MambaMIR: An Arbitrary-Masked Mamba for Joint Medical Image Reconstruction and Uncertainty Estimation

The recent Mamba model has shown remarkable adaptability for visual representation learning, including in medical imaging tasks. This study introduces MambaMIR, a Mamba-based model for medical image reconstruction, as well as its Generative Adversarial Network-based variant, MambaMIR-GAN. Our proposed MambaMIR inherits several advantages, such as linear complexity, global receptive fields, and dynamic weights, from the original Mamba model. The innovated arbitrary-mask mechanism effectively adapt Mamba to our image reconstruction task, providing randomness for subsequent Monte Carlo-based uncertainty estimation. Experiments conducted on various medical image reconstruction tasks, including fast MRI and SVCT, which cover anatomical regions such as the knee, chest, and abdomen, have demonstrated that MambaMIR and MambaMIR-GAN achieve comparable or superior reconstruction results relative to state-of-the-art methods. Additionally, the estimated uncertainty maps offer further insights into the reliability of the reconstruction quality. The code is publicly available at https://github.com/ayanglab/MambaMIR.

Make it more specific: A novel uncertainty based airway segmentation application on 3D U-Net and its variants

Each medical segmentation task should be considered with a specific AI algorithm based on its scenario so that the most accurate prediction model can be obtained. The most popular algorithms in medical segmentation, 3D U-Net and its variants, can directly implement the task of lung trachea segmentation, but its failure to consider the special tree-like structure of the trachea suggests that there is much room for improvement in its segmentation accuracy. Therefore, a research gap exists because a great amount of state-of-the-art DL algorithms are vanilla 3D U-Net structures, which do not introduce the various performance-enhancing modules that come with special natural image modality in lung airway segmentation. In this paper, we proposed two different network structures Branch-Level U-Net (B-UNet) and Branch-Level CE-UNet (B-CE-UNet) which are based on U-Net structure and compared the prediction results with the same dataset. Specially, both of the two networks add branch loss and central line loss to learn the feature of fine branch endings of the airways. Uncertainty estimation algorithms are also included to attain confident predictions and thereby, increase the overall trustworthiness of our whole model. In addition, predictions of the lung trachea based on the maximum connectivity rate were calculated and extracted during post-processing for segmentation refinement and pruning.

Data and Physics driven Deep Learning Models for Fast MRI Reconstruction: Fundamentals and Methodologies

Magnetic Resonance Imaging (MRI) is a pivotal clinical diagnostic tool, yet its extended scanning times often compromise patient comfort and image quality, especially in volumetric, temporal and quantitative scans. This review elucidates recent advances in MRI acceleration via data and physics-driven models, leveraging techniques from algorithm unrolling models, enhancement-based models, and plug-and-play models to emergent full spectrum of generative models. We also explore the synergistic integration of data models with physics-based insights, encompassing the advancements in multi-coil hardware accelerations like parallel imaging and simultaneous multi-slice imaging, and the optimization of sampling patterns. We then focus on domain-specific challenges and opportunities, including image redundancy exploitation, image integrity, evaluation metrics, data heterogeneity, and model generalization. This work also discusses potential solutions and future research directions, emphasizing the role of data harmonization, and federated learning for further improving the general applicability and performance of these methods in MRI reconstruction.

Hunting imaging biomarkers in pulmonary fibrosis: Benchmarks of the AIIB23 challenge

Airway-related quantitative imaging biomarkers are crucial for examination, diagnosis, and prognosis in pulmonary diseases. However, the manual delineation of airway trees remains prohibitively time-consuming. While significant efforts have been made towards enhancing airway modelling, current public-available datasets concentrate on lung diseases with moderate morphological variations. The intricate honeycombing patterns present in the lung tissues of fibrotic lung disease patients exacerbate the challenges, often leading to various prediction errors. To address this issue, the 'Airway-Informed Quantitative CT Imaging Biomarker for Fibrotic Lung Disease 2023' (AIIB23) competition was organized in conjunction with the official 2023 International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI). The airway structures were meticulously annotated by three experienced radiologists. Competitors were encouraged to develop automatic airway segmentation models with high robustness and generalization abilities, followed by exploring the most correlated QIB of mortality prediction. A training set of 120 high-resolution computerised tomography (HRCT) scans were publicly released with expert annotations and mortality status. The online validation set incorporated 52 HRCT scans from patients with fibrotic lung disease and the offline test set included 140 cases from fibrosis and COVID-19 patients. The results have shown that the capacity of extracting airway trees from patients with fibrotic lung disease could be enhanced by introducing voxel-wise weighted general union loss and continuity loss. In addition to the competitive image biomarkers for prognosis, a strong airway-derived biomarker (Hazard ratio>1.5, p<0.0001) was revealed for survival prognostication compared with existing clinical measurements, clinician assessment and AI-based biomarkers.

