Medical Matting: A New Perspective on Medical Segmentation with Uncertainty

In medical image segmentation, it is difficult to mark ambiguous areas accurately with binary masks, especially when dealing with small lesions. Therefore, it is a challenge for radiologists to reach a consensus by using binary masks under the condition of multiple annotations. However, these areas may contain anatomical structures that are conducive to diagnosis. Uncertainty is introduced to study these situations. Nevertheless, the uncertainty is usually measured by the variances between predictions in a multiple trial way. It is not intuitive, and there is no exact correspondence in the image. Inspired by image matting, we introduce matting as a soft segmentation method and a new perspective to deal with and represent uncertain regions into medical scenes, namely medical matting. More specifically, because there is no available medical matting dataset, we first labeled two medical datasets with alpha matte. Secondly, the matting method applied to the natural image is not suitable for the medical scene, so we propose a new architecture to generate binary masks and alpha matte in a row. Thirdly, the uncertainty map is introduced to highlight the ambiguous regions from the binary results and improve the matting performance. Evaluated on these datasets, the proposed model outperformed state-of-the-art matting algorithms by a large margin, and alpha matte is proved to be a more efficient labeling form than a binary mask.

Relational Subsets Knowledge Distillation for Long-tailed Retinal Diseases Recognition

In the real world, medical datasets often exhibit a long-tailed data distribution (i.e., a few classes occupy most of the data, while most classes have rarely few samples), which results in a challenging imbalance learning scenario. For example, there are estimated more than 40 different kinds of retinal diseases with variable morbidity, however with more than 30+ conditions are very rare from the global patient cohorts, which results in a typical long-tailed learning problem for deep learning-based screening models. In this study, we propose class subset learning by dividing the long-tailed data into multiple class subsets according to prior knowledge, such as regions and phenotype information. It enforces the model to focus on learning the subset-specific knowledge. More specifically, there are some relational classes that reside in the fixed retinal regions, or some common pathological features are observed in both the majority and minority conditions. With those subsets learnt teacher models, then we are able to distill the multiple teacher models into a unified model with weighted knowledge distillation loss. The proposed framework proved to be effective for the long-tailed retinal diseases recognition task. The experimental results on two different datasets demonstrate that our method is flexible and can be easily plugged into many other state-of-the-art techniques with significant improvements.

Semi-supervised Left Atrium Segmentation with Mutual Consistency Training

Semi-supervised learning has attracted great attention in the field of machine learning, especially for medical image segmentation tasks, since it alleviates the heavy burden of collecting abundant densely annotated data for training. However, most of existing methods underestimate the importance of challenging regions (e.g. small branches or blurred edges) during training. We believe that these unlabeled regions may contain more crucial information to minimize the uncertainty prediction for the model and should be emphasized in the training process. Therefore, in this paper, we propose a novel Mutual Consistency Network (MC-Net) for semi-supervised left atrium segmentation from 3D MR images. Particularly, our MC-Net consists of one encoder and two slightly different decoders, and the prediction discrepancies of two decoders are transformed as an unsupervised loss by our designed cycled pseudo label scheme to encourage mutual consistency. Such mutual consistency encourages the two decoders to have consistent and low-entropy predictions and enables the model to gradually capture generalized features from these unlabeled challenging regions. We evaluate our MC-Net on the public Left Atrium (LA) database and it obtains impressive performance gains by exploiting the unlabeled data effectively. Our MC-Net outperforms six recent semi-supervised methods for left atrium segmentation, and sets the new state-of-the-art performance on the LA database.

Improving Medical Image Classification with Label Noise Using Dual-uncertainty Estimation

Deep neural networks are known to be data-driven and label noise can have a marked impact on model performance. Recent studies have shown great robustness to classic image recognition even under a high noisy rate. In medical applications, learning from datasets with label noise is more challenging since medical imaging datasets tend to have asymmetric (class-dependent) noise and suffer from high observer variability. In this paper, we systematically discuss and define the two common types of label noise in medical images - disagreement label noise from inconsistency expert opinions and single-target label noise from wrong diagnosis record. We then propose an uncertainty estimation-based framework to handle these two label noise amid the medical image classification task. We design a dual-uncertainty estimation approach to measure the disagreement label noise and single-target label noise via Direct Uncertainty Prediction and Monte-Carlo-Dropout. A boosting-based curriculum training procedure is later introduced for robust learning. We demonstrate the effectiveness of our method by conducting extensive experiments on three different diseases: skin lesions, prostate cancer, and retinal diseases. We also release a large re-engineered database that consists of annotations from more than ten ophthalmologists with an unbiased golden standard dataset for evaluation and benchmarking.

