URL: Combating Label Noise for Lung Nodule Malignancy Grading

Due to the complexity of annotation and inter-annotator variability, most lung nodule malignancy grading datasets contain label noise, which inevitably degrades the performance and generalizability of models. Although researchers adopt the label-noise-robust methods to handle label noise for lung nodule malignancy grading, they do not consider the inherent ordinal relation among classes of this task. To model the ordinal relation among classes to facilitate tackling label noise in this task, we propose a Unimodal-Regularized Label-noise-tolerant (URL) framework. Our URL contains two stages, the Supervised Contrastive Learning (SCL) stage and the Memory pseudo-labels generation and Unimodal regularization (MU) stage. In the SCL stage, we select reliable samples and adopt supervised contrastive learning to learn better representations. In the MU stage, we split samples with multiple annotations into multiple samples with a single annotation and shuffle them into different batches. To handle label noise, pseudo-labels are generated using the similarity between each sample and the central feature of each class, and temporal ensembling is used to obtain memory pseudo-labels that supervise the model training. To model the ordinal relation, we introduce unimodal regularization to keep the ordinal relation among classes in the predictions. Moreover, each lung nodule is characterized by three orthographic views. Experiments conducted on the LIDC-IDRI dataset indicate the superiority of our URL over other competing methods. Code is available at https://github.com/axz520/UR.

Devil is in Channels: Contrastive Single Domain Generalization for Medical Image Segmentation

Deep learning-based medical image segmentation models suffer from performance degradation when deployed to a new healthcare center. To address this issue, unsupervised domain adaptation and multi-source domain generalization methods have been proposed, which, however, are less favorable for clinical practice due to the cost of acquiring target-domain data and the privacy concerns associated with redistributing the data from multiple source domains. In this paper, we propose a \textbf{C}hannel-level \textbf{C}ontrastive \textbf{S}ingle \textbf{D}omain \textbf{G}eneralization (\textbf{C$^2$SDG}) model for medical image segmentation. In C$^2$SDG, the shallower features of each image and its style-augmented counterpart are extracted and used for contrastive training, resulting in the disentangled style representations and structure representations. The segmentation is performed based solely on the structure representations. Our method is novel in the contrastive perspective that enables channel-wise feature disentanglement using a single source domain. We evaluated C$^2$SDG against six SDG methods on a multi-domain joint optic cup and optic disc segmentation benchmark. Our results suggest the effectiveness of each module in C$^2$SDG and also indicate that C$^2$SDG outperforms the baseline and all competing methods with a large margin. The code will be available at \url{https://github.com/ShishuaiHu/CCSDG}.

Transformer-based Annotation Bias-aware Medical Image Segmentation

Manual medical image segmentation is subjective and suffers from annotator-related bias, which can be mimicked or amplified by deep learning methods. Recently, researchers have suggested that such bias is the combination of the annotator preference and stochastic error, which are modeled by convolution blocks located after decoder and pixel-wise independent Gaussian distribution, respectively. It is unlikely that convolution blocks can effectively model the varying degrees of preference at the full resolution level. Additionally, the independent pixel-wise Gaussian distribution disregards pixel correlations, leading to a discontinuous boundary. This paper proposes a Transformer-based Annotation Bias-aware (TAB) medical image segmentation model, which tackles the annotator-related bias via modeling annotator preference and stochastic errors. TAB employs the Transformer with learnable queries to extract the different preference-focused features. This enables TAB to produce segmentation with various preferences simultaneously using a single segmentation head. Moreover, TAB takes the multivariant normal distribution assumption that models pixel correlations, and learns the annotation distribution to disentangle the stochastic error. We evaluated our TAB on an OD/OC segmentation benchmark annotated by six annotators. Our results suggest that TAB outperforms existing medical image segmentation models which take into account the annotator-related bias.

Instance-specific Label Distribution Regularization for Learning with Label Noise

Modeling noise transition matrix is a kind of promising method for learning with label noise. Based on the estimated noise transition matrix and the noisy posterior probabilities, the clean posterior probabilities, which are jointly called Label Distribution (LD) in this paper, can be calculated as the supervision. To reliably estimate the noise transition matrix, some methods assume that anchor points are available during training. Nonetheless, if anchor points are invalid, the noise transition matrix might be poorly learned, resulting in poor performance. Consequently, other methods treat reliable data points, extracted from training data, as pseudo anchor points. However, from a statistical point of view, the noise transition matrix can be inferred from data with noisy labels under the clean-label-domination assumption. Therefore, we aim to estimate the noise transition matrix without (pseudo) anchor points. There is evidence showing that samples are more likely to be mislabeled as other similar class labels, which means the mislabeling probability is highly correlated with the inter-class correlation. Inspired by this observation, we propose an instance-specific Label Distribution Regularization (LDR), in which the instance-specific LD is estimated as the supervision, to prevent DCNNs from memorizing noisy labels. Specifically, we estimate the noisy posterior under the supervision of noisy labels, and approximate the batch-level noise transition matrix by estimating the inter-class correlation matrix with neither anchor points nor pseudo anchor points. Experimental results on two synthetic noisy datasets and two real-world noisy datasets demonstrate that our LDR outperforms existing methods.

