Abn-BLIP: Abnormality-aligned Bootstrapping Language-Image Pre-training for Pulmonary Embolism Diagnosis and Report Generation from CTPA

Medical imaging plays a pivotal role in modern healthcare, with computed tomography pulmonary angiography (CTPA) being a critical tool for diagnosing pulmonary embolism and other thoracic conditions. However, the complexity of interpreting CTPA scans and generating accurate radiology reports remains a significant challenge. This paper introduces Abn-BLIP (Abnormality-aligned Bootstrapping Language-Image Pretraining), an advanced diagnosis model designed to align abnormal findings to generate the accuracy and comprehensiveness of radiology reports. By leveraging learnable queries and cross-modal attention mechanisms, our model demonstrates superior performance in detecting abnormalities, reducing missed findings, and generating structured reports compared to existing methods. Our experiments show that Abn-BLIP outperforms state-of-the-art medical vision-language models and 3D report generation methods in both accuracy and clinical relevance. These results highlight the potential of integrating multimodal learning strategies for improving radiology reporting. The source code is available at https://github.com/zzs95/abn-blip.

Evaluating unsupervised contrastive learning framework for MRI sequences classification

The automatic identification of Magnetic Resonance Imaging (MRI) sequences can streamline clinical workflows by reducing the time radiologists spend manually sorting and identifying sequences, thereby enabling faster diagnosis and treatment planning for patients. However, the lack of standardization in the parameters of MRI scans poses challenges for automated systems and complicates the generation and utilization of datasets for machine learning research. To address this issue, we propose a system for MRI sequence identification using an unsupervised contrastive deep learning framework. By training a convolutional neural network based on the ResNet-18 architecture, our system classifies nine common MRI sequence types as a 9-class classification problem. The network was trained using an in-house internal dataset and validated on several public datasets, including BraTS, ADNI, Fused Radiology-Pathology Prostate Dataset, the Breast Cancer Dataset (ACRIN), among others, encompassing diverse acquisition protocols and requiring only 2D slices for training. Our system achieves a classification accuracy of over 0.95 across the nine most common MRI sequence types.

Optimizing Prompt Strategies for SAM: Advancing lesion Segmentation Across Diverse Medical Imaging Modalities

Purpose: To evaluate various Segmental Anything Model (SAM) prompt strategies across four lesions datasets and to subsequently develop a reinforcement learning (RL) agent to optimize SAM prompt placement. Materials and Methods: This retrospective study included patients with four independent ovarian, lung, renal, and breast tumor datasets. Manual segmentation and SAM-assisted segmentation were performed for all lesions. A RL model was developed to predict and select SAM points to maximize segmentation performance. Statistical analysis of segmentation was conducted using pairwise t-tests. Results: Results show that increasing the number of prompt points significantly improves segmentation accuracy, with Dice coefficients rising from 0.272 for a single point to 0.806 for five or more points in ovarian tumors. The prompt location also influenced performance, with surface and union-based prompts outperforming center-based prompts, achieving mean Dice coefficients of 0.604 and 0.724 for ovarian and breast tumors, respectively. The RL agent achieved a peak Dice coefficient of 0.595 for ovarian tumors, outperforming random and alternative RL strategies. Additionally, it significantly reduced segmentation time, achieving a nearly 10-fold improvement compared to manual methods using SAM. Conclusion: While increased SAM prompts and non-centered prompts generally improved segmentation accuracy, each pathology and modality has specific optimal thresholds and placement strategies. Our RL agent achieved superior performance compared to other agents while achieving a significant reduction in segmentation time.

Optimizing prompt strategies for the Segment Anything Model are explored, focusing on prompt location, number, and reinforcement learning-based agent for prompt placement across four lesion datasets

