Clinical Domain Knowledge-Derived Template Improves Post Hoc AI Explanations in Pneumothorax Classification

Background: Pneumothorax is an acute thoracic disease caused by abnormal air collection between the lungs and chest wall. To address the opaqueness often associated with deep learning (DL) models, explainable artificial intelligence (XAI) methods have been introduced to outline regions related to pneumothorax diagnoses made by DL models. However, these explanations sometimes diverge from actual lesion areas, highlighting the need for further improvement. Method: We propose a template-guided approach to incorporate the clinical knowledge of pneumothorax into model explanations generated by XAI methods, thereby enhancing the quality of these explanations. Utilizing one lesion delineation created by radiologists, our approach first generates a template that represents potential areas of pneumothorax occurrence. This template is then superimposed on model explanations to filter out extraneous explanations that fall outside the template's boundaries. To validate its efficacy, we carried out a comparative analysis of three XAI methods with and without our template guidance when explaining two DL models in two real-world datasets. Results: The proposed approach consistently improved baseline XAI methods across twelve benchmark scenarios built on three XAI methods, two DL models, and two datasets. The average incremental percentages, calculated by the performance improvements over the baseline performance, were 97.8% in Intersection over Union (IoU) and 94.1% in Dice Similarity Coefficient (DSC) when comparing model explanations and ground-truth lesion areas. Conclusions: In the context of pneumothorax diagnoses, we proposed a template-guided approach for improving AI explanations. We anticipate that our template guidance will forge a fresh approach to elucidating AI models by integrating clinical domain expertise.

RLPeri: Accelerating Visual Perimetry Test with Reinforcement Learning and Convolutional Feature Extraction

Visual perimetry is an important eye examination that helps detect vision problems caused by ocular or neurological conditions. During the test, a patient's gaze is fixed at a specific location while light stimuli of varying intensities are presented in central and peripheral vision. Based on the patient's responses to the stimuli, the visual field mapping and sensitivity are determined. However, maintaining high levels of concentration throughout the test can be challenging for patients, leading to increased examination times and decreased accuracy. In this work, we present RLPeri, a reinforcement learning-based approach to optimize visual perimetry testing. By determining the optimal sequence of locations and initial stimulus values, we aim to reduce the examination time without compromising accuracy. Additionally, we incorporate reward shaping techniques to further improve the testing performance. To monitor the patient's responses over time during testing, we represent the test's state as a pair of 3D matrices. We apply two different convolutional kernels to extract spatial features across locations as well as features across different stimulus values for each location. Through experiments, we demonstrate that our approach results in a 10-20% reduction in examination time while maintaining the accuracy as compared to state-of-the-art methods. With the presented approach, we aim to make visual perimetry testing more efficient and patient-friendly, while still providing accurate results.

Learning Prompt with Distribution-Based Feature Replay for Few-Shot Class-Incremental Learning

Few-shot Class-Incremental Learning (FSCIL) aims to continuously learn new classes based on very limited training data without forgetting the old ones encountered. Existing studies solely relied on pure visual networks, while in this paper we solved FSCIL by leveraging the Vision-Language model (e.g., CLIP) and propose a simple yet effective framework, named Learning Prompt with Distribution-based Feature Replay (LP-DiF). We observe that simply using CLIP for zero-shot evaluation can substantially outperform the most influential methods. Then, prompt tuning technique is involved to further improve its adaptation ability, allowing the model to continually capture specific knowledge from each session. To prevent the learnable prompt from forgetting old knowledge in the new session, we propose a pseudo-feature replay approach. Specifically, we preserve the old knowledge of each class by maintaining a feature-level Gaussian distribution with a diagonal covariance matrix, which is estimated by the image features of training images and synthesized features generated from a VAE. When progressing to a new session, pseudo-features are sampled from old-class distributions combined with training images of the current session to optimize the prompt, thus enabling the model to learn new knowledge while retaining old knowledge. Experiments on three prevalent benchmarks, i.e., CIFAR100, mini-ImageNet, CUB-200, and two more challenging benchmarks, i.e., SUN-397 and CUB-200$^*$ proposed in this paper showcase the superiority of LP-DiF, achieving new state-of-the-art (SOTA) in FSCIL. Code is publicly available at https://github.com/1170300714/LP-DiF.

