Daily Papers

Self-supervised monocular depth estimation that does not require ground truth for training has attracted attention in recent years. It is of high interest to design lightweight but effective models so that they can be deployed on edge devices. Many existing architectures benefit from using heavier backbones at the expense of model sizes. This paper achieves comparable results with a lightweight architecture. Specifically, the efficient combination of CNNs and Transformers is investigated, and a hybrid architecture called Lite-Mono is presented. A Consecutive Dilated Convolutions (CDC) module and a Local-Global Features Interaction (LGFI) module are proposed. The former is used to extract rich multi-scale local features, and the latter takes advantage of the self-attention mechanism to encode long-range global information into the features. Experiments demonstrate that Lite-Mono outperforms Monodepth2 by a large margin in accuracy, with about 80% fewer trainable parameters.

Computer-aided medical image segmentation has been applied widely in diagnosis and treatment to obtain clinically useful information of shapes and volumes of target organs and tissues. In the past several years, convolutional neural network (CNN) based methods (e.g., U-Net) have dominated this area, but still suffered from inadequate long-range information capturing. Hence, recent work presented computer vision Transformer variants for medical image segmentation tasks and obtained promising performances. Such Transformers model long-range dependency by computing pair-wise patch relations. However, they incur prohibitive computational costs, especially on 3D medical images (e.g., CT and MRI). In this paper, we propose a new method called Dilated Transformer, which conducts self-attention for pair-wise patch relations captured alternately in local and global scopes. Inspired by dilated convolution kernels, we conduct the global self-attention in a dilated manner, enlarging receptive fields without increasing the patches involved and thus reducing computational costs. Based on this design of Dilated Transformer, we construct a U-shaped encoder-decoder hierarchical architecture called D-Former for 3D medical image segmentation. Experiments on the Synapse and ACDC datasets show that our D-Former model, trained from scratch, outperforms various competitive CNN-based or Transformer-based segmentation models at a low computational cost without time-consuming per-training process.

State-of-the-art models for semantic segmentation are based on adaptations of convolutional networks that had originally been designed for image classification. However, dense prediction and image classification are structurally different. In this work, we develop a new convolutional network module that is specifically designed for dense prediction. The presented module uses dilated convolutions to systematically aggregate multi-scale contextual information without losing resolution. The architecture is based on the fact that dilated convolutions support exponential expansion of the receptive field without loss of resolution or coverage. We show that the presented context module increases the accuracy of state-of-the-art semantic segmentation systems. In addition, we examine the adaptation of image classification networks to dense prediction and show that simplifying the adapted network can increase accuracy.

As a variant of standard convolution, a dilated convolution can control effective receptive fields and handle large scale variance of objects without introducing additional computational costs. To fully explore the potential of dilated convolution, we proposed a new type of dilated convolution (referred to as inception convolution), where the convolution operations have independent dilation patterns among different axes, channels and layers. To develop a practical method for learning complex inception convolution based on the data, a simple but effective search algorithm, referred to as efficient dilation optimization (EDO), is developed. Based on statistical optimization, the EDO method operates in a low-cost manner and is extremely fast when it is applied on large scale datasets. Empirical results validate that our method achieves consistent performance gains for image recognition, object detection, instance segmentation, human detection, and human pose estimation. For instance, by simply replacing the 3x3 standard convolution in the ResNet-50 backbone with inception convolution, we significantly improve the AP of Faster R-CNN from 36.4% to 39.2% on MS COCO.

Automatic organ segmentation is an important yet challenging problem for medical image analysis. The pancreas is an abdominal organ with very high anatomical variability. This inhibits previous segmentation methods from achieving high accuracies, especially compared to other organs such as the liver, heart or kidneys. In this paper, we present a probabilistic bottom-up approach for pancreas segmentation in abdominal computed tomography (CT) scans, using multi-level deep convolutional networks (ConvNets). We propose and evaluate several variations of deep ConvNets in the context of hierarchical, coarse-to-fine classification on image patches and regions, i.e. superpixels. We first present a dense labeling of local image patches via P{-}ConvNet and nearest neighbor fusion. Then we describe a regional ConvNet (R_1{-}ConvNet) that samples a set of bounding boxes around each image superpixel at different scales of contexts in a "zoom-out" fashion. Our ConvNets learn to assign class probabilities for each superpixel region of being pancreas. Last, we study a stacked R_2{-}ConvNet leveraging the joint space of CT intensities and the P{-}ConvNet dense probability maps. Both 3D Gaussian smoothing and 2D conditional random fields are exploited as structured predictions for post-processing. We evaluate on CT images of 82 patients in 4-fold cross-validation. We achieve a Dice Similarity Coefficient of 83.6pm6.3% in training and 71.8pm10.7% in testing.

Efficiently capturing the long-range patterns in sequential data sources salient to a given task -- such as classification and generative modeling -- poses a fundamental challenge. Popular approaches in the space tradeoff between the memory burden of brute-force enumeration and comparison, as in transformers, the computational burden of complicated sequential dependencies, as in recurrent neural networks, or the parameter burden of convolutional networks with many or large filters. We instead take inspiration from wavelet-based multiresolution analysis to define a new building block for sequence modeling, which we call a MultiresLayer. The key component of our model is the multiresolution convolution, capturing multiscale trends in the input sequence. Our MultiresConv can be implemented with shared filters across a dilated causal convolution tree. Thus it garners the computational advantages of convolutional networks and the principled theoretical motivation of wavelet decompositions. Our MultiresLayer is straightforward to implement, requires significantly fewer parameters, and maintains at most a O(Nlog N) memory footprint for a length N sequence. Yet, by stacking such layers, our model yields state-of-the-art performance on a number of sequence classification and autoregressive density estimation tasks using CIFAR-10, ListOps, and PTB-XL datasets.

Conventional neural architectures for sequential data present important limitations. Recurrent networks suffer from exploding and vanishing gradients, small effective memory horizons, and must be trained sequentially. Convolutional networks are unable to handle sequences of unknown size and their memory horizon must be defined a priori. In this work, we show that all these problems can be solved by formulating convolutional kernels in CNNs as continuous functions. The resulting Continuous Kernel Convolution (CKConv) allows us to model arbitrarily long sequences in a parallel manner, within a single operation, and without relying on any form of recurrence. We show that Continuous Kernel Convolutional Networks (CKCNNs) obtain state-of-the-art results in multiple datasets, e.g., permuted MNIST, and, thanks to their continuous nature, are able to handle non-uniformly sampled datasets and irregularly-sampled data natively. CKCNNs match or perform better than neural ODEs designed for these purposes in a faster and simpler manner.

We present a deep learning segmentation model that can automatically and robustly segment all major anatomical structures in body CT images. In this retrospective study, 1204 CT examinations (from the years 2012, 2016, and 2020) were used to segment 104 anatomical structures (27 organs, 59 bones, 10 muscles, 8 vessels) relevant for use cases such as organ volumetry, disease characterization, and surgical or radiotherapy planning. The CT images were randomly sampled from routine clinical studies and thus represent a real-world dataset (different ages, pathologies, scanners, body parts, sequences, and sites). The authors trained an nnU-Net segmentation algorithm on this dataset and calculated Dice similarity coefficients (Dice) to evaluate the model's performance. The trained algorithm was applied to a second dataset of 4004 whole-body CT examinations to investigate age dependent volume and attenuation changes. The proposed model showed a high Dice score (0.943) on the test set, which included a wide range of clinical data with major pathologies. The model significantly outperformed another publicly available segmentation model on a separate dataset (Dice score, 0.932 versus 0.871, respectively). The aging study demonstrated significant correlations between age and volume and mean attenuation for a variety of organ groups (e.g., age and aortic volume; age and mean attenuation of the autochthonous dorsal musculature). The developed model enables robust and accurate segmentation of 104 anatomical structures. The annotated dataset (https://doi.org/10.5281/zenodo.6802613) and toolkit (https://www.github.com/wasserth/TotalSegmentator) are publicly available.

The rapid advancement of Artificial Intelligence (AI) in biomedical imaging and radiotherapy is hindered by the limited availability of large imaging data repositories. With recent research and improvements in denoising diffusion probabilistic models (DDPM), high quality synthetic medical scans are now possible. Despite this, there is currently no way of generating multiple related images, such as a corresponding ground truth which can be used to train models, so synthetic scans are often manually annotated before use. This research introduces a novel architecture that is able to generate multiple, related PET-CT-tumour mask pairs using paired networks and conditional encoders. Our approach includes innovative, time step-controlled mechanisms and a `noise-seeding' strategy to improve DDPM sampling consistency. While our model requires a modified perceptual loss function to ensure accurate feature alignment we show generation of clearly aligned synthetic images and improvement in segmentation accuracy with generated images.

Automatic identification of brain lesions from magnetic resonance imaging (MRI) scans of stroke survivors would be a useful aid in patient diagnosis and treatment planning. We propose a multi-modal multi-path convolutional neural network system for automating stroke lesion segmentation. Our system has nine end-to-end UNets that take as input 2-dimensional (2D) slices and examines all three planes with three different normalizations. Outputs from these nine total paths are concatenated into a 3D volume that is then passed to a 3D convolutional neural network to output a final lesion mask. We trained and tested our method on datasets from three sources: Medical College of Wisconsin (MCW), Kessler Foundation (KF), and the publicly available Anatomical Tracings of Lesions After Stroke (ATLAS) dataset. Cross-study validation results (with independent training and validation datasets) were obtained to compare with previous methods based on naive Bayes, random forests, and three recently published convolutional neural networks. Model performance was quantified in terms of the Dice coefficient. Training on the KF and MCW images and testing on the ATLAS images yielded a mean Dice coefficient of 0.54. This was reliably better than the next best previous model, UNet, at 0.47. Reversing the train and test datasets yields a mean Dice of 0.47 on KF and MCW images, whereas the next best UNet reaches 0.45. With all three datasets combined, the current system compared to previous methods also attained a reliably higher cross-validation accuracy. It also achieved high Dice values for many smaller lesions that existing methods have difficulty identifying. Overall, our system is a clear improvement over previous methods for automating stroke lesion segmentation, bringing us an important step closer to the inter-rater accuracy level of human experts.

