Endora: Video Generation Models as Endoscopy Simulators

Generative models hold promise for revolutionizing medical education, robot-assisted surgery, and data augmentation for machine learning. Despite progress in generating 2D medical images, the complex domain of clinical video generation has largely remained untapped.This paper introduces \model, an innovative approach to generate medical videos that simulate clinical endoscopy scenes. We present a novel generative model design that integrates a meticulously crafted spatial-temporal video transformer with advanced 2D vision foundation model priors, explicitly modeling spatial-temporal dynamics during video generation. We also pioneer the first public benchmark for endoscopy simulation with video generation models, adapting existing state-of-the-art methods for this endeavor.Endora demonstrates exceptional visual quality in generating endoscopy videos, surpassing state-of-the-art methods in extensive testing. Moreover, we explore how this endoscopy simulator can empower downstream video analysis tasks and even generate 3D medical scenes with multi-view consistency. In a nutshell, Endora marks a notable breakthrough in the deployment of generative AI for clinical endoscopy research, setting a substantial stage for further advances in medical content generation. For more details, please visit our project page: https://endora-medvidgen.github.io/.

Medical Image Synthesis via Fine-Grained Image-Text Alignment and Anatomy-Pathology Prompting

Data scarcity and privacy concerns limit the availability of high-quality medical images for public use, which can be mitigated through medical image synthesis. However, current medical image synthesis methods often struggle to accurately capture the complexity of detailed anatomical structures and pathological conditions. To address these challenges, we propose a novel medical image synthesis model that leverages fine-grained image-text alignment and anatomy-pathology prompts to generate highly detailed and accurate synthetic medical images. Our method integrates advanced natural language processing techniques with image generative modeling, enabling precise alignment between descriptive text prompts and the synthesized images' anatomical and pathological details. The proposed approach consists of two key components: an anatomy-pathology prompting module and a fine-grained alignment-based synthesis module. The anatomy-pathology prompting module automatically generates descriptive prompts for high-quality medical images. To further synthesize high-quality medical images from the generated prompts, the fine-grained alignment-based synthesis module pre-defines a visual codebook for the radiology dataset and performs fine-grained alignment between the codebook and generated prompts to obtain key patches as visual clues, facilitating accurate image synthesis. We validate the superiority of our method through experiments on public chest X-ray datasets and demonstrate that our synthetic images preserve accurate semantic information, making them valuable for various medical applications.

UN-SAM: Universal Prompt-Free Segmentation for Generalized Nuclei Images

In digital pathology, precise nuclei segmentation is pivotal yet challenged by the diversity of tissue types, staining protocols, and imaging conditions. Recently, the segment anything model (SAM) revealed overwhelming performance in natural scenarios and impressive adaptation to medical imaging. Despite these advantages, the reliance of labor-intensive manual annotation as segmentation prompts severely hinders their clinical applicability, especially for nuclei image analysis containing massive cells where dense manual prompts are impractical. To overcome the limitations of current SAM methods while retaining the advantages, we propose the Universal prompt-free SAM framework for Nuclei segmentation (UN-SAM), by providing a fully automated solution with remarkable generalization capabilities. Specifically, to eliminate the labor-intensive requirement of per-nuclei annotations for prompt, we devise a multi-scale Self-Prompt Generation (SPGen) module to revolutionize clinical workflow by automatically generating high-quality mask hints to guide the segmentation tasks. Moreover, to unleash the generalization capability of SAM across a variety of nuclei images, we devise a Domain-adaptive Tuning Encoder (DT-Encoder) to seamlessly harmonize visual features with domain-common and domain-specific knowledge, and further devise a Domain Query-enhanced Decoder (DQ-Decoder) by leveraging learnable domain queries for segmentation decoding in different nuclei domains. Extensive experiments prove that UN-SAM with exceptional performance surpasses state-of-the-arts in nuclei instance and semantic segmentation, especially the generalization capability in zero-shot scenarios. The source code is available at https://github.com/CUHK-AIM-Group/UN-SAM.

EndoGaussian: Gaussian Splatting for Deformable Surgical Scene Reconstruction

Reconstructing deformable tissues from endoscopic stereo videos is essential in many downstream surgical applications. However, existing methods suffer from slow inference speed, which greatly limits their practical use. In this paper, we introduce EndoGaussian, a real-time surgical scene reconstruction framework that builds on 3D Gaussian Splatting. Our framework represents dynamic surgical scenes as canonical Gaussians and a time-dependent deformation field, which predicts Gaussian deformations at novel timestamps. Due to the efficient Gaussian representation and parallel rendering pipeline, our framework significantly accelerates the rendering speed compared to previous methods. In addition, we design the deformation field as the combination of a lightweight encoding voxel and an extremely tiny MLP, allowing for efficient Gaussian tracking with a minor rendering burden. Furthermore, we design a holistic Gaussian initialization method to fully leverage the surface distribution prior, achieved by searching informative points from across the input image sequence. Experiments on public endoscope datasets demonstrate that our method can achieve real-time rendering speed (195 FPS real-time, 100$\times$ gain) while maintaining the state-of-the-art reconstruction quality (35.925 PSNR) and the fastest training speed (within 2 min/scene), showing significant promise for intraoperative surgery applications. Code is available at: \url{https://yifliu3.github.io/EndoGaussian/}.

