Medical image computing and computer-assisted intervention : MICCAI ... International Conference on Medical Image Computing and Computer-Assisted Intervention最新文献

Weakly supervised whole slide image (WSI) classification is challenging due to the lack of patch-level labels and high computational costs. State-of-the-art methods use self-supervised patch-wise feature representations for multiple instance learning (MIL). Recently, methods have been proposed to fine-tune the feature representation on the downstream task using pseudo labeling, but mostly focusing on selecting high-quality positive patches. In this paper, we propose to mine hard negative samples during fine-tuning. This allows us to obtain better feature representations and reduce the training cost. Furthermore, we propose a novel patch-wise ranking loss in MIL to better exploit these hard negative samples. Experiments on two public datasets demonstrate the efficacy of these proposed ideas. Our codes are available at https://github.com/winston52/HNM-WSI.

In this paper, we present PRISM, a Promptable and Robust Interactive Segmentation Model, aiming for precise segmentation of 3D medical images. PRISM accepts various visual inputs, including points, boxes, and scribbles as sparse prompts, as well as masks as dense prompts. Specifically, PRISM is designed with four principles to achieve robustness: (1) Iterative learning. The model produces segmentations by using visual prompts from previous iterations to achieve progressive improvement. (2) Confidence learning. PRISM employs multiple segmentation heads per input image, each generating a continuous map and a confidence score to optimize predictions. (3) Corrective learning. Following each segmentation iteration, PRISM employs a shallow corrective refinement network to reassign mislabeled voxels. (4) Hybrid design. PRISM integrates hybrid encoders to better capture both the local and global information. Comprehensive validation of PRISM is conducted using four public datasets for tumor segmentation in the colon, pancreas, liver, and kidney, highlighting challenges caused by anatomical variations and ambiguous boundaries in accurate tumor identification. Compared to state-of-the-art methods, both with and without prompt engineering, PRISM significantly improves performance, achieving results that are close to human levels. The code is publicly available at https://github.com/MedICL-VU/PRISM.

Cone Beam Computed Tomography (CBCT) finds diverse applications in medicine. Ensuring high image quality in CBCT scans is essential for accurate diagnosis and treatment delivery. Yet, the susceptibility of CBCT images to noise and artifacts undermines both their usefulness and reliability. Existing methods typically address CBCT artifacts through image-to-image translation approaches. These methods, however, are limited by the artifact types present in the training data, which may not cover the complete spectrum of CBCT degradations stemming from variations in imaging protocols. Gathering additional data to encompass all possible scenarios can often pose a challenge. To address this, we present SinoSynth, a physics-based degradation model that simulates various CBCT-specific artifacts to generate a diverse set of synthetic CBCT images from high-quality CT images, without requiring pre-aligned data. Through extensive experiments, we demonstrate that several different generative networks trained on our synthesized data achieve remarkable results on heterogeneous multi-institutional datasets, outperforming even the same networks trained on actual data. We further show that our degradation model conveniently provides an avenue to enforce anatomical constraints in conditional generative models, yielding high-quality and structure-preserving synthetic CT images (https://github.com/Pangyk/SinoSynth).

3D reconstruction of cerebral vasculature from 2D biplanar projections could significantly improve diagnosis and treatment planning. We introduce a novel approach to tackle this challenging task by initially backprojecting the two projections, a process that traditionally results in unsatisfactory outcomes due to inherent ambiguities. To overcome this, we employ a U-Net approach trained to resolve these ambiguities, leading to significant improvement in reconstruction quality. The process is further refined using a Maximum A Posteriori strategy with a prior that favors continuity, leading to enhanced 3D reconstructions. We evaluated our approach using a comprehensive dataset comprising segmentations from approximately 700 MR angiography scans, from which we generated paired realistic biplanar DRRs. Upon testing with held-out data, our method achieved an 80% Dice similarity w.r.t the ground truth, superior to existing methods. Our code and dataset are available at https://github.com/Wapity/3DBrainXVascular.

Accurate diagnosis of ocular surface diseases is critical in optometry and ophthalmology, which hinge on integrating clinical data sources (e.g., meibography imaging and clinical metadata). Traditional human assessments lack precision in quantifying clinical observations, while current machine-based methods often treat diagnoses as multi-class classification problems, limiting the diagnoses to a predefined closed-set of curated answers without reasoning the clinical relevance of each variable to the diagnosis. To tackle these challenges, we introduce an innovative multi-modal diagnostic pipeline (MDPipe) by employing large language models (LLMs) for ocular surface disease diagnosis. We first employ a visual translator to interpret meibography images by converting them into quantifiable morphology data, facilitating their integration with clinical metadata and enabling the communication of nuanced medical insight to LLMs. To further advance this communication, we introduce a LLM-based summarizer to contextualize the insight from the combined morphology and clinical metadata, and generate clinical report summaries. Finally, we refine the LLMs' reasoning ability with domain-specific insight from real-life clinician diagnoses. Our evaluation across diverse ocular surface disease diagnosis benchmarks demonstrates that MDPipe outperforms existing standards, including GPT-4, and provides clinically sound rationales for diagnoses. The project is available at https://danielchyeh.github.io/MDPipe/.

