseases, which assist the framework in pre-training without requiring extra annotations from experts. We also propose a novel pre-training framework with a quasi-textual feature transformer, a module designed to transform visual features into a quasi-textual space closer to the textual domain via a contrastive learning strategy. This narrows the vision-language gap and facilitates modality alignment. Our framework is applied to four downstream tasks: report generation, classification, segmentation, and detection across five datasets. Extensive experiments demonstrate the superiority of our framework compared to other state-of-the-art methods. Our code will be released upon acceptance.

Progressive Frequency-Aware Network for Laparoscopic Image Desmoking

Laparoscopic surgery offers minimally invasive procedures with better patient outcomes, but smoke presence challenges visibility and safety. Existing learning-based methods demand large datasets and high computational resources. We propose the Progressive Frequency-Aware Network (PFAN), a lightweight GAN framework for laparoscopic image desmoking, combining the strengths of CNN and Transformer for progressive information extraction in the frequency domain. PFAN features CNN-based Multi-scale Bottleneck-Inverting (MBI) Blocks for capturing local high-frequency information and Locally-Enhanced Axial Attention Transformers (LAT) for efficiently handling global low-frequency information. PFAN efficiently desmokes laparoscopic images even with limited training data. Our method outperforms state-of-the-art approaches in PSNR, SSIM, CIEDE2000, and visual quality on the Cholec80 dataset and retains only 629K parameters. Our code and models are made publicly available at: https://github.com/jlzcode/PFAN.

Shifting More Attention to Breast Lesion Segmentation in Ultrasound Videos

Breast lesion segmentation in ultrasound (US) videos is essential for diagnosing and treating axillary lymph node metastasis. However, the lack of a well-established and large-scale ultrasound video dataset with high-quality annotations has posed a persistent challenge for the research community. To overcome this issue, we meticulously curated a US video breast lesion segmentation dataset comprising 572 videos and 34,300 annotated frames, covering a wide range of realistic clinical scenarios. Furthermore, we propose a novel frequency and localization feature aggregation network (FLA-Net) that learns temporal features from the frequency domain and predicts additional lesion location positions to assist with breast lesion segmentation. We also devise a localization-based contrastive loss to reduce the lesion location distance between neighboring video frames within the same video and enlarge the location distances between frames from different ultrasound videos. Our experiments on our annotated dataset and two public video polyp segmentation datasets demonstrate that our proposed FLA-Net achieves state-of-the-art performance in breast lesion segmentation in US videos and video polyp segmentation while significantly reducing time and space complexity. Our model and dataset are available at https://github.com/jhl-Det/FLA-Net.

Distribution-Aware Calibration for Object Detection with Noisy Bounding Boxes

Large-scale well-annotated datasets are of great importance for training an effective object detector. However, obtaining accurate bounding box annotations is laborious and demanding. Unfortunately, the resultant noisy bounding boxes could cause corrupt supervision signals and thus diminish detection performance. Motivated by the observation that the real ground-truth is usually situated in the aggregation region of the proposals assigned to a noisy ground-truth, we propose DIStribution-aware CalibratiOn (DISCO) to model the spatial distribution of proposals for calibrating supervision signals. In DISCO, spatial distribution modeling is performed to statistically extract the potential locations of objects. Based on the modeled distribution, three distribution-aware techniques, i.e., distribution-aware proposal augmentation (DA-Aug), distribution-aware box refinement (DA-Ref), and distribution-aware confidence estimation (DA-Est), are developed to improve classification, localization, and interpretability, respectively. Extensive experiments on large-scale noisy image datasets (i.e., Pascal VOC and MS-COCO) demonstrate that DISCO can achieve state-of-the-art detection performance, especially at high noise levels.

Semi-Supervised Semantic Segmentation With Region Relevance

Semi-supervised semantic segmentation aims to learn from a small amount of labeled data and plenty of unlabeled ones for the segmentation task. The most common approach is to generate pseudo-labels for unlabeled images to augment the training data. However, the noisy pseudo-labels will lead to cumulative classification errors and aggravate the local inconsistency in prediction. This paper proposes a Region Relevance Network (RRN) to alleviate the problem mentioned above. Specifically, we first introduce a local pseudo-label filtering module that leverages discriminator networks to assess the accuracy of the pseudo-label at the region level. A local selection loss is proposed to mitigate the negative impact of wrong pseudo-labels in consistency regularization training. In addition, we propose a dynamic region-loss correction module, which takes the merit of network diversity to further rate the reliability of pseudo-labels and correct the convergence direction of the segmentation network with a dynamic region loss. Extensive experiments are conducted on PASCAL VOC 2012 and Cityscapes datasets with varying amounts of labeled data, demonstrating that our proposed approach achieves state-of-the-art performance compared to current counterparts.

Learning Agreement from Multi-source Annotations for Medical Image Segmentation

In medical image analysis, it is typical to merge multiple independent annotations as ground truth to mitigate the bias caused by individual annotation preference. However, arbitrating the final annotation is not always effective because new biases might be produced during the process, especially when there are significant variations among annotations. This paper proposes a novel Uncertainty-guided Multi-source Annotation Network (UMA-Net) to learn medical image segmentation directly from multiple annotations. UMA-Net consists of a UNet with two quality-specific predictors, an Annotation Uncertainty Estimation Module (AUEM) and a Quality Assessment Module (QAM). Specifically, AUEM estimates pixel-wise uncertainty maps of each annotation and encourages them to reach an agreement on reliable pixels/voxels. The uncertainty maps then guide the UNet to learn from the reliable pixels/voxels by weighting the segmentation loss. QAM grades the uncertainty maps into high-quality or low-quality groups based on assessment scores. The UNet is further implemented to contain a high-quality learning head (H-head) and a low-quality learning head (L-head). H-head purely learns with high-quality uncertainty maps to avoid error accumulation and keeps strong prediction ability, while L-head leverages the low-quality uncertainty maps to assist the backbone to learn maximum representation knowledge. UNet with H-head will be reserved during the inference stage, and the rest of the modules can be removed freely for computational efficiency. We conduct extensive experiments on an unsupervised 3D segmentation task and a supervised 2D segmentation task, respectively. The results show that our proposed UMA-Net outperforms state-of-the-art approaches, demonstrating its generality and effectiveness.

Masked Image Training for Generalizable Deep Image Denoising

When capturing and storing images, devices inevitably introduce noise. Reducing this noise is a critical task called image denoising. Deep learning has become the de facto method for image denoising, especially with the emergence of Transformer-based models that have achieved notable state-of-the-art results on various image tasks. However, deep learning-based methods often suffer from a lack of generalization ability. For example, deep models trained on Gaussian noise may perform poorly when tested on other noise distributions. To address this issue, we present a novel approach to enhance the generalization performance of denoising networks, known as masked training. Our method involves masking random pixels of the input image and reconstructing the missing information during training. We also mask out the features in the self-attention layers to avoid the impact of training-testing inconsistency. Our approach exhibits better generalization ability than other deep learning models and is directly applicable to real-world scenarios. Additionally, our interpretability analysis demonstrates the superiority of our method.