Fine-Grained Image-Text Alignment in Medical Imaging Enables Cyclic Image-Report Generation

To address these issues, we propose a novel Adaptive patch-word Matching (AdaMatch) model to correlate chest X-ray (CXR) image regions with words in medical reports and apply it to CXR-report generation to provide explainability for the generation process. AdaMatch exploits the fine-grained relation between adaptive patches and words to provide explanations of specific image regions with corresponding words. To capture the abnormal regions of varying sizes and positions, we introduce the Adaptive Patch extraction (AdaPatch) module to acquire the adaptive patches for these regions adaptively. In order to provide explicit explainability for CXR-report generation task, we propose an AdaMatch-based bidirectional large language model for Cyclic CXR-report generation (AdaMatch-Cyclic). It employs the AdaMatch to obtain the keywords for CXR images and `keypatches' for medical reports as hints to guide CXR-report generation. Extensive experiments on two publicly available CXR datasets prove the effectiveness of our method and its superior performance to existing methods.

Alternate Diverse Teaching for Semi-supervised Medical Image Segmentation

Semi-supervised medical image segmentation studies have shown promise in training models with limited labeled data. However, current dominant teacher-student based approaches can suffer from the confirmation bias. To address this challenge, we propose AD-MT, an alternate diverse teaching approach in a teacher-student framework. It involves a single student model and two non-trainable teacher models that are momentum-updated periodically and randomly in an alternate fashion. To mitigate the confirmation bias from the diverse supervision, the core of AD-MT lies in two proposed modules: the Random Periodic Alternate (RPA) Updating Module and the Conflict-Combating Module (CCM). The RPA schedules the alternating diverse updating process with complementary data batches, distinct data augmentation, and random switching periods to encourage diverse reasoning from different teaching perspectives. The CCM employs an entropy-based ensembling strategy to encourage the model to learn from both the consistent and conflicting predictions between the teachers. Experimental results demonstrate the effectiveness and superiority of our AD-MT on the 2D and 3D medical segmentation benchmarks across various semi-supervised settings.

Rethinking Data Perturbation and Model Stabilization for Semi-supervised Medical Image Segmentation

Studies on semi-supervised medical image segmentation (SSMIS) have seen fast progress recently. Due to the limited labelled data, SSMIS methods mainly focus on effectively leveraging unlabeled data to enhance the segmentation performance. However, despite their promising performance, current state-of-the-art methods often prioritize integrating complex techniques and loss terms rather than addressing the core challenges of semi-supervised scenarios directly. We argue that the key to SSMIS lies in generating substantial and appropriate prediction disagreement on unlabeled data. To this end, we emphasize the crutiality of data perturbation and model stabilization in semi-supervised segmentation, and propose a simple yet effective approach to boost SSMIS performance significantly, dubbed DPMS. Specifically, we first revisit SSMIS from three distinct perspectives: the data, the model, and the loss, and conduct a comprehensive study of corresponding strategies to examine their effectiveness. Based on these examinations, we then propose DPMS, which adopts a plain teacher-student framework with a standard supervised loss and unsupervised consistency loss. To produce appropriate prediction disagreements, DPMS perturbs the unlabeled data via strong augmentations to enlarge prediction disagreements considerably. On the other hand, using EMA teacher when strong augmentation is applied does not necessarily improve performance. DPMS further utilizes a forwarding-twice and momentum updating strategies for normalization statistics to stabilize the training on unlabeled data effectively. Despite its simplicity, DPMS can obtain new state-of-the-art performance on the public 2D ACDC and 3D LA datasets across various semi-supervised settings, e.g. obtaining a remarkable 22.62% improvement against previous SOTA on ACDC with 5% labels.

Review of Large Vision Models and Visual Prompt Engineering

Visual prompt engineering is a fundamental technology in the field of visual and image Artificial General Intelligence, serving as a key component for achieving zero-shot capabilities. As the development of large vision models progresses, the importance of prompt engineering becomes increasingly evident. Designing suitable prompts for specific visual tasks has emerged as a meaningful research direction. This review aims to summarize the methods employed in the computer vision domain for large vision models and visual prompt engineering, exploring the latest advancements in visual prompt engineering. We present influential large models in the visual domain and a range of prompt engineering methods employed on these models. It is our hope that this review provides a comprehensive and systematic description of prompt engineering methods based on large visual models, offering valuable insights for future researchers in their exploration of this field.

Artificial General Intelligence for Medical Imaging

In this review, we explore the potential applications of Artificial General Intelligence (AGI) models in healthcare, focusing on foundational Large Language Models (LLMs), Large Vision Models, and Large Multimodal Models. We emphasize the importance of integrating clinical expertise, domain knowledge, and multimodal capabilities into AGI models. In addition, we lay out key roadmaps that guide the development and deployment of healthcare AGI models. Throughout the review, we provide critical perspectives on the potential challenges and pitfalls associated with deploying large-scale AGI models in the medical field. This comprehensive review aims to offer insights into the future implications of AGI in medical imaging, healthcare and beyond.