Recent advancements in Contrastive Language-Image Pre-training (CLIP) [21] have demonstrated notable success in self-supervised representation learning across various tasks. However, the existing CLIP-like approaches often demand extensive GPU resources and prolonged training times due to the considerable size of the model and dataset, making them poor for medical applications, in which large datasets are not always common. Meanwhile, the language model prompts are mainly manually derived from labels tied to images, potentially overlooking the richness of information within training samples. We introduce a novel language-image Contrastive Learning method with an Efficient large language model and prompt Fine-Tuning (CLEFT) that harnesses the strengths of the extensive pre-trained language and visual models. Furthermore, we present an efficient strategy for learning context-based prompts that mitigates the gap between informative clinical diagnostic data and simple class labels. Our method demonstrates state-of-the-art performance on multiple chest X-ray and mammography datasets compared with various baselines. The proposed parameter efficient framework can reduce the total trainable model size by 39% and reduce the trainable language model to only 4% compared with the current BERT encoder.

Tagged magnetic resonance imaging (MRI) has been successfully used to track the motion of internal tissue points within moving organs. Typically, to analyze motion using tagged MRI, cine MRI data in the same coordinate system are acquired, incurring additional time and costs. Consequently, tagged-to-cine MR synthesis holds the potential to reduce the extra acquisition time and costs associated with cine MRI, without disrupting downstream motion analysis tasks. Previous approaches have processed each frame independently, thereby overlooking the fact that complementary information from occluded regions of the tag patterns could be present in neighboring frames exhibiting motion. Furthermore, the inconsistent visual appearance, e.g., tag fading, across frames can reduce synthesis performance. To address this, we propose an efficient framework for tagged-to-cine MR sequence synthesis, leveraging both spatial and temporal information with relatively limited data. Specifically, we follow a split-and-integral protocol to balance spatialtemporal modeling efficiency and consistency. The light spatial-temporal transformer (LiST²) is designed to exploit the local and global attention in motion sequence with relatively lightweight training parameters. The directional product relative position-time bias is adapted to make the model aware of the spatial-temporal correlation, while the shifted window is used for motion alignment. Then, a recurrent sliding fine-tuning (ReST) scheme is applied to further enhance the temporal consistency. Our framework is evaluated on paired tagged and cine MRI sequences, demonstrating superior performance over comparison methods.

This paper presents a novel approach, termed Temporal Latent Residual Network (TLRN), to predict a sequence of deformation fields in time-series image registration. The challenge of registering time-series images often lies in the occurrence of large motions, especially when images differ significantly from a reference (e.g., the start of a cardiac cycle compared to the peak stretching phase). To achieve accurate and robust registration results, we leverage the nature of motion continuity and exploit the temporal smoothness in consecutive image frames. Our proposed TLRN highlights a temporal residual network with residual blocks carefully designed in latent deformation spaces, which are parameterized by time-sequential initial velocity fields. We treat a sequence of residual blocks over time as a dynamic training system, where each block is designed to learn the residual function between desired deformation features and current input accumulated from previous time frames. We validate the effectivenss of TLRN on both synthetic data and real-world cine cardiac magnetic resonance (CMR) image videos. Our experimental results shows that TLRN is able to achieve substantially improved registration accuracy compared to the state-of-the-art. Our code is publicly available at https://github.com/nellie689/TLRN.

Panoramic image segmentation in computational pathology presents a remarkable challenge due to the morphologically complex and variably scaled anatomy. For instance, the intricate organization in kidney pathology spans multiple layers, from regions like the cortex and medulla to functional units such as glomeruli, tubules, and vessels, down to various cell types. In this paper, we propose a novel Hierarchical Adaptive Taxonomy Segmentation (HATs) method, which is designed to thoroughly segment panoramic views of kidney structures by leveraging detailed anatomical insights. Our approach entails (1) the innovative HATs technique which translates spatial relationships among 15 distinct object classes into a versatile "plug-and-play" loss function that spans across regions, functional units, and cells, (2) the incorporation of anatomical hierarchies and scale considerations into a unified simple matrix representation for all panoramic entities, (3) the adoption of the latest AI foundation model (EfficientSAM) as a feature extraction tool to boost the model's adaptability, yet eliminating the need for manual prompt generation in conventional segment anything model (SAM). Experimental findings demonstrate that the HATs method offers an efficient and effective strategy for integrating clinical insights and imaging precedents into a unified segmentation model across more than 15 categories. The official implementation is publicly available at https://github.com/hrlblab/HATs.

Since its introduction, UNet has been leading a variety of medical image segmentation tasks. Although numerous follow-up studies have also been dedicated to improving the performance of standard UNet, few have conducted in-depth analyses of the underlying interest pattern of UNet in medical image segmentation. In this paper, we explore the patterns learned in a UNet and observe two important factors that potentially affect its performance: (i) irrelative feature learned caused by asymmetric supervision; (ii) feature redundancy in the feature map. To this end, we propose to balance the supervision between encoder and decoder and reduce the redundant information in the UNet. Specifically, we use the feature map that contains the most semantic information (i.e., the last layer of the decoder) to provide additional supervision to other blocks to provide additional supervision and reduce feature redundancy by leveraging feature distillation. The proposed method can be easily integrated into existing UNet architecture in a plug-and-play fashion with negligible computational cost. The experimental results suggest that the proposed method consistently improves the performance of standard UNets on four medical image segmentation datasets. The code is available at https://github.com/ChongQingNoSubway/SelfReg-UNet.