LVM-Med: Learning Large-Scale Self-Supervised Vision Models for Medical Imaging via Second-order Graph Matching

Obtaining large pre-trained models that can be fine-tuned to new tasks with limited annotated samples has remained an open challenge for medical imaging data. While pre-trained deep networks on ImageNet and vision-language foundation models trained on web-scale data are prevailing approaches, their effectiveness on medical tasks is limited due to the significant domain shift between natural and medical images. To bridge this gap, we introduce LVM-Med, the first family of deep networks trained on large-scale medical datasets. We have collected approximately 1.3 million medical images from 55 publicly available datasets, covering a large number of organs and modalities such as CT, MRI, X-ray, and Ultrasound. We benchmark several state-of-the-art self-supervised algorithms on this dataset and propose a novel self-supervised contrastive learning algorithm using a graph-matching formulation. The proposed approach makes three contributions: (i) it integrates prior pair-wise image similarity metrics based on local and global information; (ii) it captures the structural constraints of feature embeddings through a loss function constructed via a combinatorial graph-matching objective; and (iii) it can be trained efficiently end-to-end using modern gradient-estimation techniques for black-box solvers. We thoroughly evaluate the proposed LVM-Med on 15 downstream medical tasks ranging from segmentation and classification to object detection, and both for the in and out-of-distribution settings. LVM-Med empirically outperforms a number of state-of-the-art supervised, self-supervised, and foundation models. For challenging tasks such as Brain Tumor Classification or Diabetic Retinopathy Grading, LVM-Med improves previous vision-language models trained on 1 billion masks by 6-7% while using only a ResNet-50.

LYSTO: The Lymphocyte Assessment Hackathon and Benchmark Dataset

We introduce LYSTO, the Lymphocyte Assessment Hackathon, which was held in conjunction with the MICCAI 2019 Conference in Shenzen (China). The competition required participants to automatically assess the number of lymphocytes, in particular T-cells, in histopathological images of colon, breast, and prostate cancer stained with CD3 and CD8 immunohistochemistry. Differently from other challenges setup in medical image analysis, LYSTO participants were solely given a few hours to address this problem. In this paper, we describe the goal and the multi-phase organization of the hackathon; we describe the proposed methods and the on-site results. Additionally, we present post-competition results where we show how the presented methods perform on an independent set of lung cancer slides, which was not part of the initial competition, as well as a comparison on lymphocyte assessment between presented methods and a panel of pathologists. We show that some of the participants were capable to achieve pathologist-level performance at lymphocyte assessment. After the hackathon, LYSTO was left as a lightweight plug-and-play benchmark dataset on grand-challenge website, together with an automatic evaluation platform. LYSTO has supported a number of research in lymphocyte assessment in oncology. LYSTO will be a long-lasting educational challenge for deep learning and digital pathology, it is available at https://lysto.grand-challenge.org/.

Joint Self-Supervised Image-Volume Representation Learning with Intra-Inter Contrastive Clustering

Collecting large-scale medical datasets with fully annotated samples for training of deep networks is prohibitively expensive, especially for 3D volume data. Recent breakthroughs in self-supervised learning (SSL) offer the ability to overcome the lack of labeled training samples by learning feature representations from unlabeled data. However, most current SSL techniques in the medical field have been designed for either 2D images or 3D volumes. In practice, this restricts the capability to fully leverage unlabeled data from numerous sources, which may include both 2D and 3D data. Additionally, the use of these pre-trained networks is constrained to downstream tasks with compatible data dimensions. In this paper, we propose a novel framework for unsupervised joint learning on 2D and 3D data modalities. Given a set of 2D images or 2D slices extracted from 3D volumes, we construct an SSL task based on a 2D contrastive clustering problem for distinct classes. The 3D volumes are exploited by computing vectored embedding at each slice and then assembling a holistic feature through deformable self-attention mechanisms in Transformer, allowing incorporating long-range dependencies between slices inside 3D volumes. These holistic features are further utilized to define a novel 3D clustering agreement-based SSL task and masking embedding prediction inspired by pre-trained language models. Experiments on downstream tasks, such as 3D brain segmentation, lung nodule detection, 3D heart structures segmentation, and abnormal chest X-ray detection, demonstrate the effectiveness of our joint 2D and 3D SSL approach. We improve plain 2D Deep-ClusterV2 and SwAV by a significant margin and also surpass various modern 2D and 3D SSL approaches.