Accurate localization and segmentation of intervertebral disc (IVD) is crucial for the assessment of spine disease diagnosis. Despite the technological advances in medical imaging, IVD localization and segmentation are still manually performed, which is time-consuming and prone to errors. If, in addition, multi-modal imaging is considered, the burden imposed on disease assessments increases substantially. In this paper, we propose an architecture for IVD localization and segmentation in multi-modal MRI, which extends the well-known UNet. Compared to single images, multi-modal data brings complementary information, contributing to better data representation and discriminative power. Our contributions are three-fold. First, how to effectively integrate and fully leverage multi-modal data remains almost unexplored. In this work, each MRI modality is processed in a different path to better exploit their unique information. Second, inspired by HyperDenseNet, the network is densely-connected both within each path and across different paths, granting the model the freedom to learn where and how the different modalities should be processed and combined. Third, we improved standard U-Net modules by extending inception modules with two dilated convolutions blocks of different scale, which helps handling multi-scale context. We report experiments over the data set of the public MICCAI 2018 Challenge on Automatic Intervertebral Disc Localization and Segmentation, with 13 multi-modal MRI images used for training and 3 for validation. We trained IVD-Net on an NVidia TITAN XP GPU with 16 GBs RAM, using ADAM as optimizer and a learning rate of 10e-5 during 200 epochs. Training took about 5 hours, and segmentation of a whole volume about 2-3 seconds, on average. Several baselines, with different multi-modal fusion strategies, were used to demonstrate the effectiveness of the proposed architecture.

Medical imaging plays a crucial role in diagnosis, with radiology reports serving as vital documentation. Automating report generation has emerged as a critical need to alleviate the workload of radiologists. While machine learning has facilitated report generation for 2D medical imaging, extending this to 3D has been unexplored due to computational complexity and data scarcity. We introduce the first method to generate radiology reports for 3D medical imaging, specifically targeting chest CT volumes. Given the absence of comparable methods, we establish a baseline using an advanced 3D vision encoder in medical imaging to demonstrate our method's effectiveness, which leverages a novel auto-regressive causal transformer. Furthermore, recognizing the benefits of leveraging information from previous visits, we augment CT2Rep with a cross-attention-based multi-modal fusion module and hierarchical memory, enabling the incorporation of longitudinal multimodal data. Access our code at https://github.com/ibrahimethemhamamci/CT2Rep

Diffusion models have been used extensively for high quality image and video generation tasks. In this paper, we propose a novel conditional diffusion model with spatial attention and latent embedding (cDAL) for medical image segmentation. In cDAL, a convolutional neural network (CNN) based discriminator is used at every time-step of the diffusion process to distinguish between the generated labels and the real ones. A spatial attention map is computed based on the features learned by the discriminator to help cDAL generate more accurate segmentation of discriminative regions in an input image. Additionally, we incorporated a random latent embedding into each layer of our model to significantly reduce the number of training and sampling time-steps, thereby making it much faster than other diffusion models for image segmentation. We applied cDAL on 3 publicly available medical image segmentation datasets (MoNuSeg, Chest X-ray and Hippocampus) and observed significant qualitative and quantitative improvements with higher Dice scores and mIoU over the state-of-the-art algorithms. The source code is publicly available at https://github.com/Hejrati/cDAL/.

In biomedical imaging analysis, the dichotomy between 2D and 3D data presents a significant challenge. While 3D volumes offer superior real-world applicability, they are less available for each modality and not easy to train in large scale, whereas 2D samples are abundant but less comprehensive. This paper introduces the Cross-D Conv operation, a novel approach that bridges the dimensional gap by learning the phase shifting in the Fourier domain. Our method enables seamless weight transfer between 2D and 3D convolution operations, effectively facilitating cross-dimensional learning. The proposed architecture leverages the abundance of 2D training data to enhance 3D model performance, offering a practical solution to the multimodal data scarcity challenge in 3D medical model pretraining. Experimental validation on the RadImagenet (2D) and multimodal (3D) sets demonstrates that our approach achieves comparable or superior performance in feature quality assessment comparable to conventional methods. The enhanced convolution operation presents new opportunities for developing efficient classification and segmentation models in medical imaging. This work represents an advancement in cross-dimensional and multi-modal medical image analysis, offering a robust framework for utilizing 2D priors in 3D model pretraining or vice versa while maintaining computational efficiency.

Instance level detection and segmentation of thoracic diseases or abnormalities are crucial for automatic diagnosis in chest X-ray images. Leveraging on constant structure and disease relations extracted from domain knowledge, we propose a structure-aware relation network (SAR-Net) extending Mask R-CNN. The SAR-Net consists of three relation modules: 1. the anatomical structure relation module encoding spatial relations between diseases and anatomical parts. 2. the contextual relation module aggregating clues based on query-key pair of disease RoI and lung fields. 3. the disease relation module propagating co-occurrence and causal relations into disease proposals. Towards making a practical system, we also provide ChestX-Det, a chest X-Ray dataset with instance-level annotations (boxes and masks). ChestX-Det is a subset of the public dataset NIH ChestX-ray14. It contains ~3500 images of 13 common disease categories labeled by three board-certified radiologists. We evaluate our SAR-Net on it and another dataset DR-Private. Experimental results show that it can enhance the strong baseline of Mask R-CNN with significant improvements. The ChestX-Det is released at https://github.com/Deepwise-AILab/ChestX-Det-Dataset.

Deformable image registration (DIR) is an active research topic in biomedical imaging. There is a growing interest in developing DIR methods based on deep learning (DL). A traditional DL approach to DIR is based on training a convolutional neural network (CNN) to estimate the registration field between two input images. While conceptually simple, this approach comes with a limitation that it exclusively relies on a pre-trained CNN without explicitly enforcing fidelity between the registered image and the reference. We present plug-and-play image registration network (PIRATE) as a new DIR method that addresses this issue by integrating an explicit data-fidelity penalty and a CNN prior. PIRATE pre-trains a CNN denoiser on the registration field and "plugs" it into an iterative method as a regularizer. We additionally present PIRATE+ that fine-tunes the CNN prior in PIRATE using deep equilibrium models (DEQ). PIRATE+ interprets the fixed-point iteration of PIRATE as a network with effectively infinite layers and then trains the resulting network end-to-end, enabling it to learn more task-specific information and boosting its performance. Our numerical results on OASIS and CANDI datasets show that our methods achieve state-of-the-art performance on DIR.

Weakly-Supervised Semantic Segmentation (WSSS) using image-level labels typically utilizes Class Activation Map (CAM) to generate the pseudo labels. Limited by the local structure perception of CNN, CAM usually cannot identify the integral object regions. Though the recent Vision Transformer (ViT) can remedy this flaw, we observe it also brings the over-smoothing issue, \ie, the final patch tokens incline to be uniform. In this work, we propose Token Contrast (ToCo) to address this issue and further explore the virtue of ViT for WSSS. Firstly, motivated by the observation that intermediate layers in ViT can still retain semantic diversity, we designed a Patch Token Contrast module (PTC). PTC supervises the final patch tokens with the pseudo token relations derived from intermediate layers, allowing them to align the semantic regions and thus yield more accurate CAM. Secondly, to further differentiate the low-confidence regions in CAM, we devised a Class Token Contrast module (CTC) inspired by the fact that class tokens in ViT can capture high-level semantics. CTC facilitates the representation consistency between uncertain local regions and global objects by contrasting their class tokens. Experiments on the PASCAL VOC and MS COCO datasets show the proposed ToCo can remarkably surpass other single-stage competitors and achieve comparable performance with state-of-the-art multi-stage methods. Code is available at https://github.com/rulixiang/ToCo.

Convolutional layers are one of the basic building blocks of modern deep neural networks. One fundamental assumption is that convolutional kernels should be shared for all examples in a dataset. We propose conditionally parameterized convolutions (CondConv), which learn specialized convolutional kernels for each example. Replacing normal convolutions with CondConv enables us to increase the size and capacity of a network, while maintaining efficient inference. We demonstrate that scaling networks with CondConv improves the performance and inference cost trade-off of several existing convolutional neural network architectures on both classification and detection tasks. On ImageNet classification, our CondConv approach applied to EfficientNet-B0 achieves state-of-the-art performance of 78.3% accuracy with only 413M multiply-adds. Code and checkpoints for the CondConv Tensorflow layer and CondConv-EfficientNet models are available at: https://github.com/tensorflow/tpu/tree/master/models/official/efficientnet/condconv.

This paper reports Deep LOGISMOS approach to 3D tumor segmentation by incorporating boundary information derived from deep contextual learning to LOGISMOS - layered optimal graph image segmentation of multiple objects and surfaces. Accurate and reliable tumor segmentation is essential to tumor growth analysis and treatment selection. A fully convolutional network (FCN), UNet, is first trained using three adjacent 2D patches centered at the tumor, providing contextual UNet segmentation and probability map for each 2D patch. The UNet segmentation is then refined by Gaussian Mixture Model (GMM) and morphological operations. The refined UNet segmentation is used to provide the initial shape boundary to build a segmentation graph. The cost for each node of the graph is determined by the UNet probability maps. Finally, a max-flow algorithm is employed to find the globally optimal solution thus obtaining the final segmentation. For evaluation, we applied the method to pancreatic tumor segmentation on a dataset of 51 CT scans, among which 30 scans were used for training and 21 for testing. With Deep LOGISMOS, DICE Similarity Coefficient (DSC) and Relative Volume Difference (RVD) reached 83.2+-7.8% and 18.6+-17.4% respectively, both are significantly improved (p<0.05) compared with contextual UNet and/or LOGISMOS alone.