VQA4CIR: Boosting Composed Image Retrieval with Visual Question Answering

Albeit progress has been made in Composed Image Retrieval (CIR), we empirically find that a certain percentage of failure retrieval results are not consistent with their relative captions. To address this issue, this work provides a Visual Question Answering (VQA) perspective to boost the performance of CIR. The resulting VQA4CIR is a post-processing approach and can be directly plugged into existing CIR methods. Given the top-C retrieved images by a CIR method, VQA4CIR aims to decrease the adverse effect of the failure retrieval results being inconsistent with the relative caption. To find the retrieved images inconsistent with the relative caption, we resort to the "QA generation to VQA" self-verification pipeline. For QA generation, we suggest fine-tuning LLM (e.g., LLaMA) to generate several pairs of questions and answers from each relative caption. We then fine-tune LVLM (e.g., LLaVA) to obtain the VQA model. By feeding the retrieved image and question to the VQA model, one can find the images inconsistent with relative caption when the answer by VQA is inconsistent with the answer in the QA pair. Consequently, the CIR performance can be boosted by modifying the ranks of inconsistently retrieved images. Experimental results show that our proposed method outperforms state-of-the-art CIR methods on the CIRR and Fashion-IQ datasets.

Leveraging Anatomical Constraints with Uncertainty for Pneumothorax Segmentation

Pneumothorax is a medical emergency caused by abnormal accumulation of air in the pleural space - the potential space between the lungs and chest wall. On 2D chest radiographs, pneumothorax occurs within the thoracic cavity and outside of the mediastinum and we refer to this area as "lung+ space". While deep learning (DL) has increasingly been utilized to segment pneumothorax lesions in chest radiographs, many existing DL models employ an end-to-end approach. These models directly map chest radiographs to clinician-annotated lesion areas, often neglecting the vital domain knowledge that pneumothorax is inherently location-sensitive. We propose a novel approach that incorporates the lung+ space as a constraint during DL model training for pneumothorax segmentation on 2D chest radiographs. To circumvent the need for additional annotations and to prevent potential label leakage on the target task, our method utilizes external datasets and an auxiliary task of lung segmentation. This approach generates a specific constraint of lung+ space for each chest radiograph. Furthermore, we have incorporated a discriminator to eliminate unreliable constraints caused by the domain shift between the auxiliary and target datasets. Our results demonstrated significant improvements, with average performance gains of 4.6%, 3.6%, and 3.3% regarding Intersection over Union (IoU), Dice Similarity Coefficient (DSC), and Hausdorff Distance (HD). Our research underscores the significance of incorporating medical domain knowledge about the location-specific nature of pneumothorax to enhance DL-based lesion segmentation.

Sentence-level Prompts Benefit Composed Image Retrieval

Composed image retrieval (CIR) is the task of retrieving specific images by using a query that involves both a reference image and a relative caption. Most existing CIR models adopt the late-fusion strategy to combine visual and language features. Besides, several approaches have also been suggested to generate a pseudo-word token from the reference image, which is further integrated into the relative caption for CIR. However, these pseudo-word-based prompting methods have limitations when target image encompasses complex changes on reference image, e.g., object removal and attribute modification. In this work, we demonstrate that learning an appropriate sentence-level prompt for the relative caption (SPRC) is sufficient for achieving effective composed image retrieval. Instead of relying on pseudo-word-based prompts, we propose to leverage pretrained V-L models, e.g., BLIP-2, to generate sentence-level prompts. By concatenating the learned sentence-level prompt with the relative caption, one can readily use existing text-based image retrieval models to enhance CIR performance. Furthermore, we introduce both image-text contrastive loss and text prompt alignment loss to enforce the learning of suitable sentence-level prompts. Experiments show that our proposed method performs favorably against the state-of-the-art CIR methods on the Fashion-IQ and CIRR datasets. The source code and pretrained model are publicly available at https://github.com/chunmeifeng/SPRC

