CLIP in Medical Imaging: A Comprehensive Survey

Contrastive Language-Image Pre-training (CLIP), a simple yet effective pre-training paradigm, successfully introduces text supervision to vision models. It has shown promising results across various tasks, attributable to its generalizability and interpretability. The use of CLIP has recently gained increasing interest in the medical imaging domain, serving both as a pre-training paradigm for aligning medical vision and language, and as a critical component in diverse clinical tasks. With the aim of facilitating a deeper understanding of this promising direction, this survey offers an in-depth exploration of the CLIP paradigm within the domain of medical imaging, regarding both refined CLIP pre-training and CLIP-driven applications. In this study, We (1) start with a brief introduction to the fundamentals of CLIP methodology. (2) Then, we investigate the adaptation of CLIP pre-training in the medical domain, focusing on how to optimize CLIP given characteristics of medical images and reports. (3) Furthermore, we explore the practical utilization of CLIP pre-trained models in various tasks, including classification, dense prediction, and cross-modal tasks. (4) Finally, we discuss existing limitations of CLIP in the context of medical imaging and propose forward-looking directions to address the demands of medical imaging domain. We expect that this comprehensive survey will provide researchers in the field of medical image analysis with a holistic understanding of the CLIP paradigm and its potential implications. The project page can be found on https://github.com/zhaozh10/Awesome-CLIP-in-Medical-Imaging.

3D Structure-guided Network for Tooth Alignment in 2D Photograph

Orthodontics focuses on rectifying misaligned teeth (i.e., malocclusions), affecting both masticatory function and aesthetics. However, orthodontic treatment often involves complex, lengthy procedures. As such, generating a 2D photograph depicting aligned teeth prior to orthodontic treatment is crucial for effective dentist-patient communication and, more importantly, for encouraging patients to accept orthodontic intervention. In this paper, we propose a 3D structure-guided tooth alignment network that takes 2D photographs as input (e.g., photos captured by smartphones) and aligns the teeth within the 2D image space to generate an orthodontic comparison photograph featuring aesthetically pleasing, aligned teeth. Notably, while the process operates within a 2D image space, our method employs 3D intra-oral scanning models collected in clinics to learn about orthodontic treatment, i.e., projecting the pre- and post-orthodontic 3D tooth structures onto 2D tooth contours, followed by a diffusion model to learn the mapping relationship. Ultimately, the aligned tooth contours are leveraged to guide the generation of a 2D photograph with aesthetically pleasing, aligned teeth and realistic textures. We evaluate our network on various facial photographs, demonstrating its exceptional performance and strong applicability within the orthodontic industry.

Tissue Segmentation of Thick-Slice Fetal Brain MR Scans with Guidance from High-Quality Isotropic Volumes

Accurate tissue segmentation of thick-slice fetal brain magnetic resonance (MR) scans is crucial for both reconstruction of isotropic brain MR volumes and the quantification of fetal brain development. However, this task is challenging due to the use of thick-slice scans in clinically-acquired fetal brain data. To address this issue, we propose to leverage high-quality isotropic fetal brain MR volumes (and also their corresponding annotations) as guidance for segmentation of thick-slice scans. Due to existence of significant domain gap between high-quality isotropic volume (i.e., source data) and thick-slice scans (i.e., target data), we employ a domain adaptation technique to achieve the associated knowledge transfer (from high-quality <source> volumes to thick-slice <target> scans). Specifically, we first register the available high-quality isotropic fetal brain MR volumes across different gestational weeks to construct longitudinally-complete source data. To capture domain-invariant information, we then perform Fourier decomposition to extract image content and style codes. Finally, we propose a novel Cycle-Consistent Domain Adaptation Network (C2DA-Net) to efficiently transfer the knowledge learned from high-quality isotropic volumes for accurate tissue segmentation of thick-slice scans. Our C2DA-Net can fully utilize a small set of annotated isotropic volumes to guide tissue segmentation on unannotated thick-slice scans. Extensive experiments on a large-scale dataset of 372 clinically acquired thick-slice MR scans demonstrate that our C2DA-Net achieves much better performance than cutting-edge methods quantitatively and qualitatively.

Multi-View Vertebra Localization and Identification from CT Images

Accurately localizing and identifying vertebrae from CT images is crucial for various clinical applications. However, most existing efforts are performed on 3D with cropping patch operation, suffering from the large computation costs and limited global information. In this paper, we propose a multi-view vertebra localization and identification from CT images, converting the 3D problem into a 2D localization and identification task on different views. Without the limitation of the 3D cropped patch, our method can learn the multi-view global information naturally. Moreover, to better capture the anatomical structure information from different view perspectives, a multi-view contrastive learning strategy is developed to pre-train the backbone. Additionally, we further propose a Sequence Loss to maintain the sequential structure embedded along the vertebrae. Evaluation results demonstrate that, with only two 2D networks, our method can localize and identify vertebrae in CT images accurately, and outperforms the state-of-the-art methods consistently. Our code is available at https://github.com/ShanghaiTech-IMPACT/Multi-View-Vertebra-Localization-and-Identification-from-CT-Images.

