Convolutional neural networks have been widely applied to medical image segmentation and have achieved considerable performance. However, the performance may be significantly affected by the domain gap between training data (source domain) and testing data (target domain). To address this issue, we propose a data manipulation based domain generalization method, called Automated Augmentation for Domain Generalization (AADG). Our AADG framework can effectively sample data augmentation policies that generate novel domains and diversify the training set from an appropriate search space. Specifically, we introduce a novel proxy task maximizing the diversity among multiple augmented novel domains as measured by the Sinkhorn distance in a unit sphere space, making automated augmentation tractable. Adversarial training and deep reinforcement learning are employed to efficiently search the objectives. Quantitative and qualitative experiments on 11 publicly-accessible fundus image datasets (four for retinal vessel segmentation, four for optic disc and cup (OD/OC) segmentation and three for retinal lesion segmentation) are comprehensively performed. Two OCTA datasets for retinal vasculature segmentation are further involved to validate cross-modality generalization. Our proposed AADG exhibits state-of-the-art generalization performance and outperforms existing approaches by considerable margins on retinal vessel, OD/OC and lesion segmentation tasks. The learned policies are empirically validated to be model-agnostic and can transfer well to other models. The source code is available at https://github.com/CRazorback/AADG.
Federated learning (FL) is a distributed machine learning paradigm that selects a subset of clients to participate in training to reduce communication burdens. However, partial client participation in FL causes \emph{objective inconsistency}, which can hinder the convergence, while this objective inconsistency has not been analyzed in existing studies on sampling methods. To tackle this issue, we propose an improved analysis method that focuses on the convergence behavior of the practical participated client's objective. Moreover, based on our convergence analysis, we give a novel unbiased sampling strategy, i.e., FedSRC-D, whose sampling probability is proportional to the client's gradient diversity and local variance. FedSRC-D is provable the optimal unbiased sampling in non-convex settings for non-IID FL with respect to the given bounds. Specifically, FedSRC-D achieves $\mathop{O}(\frac{G^2}{\epsilon^2}+\frac{1}{\epsilon^{2/3}})$ higher than SOTA convergence rate of FedAvg, and $\mathop{O}(\frac{G^2}{\epsilon^2})$ higher than other unbiased sampling methods. We corroborate our results with experiments on both synthetic and real data sets.
Federated Learning (FL) is a machine learning paradigm that learns from data kept locally to safeguard the privacy of clients, whereas local SGD is typically employed on the clients' devices to improve communication efficiency. However, such a scheme is currently constrained by the slow and unstable convergence induced by clients' heterogeneous data. In this work, we identify three under-explored phenomena of the biased local learning that may explain these challenges caused by local updates in supervised FL. As a remedy, we propose FedAug, a novel unified algorithm that reduces the local learning bias on features and classifiers to tackle these challenges. FedAug consists of two components: AugMean and AugCA. AugMean alleviates the bias in the local classifiers by balancing the output distribution of models. AugCA learns client invariant features that are close to global features but considerably distinct from those learned from other input distributions. In a series of experiments, we show that FedAug consistently outperforms other SOTA FL and domain generalization (DG) baselines, in which both two components (i.e., AugMean and AugCA) have individual performance gains.
Contrast-enhanced T1 (T1ce) is one of the most essential magnetic resonance imaging (MRI) modalities for diagnosing and analyzing brain tumors, especially gliomas. In clinical practice, common MRI modalities such as T1, T2, and fluid attenuation inversion recovery are relatively easy to access while T1ce is more challenging considering the additional cost and potential risk of allergies to the contrast agent. Therefore, it is of great clinical necessity to develop a method to synthesize T1ce from other common modalities. Current paired image translation methods typically have the issue of requiring a large amount of paired data and do not focus on specific regions of interest, e.g., the tumor region, in the synthesization process. To address these issues, we propose a Difficulty-perceived common-to-T1ce Semi-Supervised multimodal MRI Synthesis network (DS3-Net), involving both paired and unpaired data together with dual-level knowledge distillation. DS3-Net predicts a difficulty map to progressively promote the synthesis task. Specifically, a pixelwise constraint and a patchwise contrastive constraint are guided by the predicted difficulty map. Through extensive experiments on the publiclyavailable BraTS2020 dataset, DS3-Net outperforms its supervised counterpart in each respect. Furthermore, with only 5% paired data, the proposed DS3-Net achieves competitive performance with state-of-theart image translation methods utilizing 100% paired data, delivering an average SSIM of 0.8947 and an average PSNR of 23.60.
Due to the high cost of manually annotating medical images, especially for large-scale datasets, anomaly detection has been explored through training models with only normal data. Lacking prior knowledge of true anomalies is the main reason for the limited application of previous anomaly detection methods, especially in the medical image analysis realm. In this work, we propose a one-shot anomaly detection framework, namely LesionPaste, that utilizes true anomalies from a single annotated sample and synthesizes artificial anomalous samples for anomaly detection. First, a lesion bank is constructed by applying augmentation to randomly selected lesion patches. Then, MixUp is adopted to paste patches from the lesion bank at random positions in normal images to synthesize anomalous samples for training. Finally, a classification network is trained using the synthetic abnormal samples and the true normal data. Extensive experiments are conducted on two publicly-available medical image datasets with different types of abnormalities. On both datasets, our proposed LesionPaste largely outperforms several state-of-the-art unsupervised and semi-supervised anomaly detection methods, and is on a par with the fully-supervised counterpart. To note, LesionPaste is even better than the fully-supervised method in detecting early-stage diabetic retinopathy.