Leveraging Regular Fundus Images for Training UWF Fundus Diagnosis Models via Adversarial Learning and Pseudo-Labeling

Recently, ultra-widefield (UWF) 200-degree fundus imaging by Optos cameras has gradually been introduced because of its broader insights for detecting more information on the fundus than regular 30-degree - 60-degree fundus cameras. Compared with UWF fundus images, regular fundus images contain a large amount of high-quality and well-annotated data. Due to the domain gap, models trained by regular fundus images to recognize UWF fundus images perform poorly. Hence, given that annotating medical data is labor intensive and time consuming, in this paper, we explore how to leverage regular fundus images to improve the limited UWF fundus data and annotations for more efficient training. We propose the use of a modified cycle generative adversarial network (CycleGAN) model to bridge the gap between regular and UWF fundus and generate additional UWF fundus images for training. A consistency regularization term is proposed in the loss of the GAN to improve and regulate the quality of the generated data. Our method does not require that images from the two domains be paired or even that the semantic labels be the same, which provides great convenience for data collection. Furthermore, we show that our method is robust to noise and errors introduced by the generated unlabeled data with the pseudo-labeling technique. We evaluated the effectiveness of our methods on several common fundus diseases and tasks, such as diabetic retinopathy (DR) classification, lesion detection and tessellated fundus segmentation. The experimental results demonstrate that our proposed method simultaneously achieves superior generalizability of the learned representations and performance improvements in multiple tasks.

Hierarchical Neural Architecture Search for Deep Stereo Matching

To reduce the human efforts in neural network design, Neural Architecture Search (NAS) has been applied with remarkable success to various high-level vision tasks such as classification and semantic segmentation. The underlying idea for the NAS algorithm is straightforward, namely, to enable the network the ability to choose among a set of operations (e.g., convolution with different filter sizes), one is able to find an optimal architecture that is better adapted to the problem at hand. However, so far the success of NAS has not been enjoyed by low-level geometric vision tasks such as stereo matching. This is partly due to the fact that state-of-the-art deep stereo matching networks, designed by humans, are already sheer in size. Directly applying the NAS to such massive structures is computationally prohibitive based on the currently available mainstream computing resources. In this paper, we propose the first end-to-end hierarchical NAS framework for deep stereo matching by incorporating task-specific human knowledge into the neural architecture search framework. Specifically, following the gold standard pipeline for deep stereo matching (i.e., feature extraction -- feature volume construction and dense matching), we optimize the architectures of the entire pipeline jointly. Extensive experiments show that our searched network outperforms all state-of-the-art deep stereo matching architectures and is ranked at the top 1 accuracy on KITTI stereo 2012, 2015 and Middlebury benchmarks, as well as the top 1 on SceneFlow dataset with a substantial improvement on the size of the network and the speed of inference. The code is available at https://github.com/XuelianCheng/LEAStereo.

Melanoma Diagnosis with Spatio-Temporal Feature Learning on Sequential Dermoscopic Images

Existing studies for automated melanoma diagnosis are based on single-time point images of lesions. However, melanocytic lesions de facto are progressively evolving and, moreover, benign lesions can progress into malignant melanoma. Ignoring cross-time morphological changes of lesions thus may lead to misdiagnosis in borderline cases. Based on the fact that dermatologists diagnose ambiguous skin lesions by evaluating the dermoscopic changes over time via follow-up examination, in this study, we propose an automated framework for melanoma diagnosis using sequential dermoscopic images. To capture the spatio-temporal characterization of dermoscopic evolution, we construct our model in a two-stream network architecture which capable of simultaneously learning appearance representations of individual lesions while performing temporal reasoning on both raw pixels difference and abstract features difference. We collect 184 cases of serial dermoscopic image data, which consists of histologically confirmed 92 benign lesions and 92 melanoma lesions, to evaluate the effectiveness of the proposed method. Our model achieved AUC of 74.34%, which is ~8% higher than that of only using single images and ~6% higher than the widely used sequence learning model based on LSTM.

Synergic Adversarial Label Learning with DR and AMD for Retinal Image Grading

The need for comprehensive and automated screening methods for retinal image classification has long been recognized. Well-qualified doctors annotated images are very expensive and only a limited amount of data is available for various retinal diseases such as age-related macular degeneration (AMD) and diabetic retinopathy (DR). Some studies show that AMD and DR share some common features like hemorrhagic points and exudation but most classification algorithms only train those disease models independently. Inspired by knowledge distillation where additional monitoring signals from various sources is beneficial to train a robust model with much fewer data. We propose a method called synergic adversarial label learning (SALL) which leverages relevant retinal disease labels in both semantic and feature space as additional signals and train the model in a collaborative manner. Our experiments on DR and AMD fundus image classification task demonstrate that the proposed method can significantly improve the accuracy of the model for grading diseases. In addition, we conduct additional experiments to show the effectiveness of SALL from the aspects of reliability and interpretability in the context of medical imaging application.

Bridge the Domain Gap Between Ultra-wide-field and Traditional Fundus Images via Adversarial Domain Adaptation

For decades, advances in retinal imaging technology have enabled effective diagnosis and management of retinal disease using fundus cameras. Recently, ultra-wide-field (UWF) fundus imaging by Optos camera is gradually put into use because of its broader insights on fundus for some lesions that are not typically seen in traditional fundus images. Research on traditional fundus images is an active topic but studies on UWF fundus images are few. One of the most important reasons is that UWF fundus images are hard to obtain. In this paper, for the first time, we explore domain adaptation from the traditional fundus to UWF fundus images. We propose a flexible framework to bridge the domain gap between two domains and co-train a UWF fundus diagnosis model by pseudo-labelling and adversarial learning. We design a regularisation technique to regulate the domain adaptation. Also, we apply MixUp to overcome the over-fitting issue from incorrect generated pseudo-labels. Our experimental results on either single or both domains demonstrate that the proposed method can well adapt and transfer the knowledge from traditional fundus images to UWF fundus images and improve the performance of retinal disease recognition.