Classification of Endoscopy and Video Capsule Images using CNN-Transformer Model

Gastrointestinal cancer is a leading cause of cancer-related incidence and death, making it crucial to develop novel computer-aided diagnosis systems for early detection and enhanced treatment. Traditional approaches rely on the expertise of gastroenterologists to identify diseases; however, this process is subjective, and interpretation can vary even among expert clinicians. Considering recent advancements in classifying gastrointestinal anomalies and landmarks in endoscopic and video capsule endoscopy images, this study proposes a hybrid model that combines the advantages of Transformers and Convolutional Neural Networks (CNNs) to enhance classification performance. Our model utilizes DenseNet201 as a CNN branch to extract local features and integrates a Swin Transformer branch for global feature understanding, combining both to perform the classification task. For the GastroVision dataset, our proposed model demonstrates excellent performance with Precision, Recall, F1 score, Accuracy, and Matthews Correlation Coefficient (MCC) of 0.8320, 0.8386, 0.8324, 0.8386, and 0.8191, respectively, showcasing its robustness against class imbalance and surpassing other CNNs as well as the Swin Transformer model. Similarly, for the Kvasir-Capsule, a large video capsule endoscopy dataset, our model outperforms all others, achieving overall Precision, Recall, F1 score, Accuracy, and MCC of 0.7007, 0.7239, 0.6900, 0.7239, and 0.3871. Moreover, we generated saliency maps to explain our model's focus areas, demonstrating its reliable decision-making process. The results underscore the potential of our hybrid CNN-Transformer model in aiding the early and accurate detection of gastrointestinal (GI) anomalies.

A Novel Momentum-Based Deep Learning Techniques for Medical Image Classification and Segmentation

Accurately segmenting different organs from medical images is a critical prerequisite for computer-assisted diagnosis and intervention planning. This study proposes a deep learning-based approach for segmenting various organs from CT and MRI scans and classifying diseases. Our study introduces a novel technique integrating momentum within residual blocks for enhanced training dynamics in medical image analysis. We applied our method in two distinct tasks: segmenting liver, lung, & colon data and classifying abdominal pelvic CT and MRI scans. The proposed approach has shown promising results, outperforming state-of-the-art methods on publicly available benchmarking datasets. For instance, in the lung segmentation dataset, our approach yielded significant enhancements over the TransNetR model, including a 5.72% increase in dice score, a 5.04% improvement in mean Intersection over Union (mIoU), an 8.02% improvement in recall, and a 4.42% improvement in precision. Hence, incorporating momentum led to state-of-the-art performance in both segmentation and classification tasks, representing a significant advancement in the field of medical imaging.

Towards Synergistic Deep Learning Models for Volumetric Cirrhotic Liver Segmentation in MRIs

Liver cirrhosis, a leading cause of global mortality, requires precise segmentation of ROIs for effective disease monitoring and treatment planning. Existing segmentation models often fail to capture complex feature interactions and generalize across diverse datasets. To address these limitations, we propose a novel synergistic theory that leverages complementary latent spaces for enhanced feature interaction modeling. Our proposed architecture, nnSynergyNet3D integrates continuous and discrete latent spaces for 3D volumes and features auto-configured training. This approach captures both fine-grained and coarse features, enabling effective modeling of intricate feature interactions. We empirically validated nnSynergyNet3D on a private dataset of 628 high-resolution T1 abdominal MRI scans from 339 patients. Our model outperformed the baseline nnUNet3D by approximately 2%. Additionally, zero-shot testing on healthy liver CT scans from the public LiTS dataset demonstrated superior cross-modal generalization capabilities. These results highlight the potential of synergistic latent space models to improve segmentation accuracy and robustness, thereby enhancing clinical workflows by ensuring consistency across CT and MRI modalities.

Optimizing Synthetic Data for Enhanced Pancreatic Tumor Segmentation

Pancreatic cancer remains one of the leading causes of cancer-related mortality worldwide. Precise segmentation of pancreatic tumors from medical images is a bottleneck for effective clinical decision-making. However, achieving a high accuracy is often limited by the small size and availability of real patient data for training deep learning models. Recent approaches have employed synthetic data generation to augment training datasets. While promising, these methods may not yet meet the performance benchmarks required for real-world clinical use. This study critically evaluates the limitations of existing generative-AI based frameworks for pancreatic tumor segmentation. We conduct a series of experiments to investigate the impact of synthetic \textit{tumor size} and \textit{boundary definition} precision on model performance. Our findings demonstrate that: (1) strategically selecting a combination of synthetic tumor sizes is crucial for optimal segmentation outcomes, and (2) generating synthetic tumors with precise boundaries significantly improves model accuracy. These insights highlight the importance of utilizing refined synthetic data augmentation for enhancing the clinical utility of segmentation models in pancreatic cancer decision making including diagnosis, prognosis, and treatment plans. Our code will be available at https://github.com/lkpengcs/SynTumorAnalyzer.