Towards Instance-adaptive Inference for Federated Learning

Federated learning (FL) is a distributed learning paradigm that enables multiple clients to learn a powerful global model by aggregating local training. However, the performance of the global model is often hampered by non-i.i.d. distribution among the clients, requiring extensive efforts to mitigate inter-client data heterogeneity. Going beyond inter-client data heterogeneity, we note that intra-client heterogeneity can also be observed on complex real-world data and seriously deteriorate FL performance. In this paper, we present a novel FL algorithm, i.e., FedIns, to handle intra-client data heterogeneity by enabling instance-adaptive inference in the FL framework. Instead of huge instance-adaptive models, we resort to a parameter-efficient fine-tuning method, i.e., scale and shift deep features (SSF), upon a pre-trained model. Specifically, we first train an SSF pool for each client, and aggregate these SSF pools on the server side, thus still maintaining a low communication cost. To enable instance-adaptive inference, for a given instance, we dynamically find the best-matched SSF subsets from the pool and aggregate them to generate an adaptive SSF specified for the instance, thereby reducing the intra-client as well as the inter-client heterogeneity. Extensive experiments show that our FedIns outperforms state-of-the-art FL algorithms, e.g., a 6.64\% improvement against the top-performing method with less than 15\% communication cost on Tiny-ImageNet. Our code and models will be publicly released.

DS-Depth: Dynamic and Static Depth Estimation via a Fusion Cost Volume

Self-supervised monocular depth estimation methods typically rely on the reprojection error to capture geometric relationships between successive frames in static environments. However, this assumption does not hold in dynamic objects in scenarios, leading to errors during the view synthesis stage, such as feature mismatch and occlusion, which can significantly reduce the accuracy of the generated depth maps. To address this problem, we propose a novel dynamic cost volume that exploits residual optical flow to describe moving objects, improving incorrectly occluded regions in static cost volumes used in previous work. Nevertheless, the dynamic cost volume inevitably generates extra occlusions and noise, thus we alleviate this by designing a fusion module that makes static and dynamic cost volumes compensate for each other. In other words, occlusion from the static volume is refined by the dynamic volume, and incorrect information from the dynamic volume is eliminated by the static volume. Furthermore, we propose a pyramid distillation loss to reduce photometric error inaccuracy at low resolutions and an adaptive photometric error loss to alleviate the flow direction of the large gradient in the occlusion regions. We conducted extensive experiments on the KITTI and Cityscapes datasets, and the results demonstrate that our model outperforms previously published baselines for self-supervised monocular depth estimation.

Uncertainty-inspired Open Set Learning for Retinal Anomaly Identification

Failure to recognize samples from the classes unseen during training is a major limit of artificial intelligence (AI) in real-world implementation of retinal anomaly classification. To resolve this obstacle, we propose an uncertainty-inspired open-set (UIOS) model which was trained with fundus images of 9 common retinal conditions. Besides the probability of each category, UIOS also calculates an uncertainty score to express its confidence. Our UIOS model with thresholding strategy achieved an F1 score of 99.55%, 97.01% and 91.91% for the internal testing set, external testing set and non-typical testing set, respectively, compared to the F1 score of 92.20%, 80.69% and 64.74% by the standard AI model. Furthermore, UIOS correctly predicted high uncertainty scores, which prompted the need for a manual check, in the datasets of rare retinal diseases, low-quality fundus images, and non-fundus images. This work provides a robust method for real-world screening of retinal anomalies.