Foundation Model for Advancing Healthcare: Challenges, Opportunities, and Future Directions

Foundation model, which is pre-trained on broad data and is able to adapt to a wide range of tasks, is advancing healthcare. It promotes the development of healthcare artificial intelligence (AI) models, breaking the contradiction between limited AI models and diverse healthcare practices. Much more widespread healthcare scenarios will benefit from the development of a healthcare foundation model (HFM), improving their advanced intelligent healthcare services. Despite the impending widespread deployment of HFMs, there is currently a lack of clear understanding about how they work in the healthcare field, their current challenges, and where they are headed in the future. To answer these questions, a comprehensive and deep survey of the challenges, opportunities, and future directions of HFMs is presented in this survey. It first conducted a comprehensive overview of the HFM including the methods, data, and applications for a quick grasp of the current progress. Then, it made an in-depth exploration of the challenges present in data, algorithms, and computing infrastructures for constructing and widespread application of foundation models in healthcare. This survey also identifies emerging and promising directions in this field for future development. We believe that this survey will enhance the community's comprehension of the current progress of HFM and serve as a valuable source of guidance for future development in this field. The latest HFM papers and related resources are maintained on our website: https://github.com/YutingHe-list/Awesome-Foundation-Models-for-Advancing-Healthcare.

Knowledge Boosting: Rethinking Medical Contrastive Vision-Language Pre-Training

The foundation models based on pre-training technology have significantly advanced artificial intelligence from theoretical to practical applications. These models have facilitated the feasibility of computer-aided diagnosis for widespread use. Medical contrastive vision-language pre-training, which does not require human annotations, is an effective approach for guiding representation learning using description information in diagnostic reports. However, the effectiveness of pre-training is limited by the large-scale semantic overlap and shifting problems in medical field. To address these issues, we propose the Knowledge-Boosting Contrastive Vision-Language Pre-training framework (KoBo), which integrates clinical knowledge into the learning of vision-language semantic consistency. The framework uses an unbiased, open-set sample-wise knowledge representation to measure negative sample noise and supplement the correspondence between vision-language mutual information and clinical knowledge. Extensive experiments validate the effect of our framework on eight tasks including classification, segmentation, retrieval, and semantic relatedness, achieving comparable or better performance with the zero-shot or few-shot settings. Our code is open on https://github.com/ChenXiaoFei-CS/KoBo.

Dynamic Snake Convolution based on Topological Geometric Constraints for Tubular Structure Segmentation

Accurate segmentation of topological tubular structures, such as blood vessels and roads, is crucial in various fields, ensuring accuracy and efficiency in downstream tasks. However, many factors complicate the task, including thin local structures and variable global morphologies. In this work, we note the specificity of tubular structures and use this knowledge to guide our DSCNet to simultaneously enhance perception in three stages: feature extraction, feature fusion, and loss constraint. First, we propose a dynamic snake convolution to accurately capture the features of tubular structures by adaptively focusing on slender and tortuous local structures. Subsequently, we propose a multi-view feature fusion strategy to complement the attention to features from multiple perspectives during feature fusion, ensuring the retention of important information from different global morphologies. Finally, a continuity constraint loss function, based on persistent homology, is proposed to constrain the topological continuity of the segmentation better. Experiments on 2D and 3D datasets show that our DSCNet provides better accuracy and continuity on the tubular structure segmentation task compared with several methods. Our codes will be publicly available.