3DTeethSeg'22: 3D Teeth Scan Segmentation and Labeling Challenge

Teeth localization, segmentation, and labeling from intra-oral 3D scans are essential tasks in modern dentistry to enhance dental diagnostics, treatment planning, and population-based studies on oral health. However, developing automated algorithms for teeth analysis presents significant challenges due to variations in dental anatomy, imaging protocols, and limited availability of publicly accessible data. To address these challenges, the 3DTeethSeg'22 challenge was organized in conjunction with the International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) in 2022, with a call for algorithms tackling teeth localization, segmentation, and labeling from intraoral 3D scans. A dataset comprising a total of 1800 scans from 900 patients was prepared, and each tooth was individually annotated by a human-machine hybrid algorithm. A total of 6 algorithms were evaluated on this dataset. In this study, we present the evaluation results of the 3DTeethSeg'22 challenge. The 3DTeethSeg'22 challenge code can be accessed at: https://github.com/abenhamadou/3DTeethSeg22_challenge

ChatCAD+: Towards a Universal and Reliable Interactive CAD using LLMs

The potential of integrating Computer-Assisted Diagnosis (CAD) with Large Language Models (LLMs) in clinical applications, particularly in digital family doctor and clinic assistant roles, shows promise. However, existing works have limitations in terms of reliability, effectiveness, and their narrow applicability to specific image domains, which restricts their overall processing capabilities. Moreover, the mismatch in writing style between LLMs and radiologists undermines their practical utility. To address these challenges, we present ChatCAD+, an interactive CAD system that is universal, reliable, and capable of handling medical images from diverse domains. ChatCAD+ utilizes current information obtained from reputable medical websites to offer precise medical advice. Additionally, it incorporates a template retrieval system that emulates real-world diagnostic reporting, thereby improving its seamless integration into existing clinical workflows. The source code is available at https://github.com/zhaozh10/ChatCAD. The online demo will be available soon.

Domain Generalization for Mammographic Image Analysis via Contrastive Learning

Mammographic image analysis is a fundamental problem in the computer-aided diagnosis scheme, which has recently made remarkable progress with the advance of deep learning. However, the construction of a deep learning model requires training data that are large and sufficiently diverse in terms of image style and quality. In particular, the diversity of image style may be majorly attributed to the vendor factor. However, mammogram collection from vendors as many as possible is very expensive and sometimes impractical for laboratory-scale studies. Accordingly, to further augment the generalization capability of deep learning models to various vendors with limited resources, a new contrastive learning scheme is developed. Specifically, the backbone network is firstly trained with a multi-style and multi-view unsupervised self-learning scheme for the embedding of invariant features to various vendor styles. Afterward, the backbone network is then recalibrated to the downstream tasks of mass detection, multi-view mass matching, BI-RADS classification and breast density classification with specific supervised learning. The proposed method is evaluated with mammograms from four vendors and two unseen public datasets. The experimental results suggest that our approach can effectively improve analysis performance on both seen and unseen domains, and outperforms many state-of-the-art (SOTA) generalization methods.

Construction of unbiased dental template and parametric dental model for precision digital dentistry

Dental template and parametric dental models are important tools for various applications in digital dentistry. However, constructing an unbiased dental template and accurate parametric dental models remains a challenging task due to the complex anatomical and morphological dental structures and also low volume ratio of the teeth. In this study, we develop an unbiased dental template by constructing an accurate dental atlas from CBCT images with guidance of teeth segmentation. First, to address the challenges, we propose to enhance the CBCT images and their segmentation images, including image cropping, image masking and segmentation intensity reassigning. Then, we further use the segmentation images to perform co-registration with the CBCT images to generate an accurate dental atlas, from which an unbiased dental template can be generated. By leveraging the unbiased dental template, we construct parametric dental models by estimating point-to-point correspondences between the dental models and employing Principal Component Analysis to determine shape subspaces of the parametric dental models. A total of 159 CBCT images of real subjects are collected to perform the constructions. Experimental results demonstrate effectiveness of our proposed method in constructing unbiased dental template and parametric dental model. The developed dental template and parametric dental models are available at https://github.com/Marvin0724/Teeth_template.

Geometry-Aware Attenuation Field Learning for Sparse-View CBCT Reconstruction

Cone Beam Computed Tomography (CBCT) is the most widely used imaging method in dentistry. As hundreds of X-ray projections are needed to reconstruct a high-quality CBCT image (i.e., the attenuation field) in traditional algorithms, sparse-view CBCT reconstruction has become a main focus to reduce radiation dose. Several attempts have been made to solve it while still suffering from insufficient data or poor generalization ability for novel patients. This paper proposes a novel attenuation field encoder-decoder framework by first encoding the volumetric feature from multi-view X-ray projections, then decoding it into the desired attenuation field. The key insight is when building the volumetric feature, we comply with the multi-view CBCT reconstruction nature and emphasize the view consistency property by geometry-aware spatial feature querying and adaptive feature fusing. Moreover, the prior knowledge information learned from data population guarantees our generalization ability when dealing with sparse view input. Comprehensive evaluations have demonstrated the superiority in terms of reconstruction quality, and the downstream application further validates the feasibility of our method in real-world clinics.

SNAF: Sparse-view CBCT Reconstruction with Neural Attenuation Fields

Cone beam computed tomography (CBCT) has been widely used in clinical practice, especially in dental clinics, while the radiation dose of X-rays when capturing has been a long concern in CBCT imaging. Several research works have been proposed to reconstruct high-quality CBCT images from sparse-view 2D projections, but the current state-of-the-arts suffer from artifacts and the lack of fine details. In this paper, we propose SNAF for sparse-view CBCT reconstruction by learning the neural attenuation fields, where we have invented a novel view augmentation strategy to overcome the challenges introduced by insufficient data from sparse input views. Our approach achieves superior performance in terms of high reconstruction quality (30+ PSNR) with only 20 input views (25 times fewer than clinical collections), which outperforms the state-of-the-arts. We have further conducted comprehensive experiments and ablation analysis to validate the effectiveness of our approach.