What can we learn about a generated image corrupting its latent representation?

Generative adversarial networks (GANs) offer an effective solution to the image-to-image translation problem, thereby allowing for new possibilities in medical imaging. They can translate images from one imaging modality to another at a low cost. For unpaired datasets, they rely mostly on cycle loss. Despite its effectiveness in learning the underlying data distribution, it can lead to a discrepancy between input and output data. The purpose of this work is to investigate the hypothesis that we can predict image quality based on its latent representation in the GANs bottleneck. We achieve this by corrupting the latent representation with noise and generating multiple outputs. The degree of differences between them is interpreted as the strength of the representation: the more robust the latent representation, the fewer changes in the output image the corruption causes. Our results demonstrate that our proposed method has the ability to i) predict uncertain parts of synthesized images, and ii) identify samples that may not be reliable for downstream tasks, e.g., liver segmentation task.

FLamby: Datasets and Benchmarks for Cross-Silo Federated Learning in Realistic Healthcare Settings

Federated Learning (FL) is a novel approach enabling several clients holding sensitive data to collaboratively train machine learning models, without centralizing data. The cross-silo FL setting corresponds to the case of few ($2$--$50$) reliable clients, each holding medium to large datasets, and is typically found in applications such as healthcare, finance, or industry. While previous works have proposed representative datasets for cross-device FL, few realistic healthcare cross-silo FL datasets exist, thereby slowing algorithmic research in this critical application. In this work, we propose a novel cross-silo dataset suite focused on healthcare, FLamby (Federated Learning AMple Benchmark of Your cross-silo strategies), to bridge the gap between theory and practice of cross-silo FL. FLamby encompasses 7 healthcare datasets with natural splits, covering multiple tasks, modalities, and data volumes, each accompanied with baseline training code. As an illustration, we additionally benchmark standard FL algorithms on all datasets. Our flexible and modular suite allows researchers to easily download datasets, reproduce results and re-use the different components for their research. FLamby is available at~\url{www.github.com/owkin/flamby}.

Transformer based Models for Unsupervised Anomaly Segmentation in Brain MR Images

The quality of patient care associated with diagnostic radiology is proportionate to a physician workload. Segmentation is a fundamental limiting precursor to diagnostic and therapeutic procedures. Advances in Machine Learning (ML) aim to increase diagnostic efficiency to replace single application with generalized algorithms. In Unsupervised Anomaly Detection (UAD), Convolutional Neural Network (CNN) based Autoencoders (AEs) and Variational Autoencoders (VAEs) are considered as a de facto approach for reconstruction based anomaly segmentation. Looking for anomalous regions in medical images is one of the main applications that use anomaly segmentation. The restricted receptive field in CNNs limit the CNN to model the global context and hence if the anomalous regions cover parts of the image, the CNN-based AEs are not capable to bring semantic understanding of the image. On the other hand, Vision Transformers (ViTs) have emerged as a competitive alternative to CNNs. It relies on the self-attention mechanism that is capable to relate image patches to each other. To reconstruct a coherent and more realistic image, in this work, we investigate Transformer capabilities in building AEs for reconstruction based UAD task. We focus on anomaly segmentation for Brain Magnetic Resonance Imaging (MRI) and present five Transformer-based models while enabling segmentation performance comparable or superior to State-of-The-Art (SOTA) models. The source code is available on Github https://github.com/ahmedgh970/Transformers_Unsupervised_Anomaly_Segmentation.git