JCCS-PFGM: A Novel Circle-Supervision based Poisson Flow Generative Model for Multiphase CECT Progressive Low-Dose Reconstruction with Joint Condition

Multiphase contrast-enhanced computed tomography (CECT) scan is clinically significant to demonstrate the anatomy at different phases. In practice, such a multiphase CECT scan inherently takes longer time and deposits much more radiation dose into a patient body than a regular CT scan, and reduction of the radiation dose typically compromise the CECT image quality and its diagnostic value. With Joint Condition and Circle-Supervision, here we propose a novel Poisson Flow Generative Model (JCCS-PFGM) to promote the progressive low-dose reconstruction for multiphase CECT. JCCS-PFGM is characterized by the following three aspects: a progressive low-dose reconstruction scheme, a circle-supervision strategy, and a joint condition mechanism. Our extensive experiments are performed on a clinical dataset consisting of 11436 images. The results show that our JCCS-PFGM achieves promising PSNR up to 46.3dB, SSIM up to 98.5%, and MAE down to 9.67 HU averagely on phases I, II and III, in quantitative evaluations, as well as gains high-quality readable visualizations in qualitative assessments. All of these findings reveal our method a great potential to be adapted for clinical CECT scans at a much-reduced radiation dose.

Geometric Visual Similarity Learning in 3D Medical Image Self-supervised Pre-training

Learning inter-image similarity is crucial for 3D medical images self-supervised pre-training, due to their sharing of numerous same semantic regions. However, the lack of the semantic prior in metrics and the semantic-independent variation in 3D medical images make it challenging to get a reliable measurement for the inter-image similarity, hindering the learning of consistent representation for same semantics. We investigate the challenging problem of this task, i.e., learning a consistent representation between images for a clustering effect of same semantic features. We propose a novel visual similarity learning paradigm, Geometric Visual Similarity Learning, which embeds the prior of topological invariance into the measurement of the inter-image similarity for consistent representation of semantic regions. To drive this paradigm, we further construct a novel geometric matching head, the Z-matching head, to collaboratively learn the global and local similarity of semantic regions, guiding the efficient representation learning for different scale-level inter-image semantic features. Our experiments demonstrate that the pre-training with our learning of inter-image similarity yields more powerful inner-scene, inter-scene, and global-local transferring ability on four challenging 3D medical image tasks. Our codes and pre-trained models will be publicly available on https://github.com/YutingHe-list/GVSL.

Yield Evaluation of Citrus Fruits based on the YoloV5 compressed by Knowledge Distillation

In the field of planting fruit trees, pre-harvest estimation of fruit yield is important for fruit storage and price evaluation. However, considering the cost, the yield of each tree cannot be assessed by directly picking the immature fruit. Therefore, the problem is a very difficult task. In this paper, a fruit counting and yield assessment method based on computer vision is proposed for citrus fruit trees as an example. Firstly, images of single fruit trees from different angles are acquired and the number of fruits is detected using a deep Convolutional Neural Network model YOLOv5, and the model is compressed using a knowledge distillation method. Then, a linear regression method is used to model yield-related features and evaluate yield. Experiments show that the proposed method can accurately count fruits and approximate the yield.

FFCNet: Fourier Transform-Based Frequency Learning and Complex Convolutional Network for Colon Disease Classification

Reliable automatic classification of colonoscopy images is of great significance in assessing the stage of colonic lesions and formulating appropriate treatment plans. However, it is challenging due to uneven brightness, location variability, inter-class similarity, and intra-class dissimilarity, affecting the classification accuracy. To address the above issues, we propose a Fourier-based Frequency Complex Network (FFCNet) for colon disease classification in this study. Specifically, FFCNet is a novel complex network that enables the combination of complex convolutional networks with frequency learning to overcome the loss of phase information caused by real convolution operations. Also, our Fourier transform transfers the average brightness of an image to a point in the spectrum (the DC component), alleviating the effects of uneven brightness by decoupling image content and brightness. Moreover, the image patch scrambling module in FFCNet generates random local spectral blocks, empowering the network to learn long-range and local diseasespecific features and improving the discriminative ability of hard samples. We evaluated the proposed FFCNet on an in-house dataset with 2568 colonoscopy images, showing our method achieves high performance outperforming previous state-of-the art methods with an accuracy of 86:35% and an accuracy of 4.46% higher than the backbone. The project page with code is available at https://github.com/soleilssss/FFCNet.