Continuous convolution has recently gained prominence due to its ability to handle irregularly sampled data and model long-term dependency. Also, the promising experimental results of using large convolutional kernels have catalyzed the development of continuous convolution since they can construct large kernels very efficiently. Leveraging neural networks, more specifically multilayer perceptrons (MLPs), is by far the most prevalent approach to implementing continuous convolution. However, there are a few drawbacks, such as high computational costs, complex hyperparameter tuning, and limited descriptive power of filters. This paper suggests an alternative approach to building a continuous convolution without neural networks, resulting in more computationally efficient and improved performance. We present self-moving point representations where weight parameters freely move, and interpolation schemes are used to implement continuous functions. When applied to construct convolutional kernels, the experimental results have shown improved performance with drop-in replacement in the existing frameworks. Due to its lightweight structure, we are first to demonstrate the effectiveness of continuous convolution in a large-scale setting, e.g., ImageNet, presenting the improvements over the prior arts. Our code is available on https://github.com/sangnekim/SMPConv

Music source separation involves a large input field to model a long-term dependence of an audio signal. Previous convolutional neural network (CNN)-based approaches address the large input field modeling using sequentially down- and up-sampling feature maps or dilated convolution. In this paper, we claim the importance of a rapid growth of a receptive field and a simultaneous modeling of multi-resolution data in a single convolution layer, and propose a novel CNN architecture called densely connected dilated DenseNet (D3Net). D3Net involves a novel multi-dilated convolution that has different dilation factors in a single layer to model different resolutions simultaneously. By combining the multi-dilated convolution with DenseNet architecture, D3Net avoids the aliasing problem that exists when we naively incorporate the dilated convolution in DenseNet. Experimental results on MUSDB18 dataset show that D3Net achieves state-of-the-art performance with an average signal to distortion ratio (SDR) of 6.01 dB.

Deep learning (DL) has proven highly effective for ultrasound-based computer-aided diagnosis (CAD) of breast cancers. In an automaticCAD system, lesion detection is critical for the following diagnosis. However, existing DL-based methods generally require voluminous manually-annotated region of interest (ROI) labels and class labels to train both the lesion detection and diagnosis models. In clinical practice, the ROI labels, i.e. ground truths, may not always be optimal for the classification task due to individual experience of sonologists, resulting in the issue of coarse annotation that limits the diagnosis performance of a CAD model. To address this issue, a novel Two-Stage Detection and Diagnosis Network (TSDDNet) is proposed based on weakly supervised learning to enhance diagnostic accuracy of the ultrasound-based CAD for breast cancers. In particular, all the ROI-level labels are considered as coarse labels in the first training stage, and then a candidate selection mechanism is designed to identify optimallesion areas for both the fully and partially annotated samples. It refines the current ROI-level labels in the fully annotated images and the detected ROIs in the partially annotated samples with a weakly supervised manner under the guidance of class labels. In the second training stage, a self-distillation strategy further is further proposed to integrate the detection network and classification network into a unified framework as the final CAD model for joint optimization, which then further improves the diagnosis performance. The proposed TSDDNet is evaluated on a B-mode ultrasound dataset, and the experimental results show that it achieves the best performance on both lesion detection and diagnosis tasks, suggesting promising application potential.

Multimodal learning significantly benefits cancer survival prediction, especially the integration of pathological images and genomic data. Despite advantages of multimodal learning for cancer survival prediction, massive redundancy in multimodal data prevents it from extracting discriminative and compact information: (1) An extensive amount of intra-modal task-unrelated information blurs discriminability, especially for gigapixel whole slide images (WSIs) with many patches in pathology and thousands of pathways in genomic data, leading to an ``intra-modal redundancy" issue. (2) Duplicated information among modalities dominates the representation of multimodal data, which makes modality-specific information prone to being ignored, resulting in an ``inter-modal redundancy" issue. To address these, we propose a new framework, Prototypical Information Bottlenecking and Disentangling (PIBD), consisting of Prototypical Information Bottleneck (PIB) module for intra-modal redundancy and Prototypical Information Disentanglement (PID) module for inter-modal redundancy. Specifically, a variant of information bottleneck, PIB, is proposed to model prototypes approximating a bunch of instances for different risk levels, which can be used for selection of discriminative instances within modality. PID module decouples entangled multimodal data into compact distinct components: modality-common and modality-specific knowledge, under the guidance of the joint prototypical distribution. Extensive experiments on five cancer benchmark datasets demonstrated our superiority over other methods.

Generative modeling has experienced substantial progress in recent years, particularly in text-to-image and text-to-video synthesis. However, the medical field has not yet fully exploited the potential of large-scale foundational models for synthetic data generation. In this paper, we introduce GenerateCT, the first method for text-conditional computed tomography (CT) generation, addressing the limitations in 3D medical imaging research and making our entire framework open-source. GenerateCT consists of a pre-trained large language model, a transformer-based text-conditional 3D chest CT generation architecture, and a text-conditional spatial super-resolution diffusion model. We also propose CT-ViT, which efficiently compresses CT volumes while preserving auto-regressiveness in-depth, enabling the generation of 3D CT volumes with variable numbers of axial slices. Our experiments demonstrate that GenerateCT can produce realistic, high-resolution, and high-fidelity 3D chest CT volumes consistent with medical language text prompts. We further investigate the potential of GenerateCT by training a model using generated CT volumes for multi-abnormality classification of chest CT volumes. Our contributions provide a valuable foundation for future research in text-conditional 3D medical image generation and have the potential to accelerate advancements in medical imaging research. Our code, pre-trained models, and generated data are available at https://github.com/ibrahimethemhamamci/GenerateCT.

Longitudinal analysis has great potential to reveal developmental trajectories and monitor disease progression in medical imaging. This process relies on consistent and robust joint 4D segmentation. Traditional techniques are dependent on the similarity of images over time and the use of subject-specific priors to reduce random variation and improve the robustness and sensitivity of the overall longitudinal analysis. This is however slow and computationally intensive as subject-specific templates need to be rebuilt every time. The focus of this work to accelerate this analysis with the use of deep learning. The proposed approach is based on deep CNNs and incorporates semantic segmentation and provides a longitudinal relationship for the same subject. The proposed approach is based on deep CNNs and incorporates semantic segmentation and provides a longitudinal relationship for the same subject. The state of art using 3D patches as inputs to modified Unet provides results around {0.91 pm 0.5} Dice and using multi-view atlas in CNNs provide around the same results. In this work, different models are explored, each offers better accuracy and fast results while increasing the segmentation quality. These methods are evaluated on 135 scans from the EADC-ADNI Harmonized Hippocampus Protocol. Proposed CNN based segmentation approaches demonstrate how 2D segmentation using prior slices can provide similar results to 3D segmentation while maintaining good continuity in the 3D dimension and improved speed. Just using 2D modified sagittal slices provide us a better Dice and longitudinal analysis for a given subject. For the ADNI dataset, using the simple UNet CNN technique gives us {0.84 pm 0.5} and while using modified CNN techniques on the same input yields {0.89 pm 0.5}. Rate of atrophy and RMS error are calculated for several test cases using various methods and analyzed.

Machine Learning methods can learn how to reconstruct Magnetic Resonance Images and thereby accelerate acquisition, which is of paramount importance to the clinical workflow. Physics-informed networks incorporate the forward model of accelerated MRI reconstruction in the learning process. With increasing network complexity, robustness is not ensured when reconstructing data unseen during training. We aim to embed data consistency (DC) in deep networks while balancing the degree of network complexity. While doing so, we will assess whether either explicit or implicit enforcement of DC in varying network architectures is preferred to optimize performance. We propose a scheme called Cascades of Independently Recurrent Inference Machines (CIRIM) to assess DC through unrolled optimization. Herein we assess DC both implicitly by gradient descent and explicitly by a designed term. Extensive comparison of the CIRIM to CS as well as to other methods is performed: the E2EVN, CascadeNet, KIKINet, LPDNet, RIM, IRIM, and UNet. Models were trained and evaluated on T1-weighted and FLAIR contrast brain data, and T2-weighted knee data. Both 1D and 2D undersampling patterns were evaluated. Robustness was tested by reconstructing 7.5x prospectively undersampled 3D FLAIR MRI data of Multiple Sclerosis (MS) patients with white matter lesions. The CIRIM performed best when implicitly enforcing DC, while the E2EVN required an explicit DC formulation. In reconstructing MS patient data, prospectively acquired with a sampling pattern unseen during model training, the CIRIM maintained lesion contrast while efficiently denoising the images. The CIRIM showed highly promising generalization capabilities maintaining a very fair trade-off between reconstructed image quality and fast reconstruction times, which is crucial in the clinical workflow.

Look-up table(LUT)-based methods have shown the great efficacy in single image super-resolution (SR) task. However, previous methods ignore the essential reason of restricted receptive field (RF) size in LUT, which is caused by the interaction of space and channel features in vanilla convolution. They can only increase the RF at the cost of linearly increasing LUT size. To enlarge RF with contained LUT sizes, we propose a novel Reconstructed Convolution(RC) module, which decouples channel-wise and spatial calculation. It can be formulated as n^2 1D LUTs to maintain ntimes n receptive field, which is obviously smaller than ntimes nD LUT formulated before. The LUT generated by our RC module reaches less than 1/10000 storage compared with SR-LUT baseline. The proposed Reconstructed Convolution module based LUT method, termed as RCLUT, can enlarge the RF size by 9 times than the state-of-the-art LUT-based SR method and achieve superior performance on five popular benchmark dataset. Moreover, the efficient and robust RC module can be used as a plugin to improve other LUT-based SR methods. The code is available at https://github.com/liuguandu/RC-LUT.

