Rapid and Accurate Diagnosis of Acute Aortic Syndrome using Non-contrast CT: A Large-scale, Retrospective, Multi-center and AI-based Study

Chest pain symptoms are highly prevalent in emergency departments (EDs), where acute aortic syndrome (AAS) is a catastrophic cardiovascular emergency with a high fatality rate, especially when timely and accurate treatment is not administered. However, current triage practices in the ED can cause up to approximately half of patients with AAS to have an initially missed diagnosis or be misdiagnosed as having other acute chest pain conditions. Subsequently, these AAS patients will undergo clinically inaccurate or suboptimal differential diagnosis. Fortunately, even under these suboptimal protocols, nearly all these patients underwent non-contrast CT covering the aorta anatomy at the early stage of differential diagnosis. In this study, we developed an artificial intelligence model (DeepAAS) using non-contrast CT, which is highly accurate for identifying AAS and provides interpretable results to assist in clinical decision-making. Performance was assessed in two major phases: a multi-center retrospective study (n = 20,750) and an exploration in real-world emergency scenarios (n = 137,525). In the multi-center cohort, DeepAAS achieved a mean area under the receiver operating characteristic curve of 0.958 (95% CI 0.950-0.967). In the real-world cohort, DeepAAS detected 109 AAS patients with misguided initial suspicion, achieving 92.6% (95% CI 76.2%-97.5%) in mean sensitivity and 99.2% (95% CI 99.1%-99.3%) in mean specificity. Our AI model performed well on non-contrast CT at all applicable early stages of differential diagnosis workflows, effectively reduced the overall missed diagnosis and misdiagnosis rate from 48.8% to 4.8% and shortened the diagnosis time for patients with misguided initial suspicion from an average of 681.8 (74-11,820) mins to 68.5 (23-195) mins. DeepAAS could effectively fill the gap in the current clinical workflow without requiring additional tests.

Bootstrapping Chest CT Image Understanding by Distilling Knowledge from X-ray Expert Models

Radiologists highly desire fully automated versatile AI for medical imaging interpretation. However, the lack of extensively annotated large-scale multi-disease datasets has hindered the achievement of this goal. In this paper, we explore the feasibility of leveraging language as a naturally high-quality supervision for chest CT imaging. In light of the limited availability of image-report pairs, we bootstrap the understanding of 3D chest CT images by distilling chest-related diagnostic knowledge from an extensively pre-trained 2D X-ray expert model. Specifically, we propose a language-guided retrieval method to match each 3D CT image with its semantically closest 2D X-ray image, and perform pair-wise and semantic relation knowledge distillation. Subsequently, we use contrastive learning to align images and reports within the same patient while distinguishing them from the other patients. However, the challenge arises when patients have similar semantic diagnoses, such as healthy patients, potentially confusing if treated as negatives. We introduce a robust contrastive learning that identifies and corrects these false negatives. We train our model with over 12,000 pairs of chest CT images and radiology reports. Extensive experiments across multiple scenarios, including zero-shot learning, report generation, and fine-tuning processes, demonstrate the model's feasibility in interpreting chest CT images.

Modality-Agnostic Structural Image Representation Learning for Deformable Multi-Modality Medical Image Registration

Establishing dense anatomical correspondence across distinct imaging modalities is a foundational yet challenging procedure for numerous medical image analysis studies and image-guided radiotherapy. Existing multi-modality image registration algorithms rely on statistical-based similarity measures or local structural image representations. However, the former is sensitive to locally varying noise, while the latter is not discriminative enough to cope with complex anatomical structures in multimodal scans, causing ambiguity in determining the anatomical correspondence across scans with different modalities. In this paper, we propose a modality-agnostic structural representation learning method, which leverages Deep Neighbourhood Self-similarity (DNS) and anatomy-aware contrastive learning to learn discriminative and contrast-invariance deep structural image representations (DSIR) without the need for anatomical delineations or pre-aligned training images. We evaluate our method on multiphase CT, abdomen MR-CT, and brain MR T1w-T2w registration. Comprehensive results demonstrate that our method is superior to the conventional local structural representation and statistical-based similarity measures in terms of discriminability and accuracy.