XMorpher: Full Transformer for Deformable Medical Image Registration via Cross Attention

An effective backbone network is important to deep learning-based Deformable Medical Image Registration (DMIR), because it extracts and matches the features between two images to discover the mutual correspondence for fine registration. However, the existing deep networks focus on single image situation and are limited in registration task which is performed on paired images. Therefore, we advance a novel backbone network, XMorpher, for the effective corresponding feature representation in DMIR. 1) It proposes a novel full transformer architecture including dual parallel feature extraction networks which exchange information through cross attention, thus discovering multi-level semantic correspondence while extracting respective features gradually for final effective registration. 2) It advances the Cross Attention Transformer (CAT) blocks to establish the attention mechanism between images which is able to find the correspondence automatically and prompts the features to fuse efficiently in the network. 3) It constrains the attention computation between base windows and searching windows with different sizes, and thus focuses on the local transformation of deformable registration and enhances the computing efficiency at the same time. Without any bells and whistles, our XMorpher gives Voxelmorph 2.8% improvement on DSC , demonstrating its effective representation of the features from the paired images in DMIR. We believe that our XMorpher has great application potential in more paired medical images. Our XMorpher is open on https://github.com/Solemoon/XMorpher

MNet: Rethinking 2D/3D Networks for Anisotropic Medical Image Segmentation

The nature of thick-slice scanning causes severe inter-slice discontinuities of 3D medical images, and the vanilla 2D/3D convolutional neural networks (CNNs) fail to represent sparse inter-slice information and dense intra-slice information in a balanced way, leading to severe underfitting to inter-slice features (for vanilla 2D CNNs) and overfitting to noise from long-range slices (for vanilla 3D CNNs). In this work, a novel mesh network (MNet) is proposed to balance the spatial representation inter axes via learning. 1) Our MNet latently fuses plenty of representation processes by embedding multi-dimensional convolutions deeply into basic modules, making the selections of representation processes flexible, thus balancing representation for sparse inter-slice information and dense intra-slice information adaptively. 2) Our MNet latently fuses multi-dimensional features inside each basic module, simultaneously taking the advantages of 2D (high segmentation accuracy of the easily recognized regions in 2D view) and 3D (high smoothness of 3D organ contour) representations, thus obtaining more accurate modeling for target regions. Comprehensive experiments are performed on four public datasets (CT\&MR), the results consistently demonstrate the proposed MNet outperforms the other methods. The code and datasets are available at: https://github.com/zfdong-code/MNet

CPNet: Cycle Prototype Network for Weakly-supervised 3D Renal Compartments Segmentation on CT Images

Renal compartment segmentation on CT images targets on extracting the 3D structure of renal compartments from abdominal CTA images and is of great significance to the diagnosis and treatment for kidney diseases. However, due to the unclear compartment boundary, thin compartment structure and large anatomy variation of 3D kidney CT images, deep-learning based renal compartment segmentation is a challenging task. We propose a novel weakly supervised learning framework, Cycle Prototype Network, for 3D renal compartment segmentation. It has three innovations: 1) A Cycle Prototype Learning (CPL) is proposed to learn consistency for generalization. It learns from pseudo labels through the forward process and learns consistency regularization through the reverse process. The two processes make the model robust to noise and label-efficient. 2) We propose a Bayes Weakly Supervised Module (BWSM) based on cross-period prior knowledge. It learns prior knowledge from cross-period unlabeled data and perform error correction automatically, thus generates accurate pseudo labels. 3) We present a Fine Decoding Feature Extractor (FDFE) for fine-grained feature extraction. It combines global morphology information and local detail information to obtain feature maps with sharp detail, so the model will achieve fine segmentation on thin structures. Our model achieves Dice of 79.1% and 78.7% with only four labeled images, achieving a significant improvement by about 20% than typical prototype model PANet.