Improving Multi-Center Generalizability of GAN-Based Fat Suppression using Federated Learning

Generative Adversarial Network (GAN)-based synthesis of fat suppressed (FS) MRIs from non-FS proton density sequences has the potential to accelerate acquisition of knee MRIs. However, GANs trained on single-site data have poor generalizability to external data. We show that federated learning can improve multi-center generalizability of GANs for synthesizing FS MRIs, while facilitating privacy-preserving multi-institutional collaborations.

Anytime, Anywhere, Anyone: Investigating the Feasibility of Segment Anything Model for Crowd-Sourcing Medical Image Annotations

Curating annotations for medical image segmentation is a labor-intensive and time-consuming task that requires domain expertise, resulting in "narrowly" focused deep learning (DL) models with limited translational utility. Recently, foundation models like the Segment Anything Model (SAM) have revolutionized semantic segmentation with exceptional zero-shot generalizability across various domains, including medical imaging, and hold a lot of promise for streamlining the annotation process. However, SAM has yet to be evaluated in a crowd-sourced setting to curate annotations for training 3D DL segmentation models. In this work, we explore the potential of SAM for crowd-sourcing "sparse" annotations from non-experts to generate "dense" segmentation masks for training 3D nnU-Net models, a state-of-the-art DL segmentation model. Our results indicate that while SAM-generated annotations exhibit high mean Dice scores compared to ground-truth annotations, nnU-Net models trained on SAM-generated annotations perform significantly worse than nnU-Net models trained on ground-truth annotations ($p<0.001$, all).

Hidden in Plain Sight: Undetectable Adversarial Bias Attacks on Vulnerable Patient Populations

The proliferation of artificial intelligence (AI) in radiology has shed light on the risk of deep learning (DL) models exacerbating clinical biases towards vulnerable patient populations. While prior literature has focused on quantifying biases exhibited by trained DL models, demographically targeted adversarial bias attacks on DL models and its implication in the clinical environment remains an underexplored field of research in medical imaging. In this work, we demonstrate that demographically targeted label poisoning attacks can introduce adversarial underdiagnosis bias in DL models and degrade performance on underrepresented groups without impacting overall model performance. Moreover, our results across multiple performance metrics and demographic groups like sex, age, and their intersectional subgroups indicate that a group's vulnerability to undetectable adversarial bias attacks is directly correlated with its representation in the model's training data.

One Copy Is All You Need: Resource-Efficient Streaming of Medical Imaging Data at Scale

Large-scale medical imaging datasets have accelerated development of artificial intelligence tools for clinical decision support. However, the large size of these datasets is a bottleneck for users with limited storage and bandwidth. Many users may not even require such large datasets as AI models are often trained on lower resolution images. If users could directly download at their desired resolution, storage and bandwidth requirements would significantly decrease. However, it is impossible to anticipate every users' requirements and impractical to store the data at multiple resolutions. What if we could store images at a single resolution but send them at different ones? We propose MIST, an open-source framework to operationalize progressive resolution for streaming medical images at multiple resolutions from a single high-resolution copy. We demonstrate that MIST can dramatically reduce imaging infrastructure inefficiencies for hosting and streaming medical images by >90%, while maintaining diagnostic quality for deep learning applications.

A framework for dynamically training and adapting deep reinforcement learning models to different, low-compute, and continuously changing radiology deployment environments

While Deep Reinforcement Learning has been widely researched in medical imaging, the training and deployment of these models usually require powerful GPUs. Since imaging environments evolve rapidly and can be generated by edge devices, the algorithm is required to continually learn and adapt to changing environments, and adjust to low-compute devices. To this end, we developed three image coreset algorithms to compress and denoise medical images for selective experience replayed-based lifelong reinforcement learning. We implemented neighborhood averaging coreset, neighborhood sensitivity-based sampling coreset, and maximum entropy coreset on full-body DIXON water and DIXON fat MRI images. All three coresets produced 27x compression with excellent performance in localizing five anatomical landmarks: left knee, right trochanter, left kidney, spleen, and lung across both imaging environments. Maximum entropy coreset obtained the best performance of $11.97\pm 12.02$ average distance error, compared to the conventional lifelong learning framework's $19.24\pm 50.77$.