TAROT: A Hierarchical Framework with Multitask Co-Pretraining on Semi-Structured Data towards Effective Person-Job Fit

Person-job fit is an essential part of online recruitment platforms in serving various downstream applications like Job Search and Candidate Recommendation. Recently, pretrained large language models have further enhanced the effectiveness by leveraging richer textual information in user profiles and job descriptions apart from user behavior features and job metadata. However, the general domain-oriented design struggles to capture the unique structural information within user profiles and job descriptions, leading to a loss of latent semantic correlations. We propose TAROT, a hierarchical multitask co-pretraining framework, to better utilize structural and semantic information for informative text embeddings. TAROT targets semi-structured text in profiles and jobs, and it is co-pretained with multi-grained pretraining tasks to constrain the acquired semantic information at each level. Experiments on a real-world LinkedIn dataset show significant performance improvements, proving its effectiveness in person-job fit tasks.

Professional Network Matters: Connections Empower Person-Job Fit

Online recruitment platforms typically employ Person-Job Fit models in the core service that automatically match suitable job seekers with appropriate job positions. While existing works leverage historical or contextual information, they often disregard a crucial aspect: job seekers' social relationships in professional networks. This paper emphasizes the importance of incorporating professional networks into the Person-Job Fit model. Our innovative approach consists of two stages: (1) defining a Workplace Heterogeneous Information Network (WHIN) to capture heterogeneous knowledge, including professional connections and pre-training representations of various entities using a heterogeneous graph neural network; (2) designing a Contextual Social Attention Graph Neural Network (CSAGNN) that supplements users' missing information with professional connections' contextual information. We introduce a job-specific attention mechanism in CSAGNN to handle noisy professional networks, leveraging pre-trained entity representations from WHIN. We demonstrate the effectiveness of our approach through experimental evaluations conducted across three real-world recruitment datasets from LinkedIn, showing superior performance compared to baseline models.

SAME++: A Self-supervised Anatomical eMbeddings Enhanced medical image registration framework using stable sampling and regularized transformation

Image registration is a fundamental medical image analysis task. Ideally, registration should focus on aligning semantically corresponding voxels, i.e., the same anatomical locations. However, existing methods often optimize similarity measures computed directly on intensities or on hand-crafted features, which lack anatomical semantic information. These similarity measures may lead to sub-optimal solutions where large deformations, complex anatomical differences, or cross-modality imagery exist. In this work, we introduce a fast and accurate method for unsupervised 3D medical image registration building on top of a Self-supervised Anatomical eMbedding (SAM) algorithm, which is capable of computing dense anatomical correspondences between two images at the voxel level. We name our approach SAM-Enhanced registration (SAME++), which decomposes image registration into four steps: affine transformation, coarse deformation, deep non-parametric transformation, and instance optimization. Using SAM embeddings, we enhance these steps by finding more coherent correspondence and providing features with better semantic guidance. We extensively evaluated SAME++ using more than 50 labeled organs on three challenging inter-subject registration tasks of different body parts. As a complete registration framework, SAME++ markedly outperforms leading methods by $4.2\%$ - $8.2\%$ in terms of Dice score while being orders of magnitude faster than numerical optimization-based methods. Code is available at \url{https://github.com/alibaba-damo-academy/same}.

SAMConvex: Fast Discrete Optimization for CT Registration using Self-supervised Anatomical Embedding and Correlation Pyramid

Estimating displacement vector field via a cost volume computed in the feature space has shown great success in image registration, but it suffers excessive computation burdens. Moreover, existing feature descriptors only extract local features incapable of representing the global semantic information, which is especially important for solving large transformations. To address the discussed issues, we propose SAMConvex, a fast coarse-to-fine discrete optimization method for CT registration that includes a decoupled convex optimization procedure to obtain deformation fields based on a self-supervised anatomical embedding (SAM) feature extractor that captures both local and global information. To be specific, SAMConvex extracts per-voxel features and builds 6D correlation volumes based on SAM features, and iteratively updates a flow field by performing lookups on the correlation volumes with a coarse-to-fine scheme. SAMConvex outperforms the state-of-the-art learning-based methods and optimization-based methods over two inter-patient registration datasets (Abdomen CT and HeadNeck CT) and one intra-patient registration dataset (Lung CT). Moreover, as an optimization-based method, SAMConvex only takes $\sim2$s ($\sim5s$ with instance optimization) for one paired images.