Cell instance segmentation in cytology images has significant importance for biology analysis and cancer screening, while remains challenging due to 1) the extensive overlapping translucent cell clusters that cause the ambiguous boundaries, and 2) the confusion of mimics and debris as nuclei. In this work, we proposed a De-overlapping Network (DoNet) in a decompose-and-recombined strategy. A Dual-path Region Segmentation Module (DRM) explicitly decomposes the cell clusters into intersection and complement regions, followed by a Semantic Consistency-guided Recombination Module (CRM) for integration. To further introduce the containment relationship of the nucleus in the cytoplasm, we design a Mask-guided Region Proposal Strategy (MRP) that integrates the cell attention maps for inner-cell instance prediction. We validate the proposed approach on ISBI2014 and CPS datasets. Experiments show that our proposed DoNet significantly outperforms other state-of-the-art (SOTA) cell instance segmentation methods. The code is available at https://github.com/DeepDoNet/DoNet.

Vision-language models can connect the text description of an object to its specific location in an image through visual grounding. This has potential applications in enhanced radiology reporting. However, these models require large annotated image-text datasets, which are lacking for PET/CT. We developed an automated pipeline to generate weak labels linking PET/CT report descriptions to their image locations and used it to train a 3D vision-language visual grounding model. Our pipeline finds positive findings in PET/CT reports by identifying mentions of SUVmax and axial slice numbers. From 25,578 PET/CT exams, we extracted 11,356 sentence-label pairs. Using this data, we trained ConTEXTual Net 3D, which integrates text embeddings from a large language model with a 3D nnU-Net via token-level cross-attention. The model's performance was compared against LLMSeg, a 2.5D version of ConTEXTual Net, and two nuclear medicine physicians. The weak-labeling pipeline accurately identified lesion locations in 98% of cases (246/251), with 7.5% requiring boundary adjustments. ConTEXTual Net 3D achieved an F1 score of 0.80, outperforming LLMSeg (F1=0.22) and the 2.5D model (F1=0.53), though it underperformed both physicians (F1=0.94 and 0.91). The model achieved better performance on FDG (F1=0.78) and DCFPyL (F1=0.75) exams, while performance dropped on DOTATE (F1=0.58) and Fluciclovine (F1=0.66). The model performed consistently across lesion sizes but showed reduced accuracy on lesions with low uptake. Our novel weak labeling pipeline accurately produced an annotated dataset of PET/CT image-text pairs, facilitating the development of 3D visual grounding models. ConTEXTual Net 3D significantly outperformed other models but fell short of the performance of nuclear medicine physicians. Our study suggests that even larger datasets may be needed to close this performance gap.

In the diverse field of medical imaging, automatic segmentation has numerous applications and must handle a wide variety of input domains, such as different types of Computed Tomography (CT) scans and Magnetic Resonance (MR) images. This heterogeneity challenges automatic segmentation algorithms to maintain consistent performance across different modalities due to the requirement for spatially aligned and paired images. Typically, segmentation models are trained using a single modality, which limits their ability to generalize to other types of input data without employing transfer learning techniques. Additionally, leveraging complementary information from different modalities to enhance segmentation precision often necessitates substantial modifications to popular encoder-decoder designs, such as introducing multiple branched encoding or decoding paths for each modality. In this work, we propose a simple Multi-Modal Segmentation (MulModSeg) strategy to enhance medical image segmentation across multiple modalities, specifically CT and MR. It incorporates two key designs: a modality-conditioned text embedding framework via a frozen text encoder that adds modality awareness to existing segmentation frameworks without significant structural modifications or computational overhead, and an alternating training procedure that facilitates the integration of essential features from unpaired CT and MR inputs. Through extensive experiments with both Fully Convolutional Network and Transformer-based backbones, MulModSeg consistently outperforms previous methods in segmenting abdominal multi-organ and cardiac substructures for both CT and MR modalities. The code is available in this {https://github.com/ChengyinLee/MulModSeg_2024{link}}.

We present an interpretation of Inception modules in convolutional neural networks as being an intermediate step in-between regular convolution and the depthwise separable convolution operation (a depthwise convolution followed by a pointwise convolution). In this light, a depthwise separable convolution can be understood as an Inception module with a maximally large number of towers. This observation leads us to propose a novel deep convolutional neural network architecture inspired by Inception, where Inception modules have been replaced with depthwise separable convolutions. We show that this architecture, dubbed Xception, slightly outperforms Inception V3 on the ImageNet dataset (which Inception V3 was designed for), and significantly outperforms Inception V3 on a larger image classification dataset comprising 350 million images and 17,000 classes. Since the Xception architecture has the same number of parameters as Inception V3, the performance gains are not due to increased capacity but rather to a more efficient use of model parameters.

Feature pyramid has been an efficient method to extract features at different scales. Development over this method mainly focuses on aggregating contextual information at different levels while seldom touching the inter-level correlation in the feature pyramid. Early computer vision methods extracted scale-invariant features by locating the feature extrema in both spatial and scale dimension. Inspired by this, a convolution across the pyramid level is proposed in this study, which is termed pyramid convolution and is a modified 3-D convolution. Stacked pyramid convolutions directly extract 3-D (scale and spatial) features and outperforms other meticulously designed feature fusion modules. Based on the viewpoint of 3-D convolution, an integrated batch normalization that collects statistics from the whole feature pyramid is naturally inserted after the pyramid convolution. Furthermore, we also show that the naive pyramid convolution, together with the design of RetinaNet head, actually best applies for extracting features from a Gaussian pyramid, whose properties can hardly be satisfied by a feature pyramid. In order to alleviate this discrepancy, we build a scale-equalizing pyramid convolution (SEPC) that aligns the shared pyramid convolution kernel only at high-level feature maps. Being computationally efficient and compatible with the head design of most single-stage object detectors, the SEPC module brings significant performance improvement (>4AP increase on MS-COCO2017 dataset) in state-of-the-art one-stage object detectors, and a light version of SEPC also has sim3.5AP gain with only around 7% inference time increase. The pyramid convolution also functions well as a stand-alone module in two-stage object detectors and is able to improve the performance by sim2AP. The source code can be found at https://github.com/jshilong/SEPC.

Deep neural network is difficult to train and this predicament becomes worse as the depth increases. The essence of this problem exists in the magnitude of backpropagated errors that will result in gradient vanishing or exploding phenomenon. We show that a variant of regularizer which utilizes orthonormality among different filter banks can alleviate this problem. Moreover, we design a backward error modulation mechanism based on the quasi-isometry assumption between two consecutive parametric layers. Equipped with these two ingredients, we propose several novel optimization solutions that can be utilized for training a specific-structured (repetitively triple modules of Conv-BNReLU) extremely deep convolutional neural network (CNN) WITHOUT any shortcuts/ identity mappings from scratch. Experiments show that our proposed solutions can achieve distinct improvements for a 44-layer and a 110-layer plain networks on both the CIFAR-10 and ImageNet datasets. Moreover, we can successfully train plain CNNs to match the performance of the residual counterparts. Besides, we propose new principles for designing network structure from the insights evoked by orthonormality. Combined with residual structure, we achieve comparative performance on the ImageNet dataset.

Cervical disc herniation (CDH) is a prevalent musculoskeletal disorder that significantly impacts health and requires labor-intensive analysis from experts. Despite advancements in automated detection of medical imaging, two significant challenges hinder the real-world application of these methods. First, the computational complexity and resource demands present a significant gap for real-time application. Second, noise in MRI reduces the effectiveness of existing methods by distorting feature extraction. To address these challenges, we propose three key contributions: Firstly, we introduced MedDet, which leverages the multi-teacher single-student knowledge distillation for model compression and efficiency, meanwhile integrating generative adversarial training to enhance performance. Additionally, we customize the second-order nmODE to improve the model's resistance to noise in MRI. Lastly, we conducted comprehensive experiments on the CDH-1848 dataset, achieving up to a 5% improvement in mAP compared to previous methods. Our approach also delivers over 5 times faster inference speed, with approximately 67.8% reduction in parameters and 36.9% reduction in FLOPs compared to the teacher model. These advancements significantly enhance the performance and efficiency of automated CDH detection, demonstrating promising potential for future application in clinical practice. See project website https://steve-zeyu-zhang.github.io/MedDet

Accurate segmentation of tumors in PET/CT images is important in computer-aided diagnosis and treatment of cancer. The key issue of such a segmentation problem lies in the effective integration of complementary information from PET and CT images. However, the quality of PET and CT images varies widely in clinical settings, which leads to uncertainty in the modality information extracted by networks. To take the uncertainty into account in multi-modal information fusion, this paper proposes a novel Multi-modal Evidential Fusion Network (MEFN) comprising a Cross-Modal Feature Learning (CFL) module and a Multi-modal Trusted Fusion (MTF) module. The CFL module reduces the domain gap upon modality conversion and highlights common tumor features, thereby alleviating the needs of the segmentation module to handle modality specificity. The MTF module utilizes mutual attention mechanisms and an uncertainty calibrator to fuse modality features based on modality uncertainty and then fuse the segmentation results under the guidance of Dempster-Shafer Theory. Besides, a new uncertainty perceptual loss is introduced to force the model focusing on uncertain features and hence improve its ability to extract trusted modality information. Extensive comparative experiments are conducted on two publicly available PET/CT datasets to evaluate the performance of our proposed method whose results demonstrate that our MEFN significantly outperforms state-of-the-art methods with improvements of 2.15% and 3.23% in DSC scores on the AutoPET dataset and the Hecktor dataset, respectively. More importantly, our model can provide radiologists with credible uncertainty of the segmentation results for their decision in accepting or rejecting the automatic segmentation results, which is particularly important for clinical applications. Our code will be available at https://github.com/QPaws/MEFN.

