SAMM (Segment Any Medical Model): A 3D Slicer Integration to SAM

The Segment Anything Model (SAM) is a new image segmentation tool trained with the largest segmentation dataset at this time. The model has demonstrated that it can create high-quality masks for image segmentation with good promptability and generalizability. However, the performance of the model on medical images requires further validation. To assist with the development, assessment, and utilization of SAM on medical images, we introduce Segment Any Medical Model (SAMM), an extension of SAM on 3D Slicer, a widely-used open-source image processing and visualization software that has been extensively used in the medical imaging community. This open-source extension to 3D Slicer and its demonstrations are posted on GitHub (https://github.com/bingogome/samm). SAMM achieves 0.6-second latency of a complete cycle and can infer image masks in nearly real-time.

Unknown Sniffer for Object Detection: Don't Turn a Blind Eye to Unknown Objects

The recently proposed open-world object and open-set detection achieve a breakthrough in finding never-seen-before objects and distinguishing them from class-known ones. However, their studies on knowledge transfer from known classes to unknown ones need to be deeper, leading to the scanty capability for detecting unknowns hidden in the background. In this paper, we propose the unknown sniffer (UnSniffer) to find both unknown and known objects. Firstly, the generalized object confidence (GOC) score is introduced, which only uses class-known samples for supervision and avoids improper suppression of unknowns in the background. Significantly, such confidence score learned from class-known objects can be generalized to unknown ones. Additionally, we propose a negative energy suppression loss to further limit the non-object samples in the background. Next, the best box of each unknown is hard to obtain during inference due to lacking their semantic information in training. To solve this issue, we introduce a graph-based determination scheme to replace hand-designed non-maximum suppression (NMS) post-processing. Finally, we present the Unknown Object Detection Benchmark, the first publicly benchmark that encompasses precision evaluation for unknown object detection to our knowledge. Experiments show that our method is far better than the existing state-of-the-art methods. Code is available at: https://github.com/Went-Liang/UnSniffer.

Masked Image Training for Generalizable Deep Image Denoising

When capturing and storing images, devices inevitably introduce noise. Reducing this noise is a critical task called image denoising. Deep learning has become the de facto method for image denoising, especially with the emergence of Transformer-based models that have achieved notable state-of-the-art results on various image tasks. However, deep learning-based methods often suffer from a lack of generalization ability. For example, deep models trained on Gaussian noise may perform poorly when tested on other noise distributions. To address this issue, we present a novel approach to enhance the generalization performance of denoising networks, known as masked training. Our method involves masking random pixels of the input image and reconstructing the missing information during training. We also mask out the features in the self-attention layers to avoid the impact of training-testing inconsistency. Our approach exhibits better generalization ability than other deep learning models and is directly applicable to real-world scenarios. Additionally, our interpretability analysis demonstrates the superiority of our method.

Deformable Cross-Attention Transformer for Medical Image Registration

Transformers have recently shown promise for medical image applications, leading to an increasing interest in developing such models for medical image registration. Recent advancements in designing registration Transformers have focused on using cross-attention (CA) to enable a more precise understanding of spatial correspondences between moving and fixed images. Here, we propose a novel CA mechanism that computes windowed attention using deformable windows. In contrast to existing CA mechanisms that require intensive computational complexity by either computing CA globally or locally with a fixed and expanded search window, the proposed deformable CA can selectively sample a diverse set of features over a large search window while maintaining low computational complexity. The proposed model was extensively evaluated on multi-modal, mono-modal, and atlas-to-patient registration tasks, demonstrating promising performance against state-of-the-art methods and indicating its effectiveness for medical image registration. The source code for this work will be available after publication.

Spatially-varying Regularization with Conditional Transformer for Unsupervised Image Registration

In the past, optimization-based registration models have used spatially-varying regularization to account for deformation variations in different image regions. However, deep learning-based registration models have mostly relied on spatially-invariant regularization. Here, we introduce an end-to-end framework that uses neural networks to learn a spatially-varying deformation regularizer directly from data. The hyperparameter of the proposed regularizer is conditioned into the network, enabling easy tuning of the regularization strength. The proposed method is built upon a Transformer-based model, but it can be readily adapted to any network architecture. We thoroughly evaluated the proposed approach using publicly available datasets and observed a significant performance improvement while maintaining smooth deformation. The source code of this work will be made available after publication.

