UM-CAM: Uncertainty-weighted Multi-resolution Class Activation Maps for Weakly-supervised Fetal Brain Segmentation

Accurate segmentation of the fetal brain from Magnetic Resonance Image (MRI) is important for prenatal assessment of fetal development. Although deep learning has shown the potential to achieve this task, it requires a large fine annotated dataset that is difficult to collect. To address this issue, weakly-supervised segmentation methods with image-level labels have gained attention, which are commonly based on class activation maps from a classification network trained with image tags. However, most of these methods suffer from incomplete activation regions, due to the low-resolution localization without detailed boundary cues. To this end, we propose a novel weakly-supervised method with image-level labels based on semantic features and context information exploration. We first propose an Uncertainty-weighted Multi-resolution Class Activation Map (UM-CAM) to generate high-quality pixel-level supervision. Then, we design a Geodesic distance-based Seed Expansion (GSE) method to provide context information for rectifying the ambiguous boundaries of UM-CAM. Extensive experiments on a fetal brain dataset show that our UM-CAM can provide more accurate activation regions with fewer false positive regions than existing CAM variants, and our proposed method outperforms state-of-the-art weakly-supervised methods with image-level labels.

KiUT: Knowledge-injected U-Transformer for Radiology Report Generation

Radiology report generation aims to automatically generate a clinically accurate and coherent paragraph from the X-ray image, which could relieve radiologists from the heavy burden of report writing. Although various image caption methods have shown remarkable performance in the natural image field, generating accurate reports for medical images requires knowledge of multiple modalities, including vision, language, and medical terminology. We propose a Knowledge-injected U-Transformer (KiUT) to learn multi-level visual representation and adaptively distill the information with contextual and clinical knowledge for word prediction. In detail, a U-connection schema between the encoder and decoder is designed to model interactions between different modalities. And a symptom graph and an injected knowledge distiller are developed to assist the report generation. Experimentally, we outperform state-of-the-art methods on two widely used benchmark datasets: IU-Xray and MIMIC-CXR. Further experimental results prove the advantages of our architecture and the complementary benefits of the injected knowledge.

MedFMC: A Real-world Dataset and Benchmark For Foundation Model Adaptation in Medical Image Classification

Foundation models, often pre-trained with large-scale data, have achieved paramount success in jump-starting various vision and language applications. Recent advances further enable adapting foundation models in downstream tasks efficiently using only a few training samples, e.g., in-context learning. Yet, the application of such learning paradigms in medical image analysis remains scarce due to the shortage of publicly accessible data and benchmarks. In this paper, we aim at approaches adapting the foundation models for medical image classification and present a novel dataset and benchmark for the evaluation, i.e., examining the overall performance of accommodating the large-scale foundation models downstream on a set of diverse real-world clinical tasks. We collect five sets of medical imaging data from multiple institutes targeting a variety of real-world clinical tasks (22,349 images in total), i.e., thoracic diseases screening in X-rays, pathological lesion tissue screening, lesion detection in endoscopy images, neonatal jaundice evaluation, and diabetic retinopathy grading. Results of multiple baseline methods are demonstrated using the proposed dataset from both accuracy and cost-effective perspectives.

MidMed: Towards Mixed-Type Dialogues for Medical Consultation

Most medical dialogue systems assume that patients have clear goals (medicine querying, surgical operation querying, etc.) before medical consultation. However, in many real scenarios, due to the lack of medical knowledge, it is usually difficult for patients to determine clear goals with all necessary slots. In this paper, we identify this challenge as how to construct medical consultation dialogue systems to help patients clarify their goals. To mitigate this challenge, we propose a novel task and create a human-to-human mixed-type medical consultation dialogue corpus, termed MidMed, covering five dialogue types: task-oriented dialogue for diagnosis, recommendation, knowledge-grounded dialogue, QA, and chitchat. MidMed covers four departments (otorhinolaryngology, ophthalmology, skin, and digestive system), with 8,175 dialogues. Furthermore, we build baselines on MidMed and propose an instruction-guiding medical dialogue generation framework, termed InsMed, to address this task. Experimental results show the effectiveness of InsMed.

On the Challenges and Perspectives of Foundation Models for Medical Image Analysis

This article discusses the opportunities, applications and future directions of large-scale pre-trained models, i.e., foundation models, for analyzing medical images. Medical foundation models have immense potential in solving a wide range of downstream tasks, as they can help to accelerate the development of accurate and robust models, reduce the large amounts of required labeled data, preserve the privacy and confidentiality of patient data. Specifically, we illustrate the "spectrum" of medical foundation models, ranging from general vision models, modality-specific models, to organ/task-specific models, highlighting their challenges, opportunities and applications. We also discuss how foundation models can be leveraged in downstream medical tasks to enhance the accuracy and efficiency of medical image analysis, leading to more precise diagnosis and treatment decisions.

