Fast Denoising Diffusion Probabilistic Models for Medical Image-to-Image Generation

Denoising diffusion probabilistic models (DDPMs) have achieved unprecedented success in computer vision. However, they remain underutilized in medical imaging, a field crucial for disease diagnosis and treatment planning. This is primarily due to the high computational cost associated with (1) the use of large number of time steps (e.g., 1,000) in diffusion processes and (2) the increased dimensionality of medical images, which are often 3D or 4D. Training a diffusion model on medical images typically takes days to weeks, while sampling each image volume takes minutes to hours. To address this challenge, we introduce Fast-DDPM, a simple yet effective approach capable of improving training speed, sampling speed, and generation quality simultaneously. Unlike DDPM, which trains the image denoiser across 1,000 time steps, Fast-DDPM trains and samples using only 10 time steps. The key to our method lies in aligning the training and sampling procedures. We introduced two efficient noise schedulers with 10 time steps: one with uniform time step sampling and another with non-uniform sampling. We evaluated Fast-DDPM across three medical image-to-image generation tasks: multi-image super-resolution, image denoising, and image-to-image translation. Fast-DDPM outperformed DDPM and current state-of-the-art methods based on convolutional networks and generative adversarial networks in all tasks. Additionally, Fast-DDPM reduced training time by a factor of 5 and sampling time by a factor of 100 compared to DDPM. Our code is publicly available at: https://github.com/mirthAI/Fast-DDPM.

Mamba-R: Vision Mamba ALSO Needs Registers

Similar to Vision Transformers, this paper identifies artifacts also present within the feature maps of Vision Mamba. These artifacts, corresponding to high-norm tokens emerging in low-information background areas of images, appear much more severe in Vision Mamba -- they exist prevalently even with the tiny-sized model and activate extensively across background regions. To mitigate this issue, we follow the prior solution of introducing register tokens into Vision Mamba. To better cope with Mamba blocks' uni-directional inference paradigm, two key modifications are introduced: 1) evenly inserting registers throughout the input token sequence, and 2) recycling registers for final decision predictions. We term this new architecture Mamba-R. Qualitative observations suggest, compared to vanilla Vision Mamba, Mamba-R's feature maps appear cleaner and more focused on semantically meaningful regions. Quantitatively, Mamba-R attains stronger performance and scales better. For example, on the ImageNet benchmark, our base-size Mamba-R attains 82.9% accuracy, significantly outperforming Vim-B's 81.8%; furthermore, we provide the first successful scaling to the large model size (i.e., with 341M parameters), attaining a competitive accuracy of 83.2% (84.5% if finetuned with 384x384 inputs). Additional validation on the downstream semantic segmentation task also supports Mamba-R's efficacy.

A Flexible 2.5D Medical Image Segmentation Approach with In-Slice and Cross-Slice Attention

Deep learning has become the de facto method for medical image segmentation, with 3D segmentation models excelling in capturing complex 3D structures and 2D models offering high computational efficiency. However, segmenting 2.5D images, which have high in-plane but low through-plane resolution, is a relatively unexplored challenge. While applying 2D models to individual slices of a 2.5D image is feasible, it fails to capture the spatial relationships between slices. On the other hand, 3D models face challenges such as resolution inconsistencies in 2.5D images, along with computational complexity and susceptibility to overfitting when trained with limited data. In this context, 2.5D models, which capture inter-slice correlations using only 2D neural networks, emerge as a promising solution due to their reduced computational demand and simplicity in implementation. In this paper, we introduce CSA-Net, a flexible 2.5D segmentation model capable of processing 2.5D images with an arbitrary number of slices through an innovative Cross-Slice Attention (CSA) module. This module uses the cross-slice attention mechanism to effectively capture 3D spatial information by learning long-range dependencies between the center slice (for segmentation) and its neighboring slices. Moreover, CSA-Net utilizes the self-attention mechanism to understand correlations among pixels within the center slice. We evaluated CSA-Net on three 2.5D segmentation tasks: (1) multi-class brain MRI segmentation, (2) binary prostate MRI segmentation, and (3) multi-class prostate MRI segmentation. CSA-Net outperformed leading 2D and 2.5D segmentation methods across all three tasks, demonstrating its efficacy and superiority. Our code is publicly available at https://github.com/mirthAI/CSA-Net.