Automated slice classification is clinically relevant since it can be incorporated into medical image segmentation workflows as a preprocessing step that would flag slices with a higher probability of containing tumors, thereby directing physicians attention to the important slices. In this work, we train a ResNet-18 network to classify axial slices of lymphoma PET/CT images (collected from two institutions) depending on whether the slice intercepted a tumor (positive slice) in the 3D image or if the slice did not (negative slice). Various instances of the network were trained on 2D axial datasets created in different ways: (i) slice-level split and (ii) patient-level split; inputs of different types were used: (i) only PET slices and (ii) concatenated PET and CT slices; and different training strategies were employed: (i) center-aware (CAW) and (ii) center-agnostic (CAG). Model performances were compared using the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC), and various binary classification metrics. We observe and describe a performance overestimation in the case of slice-level split as compared to the patient-level split training. The model trained using patient-level split data with the network input containing only PET slices in the CAG training regime was the best performing/generalizing model on a majority of metrics. Our models were additionally more closely compared using the sensitivity metric on the positive slices from their respective test sets.

Conventional Computed Tomography (CT) methods require large numbers of noise-free projections for accurate density reconstructions, limiting their applicability to the more complex class of Cone Beam Geometry CT (CBCT) reconstruction. Recently, deep learning methods have been proposed to overcome these limitations, with methods based on neural fields (NF) showing strong performance, by approximating the reconstructed density through a continuous-in-space coordinate based neural network. Our focus is on improving such methods, however, unlike previous work, which requires training an NF from scratch for each new set of projections, we instead propose to leverage anatomical consistencies over different scans by training a single conditional NF on a dataset of projections. We propose a novel conditioning method where local modulations are modeled per patient as a field over the input domain through a Neural Modulation Field (NMF). The resulting Conditional Cone Beam Neural Tomography (CondCBNT) shows improved performance for both high and low numbers of available projections on noise-free and noisy data.

We introduce a Cascaded Diffusion Model (Cas-DM) that improves a Denoising Diffusion Probabilistic Model (DDPM) by effectively incorporating additional metric functions in training. Metric functions such as the LPIPS loss have been proven highly effective in consistency models derived from the score matching. However, for the diffusion counterparts, the methodology and efficacy of adding extra metric functions remain unclear. One major challenge is the mismatch between the noise predicted by a DDPM at each step and the desired clean image that the metric function works well on. To address this problem, we propose Cas-DM, a network architecture that cascades two network modules to effectively apply metric functions to the diffusion model training. The first module, similar to a standard DDPM, learns to predict the added noise and is unaffected by the metric function. The second cascaded module learns to predict the clean image, thereby facilitating the metric function computation. Experiment results show that the proposed diffusion model backbone enables the effective use of the LPIPS loss, leading to state-of-the-art image quality (FID, sFID, IS) on various established benchmarks.

Human organs constantly undergo anatomical changes due to a complex mix of short-term (e.g., heartbeat) and long-term (e.g., aging) factors. Evidently, prior knowledge of these factors will be beneficial when modeling their future state, i.e., via image generation. However, most of the medical image generation tasks only rely on the input from a single image, thus ignoring the sequential dependency even when longitudinal data is available. Sequence-aware deep generative models, where model input is a sequence of ordered and timestamped images, are still underexplored in the medical imaging domain that is featured by several unique challenges: 1) Sequences with various lengths; 2) Missing data or frame, and 3) High dimensionality. To this end, we propose a sequence-aware diffusion model (SADM) for the generation of longitudinal medical images. Recently, diffusion models have shown promising results in high-fidelity image generation. Our method extends this new technique by introducing a sequence-aware transformer as the conditional module in a diffusion model. The novel design enables learning longitudinal dependency even with missing data during training and allows autoregressive generation of a sequence of images during inference. Our extensive experiments on 3D longitudinal medical images demonstrate the effectiveness of SADM compared with baselines and alternative methods. The code is available at https://github.com/ubc-tea/SADM-Longitudinal-Medical-Image-Generation.

Automatic segmentation of the liver and hepatic lesions is an important step towards deriving quantitative biomarkers for accurate clinical diagnosis and computer-aided decision support systems. This paper presents a method to automatically segment liver and lesions in CT and MRI abdomen images using cascaded fully convolutional neural networks (CFCNs) enabling the segmentation of a large-scale medical trial or quantitative image analysis. We train and cascade two FCNs for a combined segmentation of the liver and its lesions. In the first step, we train a FCN to segment the liver as ROI input for a second FCN. The second FCN solely segments lesions within the predicted liver ROIs of step 1. CFCN models were trained on an abdominal CT dataset comprising 100 hepatic tumor volumes. Validations on further datasets show that CFCN-based semantic liver and lesion segmentation achieves Dice scores over 94% for liver with computation times below 100s per volume. We further experimentally demonstrate the robustness of the proposed method on an 38 MRI liver tumor volumes and the public 3DIRCAD dataset.

Fully convolutional neural networks (F-CNNs) have set the state-of-the-art in image segmentation for a plethora of applications. Architectural innovations within F-CNNs have mainly focused on improving spatial encoding or network connectivity to aid gradient flow. In this paper, we explore an alternate direction of recalibrating the feature maps adaptively, to boost meaningful features, while suppressing weak ones. We draw inspiration from the recently proposed squeeze & excitation (SE) module for channel recalibration of feature maps for image classification. Towards this end, we introduce three variants of SE modules for image segmentation, (i) squeezing spatially and exciting channel-wise (cSE), (ii) squeezing channel-wise and exciting spatially (sSE) and (iii) concurrent spatial and channel squeeze & excitation (scSE). We effectively incorporate these SE modules within three different state-of-the-art F-CNNs (DenseNet, SD-Net, U-Net) and observe consistent improvement of performance across all architectures, while minimally effecting model complexity. Evaluations are performed on two challenging applications: whole brain segmentation on MRI scans (Multi-Atlas Labelling Challenge Dataset) and organ segmentation on whole body contrast enhanced CT scans (Visceral Dataset).

This paper contributes to the "BraTS 2024 Brain MR Image Synthesis Challenge" and presents a conditional Wavelet Diffusion Model (cWDM) for directly solving a paired image-to-image translation task on high-resolution volumes. While deep learning-based brain tumor segmentation models have demonstrated clear clinical utility, they typically require MR scans from various modalities (T1, T1ce, T2, FLAIR) as input. However, due to time constraints or imaging artifacts, some of these modalities may be missing, hindering the application of well-performing segmentation algorithms in clinical routine. To address this issue, we propose a method that synthesizes one missing modality image conditioned on three available images, enabling the application of downstream segmentation models. We treat this paired image-to-image translation task as a conditional generation problem and solve it by combining a Wavelet Diffusion Model for high-resolution 3D image synthesis with a simple conditioning strategy. This approach allows us to directly apply our model to full-resolution volumes, avoiding artifacts caused by slice- or patch-wise data processing. While this work focuses on a specific application, the presented method can be applied to all kinds of paired image-to-image translation problems, such as CT leftrightarrow MR and MR leftrightarrow PET translation, or mask-conditioned anatomically guided image generation.

In recent years, we have witnessed the great advancement of Deep neural networks (DNNs) in image restoration. However, a critical limitation is that they cannot generalize well to real-world degradations with different degrees or types. In this paper, we are the first to propose a novel training strategy for image restoration from the causality perspective, to improve the generalization ability of DNNs for unknown degradations. Our method, termed Distortion Invariant representation Learning (DIL), treats each distortion type and degree as one specific confounder, and learns the distortion-invariant representation by eliminating the harmful confounding effect of each degradation. We derive our DIL with the back-door criterion in causality by modeling the interventions of different distortions from the optimization perspective. Particularly, we introduce counterfactual distortion augmentation to simulate the virtual distortion types and degrees as the confounders. Then, we instantiate the intervention of each distortion with a virtual model updating based on corresponding distorted images, and eliminate them from the meta-learning perspective. Extensive experiments demonstrate the effectiveness of our DIL on the generalization capability for unseen distortion types and degrees. Our code will be available at https://github.com/lixinustc/Causal-IR-DIL.

An increasing number of public datasets have shown a marked impact on automated organ segmentation and tumor detection. However, due to the small size and partially labeled problem of each dataset, as well as a limited investigation of diverse types of tumors, the resulting models are often limited to segmenting specific organs/tumors and ignore the semantics of anatomical structures, nor can they be extended to novel domains. To address these issues, we propose the CLIP-Driven Universal Model, which incorporates text embedding learned from Contrastive Language-Image Pre-training (CLIP) to segmentation models. This CLIP-based label encoding captures anatomical relationships, enabling the model to learn a structured feature embedding and segment 25 organs and 6 types of tumors. The proposed model is developed from an assembly of 14 datasets, using a total of 3,410 CT scans for training and then evaluated on 6,162 external CT scans from 3 additional datasets. We rank first on the Medical Segmentation Decathlon (MSD) public leaderboard and achieve state-of-the-art results on Beyond The Cranial Vault (BTCV). Additionally, the Universal Model is computationally more efficient (6x faster) compared with dataset-specific models, generalized better to CT scans from varying sites, and shows stronger transfer learning performance on novel tasks.

