Vivim: a Video Vision Mamba for Medical Video Object Segmentation

Traditional convolutional neural networks have a limited receptive field while transformer-based networks are mediocre in constructing long-term dependency from the perspective of computational complexity. Such the bottleneck poses a significant challenge when processing long video sequences in video analysis tasks. Very recently, the state space models (SSMs) with efficient hardware-aware designs, famous by Mamba, have exhibited impressive achievements in long sequence modeling, which facilitates the development of deep neural networks on many vision tasks. To better capture available cues in video frames, this paper presents a generic Video Vision Mamba-based framework for medical video object segmentation tasks, named Vivim. Our Vivim can effectively compress the long-term spatiotemporal representation into sequences at varying scales by our designed Temporal Mamba Block. Compared to existing video-level Transformer-based methods, our model maintains excellent segmentation results with better speed performance. Extensive experiments on breast lesion segmentation in ultrasound videos and polyp segmentation in colonoscopy videos demonstrate the effectiveness and efficiency of our Vivim. The code is available at: https://github.com/scott-yjyang/Vivim.

SegMamba: Long-range Sequential Modeling Mamba For 3D Medical Image Segmentation

The Transformer architecture has shown a remarkable ability in modeling global relationships. However, it poses a significant computational challenge when processing high-dimensional medical images. This hinders its development and widespread adoption in this task. Mamba, as a State Space Model (SSM), recently emerged as a notable manner for long-range dependencies in sequential modeling, excelling in natural language processing filed with its remarkable memory efficiency and computational speed. Inspired by its success, we introduce SegMamba, a novel 3D medical image \textbf{Seg}mentation \textbf{Mamba} model, designed to effectively capture long-range dependencies within whole volume features at every scale. Our SegMamba, in contrast to Transformer-based methods, excels in whole volume feature modeling from a state space model standpoint, maintaining superior processing speed, even with volume features at a resolution of {$64\times 64\times 64$}. Comprehensive experiments on the BraTS2023 dataset demonstrate the effectiveness and efficiency of our SegMamba. The code for SegMamba is available at: https://github.com/ge-xing/SegMamba

Hunting imaging biomarkers in pulmonary fibrosis: Benchmarks of the AIIB23 challenge

Airway-related quantitative imaging biomarkers are crucial for examination, diagnosis, and prognosis in pulmonary diseases. However, the manual delineation of airway trees remains prohibitively time-consuming. While significant efforts have been made towards enhancing airway modelling, current public-available datasets concentrate on lung diseases with moderate morphological variations. The intricate honeycombing patterns present in the lung tissues of fibrotic lung disease patients exacerbate the challenges, often leading to various prediction errors. To address this issue, the 'Airway-Informed Quantitative CT Imaging Biomarker for Fibrotic Lung Disease 2023' (AIIB23) competition was organized in conjunction with the official 2023 International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI). The airway structures were meticulously annotated by three experienced radiologists. Competitors were encouraged to develop automatic airway segmentation models with high robustness and generalization abilities, followed by exploring the most correlated QIB of mortality prediction. A training set of 120 high-resolution computerised tomography (HRCT) scans were publicly released with expert annotations and mortality status. The online validation set incorporated 52 HRCT scans from patients with fibrotic lung disease and the offline test set included 140 cases from fibrosis and COVID-19 patients. The results have shown that the capacity of extracting airway trees from patients with fibrotic lung disease could be enhanced by introducing voxel-wise weighted general union loss and continuity loss. In addition to the competitive image biomarkers for prognosis, a strong airway-derived biomarker (Hazard ratio>1.5, p<0.0001) was revealed for survival prognostication compared with existing clinical measurements, clinician assessment and AI-based biomarkers.

SegRap2023: A Benchmark of Organs-at-Risk and Gross Tumor Volume Segmentation for Radiotherapy Planning of Nasopharyngeal Carcinoma

Radiation therapy is a primary and effective NasoPharyngeal Carcinoma (NPC) treatment strategy. The precise delineation of Gross Tumor Volumes (GTVs) and Organs-At-Risk (OARs) is crucial in radiation treatment, directly impacting patient prognosis. Previously, the delineation of GTVs and OARs was performed by experienced radiation oncologists. Recently, deep learning has achieved promising results in many medical image segmentation tasks. However, for NPC OARs and GTVs segmentation, few public datasets are available for model development and evaluation. To alleviate this problem, the SegRap2023 challenge was organized in conjunction with MICCAI2023 and presented a large-scale benchmark for OAR and GTV segmentation with 400 Computed Tomography (CT) scans from 200 NPC patients, each with a pair of pre-aligned non-contrast and contrast-enhanced CT scans. The challenge's goal was to segment 45 OARs and 2 GTVs from the paired CT scans. In this paper, we detail the challenge and analyze the solutions of all participants. The average Dice similarity coefficient scores for all submissions ranged from 76.68\% to 86.70\%, and 70.42\% to 73.44\% for OARs and GTVs, respectively. We conclude that the segmentation of large-size OARs is well-addressed, and more efforts are needed for GTVs and small-size or thin-structure OARs. The benchmark will remain publicly available here: https://segrap2023.grand-challenge.org