Joint-Individual Fusion Structure with Fusion Attention Module for Multi-Modal Skin Cancer Classification

Most convolutional neural network (CNN) based methods for skin cancer classification obtain their results using only dermatological images. Although good classification results have been shown, more accurate results can be achieved by considering the patient's metadata, which is valuable clinical information for dermatologists. Current methods only use the simple joint fusion structure (FS) and fusion modules (FMs) for the multi-modal classification methods, there still is room to increase the accuracy by exploring more advanced FS and FM. Therefore, in this paper, we design a new fusion method that combines dermatological images (dermoscopy images or clinical images) and patient metadata for skin cancer classification from the perspectives of FS and FM. First, we propose a joint-individual fusion (JIF) structure that learns the shared features of multi-modality data and preserves specific features simultaneously. Second, we introduce a fusion attention (FA) module that enhances the most relevant image and metadata features based on both the self and mutual attention mechanism to support the decision-making pipeline. We compare the proposed JIF-MMFA method with other state-of-the-art fusion methods on three different public datasets. The results show that our JIF-MMFA method improves the classification results for all tested CNN backbones and performs better than the other fusion methods on the three public datasets, demonstrating our method's effectiveness and robustness

High Accuracy and Cost-Saving Active Learning 3D WD-UNet for Airway Segmentation

We propose a novel Deep Active Learning (DeepAL) model-3D Wasserstein Discriminative UNet (WD-UNet) for reducing the annotation effort of medical 3D Computed Tomography (CT) segmentation. The proposed WD-UNet learns in a semi-supervised way and accelerates learning convergence to meet or exceed the prediction metrics of supervised learning models. Our method can be embedded with different Active Learning (AL) strategies and different network structures. The model is evaluated on 3D lung airway CT scans for medical segmentation and show that the use of uncertainty metric, which is parametrized as an input of query strategy, leads to more accurate prediction results than some state-of-the-art Deep Learning (DL) supervised models, e.g.,3DUNet and 3D CEUNet. Compared to the above supervised DL methods, our WD-UNet not only saves the cost of annotation for radiologists but also saves computational resources. WD-UNet uses a limited amount of annotated data (35% of the total) to achieve better predictive metrics with a more efficient deep learning model algorithm.

Real-Time Non-Invasive Imaging and Detection of Spreading Depolarizations through EEG: An Ultra-Light Explainable Deep Learning Approach

A core aim of neurocritical care is to prevent secondary brain injury. Spreading depolarizations (SDs) have been identified as an important independent cause of secondary brain injury. SDs are usually detected using invasive electrocorticography recorded at high sampling frequency. Recent pilot studies suggest a possible utility of scalp electrodes generated electroencephalogram (EEG) for non-invasive SD detection. However, noise and attenuation of EEG signals makes this detection task extremely challenging. Previous methods focus on detecting temporal power change of EEG over a fixed high-density map of scalp electrodes, which is not always clinically feasible. Having a specialized spectrogram as an input to the automatic SD detection model, this study is the first to transform SD identification problem from a detection task on a 1-D time-series wave to a task on a sequential 2-D rendered imaging. This study presented a novel ultra-light-weight multi-modal deep-learning network to fuse EEG spectrogram imaging and temporal power vectors to enhance SD identification accuracy over each single electrode, allowing flexible EEG map and paving the way for SD detection on ultra-low-density EEG with variable electrode positioning. Our proposed model has an ultra-fast processing speed (<0.3 sec). Compared to the conventional methods (2 hours), this is a huge advancement towards early SD detection and to facilitate instant brain injury prognosis. Seeing SDs with a new dimension - frequency on spectrograms, we demonstrated that such additional dimension could improve SD detection accuracy, providing preliminary evidence to support the hypothesis that SDs may show implicit features over the frequency profile.