Automated Ventricle Parcellation and Evan's Ratio Computation in Pre- and Post-Surgical Ventriculomegaly

Normal pressure hydrocephalus~(NPH) is a brain disorder associated with enlarged ventricles and multiple cognitive and motor symptoms. The degree of ventricular enlargement can be measured using magnetic resonance images~(MRIs) and characterized quantitatively using the Evan's ratio (ER). Automatic computation of ER is desired to avoid the extra time and variations associated with manual measurements on MRI. Because shunt surgery is often used to treat NPH, it is necessary that this process be robust to image artifacts caused by the shunt and related implants. In this paper, we propose a 3D regions-of-interest aware (ROI-aware) network for segmenting the ventricles. The method achieves state-of-the-art performance on both pre-surgery MRIs and post-surgery MRIs with artifacts. Based on our segmentation results, we also describe an automated approach to compute ER from these results. Experimental results on multiple datasets demonstrate the potential of the proposed method to assist clinicians in the diagnosis and management of NPH.

A latent space for unsupervised MR image quality control via artifact assessment

Image quality control (IQC) can be used in automated magnetic resonance (MR) image analysis to exclude erroneous results caused by poorly acquired or artifact-laden images. Existing IQC methods for MR imaging generally require human effort to craft meaningful features or label large datasets for supervised training. The involvement of human labor can be burdensome and biased, as labeling MR images based on their quality is a subjective task. In this paper, we propose an automatic IQC method that evaluates the extent of artifacts in MR images without supervision. In particular, we design an artifact encoding network that learns representations of artifacts based on contrastive learning. We then use a normalizing flow to estimate the density of learned representations for unsupervised classification. Our experiments on large-scale multi-cohort MR datasets show that the proposed method accurately detects images with high levels of artifacts, which can inform downstream analysis tasks about potentially flawed data.

Deep Unsupervised Phase-based 3D Incompressible Motion Estimation in Tagged-MRI

Tagged magnetic resonance imaging (MRI) has been used for decades to observe and quantify the detailed motion of deforming tissue. However, this technique faces several challenges such as tag fading, large motion, long computation times, and difficulties in obtaining diffeomorphic incompressible flow fields. To address these issues, this paper presents a novel unsupervised phase-based 3D motion estimation technique for tagged MRI. We introduce two key innovations. First, we apply a sinusoidal transformation to the harmonic phase input, which enables end-to-end training and avoids the need for phase interpolation. Second, we propose a Jacobian determinant-based learning objective to encourage incompressible flow fields for deforming biological tissues. Our method efficiently estimates 3D motion fields that are accurate, dense, and approximately diffeomorphic and incompressible. The efficacy of the method is assessed using human tongue motion during speech, and includes both healthy controls and patients that have undergone glossectomy. We show that the method outperforms existing approaches, and also exhibits improvements in speed, robustness to tag fading, and large tongue motion.

HACA3: A Unified Approach for Multi-site MR Image Harmonization

The lack of standardization is a prominent issue in magnetic resonance (MR) imaging. This often causes undesired contrast variations due to differences in hardware and acquisition parameters. In recent years, MR harmonization using image synthesis with disentanglement has been proposed to compensate for the undesired contrast variations. Despite the success of existing methods, we argue that three major improvements can be made. First, most existing methods are built upon the assumption that multi-contrast MR images of the same subject share the same anatomy. This assumption is questionable since different MR contrasts are specialized to highlight different anatomical features. Second, these methods often require a fixed set of MR contrasts for training (e.g., both Tw-weighted and T2-weighted images must be available), which limits their applicability. Third, existing methods generally are sensitive to imaging artifacts. In this paper, we present a novel approach, Harmonization with Attention-based Contrast, Anatomy, and Artifact Awareness (HACA3), to address these three issues. We first propose an anatomy fusion module that enables HACA3 to respect the anatomical differences between MR contrasts. HACA3 is also robust to imaging artifacts and can be trained and applied to any set of MR contrasts. Experiments show that HACA3 achieves state-of-the-art performance under multiple image quality metrics. We also demonstrate the applicability of HACA3 on downstream tasks with diverse MR datasets acquired from 21 sites with different field strengths, scanner platforms, and acquisition protocols.

On Finite Difference Jacobian Computation in Deformable Image Registration

Producing spatial transformations that are diffeomorphic has been a central problem in deformable image registration. As a diffeomorphic transformation should have positive Jacobian determinant $|J|$ everywhere, the number of voxels with $|J|<0$ has been used to test for diffeomorphism and also to measure the irregularity of the transformation. For digital transformations, $|J|$ is commonly approximated using central difference, but this strategy can yield positive $|J|$'s for transformations that are clearly not diffeomorphic -- even at the voxel resolution level. To show this, we first investigate the geometric meaning of different finite difference approximations of $|J|$. We show that to determine diffeomorphism for digital images, use of any individual finite difference approximations of $|J|$ is insufficient. We show that for a 2D transformation, four unique finite difference approximations of $|J|$'s must be positive to ensure the entire domain is invertible and free of folding at the pixel level. We also show that in 3D, ten unique finite differences approximations of $|J|$'s are required to be positive. Our proposed digital diffeomorphism criteria solves several errors inherent in the central difference approximation of $|J|$ and accurately detects non-diffeomorphic digital transformations.