HybridMIM: A Hybrid Masked Image Modeling Framework for 3D Medical Image Segmentation

Masked image modeling (MIM) with transformer backbones has recently been exploited as a powerful self-supervised pre-training technique. The existing MIM methods adopt the strategy to mask random patches of the image and reconstruct the missing pixels, which only considers semantic information at a lower level, and causes a long pre-training time.This paper presents HybridMIM, a novel hybrid self-supervised learning method based on masked image modeling for 3D medical image segmentation.Specifically, we design a two-level masking hierarchy to specify which and how patches in sub-volumes are masked, effectively providing the constraints of higher level semantic information. Then we learn the semantic information of medical images at three levels, including:1) partial region prediction to reconstruct key contents of the 3D image, which largely reduces the pre-training time burden (pixel-level); 2) patch-masking perception to learn the spatial relationship between the patches in each sub-volume (region-level).and 3) drop-out-based contrastive learning between samples within a mini-batch, which further improves the generalization ability of the framework (sample-level). The proposed framework is versatile to support both CNN and transformer as encoder backbones, and also enables to pre-train decoders for image segmentation. We conduct comprehensive experiments on four widely-used public medical image segmentation datasets, including BraTS2020, BTCV, MSD Liver, and MSD Spleen. The experimental results show the clear superiority of HybridMIM against competing supervised methods, masked pre-training approaches, and other self-supervised methods, in terms of quantitative metrics, timing performance and qualitative observations. The codes of HybridMIM are available at https://github.com/ge-xing/HybridMIM

Diff-UNet: A Diffusion Embedded Network for Volumetric Segmentation

In recent years, Denoising Diffusion Models have demonstrated remarkable success in generating semantically valuable pixel-wise representations for image generative modeling. In this study, we propose a novel end-to-end framework, called Diff-UNet, for medical volumetric segmentation. Our approach integrates the diffusion model into a standard U-shaped architecture to extract semantic information from the input volume effectively, resulting in excellent pixel-level representations for medical volumetric segmentation. To enhance the robustness of the diffusion model's prediction results, we also introduce a Step-Uncertainty based Fusion (SUF) module during inference to combine the outputs of the diffusion models at each step. We evaluate our method on three datasets, including multimodal brain tumors in MRI, liver tumors, and multi-organ CT volumes, and demonstrate that Diff-UNet outperforms other state-of-the-art methods significantly. Our experimental results also indicate the universality and effectiveness of the proposed model. The proposed framework has the potential to facilitate the accurate diagnosis and treatment of medical conditions by enabling more precise segmentation of anatomical structures. The codes of Diff-UNet are available at https://github.com/ge-xing/Diff-UNet

NestedFormer: Nested Modality-Aware Transformer for Brain Tumor Segmentation

Multi-modal MR imaging is routinely used in clinical practice to diagnose and investigate brain tumors by providing rich complementary information. Previous multi-modal MRI segmentation methods usually perform modal fusion by concatenating multi-modal MRIs at an early/middle stage of the network, which hardly explores non-linear dependencies between modalities. In this work, we propose a novel Nested Modality-Aware Transformer (NestedFormer) to explicitly explore the intra-modality and inter-modality relationships of multi-modal MRIs for brain tumor segmentation. Built on the transformer-based multi-encoder and single-decoder structure, we perform nested multi-modal fusion for high-level representations of different modalities and apply modality-sensitive gating (MSG) at lower scales for more effective skip connections. Specifically, the multi-modal fusion is conducted in our proposed Nested Modality-aware Feature Aggregation (NMaFA) module, which enhances long-term dependencies within individual modalities via a tri-orientated spatial-attention transformer, and further complements key contextual information among modalities via a cross-modality attention transformer. Extensive experiments on BraTS2020 benchmark and a private meningiomas segmentation (MeniSeg) dataset show that the NestedFormer clearly outperforms the state-of-the-arts. The code is available at https://github.com/920232796/NestedFormer.