SAM-EG: Segment Anything Model with Egde Guidance framework for efficient Polyp Segmentation

Polyp segmentation, a critical concern in medical imaging, has prompted numerous proposed methods aimed at enhancing the quality of segmented masks. While current state-of-the-art techniques produce impressive results, the size and computational cost of these models pose challenges for practical industry applications. Recently, the Segment Anything Model (SAM) has been proposed as a robust foundation model, showing promise for adaptation to medical image segmentation. Inspired by this concept, we propose SAM-EG, a framework that guides small segmentation models for polyp segmentation to address the computation cost challenge. Additionally, in this study, we introduce the Edge Guiding module, which integrates edge information into image features to assist the segmentation model in addressing boundary issues from current segmentation model in this task. Through extensive experiments, our small models showcase their efficacy by achieving competitive results with state-of-the-art methods, offering a promising approach to developing compact models with high accuracy for polyp segmentation and in the broader field of medical imaging.

Computation-Efficient Era: A Comprehensive Survey of State Space Models in Medical Image Analysis

Sequence modeling plays a vital role across various domains, with recurrent neural networks being historically the predominant method of performing these tasks. However, the emergence of transformers has altered this paradigm due to their superior performance. Built upon these advances, transformers have conjoined CNNs as two leading foundational models for learning visual representations. However, transformers are hindered by the $\mathcal{O}(N^2)$ complexity of their attention mechanisms, while CNNs lack global receptive fields and dynamic weight allocation. State Space Models (SSMs), specifically the \textit{\textbf{Mamba}} model with selection mechanisms and hardware-aware architecture, have garnered immense interest lately in sequential modeling and visual representation learning, challenging the dominance of transformers by providing infinite context lengths and offering substantial efficiency maintaining linear complexity in the input sequence. Capitalizing on the advances in computer vision, medical imaging has heralded a new epoch with Mamba models. Intending to help researchers navigate the surge, this survey seeks to offer an encyclopedic review of Mamba models in medical imaging. Specifically, we start with a comprehensive theoretical review forming the basis of SSMs, including Mamba architecture and its alternatives for sequence modeling paradigms in this context. Next, we offer a structured classification of Mamba models in the medical field and introduce a diverse categorization scheme based on their application, imaging modalities, and targeted organs. Finally, we summarize key challenges, discuss different future research directions of the SSMs in the medical domain, and propose several directions to fulfill the demands of this field. In addition, we have compiled the studies discussed in this paper along with their open-source implementations on our GitHub repository.

Brain Tumor Segmentation (BraTS) Challenge 2024: Meningioma Radiotherapy Planning Automated Segmentation

The 2024 Brain Tumor Segmentation Meningioma Radiotherapy (BraTS-MEN-RT) challenge aims to advance automated segmentation algorithms using the largest known multi-institutional dataset of radiotherapy planning brain MRIs with expert-annotated target labels for patients with intact or post-operative meningioma that underwent either conventional external beam radiotherapy or stereotactic radiosurgery. Each case includes a defaced 3D post-contrast T1-weighted radiotherapy planning MRI in its native acquisition space, accompanied by a single-label "target volume" representing the gross tumor volume (GTV) and any at-risk post-operative site. Target volume annotations adhere to established radiotherapy planning protocols, ensuring consistency across cases and institutions. For pre-operative meningiomas, the target volume encompasses the entire GTV and associated nodular dural tail, while for post-operative cases, it includes at-risk resection cavity margins as determined by the treating institution. Case annotations were reviewed and approved by expert neuroradiologists and radiation oncologists. Participating teams will develop, containerize, and evaluate automated segmentation models using this comprehensive dataset. Model performance will be assessed using the lesion-wise Dice Similarity Coefficient and the 95% Hausdorff distance. The top-performing teams will be recognized at the Medical Image Computing and Computer Assisted Intervention Conference in October 2024. BraTS-MEN-RT is expected to significantly advance automated radiotherapy planning by enabling precise tumor segmentation and facilitating tailored treatment, ultimately improving patient outcomes.