Four-dimensional cone-beam computed tomography (4D CBCT) provides respiration-resolved images and can be used for image-guided radiation therapy. However, the ability to reveal respiratory motion comes at the cost of image artifacts. As raw projection data are sorted into multiple respiratory phases, the cone-beam projections become much sparser and the reconstructed 4D CBCT images will be covered by severe streak artifacts. Although several deep learning-based methods have been proposed to address this issue, most algorithms employ 2D network models as backbones, neglecting the intrinsic structural priors within 4D CBCT images. In this paper, we first explore the origin and appearance of streak artifacts in 4D CBCT images. We find that streak artifacts exhibit a unique rotational motion along with the patient's respiration, distinguishable from diaphragm-driven respiratory motion in the spatiotemporal domain. Therefore, we propose a novel 4D neural network model, RSTAR4D-Net, designed to address Rotational STreak Artifact Reduction by integrating the spatial and temporal information within 4D CBCT images. Specifically, we overcome the computational and training difficulties of a 4D neural network. The specially designed model adopts an efficient implementation of 4D convolutions to reduce computational costs and thus can process the whole 4D image in one pass. Additionally, a Tetris training strategy pertinent to the separable 4D convolutions is proposed to effectively train the model using limited 4D training samples. Extensive experiments substantiate the effectiveness of our proposed method, and the RSTAR4D-Net shows superior performance compared to other methods. The source code and dynamic demos are available at https://github.com/ivy9092111111/RSTAR.

Efficient, reliable and reproducible target volume delineation is a key step in the effective planning of breast radiotherapy. However, post-operative breast target delineation is challenging as the contrast between the tumor bed volume (TBV) and normal breast tissue is relatively low in CT images. In this study, we propose to mimic the marker-guidance procedure in manual target delineation. We developed a saliency-based deep learning segmentation (SDL-Seg) algorithm for accurate TBV segmentation in post-operative breast irradiation. The SDL-Seg algorithm incorporates saliency information in the form of markers' location cues into a U-Net model. The design forces the model to encode the location-related features, which underscores regions with high saliency levels and suppresses low saliency regions. The saliency maps were generated by identifying markers on CT images. Markers' locations were then converted to probability maps using a distance-transformation coupled with a Gaussian filter. Subsequently, the CT images and the corresponding saliency maps formed a multi-channel input for the SDL-Seg network. Our in-house dataset was comprised of 145 prone CT images from 29 post-operative breast cancer patients, who received 5-fraction partial breast irradiation (PBI) regimen on GammaPod. The performance of the proposed method was compared against basic U-Net. Our model achieved mean (standard deviation) of 76.4 %, 6.76 mm, and 1.9 mm for DSC, HD95, and ASD respectively on the test set with computation time of below 11 seconds per one CT volume. SDL-Seg showed superior performance relative to basic U-Net for all the evaluation metrics while preserving low computation cost. The findings demonstrate that SDL-Seg is a promising approach for improving the efficiency and accuracy of the on-line treatment planning procedure of PBI, such as GammaPod based PBI.

Small sample sizes are common in many disciplines, which necessitates pooling roughly similar datasets across multiple institutions to study weak but relevant associations between images and disease outcomes. Such data often manifest shift/imbalance in covariates (i.e., secondary non-imaging data). Controlling for such nuisance variables is common within standard statistical analysis, but the ideas do not directly apply to overparameterized models. Consequently, recent work has shown how strategies from invariant representation learning provides a meaningful starting point, but the current repertoire of methods is limited to accounting for shifts/imbalances in just a couple of covariates at a time. In this paper, we show how viewing this problem from the perspective of Category theory provides a simple and effective solution that completely avoids elaborate multi-stage training pipelines that would otherwise be needed. We show the effectiveness of this approach via extensive experiments on real datasets. Further, we discuss how this style of formulation offers a unified perspective on at least 5+ distinct problem settings, from self-supervised learning to matching problems in 3D reconstruction.

Following recent advancements in computer-aided detection and diagnosis systems for colonoscopy, the automated reporting of colonoscopy procedures is set to further revolutionize clinical practice. A crucial yet underexplored aspect in the development of these systems is the creation of computer vision models capable of autonomously segmenting full-procedure colonoscopy videos into anatomical sections and procedural phases. In this work, we aim to create the first open-access dataset for this task and propose a state-of-the-art approach, benchmarked against competitive models. We annotated the publicly available REAL-Colon dataset, consisting of 2.7 million frames from 60 complete colonoscopy videos, with frame-level labels for anatomical locations and colonoscopy phases across nine categories. We then present ColonTCN, a learning-based architecture that employs custom temporal convolutional blocks designed to efficiently capture long temporal dependencies for the temporal segmentation of colonoscopy videos. We also propose a dual k-fold cross-validation evaluation protocol for this benchmark, which includes model assessment on unseen, multi-center data.ColonTCN achieves state-of-the-art performance in classification accuracy while maintaining a low parameter count when evaluated using the two proposed k-fold cross-validation settings, outperforming competitive models. We report ablation studies to provide insights into the challenges of this task and highlight the benefits of the custom temporal convolutional blocks, which enhance learning and improve model efficiency. We believe that the proposed open-access benchmark and the ColonTCN approach represent a significant advancement in the temporal segmentation of colonoscopy procedures, fostering further open-access research to address this clinical need.

The scaling laws and extraordinary performance of large foundation models motivate the development and utilization of such models in biomedicine. However, despite early promising results on some biomedical benchmarks, there are still major challenges that need to be addressed before these models can be used in real-world clinics. Frontier general-domain models such as GPT-4V still have significant performance gaps in multimodal biomedical applications. More importantly, less-acknowledged pragmatic issues, including accessibility, model cost, and tedious manual evaluation make it hard for clinicians to use state-of-the-art large models directly on private patient data. Here, we explore training open-source small multimodal models (SMMs) to bridge competency gaps for unmet clinical needs in radiology. To maximize data efficiency, we adopt a modular approach by incorporating state-of-the-art pre-trained models for image and text modalities, and focusing on training a lightweight adapter to ground each modality to the text embedding space, as exemplified by LLaVA-Med. For training, we assemble a large dataset of over 697 thousand radiology image-text pairs. For evaluation, we propose CheXprompt, a GPT-4-based metric for factuality evaluation, and demonstrate its parity with expert evaluation. For best practice, we conduct a systematic ablation study on various choices in data engineering and multimodal training. The resulting LlaVA-Rad (7B) model attains state-of-the-art results on standard radiology tasks such as report generation and cross-modal retrieval, even outperforming much larger models such as GPT-4V and Med-PaLM M (84B). The inference of LlaVA-Rad is fast and can be performed on a single V100 GPU in private settings, offering a promising state-of-the-art tool for real-world clinical applications.

In some medical imaging tasks and other settings where only small parts of the image are informative for the classification task, traditional CNNs can sometimes struggle to generalise. Manually annotated Regions of Interest (ROI) are sometimes used to isolate the most informative parts of the image. However, these are expensive to collect and may vary significantly across annotators. To overcome these issues, we propose a framework that employs saliency maps to obtain soft spatial attention masks that modulate the image features at different scales. We refer to our method as Adversarial Counterfactual Attention (ACAT). ACAT increases the baseline classification accuracy of lesions in brain CT scans from 71.39% to 72.55% and of COVID-19 related findings in lung CT scans from 67.71% to 70.84% and exceeds the performance of competing methods. We investigate the best way to generate the saliency maps employed in our architecture and propose a way to obtain them from adversarially generated counterfactual images. They are able to isolate the area of interest in brain and lung CT scans without using any manual annotations. In the task of localising the lesion location out of 6 possible regions, they obtain a score of 65.05% on brain CT scans, improving the score of 61.29% obtained with the best competing method.

Convolution is a broadly useful operation with applications including signal processing, machine learning, probability, optics, polynomial multiplication, and efficient parsing. Usually, however, this operation is understood and implemented in more specialized forms, hiding commonalities and limiting usefulness. This paper formulates convolution in the common algebraic framework of semirings and semimodules and populates that framework with various representation types. One of those types is the grand abstract template and itself generalizes to the free semimodule monad. Other representations serve varied uses and performance trade-offs, with implementations calculated from simple and regular specifications. Of particular interest is Brzozowski's method for regular expression matching. Uncovering the method's essence frees it from syntactic manipulations, while generalizing from boolean to weighted membership (such as multisets and probability distributions) and from sets to n-ary relations. The classic trie data structure then provides an elegant and efficient alternative to syntax. Pleasantly, polynomial arithmetic requires no additional implementation effort, works correctly with a variety of representations, and handles multivariate polynomials and power series with ease. Image convolution also falls out as a special case.

Invertible convolutions have been an essential element for building expressive normalizing flow-based generative models since their introduction in Glow. Several attempts have been made to design invertible k times k convolutions that are efficient in training and sampling passes. Though these attempts have improved the expressivity and sampling efficiency, they severely lagged behind Glow which used only 1 times 1 convolutions in terms of sampling time. Also, many of the approaches mask a large number of parameters of the underlying convolution, resulting in lower expressivity on a fixed run-time budget. We propose a k times k convolutional layer and Deep Normalizing Flow architecture which i.) has a fast parallel inversion algorithm with running time O(n k^2) (n is height and width of the input image and k is kernel size), ii.) masks the minimal amount of learnable parameters in a layer. iii.) gives better forward pass and sampling times comparable to other k times k convolution-based models on real-world benchmarks. We provide an implementation of the proposed parallel algorithm for sampling using our invertible convolutions on GPUs. Benchmarks on CIFAR-10, ImageNet, and CelebA datasets show comparable performance to previous works regarding bits per dimension while significantly improving the sampling time.

