LightM-UNet: Mamba Assists in Lightweight UNet for Medical Image Segmentation

UNet and its variants have been widely used in medical image segmentation. However, these models, especially those based on Transformer architectures, pose challenges due to their large number of parameters and computational loads, making them unsuitable for mobile health applications. Recently, State Space Models (SSMs), exemplified by Mamba, have emerged as competitive alternatives to CNN and Transformer architectures. Building upon this, we employ Mamba as a lightweight substitute for CNN and Transformer within UNet, aiming at tackling challenges stemming from computational resource limitations in real medical settings. To this end, we introduce the Lightweight Mamba UNet (LightM-UNet) that integrates Mamba and UNet in a lightweight framework. Specifically, LightM-UNet leverages the Residual Vision Mamba Layer in a pure Mamba fashion to extract deep semantic features and model long-range spatial dependencies, with linear computational complexity. Extensive experiments conducted on two real-world 2D/3D datasets demonstrate that LightM-UNet surpasses existing state-of-the-art literature. Notably, when compared to the renowned nnU-Net, LightM-UNet achieves superior segmentation performance while drastically reducing parameter and computation costs by 116x and 21x, respectively. This highlights the potential of Mamba in facilitating model lightweighting. Our code implementation is publicly available at https://github.com/MrBlankness/LightM-UNet.

Learnable Prompt as Pseudo-Imputation: Reassessing the Necessity of Traditional EHR Data Imputation in Downstream Clinical Prediction

Analyzing the health status of patients based on Electronic Health Records (EHR) is a fundamental research problem in medical informatics. The presence of extensive missing values in EHR makes it challenging for deep neural networks to directly model the patient's health status based on EHR. Existing deep learning training protocols require the use of statistical information or imputation models to reconstruct missing values; however, the protocols inject non-realistic data into downstream EHR analysis models, significantly limiting model performance. This paper introduces Learnable Prompt as Pseudo Imputation (PAI) as a new training protocol. PAI no longer introduces any imputed data but constructs a learnable prompt to model the implicit preferences of the downstream model for missing values, resulting in a significant performance improvement for all EHR analysis models. Additionally, our experiments show that PAI exhibits higher robustness in situations of data insufficiency and high missing rates. More importantly, in a real-world application involving cross-institutional data with zero-shot evaluation, PAI demonstrates stronger model generalization capabilities for non-overlapping features.

Prompting Large Language Models for Zero-Shot Clinical Prediction with Structured Longitudinal Electronic Health Record Data

The inherent complexity of structured longitudinal Electronic Health Records (EHR) data poses a significant challenge when integrated with Large Language Models (LLMs), which are traditionally tailored for natural language processing. Motivated by the urgent need for swift decision-making during new disease outbreaks, where traditional predictive models often fail due to a lack of historical data, this research investigates the adaptability of LLMs, like GPT-4, to EHR data. We particularly focus on their zero-shot capabilities, which enable them to make predictions in scenarios in which they haven't been explicitly trained. In response to the longitudinal, sparse, and knowledge-infused nature of EHR data, our prompting approach involves taking into account specific EHR characteristics such as units and reference ranges, and employing an in-context learning strategy that aligns with clinical contexts. Our comprehensive experiments on the MIMIC-IV and TJH datasets demonstrate that with our elaborately designed prompting framework, LLMs can improve prediction performance in key tasks such as mortality, length-of-stay, and 30-day readmission by about 35\%, surpassing ML models in few-shot settings. Our research underscores the potential of LLMs in enhancing clinical decision-making, especially in urgent healthcare situations like the outbreak of emerging diseases with no labeled data. The code is publicly available at https://github.com/yhzhu99/llm4healthcare for reproducibility.

CUPre: Cross-domain Unsupervised Pre-training for Few-Shot Cell Segmentation

While pre-training on object detection tasks, such as Common Objects in Contexts (COCO) [1], could significantly boost the performance of cell segmentation, it still consumes on massive fine-annotated cell images [2] with bounding boxes, masks, and cell types for every cell in every image, to fine-tune the pre-trained model. To lower the cost of annotation, this work considers the problem of pre-training DNN models for few-shot cell segmentation, where massive unlabeled cell images are available but only a small proportion is annotated. Hereby, we propose Cross-domain Unsupervised Pre-training, namely CUPre, transferring the capability of object detection and instance segmentation for common visual objects (learned from COCO) to the visual domain of cells using unlabeled images. Given a standard COCO pre-trained network with backbone, neck, and head modules, CUPre adopts an alternate multi-task pre-training (AMT2) procedure with two sub-tasks -- in every iteration of pre-training, AMT2 first trains the backbone with cell images from multiple cell datasets via unsupervised momentum contrastive learning (MoCo) [3], and then trains the whole model with vanilla COCO datasets via instance segmentation. After pre-training, CUPre fine-tunes the whole model on the cell segmentation task using a few annotated images. We carry out extensive experiments to evaluate CUPre using LIVECell [2] and BBBC038 [4] datasets in few-shot instance segmentation settings. The experiment shows that CUPre can outperform existing pre-training methods, achieving the highest average precision (AP) for few-shot cell segmentation and detection.

MUSCLE: Multi-task Self-supervised Continual Learning to Pre-train Deep Models for X-ray Images of Multiple Body Parts

While self-supervised learning (SSL) algorithms have been widely used to pre-train deep models, few efforts [11] have been done to improve representation learning of X-ray image analysis with SSL pre-trained models. In this work, we study a novel self-supervised pre-training pipeline, namely Multi-task Self-super-vised Continual Learning (MUSCLE), for multiple medical imaging tasks, such as classification and segmentation, using X-ray images collected from multiple body parts, including heads, lungs, and bones. Specifically, MUSCLE aggregates X-rays collected from multiple body parts for MoCo-based representation learning, and adopts a well-designed continual learning (CL) procedure to further pre-train the backbone subject various X-ray analysis tasks jointly. Certain strategies for image pre-processing, learning schedules, and regularization have been used to solve data heterogeneity, overfitting, and catastrophic forgetting problems for multi-task/dataset learning in MUSCLE.We evaluate MUSCLE using 9 real-world X-ray datasets with various tasks, including pneumonia classification, skeletal abnormality classification, lung segmentation, and tuberculosis (TB) detection. Comparisons against other pre-trained models [7] confirm the proof-of-concept that self-supervised multi-task/dataset continual pre-training could boost the performance of X-ray image analysis.