PP-SAM: Perturbed Prompts for Robust Adaptation of Segment Anything Model for Polyp Segmentation

The Segment Anything Model (SAM), originally designed for general-purpose segmentation tasks, has been used recently for polyp segmentation. Nonetheless, fine-tuning SAM with data from new imaging centers or clinics poses significant challenges. This is because this necessitates the creation of an expensive and time-intensive annotated dataset, along with the potential for variability in user prompts during inference. To address these issues, we propose a robust fine-tuning technique, PP-SAM, that allows SAM to adapt to the polyp segmentation task with limited images. To this end, we utilize variable perturbed bounding box prompts (BBP) to enrich the learning context and enhance the model's robustness to BBP perturbations during inference. Rigorous experiments on polyp segmentation benchmarks reveal that our variable BBP perturbation significantly improves model resilience. Notably, on Kvasir, 1-shot fine-tuning boosts the DICE score by 20% and 37% with 50 and 100-pixel BBP perturbations during inference, respectively. Moreover, our experiments show that 1-shot, 5-shot, and 10-shot PP-SAM with 50-pixel perturbations during inference outperform a recent state-of-the-art (SOTA) polyp segmentation method by 26%, 7%, and 5% DICE scores, respectively. Our results motivate the broader applicability of our PP-SAM for other medical imaging tasks with limited samples. Our implementation is available at https://github.com/SLDGroup/PP-SAM.

DCT-Based Decorrelated Attention for Vision Transformers

Central to the Transformer architectures' effectiveness is the self-attention mechanism, a function that maps queries, keys, and values into a high-dimensional vector space. However, training the attention weights of queries, keys, and values is non-trivial from a state of random initialization. In this paper, we propose two methods. (i) We first address the initialization problem of Vision Transformers by introducing a simple, yet highly innovative, initialization approach utilizing Discrete Cosine Transform (DCT) coefficients. Our proposed DCT-based attention initialization marks a significant gain compared to traditional initialization strategies; offering a robust foundation for the attention mechanism. Our experiments reveal that the DCT-based initialization enhances the accuracy of Vision Transformers in classification tasks. (ii) We also recognize that since DCT effectively decorrelates image information in the frequency domain, this decorrelation is useful for compression because it allows the quantization step to discard many of the higher-frequency components. Based on this observation, we propose a novel DCT-based compression technique for the attention function of Vision Transformers. Since high-frequency DCT coefficients usually correspond to noise, we truncate the high-frequency DCT components of the input patches. Our DCT-based compression reduces the size of weight matrices for queries, keys, and values. While maintaining the same level of accuracy, our DCT compressed Swin Transformers obtain a considerable decrease in the computational overhead.

Large-Scale Multi-Center CT and MRI Segmentation of Pancreas with Deep Learning

Automated volumetric segmentation of the pancreas on cross-sectional imaging is needed for diagnosis and follow-up of pancreatic diseases. While CT-based pancreatic segmentation is more established, MRI-based segmentation methods are understudied, largely due to a lack of publicly available datasets, benchmarking research efforts, and domain-specific deep learning methods. In this retrospective study, we collected a large dataset (767 scans from 499 participants) of T1-weighted (T1W) and T2-weighted (T2W) abdominal MRI series from five centers between March 2004 and November 2022. We also collected CT scans of 1,350 patients from publicly available sources for benchmarking purposes. We developed a new pancreas segmentation method, called PanSegNet, combining the strengths of nnUNet and a Transformer network with a new linear attention module enabling volumetric computation. We tested PanSegNet's accuracy in cross-modality (a total of 2,117 scans) and cross-center settings with Dice and Hausdorff distance (HD95) evaluation metrics. We used Cohen's kappa statistics for intra and inter-rater agreement evaluation and paired t-tests for volume and Dice comparisons, respectively. For segmentation accuracy, we achieved Dice coefficients of 88.3% (std: 7.2%, at case level) with CT, 85.0% (std: 7.9%) with T1W MRI, and 86.3% (std: 6.4%) with T2W MRI. There was a high correlation for pancreas volume prediction with R^2 of 0.91, 0.84, and 0.85 for CT, T1W, and T2W, respectively. We found moderate inter-observer (0.624 and 0.638 for T1W and T2W MRI, respectively) and high intra-observer agreement scores. All MRI data is made available at https://osf.io/kysnj/. Our source code is available at https://github.com/NUBagciLab/PaNSegNet.