Graph-Ensemble Learning Model for Multi-label Skin Lesion Classification using Dermoscopy and Clinical Images

Many skin lesion analysis (SLA) methods recently focused on developing a multi-modal-based multi-label classification method due to two factors. The first is multi-modal data, i.e., clinical and dermoscopy images, which can provide complementary information to obtain more accurate results than single-modal data. The second one is that multi-label classification, i.e., seven-point checklist (SPC) criteria as an auxiliary classification task can not only boost the diagnostic accuracy of melanoma in the deep learning (DL) pipeline but also provide more useful functions to the clinical doctor as it is commonly used in clinical dermatologist's diagnosis. However, most methods only focus on designing a better module for multi-modal data fusion; few methods explore utilizing the label correlation between SPC and skin disease for performance improvement. This study fills the gap that introduces a Graph Convolution Network (GCN) to exploit prior co-occurrence between each category as a correlation matrix into the DL model for the multi-label classification. However, directly applying GCN degraded the performances in our experiments; we attribute this to the weak generalization ability of GCN in the scenario of insufficient statistical samples of medical data. We tackle this issue by proposing a Graph-Ensemble Learning Model (GELN) that views the prediction from GCN as complementary information of the predictions from the fusion model and adaptively fuses them by a weighted averaging scheme, which can utilize the valuable information from GCN while avoiding its negative influences as much as possible. To evaluate our method, we conduct experiments on public datasets. The results illustrate that our GELN can consistently improve the classification performance on different datasets and that the proposed method can achieve state-of-the-art performance in SPC and diagnosis classification.

Multi-site, Multi-domain Airway Tree Modeling (ATM'22): A Public Benchmark for Pulmonary Airway Segmentation

Open international challenges are becoming the de facto standard for assessing computer vision and image analysis algorithms. In recent years, new methods have extended the reach of pulmonary airway segmentation that is closer to the limit of image resolution. Since EXACT'09 pulmonary airway segmentation, limited effort has been directed to quantitative comparison of newly emerged algorithms driven by the maturity of deep learning based approaches and clinical drive for resolving finer details of distal airways for early intervention of pulmonary diseases. Thus far, public annotated datasets are extremely limited, hindering the development of data-driven methods and detailed performance evaluation of new algorithms. To provide a benchmark for the medical imaging community, we organized the Multi-site, Multi-domain Airway Tree Modeling (ATM'22), which was held as an official challenge event during the MICCAI 2022 conference. ATM'22 provides large-scale CT scans with detailed pulmonary airway annotation, including 500 CT scans (300 for training, 50 for validation, and 150 for testing). The dataset was collected from different sites and it further included a portion of noisy COVID-19 CTs with ground-glass opacity and consolidation. Twenty-three teams participated in the entire phase of the challenge and the algorithms for the top ten teams are reviewed in this paper. Quantitative and qualitative results revealed that deep learning models embedded with the topological continuity enhancement achieved superior performance in general. ATM'22 challenge holds as an open-call design, the training data and the gold standard evaluation are available upon successful registration via its homepage.

Fuzzy Attention Neural Network to Tackle Discontinuity in Airway Segmentation

Airway segmentation is crucial for the examination, diagnosis, and prognosis of lung diseases, while its manual delineation is unduly burdensome. To alleviate this time-consuming and potentially subjective manual procedure, researchers have proposed methods to automatically segment airways from computerized tomography (CT) images. However, some small-sized airway branches (e.g., bronchus and terminal bronchioles) significantly aggravate the difficulty of automatic segmentation by machine learning models. In particular, the variance of voxel values and the severe data imbalance in airway branches make the computational module prone to discontinuous and false-negative predictions. especially for cohorts with different lung diseases. Attention mechanism has shown the capacity to segment complex structures, while fuzzy logic can reduce the uncertainty in feature representations. Therefore, the integration of deep attention networks and fuzzy theory, given by the fuzzy attention layer, should be an escalated solution for better generalization and robustness. This paper presents an efficient method for airway segmentation, comprising a novel fuzzy attention neural network and a comprehensive loss function to enhance the spatial continuity of airway segmentation. The deep fuzzy set is formulated by a set of voxels in the feature map and a learnable Gaussian membership function. Different from the existing attention mechanism, the proposed channel-specific fuzzy attention addresses the issue of heterogeneous features in different channels. Furthermore, a novel evaluation metric is proposed to assess both the continuity and completeness of airway structures. The efficiency, generalization and robustness of the proposed method have been proved by training on normal lung disease while testing on datasets of lung cancer, COVID-19 and pulmonary fibrosis.