Computed tomography (CT) serves as an effective tool for lung cancer screening, diagnosis, treatment, and prognosis, providing a rich source of features to quantify temporal and spatial tumor changes. Nonetheless, the diversity of CT scanners and customized acquisition protocols can introduce significant inconsistencies in texture features, even when assessing the same patient. This variability poses a fundamental challenge for subsequent research that relies on consistent image features. Existing CT image standardization models predominantly utilize GAN-based supervised or semi-supervised learning, but their performance remains limited. We present DiffusionCT, an innovative score-based DDPM model that operates in the latent space to transform disparate non-standard distributions into a standardized form. The architecture comprises a U-Net-based encoder-decoder, augmented by a DDPM model integrated at the bottleneck position. First, the encoder-decoder is trained independently, without embedding DDPM, to capture the latent representation of the input data. Second, the latent DDPM model is trained while keeping the encoder-decoder parameters fixed. Finally, the decoder uses the transformed latent representation to generate a standardized CT image, providing a more consistent basis for downstream analysis. Empirical tests on patient CT images indicate notable improvements in image standardization using DiffusionCT. Additionally, the model significantly reduces image noise in SPAD images, further validating the effectiveness of DiffusionCT for advanced imaging tasks.

Developing generalist foundation model has recently attracted tremendous attention among researchers in the field of AI for Medicine (AI4Medicine). A pivotal insight in developing these models is their reliance on dataset scaling, which emphasizes the requirements on developing open-source medical image datasets that incorporate diverse supervision signals across various imaging modalities. In this paper, we introduce RadGenome-Chest CT, a comprehensive, large-scale, region-guided 3D chest CT interpretation dataset based on CT-RATE. Specifically, we leverage the latest powerful universal segmentation and large language models, to extend the original datasets (over 25,692 non-contrast 3D chest CT volume and reports from 20,000 patients) from the following aspects: (i) organ-level segmentation masks covering 197 categories, which provide intermediate reasoning visual clues for interpretation; (ii) 665 K multi-granularity grounded reports, where each sentence of the report is linked to the corresponding anatomical region of CT volume in the form of a segmentation mask; (iii) 1.3 M grounded VQA pairs, where questions and answers are all linked with reference segmentation masks, enabling models to associate visual evidence with textual explanations. All grounded reports and VQA pairs in the validation set have gone through manual verification to ensure dataset quality. We believe that RadGenome-Chest CT can significantly advance the development of multimodal medical foundation models, by training to generate texts based on given segmentation regions, which is unattainable with previous relevant datasets. We will release all segmentation masks, grounded reports, and VQA pairs to facilitate further research and development in this field.

Recently, attention mechanisms have been explored with ConvNets, both across the spatial and channel dimensions. However, from our knowledge, all the existing methods devote the attention modules to capture local interactions from a uni-scale. In this paper, we propose a Previous Knowledge Channel Attention Module(PKCAM), that captures channel-wise relations across different layers to model the global context. Our proposed module PKCAM is easily integrated into any feed-forward CNN architectures and trained in an end-to-end fashion with a negligible footprint due to its lightweight property. We validate our novel architecture through extensive experiments on image classification and object detection tasks with different backbones. Our experiments show consistent improvements in performances against their counterparts. Our code is published at https://github.com/eslambakr/EMCA.

Background. Fully automatic analysis of myocardial perfusion MRI datasets enables rapid and objective reporting of stress/rest studies in patients with suspected ischemic heart disease. Developing deep learning techniques that can analyze multi-center datasets despite limited training data and variations in software and hardware is an ongoing challenge. Methods. Datasets from 3 medical centers acquired at 3T (n = 150 subjects) were included: an internal dataset (inD; n = 95) and two external datasets (exDs; n = 55) used for evaluating the robustness of the trained deep neural network (DNN) models against differences in pulse sequence (exD-1) and scanner vendor (exD-2). A subset of inD (n = 85) was used for training/validation of a pool of DNNs for segmentation, all using the same spatiotemporal U-Net architecture and hyperparameters but with different parameter initializations. We employed a space-time sliding-patch analysis approach that automatically yields a pixel-wise "uncertainty map" as a byproduct of the segmentation process. In our approach, a given test case is segmented by all members of the DNN pool and the resulting uncertainty maps are leveraged to automatically select the "best" one among the pool of solutions. Results. The proposed DAUGS analysis approach performed similarly to the established approach on the internal dataset (p = n.s.) whereas it significantly outperformed on the external datasets (p < 0.005 for exD-1 and exD-2). Moreover, the number of image series with "failed" segmentation was significantly lower for the proposed vs. the established approach (4.3% vs. 17.1%, p < 0.0005). Conclusions. The proposed DAUGS analysis approach has the potential to improve the robustness of deep learning methods for segmentation of multi-center stress perfusion datasets with variations in the choice of pulse sequence, site location or scanner vendor.

While conditional diffusion models are known to have good coverage of the data distribution, they still face limitations in output diversity, particularly when sampled with a high classifier-free guidance scale for optimal image quality or when trained on small datasets. We attribute this problem to the role of the conditioning signal in inference and offer an improved sampling strategy for diffusion models that can increase generation diversity, especially at high guidance scales, with minimal loss of sample quality. Our sampling strategy anneals the conditioning signal by adding scheduled, monotonically decreasing Gaussian noise to the conditioning vector during inference to balance diversity and condition alignment. Our Condition-Annealed Diffusion Sampler (CADS) can be used with any pretrained model and sampling algorithm, and we show that it boosts the diversity of diffusion models in various conditional generation tasks. Further, using an existing pretrained diffusion model, CADS achieves a new state-of-the-art FID of 1.70 and 2.31 for class-conditional ImageNet generation at 256times256 and 512times512 respectively.

Recent advances in vision transformers (ViTs) have demonstrated the advantage of global modeling capabilities, prompting widespread integration of large-kernel convolutions for enlarging the effective receptive field (ERF). However, the quadratic scaling of parameter count and computational complexity (FLOPs) with respect to kernel size poses significant efficiency and optimization challenges. This paper introduces RecConv, a recursive decomposition strategy that efficiently constructs multi-frequency representations using small-kernel convolutions. RecConv establishes a linear relationship between parameter growth and decomposing levels which determines the effective kernel size ktimes 2^ell for a base kernel k and ell levels of decomposition, while maintaining constant FLOPs regardless of the ERF expansion. Specifically, RecConv achieves a parameter expansion of only ell+2 times and a maximum FLOPs increase of 5/3 times, compared to the exponential growth (4^ell) of standard and depthwise convolutions. RecNeXt-M3 outperforms RepViT-M1.1 by 1.9 AP^{box} on COCO with similar FLOPs. This innovation provides a promising avenue towards designing efficient and compact networks across various modalities. Codes and models can be found at https://github.com/suous/RecNeXt.

Despite that deep learning has achieved state-of-the-art performance for medical image segmentation, its success relies on a large set of manually annotated images for training that are expensive to acquire. In this paper, we propose an annotation-efficient learning framework for segmentation tasks that avoids annotations of training images, where we use an improved Cycle-Consistent Generative Adversarial Network (GAN) to learn from a set of unpaired medical images and auxiliary masks obtained either from a shape model or public datasets. We first use the GAN to generate pseudo labels for our training images under the implicit high-level shape constraint represented by a Variational Auto-encoder (VAE)-based discriminator with the help of the auxiliary masks, and build a Discriminator-guided Generator Channel Calibration (DGCC) module which employs our discriminator's feedback to calibrate the generator for better pseudo labels. To learn from the pseudo labels that are noisy, we further introduce a noise-robust iterative learning method using noise-weighted Dice loss. We validated our framework with two situations: objects with a simple shape model like optic disc in fundus images and fetal head in ultrasound images, and complex structures like lung in X-Ray images and liver in CT images. Experimental results demonstrated that 1) Our VAE-based discriminator and DGCC module help to obtain high-quality pseudo labels. 2) Our proposed noise-robust learning method can effectively overcome the effect of noisy pseudo labels. 3) The segmentation performance of our method without using annotations of training images is close or even comparable to that of learning from human annotations.

The coronavirus disease (COVID-19) has resulted in a pandemic crippling the a breadth of services critical to daily life. Segmentation of lung infections in computerized tomography (CT) slices could be be used to improve diagnosis and understanding of COVID-19 in patients. Deep learning systems lack interpretability because of their black box nature. Inspired by human communication of complex ideas through language, we propose a symbolic framework based on emergent languages for the segmentation of COVID-19 infections in CT scans of lungs. We model the cooperation between two artificial agents - a Sender and a Receiver. These agents synergistically cooperate using emergent symbolic language to solve the task of semantic segmentation. Our game theoretic approach is to model the cooperation between agents unlike Generative Adversarial Networks (GANs). The Sender retrieves information from one of the higher layers of the deep network and generates a symbolic sentence sampled from a categorical distribution of vocabularies. The Receiver ingests the stream of symbols and cogenerates the segmentation mask. A private emergent language is developed that forms the communication channel used to describe the task of segmentation of COVID infections. We augment existing state of the art semantic segmentation architectures with our symbolic generator to form symbolic segmentation models. Our symbolic segmentation framework achieves state of the art performance for segmentation of lung infections caused by COVID-19. Our results show direct interpretation of symbolic sentences to discriminate between normal and infected regions, infection morphology and image characteristics. We show state of the art results for segmentation of COVID-19 lung infections in CT.

Accurate 3D cardiac reconstruction from cine magnetic resonance imaging (cMRI) is crucial for improved cardiovascular disease diagnosis and understanding of the heart's motion. However, current cardiac MRI-based reconstruction technology used in clinical settings is 2D with limited through-plane resolution, resulting in low-quality reconstructed cardiac volumes. To better reconstruct 3D cardiac volumes from sparse 2D image stacks, we propose a morphology-guided diffusion model for 3D cardiac volume reconstruction, DMCVR, that synthesizes high-resolution 2D images and corresponding 3D reconstructed volumes. Our method outperforms previous approaches by conditioning the cardiac morphology on the generative model, eliminating the time-consuming iterative optimization process of the latent code, and improving generation quality. The learned latent spaces provide global semantics, local cardiac morphology and details of each 2D cMRI slice with highly interpretable value to reconstruct 3D cardiac shape. Our experiments show that DMCVR is highly effective in several aspects, such as 2D generation and 3D reconstruction performance. With DMCVR, we can produce high-resolution 3D cardiac MRI reconstructions, surpassing current techniques. Our proposed framework has great potential for improving the accuracy of cardiac disease diagnosis and treatment planning. Code can be accessed at https://github.com/hexiaoxiao-cs/DMCVR.