Purpose: To evaluate various Segmental Anything Model (SAM) prompt strategies across four lesions datasets and to subsequently develop a reinforcement learning (RL) agent to optimize SAM prompt placement. Materials and Methods: This retrospective study included patients with four independent ovarian, lung, renal, and breast tumor datasets. Manual segmentation and SAM-assisted segmentation were performed for all lesions. A RL model was developed to predict and select SAM points to maximize segmentation performance. Statistical analysis of segmentation was conducted using pairwise t-tests. Results: Results show that increasing the number of prompt points significantly improves segmentation accuracy, with Dice coefficients rising from 0.272 for a single point to 0.806 for five or more points in ovarian tumors. The prompt location also influenced performance, with surface and union-based prompts outperforming center-based prompts, achieving mean Dice coefficients of 0.604 and 0.724 for ovarian and breast tumors, respectively. The RL agent achieved a peak Dice coefficient of 0.595 for ovarian tumors, outperforming random and alternative RL strategies. Additionally, it significantly reduced segmentation time, achieving a nearly 10-fold improvement compared to manual methods using SAM. Conclusion: While increased SAM prompts and non-centered prompts generally improved segmentation accuracy, each pathology and modality has specific optimal thresholds and placement strategies. Our RL agent achieved superior performance compared to other agents while achieving a significant reduction in segmentation time.

Is Registering Raw Tagged-MR Enough for Strain Estimation in the Era of Deep Learning?

Magnetic Resonance Imaging with tagging (tMRI) has long been utilized for quantifying tissue motion and strain during deformation. However, a phenomenon known as tag fading, a gradual decrease in tag visibility over time, often complicates post-processing. The first contribution of this study is to model tag fading by considering the interplay between $T_1$ relaxation and the repeated application of radio frequency (RF) pulses during serial imaging sequences. This is a factor that has been overlooked in prior research on tMRI post-processing. Further, we have observed an emerging trend of utilizing raw tagged MRI within a deep learning-based (DL) registration framework for motion estimation. In this work, we evaluate and analyze the impact of commonly used image similarity objectives in training DL registrations on raw tMRI. This is then compared with the Harmonic Phase-based approach, a traditional approach which is claimed to be robust to tag fading. Our findings, derived from both simulated images and an actual phantom scan, reveal the limitations of various similarity losses in raw tMRI and emphasize caution in registration tasks where image intensity changes over time.

Efficient Annotation for Medical Image Analysis: A One-Pass Selective Annotation Approach

Annotating biomedical images for supervised learning is a complex and labor-intensive task due to data diversity and its intricate nature. In this paper, we propose an innovative method, the efficient one-pass selective annotation (EPOSA), that significantly reduces the annotation burden while maintaining robust model performance. Our approach employs a variational autoencoder (VAE) to extract salient features from unannotated images, which are subsequently clustered using the DBSCAN algorithm. This process groups similar images together, forming distinct clusters. We then use a two-stage sample selection algorithm, called representative selection (RepSel), to form a selected dataset. The first stage is a Markov Chain Monte Carlo (MCMC) sampling technique to select representative samples from each cluster for annotations. This selection process is the second stage, which is guided by the principle of maximizing intra-cluster mutual information and minimizing inter-cluster mutual information. This ensures a diverse set of features for model training and minimizes outlier inclusion. The selected samples are used to train a VGG-16 network for image classification. Experimental results on the Med-MNIST dataset demonstrate that our proposed EPOSA outperforms random selection and other state-of-the-art methods under the same annotation budget, presenting a promising direction for efficient and effective annotation in medical image analysis.

Optimal operating MR contrast for brain ventricle parcellation

Development of MR harmonization has enabled different contrast MRIs to be synthesized while preserving the underlying anatomy. In this paper, we use image harmonization to explore the impact of different T1-w MR contrasts on a state-of-the-art ventricle parcellation algorithm VParNet. We identify an optimal operating contrast (OOC) for ventricle parcellation; by showing that the performance of a pretrained VParNet can be boosted by adjusting contrast to the OOC.

Label Propagation via Random Walk for Training Robust Thalamus Nuclei Parcellation Model from Noisy Annotations

Data-driven thalamic nuclei parcellation depends on high-quality manual annotations. However, the small size and low contrast changes among thalamic nuclei, yield annotations that are often incomplete, noisy, or ambiguously labelled. To train a robust thalamic nuclei parcellation model with noisy annotations, we propose a label propagation algorithm based on random walker to refine the annotations before model training. A two-step model was trained to generate first the whole thalamus and then the nuclei masks. We conducted experiments on a mild traumatic brain injury~(mTBI) dataset with noisy thalamic nuclei annotations. Our model outperforms current state-of-the-art thalamic nuclei parcellations by a clear margin. We believe our method can also facilitate the training of other parcellation models with noisy labels.

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.