A large-scale labeled dataset is a key factor for the success of supervised deep learning in computer vision. However, a limited number of annotated data is very common, especially in ophthalmic image analysis, since manual annotation is time-consuming and labor-intensive. Self-supervised learning (SSL) methods bring huge opportunities for better utilizing unlabeled data, as they do not need massive annotations. With an attempt to use as many as possible unlabeled ophthalmic images, it is necessary to break the dimension barrier, simultaneously making use of both 2D and 3D images. In this paper, we propose a universal self-supervised Transformer framework, named Uni4Eye, to discover the inherent image property and capture domain-specific feature embedding in ophthalmic images. Uni4Eye can serve as a global feature extractor, which builds its basis on a Masked Image Modeling task with a Vision Transformer (ViT) architecture. We employ a Unified Patch Embedding module to replace the origin patch embedding module in ViT for jointly processing both 2D and 3D input images. Besides, we design a dual-branch multitask decoder module to simultaneously perform two reconstruction tasks on the input image and its gradient map, delivering discriminative representations for better convergence. We evaluate the performance of our pre-trained Uni4Eye encoder by fine-tuning it on six downstream ophthalmic image classification tasks. The superiority of Uni4Eye is successfully established through comparisons to other state-of-the-art SSL pre-training methods.
Unsupervised domain adaptation has been proposed recently to tackle the so-called domain shift between training data and test data with different distributions. However, most of them only focus on single-target domain adaptation and cannot be applied to the scenario with multiple target domains. In this paper, we propose RVms, a novel unsupervised multi-target domain adaptation approach to segment retinal vessels (RVs) from multimodal and multicenter retinal images. RVms mainly consists of a style augmentation and transfer (SAT) module and a dual-teacher knowledge distillation (DTKD) module. SAT augments and clusters images into source-similar domains and source-dissimilar domains via B\'ezier and Fourier transformations. DTKD utilizes the augmented and transformed data to train two teachers, one for source-similar domains and the other for source-dissimilar domains. Afterwards, knowledge distillation is performed to iteratively distill different domain knowledge from teachers to a generic student. The local relative intensity transformation is employed to characterize RVs in a domain invariant manner and promote the generalizability of teachers and student models. Moreover, we construct a new multimodal and multicenter vascular segmentation dataset from existing publicly-available datasets, which can be used to benchmark various domain adaptation and domain generalization methods. Through extensive experiments, RVms is found to be very close to the target-trained Oracle in terms of segmenting the RVs, largely outperforming other state-of-the-art methods.
Multi-modal magnetic resonance (MR) imaging provides great potential for diagnosing and analyzing brain gliomas. In clinical scenarios, common MR sequences such as T1, T2 and FLAIR can be obtained simultaneously in a single scanning process. However, acquiring contrast enhanced modalities such as T1ce requires additional time, cost, and injection of contrast agent. As such, it is clinically meaningful to develop a method to synthesize unavailable modalities which can also be used as additional inputs to downstream tasks (e.g., brain tumor segmentation) for performance enhancing. In this work, we propose an end-to-end framework named Modality-Level Attention Fusion Network (MAF-Net), wherein we innovatively conduct patchwise contrastive learning for extracting multi-modal latent features and dynamically assigning attention weights to fuse different modalities. Through extensive experiments on BraTS2020, our proposed MAF-Net is found to yield superior T1ce synthesis performance (SSIM of 0.8879 and PSNR of 22.78) and accurate brain tumor segmentation (mean Dice scores of 67.9%, 41.8% and 88.0% on segmenting the tumor core, enhancing tumor and whole tumor).
Fundus photography has been routinely used to document the presence and severity of various retinal degenerative diseases such as age-related macula degeneration, glaucoma, and diabetic retinopathy, for which the fovea, optic disc (OD), and optic cup (OC) are important anatomical landmarks. Identification of those anatomical landmarks is of great clinical importance. However, the presence of lesions, drusen, and other abnormalities during retinal degeneration severely complicates automatic landmark detection and segmentation. Most existing works treat the identification of each landmark as a single task and typically do not make use of any clinical prior information. In this paper, we present a novel method, named JOINED, for prior guided multi-task learning for joint OD/OC segmentation and fovea detection. An auxiliary branch for distance prediction, in addition to a segmentation branch and a detection branch, is constructed to effectively utilize the distance information from each image pixel to landmarks of interest. Our proposed JOINED pipeline consists of a coarse stage and a fine stage. At the coarse stage, we obtain the OD/OC coarse segmentation and the heatmap localization of fovea through a joint segmentation and detection module. Afterwards, we crop the regions of interest for subsequent fine processing and use predictions obtained at the coarse stage as additional information for better performance and faster convergence. Experimental results reveal that our proposed JOINED outperforms existing state-of-the-art approaches on the publicly-available GAMMA, PALM, and REFUGE datasets of fundus images. Furthermore, JOINED ranked the 5th on the OD/OC segmentation and fovea detection tasks in the GAMMA challenge hosted by the MICCAI2021 workshop OMIA8.