RetinaRegNet: A Versatile Approach for Retinal Image Registration

We introduce the RetinaRegNet model, which can achieve state-of-the-art performance across various retinal image registration tasks. RetinaRegNet does not require training on any retinal images. It begins by establishing point correspondences between two retinal images using image features derived from diffusion models. This process involves the selection of feature points from the moving image using the SIFT algorithm alongside random point sampling. For each selected feature point, a 2D correlation map is computed by assessing the similarity between the feature vector at that point and the feature vectors of all pixels in the fixed image. The pixel with the highest similarity score in the correlation map corresponds to the feature point in the moving image. To remove outliers in the estimated point correspondences, we first applied an inverse consistency constraint, followed by a transformation-based outlier detector. This method proved to outperform the widely used random sample consensus (RANSAC) outlier detector by a significant margin. To handle large deformations, we utilized a two-stage image registration framework. A homography transformation was used in the first stage and a more accurate third-order polynomial transformation was used in the second stage. The model's effectiveness was demonstrated across three retinal image datasets: color fundus images, fluorescein angiography images, and laser speckle flowgraphy images. RetinaRegNet outperformed current state-of-the-art methods in all three datasets. It was especially effective for registering image pairs with large displacement and scaling deformations. This innovation holds promise for various applications in retinal image analysis. Our code is publicly available at https://github.com/mirthAI/RetinaRegNet.

HQ-Edit: A High-Quality Dataset for Instruction-based Image Editing

This study introduces HQ-Edit, a high-quality instruction-based image editing dataset with around 200,000 edits. Unlike prior approaches relying on attribute guidance or human feedback on building datasets, we devise a scalable data collection pipeline leveraging advanced foundation models, namely GPT-4V and DALL-E 3. To ensure its high quality, diverse examples are first collected online, expanded, and then used to create high-quality diptychs featuring input and output images with detailed text prompts, followed by precise alignment ensured through post-processing. In addition, we propose two evaluation metrics, Alignment and Coherence, to quantitatively assess the quality of image edit pairs using GPT-4V. HQ-Edits high-resolution images, rich in detail and accompanied by comprehensive editing prompts, substantially enhance the capabilities of existing image editing models. For example, an HQ-Edit finetuned InstructPix2Pix can attain state-of-the-art image editing performance, even surpassing those models fine-tuned with human-annotated data. The project page is https://thefllood.github.io/HQEdit_web.

Unleashing the Potential of SAM for Medical Adaptation via Hierarchical Decoding

The Segment Anything Model (SAM) has garnered significant attention for its versatile segmentation abilities and intuitive prompt-based interface. However, its application in medical imaging presents challenges, requiring either substantial training costs and extensive medical datasets for full model fine-tuning or high-quality prompts for optimal performance. This paper introduces H-SAM: a prompt-free adaptation of SAM tailored for efficient fine-tuning of medical images via a two-stage hierarchical decoding procedure. In the initial stage, H-SAM employs SAM's original decoder to generate a prior probabilistic mask, guiding a more intricate decoding process in the second stage. Specifically, we propose two key designs: 1) A class-balanced, mask-guided self-attention mechanism addressing the unbalanced label distribution, enhancing image embedding; 2) A learnable mask cross-attention mechanism spatially modulating the interplay among different image regions based on the prior mask. Moreover, the inclusion of a hierarchical pixel decoder in H-SAM enhances its proficiency in capturing fine-grained and localized details. This approach enables SAM to effectively integrate learned medical priors, facilitating enhanced adaptation for medical image segmentation with limited samples. Our H-SAM demonstrates a 4.78% improvement in average Dice compared to existing prompt-free SAM variants for multi-organ segmentation using only 10% of 2D slices. Notably, without using any unlabeled data, H-SAM even outperforms state-of-the-art semi-supervised models relying on extensive unlabeled training data across various medical datasets. Our code is available at https://github.com/Cccccczh404/H-SAM.

3D-TransUNet for Brain Metastases Segmentation in the BraTS2023 Challenge

Segmenting brain tumors is complex due to their diverse appearances and scales. Brain metastases, the most common type of brain tumor, are a frequent complication of cancer. Therefore, an effective segmentation model for brain metastases must adeptly capture local intricacies to delineate small tumor regions while also integrating global context to understand broader scan features. The TransUNet model, which combines Transformer self-attention with U-Net's localized information, emerges as a promising solution for this task. In this report, we address brain metastases segmentation by training the 3D-TransUNet model on the Brain Tumor Segmentation (BraTS-METS) 2023 challenge dataset. Specifically, we explored two architectural configurations: the Encoder-only 3D-TransUNet, employing Transformers solely in the encoder, and the Decoder-only 3D-TransUNet, utilizing Transformers exclusively in the decoder. For Encoder-only 3D-TransUNet, we note that Masked-Autoencoder pre-training is required for a better initialization of the Transformer Encoder and thus accelerates the training process. We identify that the Decoder-only 3D-TransUNet model should offer enhanced efficacy in the segmentation of brain metastases, as indicated by our 5-fold cross-validation on the training set. However, our use of the Encoder-only 3D-TransUNet model already yield notable results, with an average lesion-wise Dice score of 59.8\% on the test set, securing second place in the BraTS-METS 2023 challenge.