Training Like a Medical Resident: Universal Medical Image Segmentation via Context Prior Learning

A major enduring focus of clinical workflows is disease analytics and diagnosis, leading to medical imaging datasets where the modalities and annotations are strongly tied to specific clinical objectives. To date, building task-specific segmentation models is intuitive yet a restrictive approach, lacking insights gained from widespread imaging cohorts. Inspired by the training of medical residents, we explore universal medical image segmentation, whose goal is to learn from diverse medical imaging sources covering a range of clinical targets, body regions, and image modalities. Following this paradigm, we propose Hermes, a context prior learning approach that addresses the challenges related to the heterogeneity on data, modality, and annotations in the proposed universal paradigm. In a collection of seven diverse datasets, we demonstrate the appealing merits of the universal paradigm over the traditional task-specific training paradigm. By leveraging the synergy among various tasks, Hermes shows superior performance and model scalability. Our in-depth investigation on two additional datasets reveals Hermes' strong capabilities for transfer learning, incremental learning, and generalization to different downstream tasks. The code is available: https://github.com/yhygao/universal-medical-image-segmentation.

Voxel2Hemodynamics: An End-to-end Deep Learning Method for Predicting Coronary Artery Hemodynamics

Local hemodynamic forces play an important role in determining the functional significance of coronary arterial stenosis and understanding the mechanism of coronary disease progression. Computational fluid dynamics (CFD) have been widely performed to simulate hemodynamics non-invasively from coronary computed tomography angiography (CCTA) images. However, accurate computational analysis is still limited by the complex construction of patient-specific modeling and time-consuming computation. In this work, we proposed an end-to-end deep learning framework, which could predict the coronary artery hemodynamics from CCTA images. The model was trained on the hemodynamic data obtained from 3D simulations of synthetic and real datasets. Extensive experiments demonstrated that the predicted hemdynamic distributions by our method agreed well with the CFD-derived results. Quantitatively, the proposed method has the capability of predicting the fractional flow reserve with an average error of 0.5\% and 2.5\% for the synthetic dataset and real dataset, respectively. Particularly, our method achieved much better accuracy for the real dataset compared to PointNet++ with the point cloud input. This study demonstrates the feasibility and great potential of our end-to-end deep learning method as a fast and accurate approach for hemodynamic analysis.

ConES: Concept Embedding Search for Parameter Efficient Tuning Large Vision Language Models

Large pre-trained vision-language models have shown great prominence in transferring pre-acquired knowledge to various domains and downstream tasks with appropriate prompting or tuning. Existing prevalent tuning methods can be generally categorized into three genres: 1) prompt engineering by creating suitable prompt texts, which is time-consuming and requires domain expertise; 2) or simply fine-tuning the whole model, which is extremely inefficient; 3) prompt tuning through parameterized prompt embeddings with the text encoder. Nevertheless, all methods rely on the text encoder for bridging the modality gap between vision and language. In this work, we question the necessity of the cumbersome text encoder for a more lightweight and efficient tuning paradigm as well as more representative prompt embeddings closer to the image representations. To achieve this, we propose a Concept Embedding Search (ConES) approach by optimizing prompt embeddings -- without the need of the text encoder -- to capture the 'concept' of the image modality through a variety of task objectives. By dropping the text encoder, we are able to significantly speed up the learning process, \eg, from about an hour to just ten minutes in our experiments for personalized text-to-image generation without impairing the generation quality. Moreover, our proposed approach is orthogonal to current existing tuning methods since the searched concept embeddings can be further utilized in the next stage of fine-tuning the pre-trained large models for boosting performance. Extensive experiments show that our approach can beat the prompt tuning and textual inversion methods in a variety of downstream tasks including objection detection, instance segmentation, and image generation. Our approach also shows better generalization capability for unseen concepts in specialized domains, such as the medical domain.

Semi-supervised Pathological Image Segmentation via Cross Distillation of Multiple Attentions

Segmentation of pathological images is a crucial step for accurate cancer diagnosis. However, acquiring dense annotations of such images for training is labor-intensive and time-consuming. To address this issue, Semi-Supervised Learning (SSL) has the potential for reducing the annotation cost, but it is challenged by a large number of unlabeled training images. In this paper, we propose a novel SSL method based on Cross Distillation of Multiple Attentions (CDMA) to effectively leverage unlabeled images. Firstly, we propose a Multi-attention Tri-branch Network (MTNet) that consists of an encoder and a three-branch decoder, with each branch using a different attention mechanism that calibrates features in different aspects to generate diverse outputs. Secondly, we introduce Cross Decoder Knowledge Distillation (CDKD) between the three decoder branches, allowing them to learn from each other's soft labels to mitigate the negative impact of incorrect pseudo labels in training. Additionally, uncertainty minimization is applied to the average prediction of the three branches, which further regularizes predictions on unlabeled images and encourages inter-branch consistency. Our proposed CDMA was compared with eight state-of-the-art SSL methods on the public DigestPath dataset, and the experimental results showed that our method outperforms the other approaches under different annotation ratios. The code is available at \href{https://github.com/HiLab-git/CDMA}{https://github.com/HiLab-git/CDMA.}