ProSFDA: Prompt Learning based Source-free Domain Adaptation for Medical Image Segmentation

The domain discrepancy existed between medical images acquired in different situations renders a major hurdle in deploying pre-trained medical image segmentation models for clinical use. Since it is less possible to distribute training data with the pre-trained model due to the huge data size and privacy concern, source-free unsupervised domain adaptation (SFDA) has recently been increasingly studied based on either pseudo labels or prior knowledge. However, the image features and probability maps used by pseudo label-based SFDA and the consistent prior assumption and the prior prediction network used by prior-guided SFDA may become less reliable when the domain discrepancy is large. In this paper, we propose a \textbf{Pro}mpt learning based \textbf{SFDA} (\textbf{ProSFDA}) method for medical image segmentation, which aims to improve the quality of domain adaption by minimizing explicitly the domain discrepancy. Specifically, in the prompt learning stage, we estimate source-domain images via adding a domain-aware prompt to target-domain images, then optimize the prompt via minimizing the statistic alignment loss, and thereby prompt the source model to generate reliable predictions on (altered) target-domain images. In the feature alignment stage, we also align the features of target-domain images and their styles-augmented counterparts to optimize the source model, and hence push the model to extract compact features. We evaluate our ProSFDA on two multi-domain medical image segmentation benchmarks. Our results indicate that the proposed ProSFDA outperforms substantially other SFDA methods and is even comparable to UDA methods. Code will be available at \url{https://github.com/ShishuaiHu/ProSFDA}.

Boundary-Aware Network for Abdominal Multi-Organ Segmentation

Automated abdominal multi-organ segmentation is a crucial yet challenging task in the computer-aided diagnosis of abdominal organ-related diseases. Although numerous deep learning models have achieved remarkable success in many medical image segmentation tasks, accurate segmentation of abdominal organs remains challenging, due to the varying sizes of abdominal organs and the ambiguous boundaries among them. In this paper, we propose a boundary-aware network (BA-Net) to segment abdominal organs on CT scans and MRI scans. This model contains a shared encoder, a boundary decoder, and a segmentation decoder. The multi-scale deep supervision strategy is adopted on both decoders, which can alleviate the issues caused by variable organ sizes. The boundary probability maps produced by the boundary decoder at each scale are used as attention to enhance the segmentation feature maps. We evaluated the BA-Net on the Abdominal Multi-Organ Segmentation (AMOS) Challenge dataset and achieved an average Dice score of 89.29$\%$ for multi-organ segmentation on CT scans and an average Dice score of 71.92$\%$ on MRI scans. The results demonstrate that BA-Net is superior to nnUNet on both segmentation tasks.

Boundary-Aware Network for Kidney Parsing

Kidney structures segmentation is a crucial yet challenging task in the computer-aided diagnosis of surgery-based renal cancer. Although numerous deep learning models have achieved remarkable success in many medical image segmentation tasks, accurate segmentation of kidney structures on computed tomography angiography (CTA) images remains challenging, due to the variable sizes of kidney tumors and the ambiguous boundaries between kidney structures and their surroundings. In this paper, we propose a boundary-aware network (BA-Net) to segment kidneys, kidney tumors, arteries, and veins on CTA scans. This model contains a shared encoder, a boundary decoder, and a segmentation decoder. The multi-scale deep supervision strategy is adopted on both decoders, which can alleviate the issues caused by variable tumor sizes. The boundary probability maps produced by the boundary decoder at each scale are used as attention to enhance the segmentation feature maps. We evaluated the BA-Net on the Kidney PArsing (KiPA) Challenge dataset and achieved an average Dice score of 89.65$\%$ for kidney structure segmentation on CTA scans using 4-fold cross-validation. The results demonstrate the effectiveness of the BA-Net.

Label Propagation for 3D Carotid Vessel Wall Segmentation and Atherosclerosis Diagnosis

Carotid vessel wall segmentation is a crucial yet challenging task in the computer-aided diagnosis of atherosclerosis. Although numerous deep learning models have achieved remarkable success in many medical image segmentation tasks, accurate segmentation of carotid vessel wall on magnetic resonance (MR) images remains challenging, due to limited annotations and heterogeneous arteries. In this paper, we propose a semi-supervised label propagation framework to segment lumen, normal vessel walls, and atherosclerotic vessel wall on 3D MR images. By interpolating the provided annotations, we get 3D continuous labels for training 3D segmentation model. With the trained model, we generate pseudo labels for unlabeled slices to incorporate them for model training. Then we use the whole MR scans and the propagated labels to re-train the segmentation model and improve its robustness. We evaluated the label propagation framework on the CarOtid vessel wall SegMentation and atherosclerOsis diagnosiS (COSMOS) Challenge dataset and achieved a QuanM score of 83.41\% on the testing dataset, which got the 1-st place on the online evaluation leaderboard. The results demonstrate the effectiveness of the proposed framework.

Modeling Human Preference and Stochastic Error for Medical Image Segmentation with Multiple Annotators

Manual annotation of medical images is highly subjective, leading to inevitable and huge annotation biases. Deep learning models may surpass human performance on a variety of tasks, but they may also mimic or amplify these biases. Although we can have multiple annotators and fuse their annotations to reduce stochastic errors, we cannot use this strategy to handle the bias caused by annotators' preferences. In this paper, we highlight the issue of annotator-related biases on medical image segmentation tasks, and propose a Preference-involved Annotation Distribution Learning (PADL) framework to address it from the perspective of disentangling an annotator's preference from stochastic errors using distribution learning so as to produce not only a meta segmentation but also the segmentation possibly made by each annotator. Under this framework, a stochastic error modeling (SEM) module estimates the meta segmentation map and average stochastic error map, and a series of human preference modeling (HPM) modules estimate each annotator's segmentation and the corresponding stochastic error. We evaluated our PADL framework on two medical image benchmarks with different imaging modalities, which have been annotated by multiple medical professionals, and achieved promising performance on all five medical image segmentation tasks.