Anomaly-aware multiple instance learning for rare anemia disorder classification

Deep learning-based classification of rare anemia disorders is challenged by the lack of training data and instance-level annotations. Multiple Instance Learning (MIL) has shown to be an effective solution, yet it suffers from low accuracy and limited explainability. Although the inclusion of attention mechanisms has addressed these issues, their effectiveness highly depends on the amount and diversity of cells in the training samples. Consequently, the poor machine learning performance on rare anemia disorder classification from blood samples remains unresolved. In this paper, we propose an interpretable pooling method for MIL to address these limitations. By benefiting from instance-level information of negative bags (i.e., homogeneous benign cells from healthy individuals), our approach increases the contribution of anomalous instances. We show that our strategy outperforms standard MIL classification algorithms and provides a meaningful explanation behind its decisions. Moreover, it can denote anomalous instances of rare blood diseases that are not seen during the training phase.

Unsupervised Cross-Domain Feature Extraction for Single Blood Cell Image Classification

Diagnosing hematological malignancies requires identification and classification of white blood cells in peripheral blood smears. Domain shifts caused by different lab procedures, staining, illumination, and microscope settings hamper the re-usability of recently developed machine learning methods on data collected from different sites. Here, we propose a cross-domain adapted autoencoder to extract features in an unsupervised manner on three different datasets of single white blood cells scanned from peripheral blood smears. The autoencoder is based on an R-CNN architecture allowing it to focus on the relevant white blood cell and eliminate artifacts in the image. To evaluate the quality of the extracted features we use a simple random forest to classify single cells. We show that thanks to the rich features extracted by the autoencoder trained on only one of the datasets, the random forest classifier performs satisfactorily on the unseen datasets, and outperforms published oracle networks in the cross-domain task. Our results suggest the possibility of employing this unsupervised approach in more complicated diagnosis and prognosis tasks without the need to add expensive expert labels to unseen data.

Virtual embeddings and self-consistency for self-supervised learning

Self-supervised Learning (SSL) has recently gained much attention due to the high cost and data limitation in the training of supervised learning models. The current paradigm in the SSL is to utilize data augmentation at the input space to create different views of the same images and train a model to maximize the representations between similar images and minimize them for different ones. While this approach achieves state-of-the-art (SOTA) results in various downstream tasks, it still lakes the opportunity to investigate the latent space augmentation. This paper proposes TriMix, a novel concept for SSL that generates virtual embeddings through linear interpolation of the data, thus providing the model with novel representations. Our strategy focuses on training the model to extract the original embeddings from virtual ones, hence, better representation learning. Additionally, we propose a self-consistency term that improves the consistency between the virtual and actual embeddings. We validate TriMix on eight benchmark datasets consisting of natural and medical images with an improvement of 2.71% and 0.41% better than the second-best models for both data types. Further, our approach outperformed the current methods in semi-supervised learning, particularly in low data regimes. Besides, our pre-trained models showed better transfer to other datasets.

FedNorm: Modality-Based Normalization in Federated Learning for Multi-Modal Liver Segmentation

Given the high incidence and effective treatment options for liver diseases, they are of great socioeconomic importance. One of the most common methods for analyzing CT and MRI images for diagnosis and follow-up treatment is liver segmentation. Recent advances in deep learning have demonstrated encouraging results for automatic liver segmentation. Despite this, their success depends primarily on the availability of an annotated database, which is often not available because of privacy concerns. Federated Learning has been recently proposed as a solution to alleviate these challenges by training a shared global model on distributed clients without access to their local databases. Nevertheless, Federated Learning does not perform well when it is trained on a high degree of heterogeneity of image data due to multi-modal imaging, such as CT and MRI, and multiple scanner types. To this end, we propose Fednorm and its extension \fednormp, two Federated Learning algorithms that use a modality-based normalization technique. Specifically, Fednorm normalizes the features on a client-level, while Fednorm+ employs the modality information of single slices in the feature normalization. Our methods were validated using 428 patients from six publicly available databases and compared to state-of-the-art Federated Learning algorithms and baseline models in heterogeneous settings (multi-institutional, multi-modal data). The experimental results demonstrate that our methods show an overall acceptable performance, achieve Dice per patient scores up to 0.961, consistently outperform locally trained models, and are on par or slightly better than centralized models.