MicroDiffusion: Implicit Representation-Guided Diffusion for 3D Reconstruction from Limited 2D Microscopy Projections

Volumetric optical microscopy using non-diffracting beams enables rapid imaging of 3D volumes by projecting them axially to 2D images but lacks crucial depth information. Addressing this, we introduce MicroDiffusion, a pioneering tool facilitating high-quality, depth-resolved 3D volume reconstruction from limited 2D projections. While existing Implicit Neural Representation (INR) models often yield incomplete outputs and Denoising Diffusion Probabilistic Models (DDPM) excel at capturing details, our method integrates INR's structural coherence with DDPM's fine-detail enhancement capabilities. We pretrain an INR model to transform 2D axially-projected images into a preliminary 3D volume. This pretrained INR acts as a global prior guiding DDPM's generative process through a linear interpolation between INR outputs and noise inputs. This strategy enriches the diffusion process with structured 3D information, enhancing detail and reducing noise in localized 2D images. By conditioning the diffusion model on the closest 2D projection, MicroDiffusion substantially enhances fidelity in resulting 3D reconstructions, surpassing INR and standard DDPM outputs with unparalleled image quality and structural fidelity. Our code and dataset are available at https://github.com/UCSC-VLAA/MicroDiffusion.

CIS-UNet: Multi-Class Segmentation of the Aorta in Computed Tomography Angiography via Context-Aware Shifted Window Self-Attention

Advancements in medical imaging and endovascular grafting have facilitated minimally invasive treatments for aortic diseases. Accurate 3D segmentation of the aorta and its branches is crucial for interventions, as inaccurate segmentation can lead to erroneous surgical planning and endograft construction. Previous methods simplified aortic segmentation as a binary image segmentation problem, overlooking the necessity of distinguishing between individual aortic branches. In this paper, we introduce Context Infused Swin-UNet (CIS-UNet), a deep learning model designed for multi-class segmentation of the aorta and thirteen aortic branches. Combining the strengths of Convolutional Neural Networks (CNNs) and Swin transformers, CIS-UNet adopts a hierarchical encoder-decoder structure comprising a CNN encoder, symmetric decoder, skip connections, and a novel Context-aware Shifted Window Self-Attention (CSW-SA) as the bottleneck block. Notably, CSW-SA introduces a unique utilization of the patch merging layer, distinct from conventional Swin transformers. It efficiently condenses the feature map, providing a global spatial context and enhancing performance when applied at the bottleneck layer, offering superior computational efficiency and segmentation accuracy compared to the Swin transformers. We trained our model on computed tomography (CT) scans from 44 patients and tested it on 15 patients. CIS-UNet outperformed the state-of-the-art SwinUNetR segmentation model, which is solely based on Swin transformers, by achieving a superior mean Dice coefficient of 0.713 compared to 0.697, and a mean surface distance of 2.78 mm compared to 3.39 mm. CIS-UNet's superior 3D aortic segmentation offers improved precision and optimization for planning endovascular treatments. Our dataset and code will be publicly available.

A Semantic Space is Worth 256 Language Descriptions: Make Stronger Segmentation Models with Descriptive Properties

This paper introduces ProLab, a novel approach using property-level label space for creating strong interpretable segmentation models. Instead of relying solely on category-specific annotations, ProLab uses descriptive properties grounded in common sense knowledge for supervising segmentation models. It is based on two core designs. First, we employ Large Language Models (LLMs) and carefully crafted prompts to generate descriptions of all involved categories that carry meaningful common sense knowledge and follow a structured format. Second, we introduce a description embedding model preserving semantic correlation across descriptions and then cluster them into a set of descriptive properties (e.g., 256) using K-Means. These properties are based on interpretable common sense knowledge consistent with theories of human recognition. We empirically show that our approach makes segmentation models perform stronger on five classic benchmarks (e.g., ADE20K, COCO-Stuff, Pascal Context, Cityscapes, and BDD). Our method also shows better scalability with extended training steps than category-level supervision. Our interpretable segmentation framework also emerges with the generalization ability to segment out-of-domain or unknown categories using only in-domain descriptive properties. Code is available at https://github.com/lambert-x/ProLab.