Matching in the Wild: Learning Anatomical Embeddings for Multi-Modality Images

Radiotherapists require accurate registration of MR/CT images to effectively use information from both modalities. In a typical registration pipeline, rigid or affine transformations are applied to roughly align the fixed and moving images before proceeding with the deformation step. While recent learning-based methods have shown promising results in the rigid/affine step, these methods often require images with similar field-of-view (FOV) for successful alignment. As a result, aligning images with different FOVs remains a challenging task. Self-supervised landmark detection methods like self-supervised Anatomical eMbedding (SAM) have emerged as a useful tool for mapping and cropping images to similar FOVs. However, these methods are currently limited to intra-modality use only. To address this limitation and enable cross-modality matching, we propose a new approach called Cross-SAM. Our approach utilizes a novel iterative process that alternates between embedding learning and CT-MRI registration. We start by applying aggressive contrast augmentation on both CT and MRI images to train a SAM model. We then use this SAM to identify corresponding regions on paired images using robust grid-points matching, followed by a point-set based affine/rigid registration, and a deformable fine-tuning step to produce registered paired images. We use these registered pairs to enhance the matching ability of SAM, which is then processed iteratively. We use the final model for cross-modality matching tasks. We evaluated our approach on two CT-MRI affine registration datasets and found that Cross-SAM achieved robust affine registration on both datasets, significantly outperforming other methods and achieving state-of-the-art performance.

Automated Learning for Deformable Medical Image Registration by Jointly Optimizing Network Architectures and Objective Functions

Deformable image registration plays a critical role in various tasks of medical image analysis. A successful registration algorithm, either derived from conventional energy optimization or deep networks requires tremendous efforts from computer experts to well design registration energy or to carefully tune network architectures for the specific type of medical data. To tackle the aforementioned problems, this paper proposes an automated learning registration algorithm (AutoReg) that cooperatively optimizes both architectures and their corresponding training objectives, enabling non-computer experts, e.g., medical/clinical users, to conveniently find off-the-shelf registration algorithms for diverse scenarios. Specifically, we establish a triple-level framework to deduce registration network architectures and objectives with an auto-searching mechanism and cooperating optimization. We conduct image registration experiments on multi-site volume datasets and various registration tasks. Extensive results demonstrate that our AutoReg may automatically learn an optimal deep registration network for given volumes and achieve state-of-the-art performance, also significantly improving computation efficiency than the mainstream UNet architectures (from 0.558 to 0.270 seconds for a 3D image pair on the same configuration).

A Multi-scale Optimization Learning Framework for Diffeomorphic Deformable Registration

Conventional deformable registration methods aim at solving a specifically designed optimization model on image pairs and offer a rigorous theoretical treatment. However, their computational costs are exceptionally high. In contrast, recent learning-based approaches can provide fast deformation estimation. These heuristic network architectures are fully data-driven and thus lack explicitly domain knowledge or geometric constraints, such as topology-preserving, which is indispensable to generate plausible deformations. To integrate the advantages and avoid the limitations of these two categories of approaches, we design a new learning-based framework to optimize a diffeomorphic model via multi-scale propagations. Specifically, we first introduce a generic optimization model to formulate diffeomorphic registration with both velocity and deformation fields. Then we propose a schematic optimization scheme with a nested splitting technique. Finally, a series of learnable architectures are utilized to obtain the final propagative updating in the coarse-to-fine feature spaces. We conduct two groups of image registration experiments on 3D adult and child brain MR volume datasets including image-to-atlas and image-to-image registrations. Extensive results demonstrate that the proposed method achieves state-of-the-art performance with diffeomorphic guarantee and extreme efficiency.