Multi-environment lifelong deep reinforcement learning for medical imaging

Deep reinforcement learning(DRL) is increasingly being explored in medical imaging. However, the environments for medical imaging tasks are constantly evolving in terms of imaging orientations, imaging sequences, and pathologies. To that end, we developed a Lifelong DRL framework, SERIL to continually learn new tasks in changing imaging environments without catastrophic forgetting. SERIL was developed using selective experience replay based lifelong learning technique for the localization of five anatomical landmarks in brain MRI on a sequence of twenty-four different imaging environments. The performance of SERIL, when compared to two baseline setups: MERT(multi-environment-best-case) and SERT(single-environment-worst-case) demonstrated excellent performance with an average distance of $9.90\pm7.35$ pixels from the desired landmark across all 120 tasks, compared to $10.29\pm9.07$ for MERT and $36.37\pm22.41$ for SERT($p<0.05$), demonstrating the excellent potential for continuously learning multiple tasks across dynamically changing imaging environments.

High-Throughput AI Inference for Medical Image Classification and Segmentation using Intelligent Streaming

As the adoption of AI systems within the clinical setup grows, limitations in bandwidth could create communication bottlenecks when streaming imaging data, leading to delays in patient diagnosis and treatment. As such, healthcare providers and AI vendors will require greater computational infrastructure, therefore dramatically increasing costs. To that end, we developed intelligent streaming, a state-of-the-art framework to enable accelerated, cost-effective, bandwidth-optimized, and computationally efficient AI inference for clinical decision making at scale. For classification, intelligent streaming reduced the data transmission by 99.01% and decoding time by 98.58%, while increasing throughput by 27.43x. For segmentation, our framework reduced data transmission by 90.32%, decoding time by 90.26%, while increasing throughput by 4.20x. Our work demonstrates that intelligent streaming results in faster turnaround times, and reduced overall cost of data and transmission, without negatively impacting clinical decision making using AI systems.

Text2Cohort: Democratizing the NCI Imaging Data Commons with Natural Language Cohort Discovery

The Imaging Data Commons (IDC) is a cloud-based database that provides researchers with open access to cancer imaging data, with the goal of facilitating collaboration in medical imaging research. However, querying the IDC database for cohort discovery and access to imaging data has a significant learning curve for researchers due to its complex nature. We developed Text2Cohort, a large language model (LLM) based toolkit to facilitate user-friendly and intuitive natural language cohort discovery in the IDC. Text2Cohorts translates user input into IDC database queries using prompt engineering and autocorrection and returns the query's response to the user. Autocorrection resolves errors in queries by passing the errors back to the model for interpretation and correction. We evaluate Text2Cohort on 50 natural language user inputs ranging from information extraction to cohort discovery. The resulting queries and outputs were verified by two computer scientists to measure Text2Cohort's accuracy and F1 score. Text2Cohort successfully generated queries and their responses with an 88% accuracy and F1 score of 0.94. However, it failed to generate queries for 6/50 (12%) user inputs due to syntax and semantic errors. Our results indicate that Text2Cohort succeeded at generating queries with correct responses, but occasionally failed due to a lack of understanding of the data schema. Despite these shortcomings, Text2Cohort demonstrates the utility of LLMs to enable researchers to discover and curate cohorts using data hosted on IDC with high levels of accuracy using natural language in a more intuitive and user-friendly way.

Asynchronous Decentralized Federated Lifelong Learning for Landmark Localization in Medical Imaging

Federated learning is a recent development in the machine learning area that allows a system of devices to train on one or more tasks without sharing their data to a single location or device. However, this framework still requires a centralized global model to consolidate individual models into one, and the devices train synchronously, which both can be potential bottlenecks for using federated learning. In this paper, we propose a novel method of asynchronous decentralized federated lifelong learning (ADFLL) method that inherits the merits of federated learning and can train on multiple tasks simultaneously without the need for a central node or synchronous training. Thus, overcoming the potential drawbacks of conventional federated learning. We demonstrate excellent performance on the brain tumor segmentation (BRATS) dataset for localizing the left ventricle on multiple image sequences and image orientation. Our framework allows agents to achieve the best performance with a mean distance error of 7.81, better than the conventional all-knowing agent's mean distance error of 11.78, and significantly (p=0.01) better than a conventional lifelong learning agent with a distance error of 15.17 after eight rounds of training. In addition, all ADFLL agents have comparable or better performance than a conventional LL agent. In conclusion, we developed an ADFLL framework with excellent performance and speed-up compared to conventional RL agents.