Assessing the Efficacy of Invisible Watermarks in AI-Generated Medical Images

AI-generated medical images are gaining growing popularity due to their potential to address the data scarcity challenge in the real world. However, the issue of accurate identification of these synthetic images, particularly when they exhibit remarkable realism with their real copies, remains a concern. To mitigate this challenge, image generators such as DALLE and Imagen, have integrated digital watermarks aimed at facilitating the discernment of synthetic images' authenticity. These watermarks are embedded within the image pixels and are invisible to the human eye while remains their detectability. Nevertheless, a comprehensive investigation into the potential impact of these invisible watermarks on the utility of synthetic medical images has been lacking. In this study, we propose the incorporation of invisible watermarks into synthetic medical images and seek to evaluate their efficacy in the context of downstream classification tasks. Our goal is to pave the way for discussions on the viability of such watermarks in boosting the detectability of synthetic medical images, fortifying ethical standards, and safeguarding against data pollution and potential scams.

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.

Dynamic Multimodal Information Bottleneck for Multimodality Classification

Effectively leveraging multimodal data such as various images, laboratory tests and clinical information is gaining traction in a variety of AI-based medical diagnosis and prognosis tasks. Most existing multi-modal techniques only focus on enhancing their performance by leveraging the differences or shared features from various modalities and fusing feature across different modalities. These approaches are generally not optimal for clinical settings, which pose the additional challenges of limited training data, as well as being rife with redundant data or noisy modality channels, leading to subpar performance. To address this gap, we study the robustness of existing methods to data redundancy and noise and propose a generalized dynamic multimodal information bottleneck framework for attaining a robust fused feature representation. Specifically, our information bottleneck module serves to filter out the task-irrelevant information and noises in the fused feature, and we further introduce a sufficiency loss to prevent dropping of task-relevant information, thus explicitly preserving the sufficiency of prediction information in the distilled feature. We validate our model on an in-house and a public COVID19 dataset for mortality prediction as well as two public biomedical datasets for diagnostic tasks. Extensive experiments show that our method surpasses the state-of-the-art and is significantly more robust, being the only method to remain performance when large-scale noisy channels exist. Our code is publicly available at https://github.com/BII-wushuang/DMIB.

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.

Data and Physics Driven Learning Models for Fast MRI -- Fundamentals and Methodologies from CNN, GAN to Attention and Transformers

Research studies have shown no qualms about using data driven deep learning models for downstream tasks in medical image analysis, e.g., anatomy segmentation and lesion detection, disease diagnosis and prognosis, and treatment planning. However, deep learning models are not the sovereign remedy for medical image analysis when the upstream imaging is not being conducted properly (with artefacts). This has been manifested in MRI studies, where the scanning is typically slow, prone to motion artefacts, with a relatively low signal to noise ratio, and poor spatial and/or temporal resolution. Recent studies have witnessed substantial growth in the development of deep learning techniques for propelling fast MRI. This article aims to (1) introduce the deep learning based data driven techniques for fast MRI including convolutional neural network and generative adversarial network based methods, (2) survey the attention and transformer based models for speeding up MRI reconstruction, and (3) detail the research in coupling physics and data driven models for MRI acceleration. Finally, we will demonstrate through a few clinical applications, explain the importance of data harmonisation and explainable models for such fast MRI techniques in multicentre and multi-scanner studies, and discuss common pitfalls in current research and recommendations for future research directions.

Explainable COVID-19 Infections Identification and Delineation Using Calibrated Pseudo Labels

The upheaval brought by the arrival of the COVID-19 pandemic has continued to bring fresh challenges over the past two years. During this COVID-19 pandemic, there has been a need for rapid identification of infected patients and specific delineation of infection areas in computed tomography (CT) images. Although deep supervised learning methods have been established quickly, the scarcity of both image-level and pixellevel labels as well as the lack of explainable transparency still hinder the applicability of AI. Can we identify infected patients and delineate the infections with extreme minimal supervision? Semi-supervised learning (SSL) has demonstrated promising performance under limited labelled data and sufficient unlabelled data. Inspired by SSL, we propose a model-agnostic calibrated pseudo-labelling strategy and apply it under a consistency regularization framework to generate explainable identification and delineation results. We demonstrate the effectiveness of our model with the combination of limited labelled data and sufficient unlabelled data or weakly-labelled data. Extensive experiments have shown that our model can efficiently utilize limited labelled data and provide explainable classification and segmentation results for decision-making in clinical routine.

Swin Transformer for Fast MRI

Magnetic resonance imaging (MRI) is an important non-invasive clinical tool that can produce high-resolution and reproducible images. However, a long scanning time is required for high-quality MR images, which leads to exhaustion and discomfort of patients, inducing more artefacts due to voluntary movements of the patients and involuntary physiological movements. To accelerate the scanning process, methods by k-space undersampling and deep learning based reconstruction have been popularised. This work introduced SwinMR, a novel Swin transformer based method for fast MRI reconstruction. The whole network consisted of an input module (IM), a feature extraction module (FEM) and an output module (OM). The IM and OM were 2D convolutional layers and the FEM was composed of a cascaded of residual Swin transformer blocks (RSTBs) and 2D convolutional layers. The RSTB consisted of a series of Swin transformer layers (STLs). The shifted windows multi-head self-attention (W-MSA/SW-MSA) of STL was performed in shifted windows rather than the multi-head self-attention (MSA) of the original transformer in the whole image space. A novel multi-channel loss was proposed by using the sensitivity maps, which was proved to reserve more textures and details. We performed a series of comparative studies and ablation studies in the Calgary-Campinas public brain MR dataset and conducted a downstream segmentation experiment in the Multi-modal Brain Tumour Segmentation Challenge 2017 dataset. The results demonstrate our SwinMR achieved high-quality reconstruction compared with other benchmark methods, and it shows great robustness with different undersampling masks, under noise interruption and on different datasets. The code is publicly available at https://github.com/ayanglab/SwinMR.