Conventional medical image segmentation methods have been found inadequate in facilitating physicians with the identification of specific lesions for diagnosis and treatment. Given the utility of text as an instructional format, we introduce a novel task termed Medical Image Referring Segmentation (MIRS), which requires segmenting specified lesions in images based on the given language expressions. Due to the varying object scales in medical images, MIRS demands robust vision-language modeling and comprehensive multi-scale interaction for precise localization and segmentation under linguistic guidance. However, existing medical image segmentation methods fall short in meeting these demands, resulting in insufficient segmentation accuracy. In response, we propose an approach named Language-guided Scale-aware MedSegmentor (LSMS), incorporating two appealing designs: (1)~a Scale-aware Vision-Language Attention module that leverages diverse convolutional kernels to acquire rich visual knowledge and interact closely with linguistic features, thereby enhancing lesion localization capability; (2)~a Full-Scale Decoder that globally models multi-modal features across various scales, capturing complementary information between scales to accurately outline lesion boundaries. Addressing the lack of suitable datasets for MIRS, we constructed a vision-language medical dataset called Reference Hepatic Lesion Segmentation (RefHL-Seg). This dataset comprises 2,283 abdominal CT slices from 231 cases, with corresponding textual annotations and segmentation masks for various liver lesions in images. We validated the performance of LSMS for MIRS and conventional medical image segmentation tasks across various datasets. Our LSMS consistently outperforms on all datasets with lower computational costs. The code and datasets will be released.

Foundation vision-language models are currently transforming computer vision, and are on the rise in medical imaging fueled by their very promising generalization capabilities. However, the initial attempts to transfer this new paradigm to medical imaging have shown less impressive performances than those observed in other domains, due to the significant domain shift and the complex, expert domain knowledge inherent to medical-imaging tasks. Motivated by the need for domain-expert foundation models, we present FLAIR, a pre-trained vision-language model for universal retinal fundus image understanding. To this end, we compiled 37 open-access, mostly categorical fundus imaging datasets from various sources, with up to 97 different target conditions and 284,660 images. We integrate the expert's domain knowledge in the form of descriptive textual prompts, during both pre-training and zero-shot inference, enhancing the less-informative categorical supervision of the data. Such a textual expert's knowledge, which we compiled from the relevant clinical literature and community standards, describes the fine-grained features of the pathologies as well as the hierarchies and dependencies between them. We report comprehensive evaluations, which illustrate the benefit of integrating expert knowledge and the strong generalization capabilities of FLAIR under difficult scenarios with domain shifts or unseen categories. When adapted with a lightweight linear probe, FLAIR outperforms fully-trained, dataset-focused models, more so in the few-shot regimes. Interestingly, FLAIR outperforms by a large margin more generalist, larger-scale image-language models, which emphasizes the potential of embedding experts' domain knowledge and the limitations of generalist models in medical imaging.

Simultaneous localisation and categorization of objects in medical images, also referred to as medical object detection, is of high clinical relevance because diagnostic decisions often depend on rating of objects rather than e.g. pixels. For this task, the cumbersome and iterative process of method configuration constitutes a major research bottleneck. Recently, nnU-Net has tackled this challenge for the task of image segmentation with great success. Following nnU-Net's agenda, in this work we systematize and automate the configuration process for medical object detection. The resulting self-configuring method, nnDetection, adapts itself without any manual intervention to arbitrary medical detection problems while achieving results en par with or superior to the state-of-the-art. We demonstrate the effectiveness of nnDetection on two public benchmarks, ADAM and LUNA16, and propose 11 further medical object detection tasks on public data sets for comprehensive method evaluation. Code is at https://github.com/MIC-DKFZ/nnDetection .

Deep learning frameworks commonly implement convolution operators with GEMM-based algorithms. In these algorithms, convolution is implemented on top of matrix-matrix multiplication (GEMM) functions, provided by highly optimized BLAS libraries. Convolutions with 1x1 kernels can be directly represented as a GEMM call, but convolutions with larger kernels require a special memory layout transformation - im2col or im2row - to fit into GEMM interface. The Indirect Convolution algorithm provides the efficiency of the GEMM primitive without the overhead of im2col transformation. In contrast to GEMM-based algorithms, the Indirect Convolution does not reshuffle the data to fit into the GEMM primitive but introduces an indirection buffer - a buffer of pointers to the start of each row of image pixels. This broadens the application of our modified GEMM function to convolutions with arbitrary kernel size, padding, stride, and dilation. The Indirect Convolution algorithm reduces memory overhead proportionally to the number of input channels and outperforms the GEMM-based algorithm by up to 62% on convolution parameters which involve im2col transformations in GEMM-based algorithms. This, however, comes at cost of minor performance reduction on 1x1 stride-1 convolutions.

Consistency Models (CM) (Song et al., 2023) accelerate score-based diffusion model sampling at the cost of sample quality but lack a natural way to trade-off quality for speed. To address this limitation, we propose Consistency Trajectory Model (CTM), a generalization encompassing CM and score-based models as special cases. CTM trains a single neural network that can -- in a single forward pass -- output scores (i.e., gradients of log-density) and enables unrestricted traversal between any initial and final time along the Probability Flow Ordinary Differential Equation (ODE) in a diffusion process. CTM enables the efficient combination of adversarial training and denoising score matching loss to enhance performance and achieves new state-of-the-art FIDs for single-step diffusion model sampling on CIFAR-10 (FID 1.73) and ImageNet at 64x64 resolution (FID 1.92). CTM also enables a new family of sampling schemes, both deterministic and stochastic, involving long jumps along the ODE solution trajectories. It consistently improves sample quality as computational budgets increase, avoiding the degradation seen in CM. Furthermore, unlike CM, CTM's access to the score function can streamline the adoption of established controllable/conditional generation methods from the diffusion community. This access also enables the computation of likelihood. The code is available at https://github.com/sony/ctm.

Deep learning has achieved significant success in the field of remote sensing image change detection (CD), yet two major challenges remain: the scarcity of sub-meter, all-inclusive open-source CD datasets, and the difficulty of achieving consistent and satisfactory detection results across images with varying change areas. To address these issues, we introduce the JL1-CD dataset, which contains 5,000 pairs of 512 x 512 pixel images with a resolution of 0.5 to 0.75 meters. Additionally, we propose a multi-teacher knowledge distillation (MTKD) framework for CD. Experimental results on the JL1-CD and SYSU-CD datasets demonstrate that the MTKD framework significantly improves the performance of CD models with various network architectures and parameter sizes, achieving new state-of-the-art results. The code is available at https://github.com/circleLZY/MTKD-CD.

Convolutional networks, transformers, hybrid models, and Mamba-based architectures have demonstrated strong performance across various medical image classification tasks. However, these methods were primarily designed to classify clean images using labeled data. In contrast, real-world clinical data often involve image corruptions that are unique to multi-center studies and stem from variations in imaging equipment across manufacturers. In this paper, we introduce the Medical Vision Transformer (MedViTV2), a novel architecture incorporating Kolmogorov-Arnold Network (KAN) layers into the transformer architecture for the first time, aiming for generalized medical image classification. We have developed an efficient KAN block to reduce computational load while enhancing the accuracy of the original MedViT. Additionally, to counteract the fragility of our MedViT when scaled up, we propose an enhanced Dilated Neighborhood Attention (DiNA), an adaptation of the efficient fused dot-product attention kernel capable of capturing global context and expanding receptive fields to scale the model effectively and addressing feature collapse issues. Moreover, a hierarchical hybrid strategy is introduced to stack our Local Feature Perception and Global Feature Perception blocks in an efficient manner, which balances local and global feature perceptions to boost performance. Extensive experiments on 17 medical image classification datasets and 12 corrupted medical image datasets demonstrate that MedViTV2 achieved state-of-the-art results in 27 out of 29 experiments with reduced computational complexity. MedViTV2 is 44\% more computationally efficient than the previous version and significantly enhances accuracy, achieving improvements of 4.6\% on MedMNIST, 5.8\% on NonMNIST, and 13.4\% on the MedMNIST-C benchmark.

Vision transformers (ViTs) have dominated computer vision in recent years. However, ViTs are computationally expensive and not well suited for mobile devices; this led to the prevalence of convolutional neural network (CNN) and ViT-based hybrid models for mobile vision applications. Recently, Vision GNN (ViG) and CNN hybrid models have also been proposed for mobile vision tasks. However, all of these methods remain slower compared to pure CNN-based models. In this work, we propose Multi-Level Dilated Convolutions to devise a purely CNN-based mobile backbone. Using Multi-Level Dilated Convolutions allows for a larger theoretical receptive field than standard convolutions. Different levels of dilation also allow for interactions between the short-range and long-range features in an image. Experiments show that our proposed model outperforms state-of-the-art (SOTA) mobile CNN, ViT, ViG, and hybrid architectures in terms of accuracy and/or speed on image classification, object detection, instance segmentation, and semantic segmentation. Our fastest model, RapidNet-Ti, achieves 76.3\% top-1 accuracy on ImageNet-1K with 0.9 ms inference latency on an iPhone 13 mini NPU, which is faster and more accurate than MobileNetV2x1.4 (74.7\% top-1 with 1.0 ms latency). Our work shows that pure CNN architectures can beat SOTA hybrid and ViT models in terms of accuracy and speed when designed properly.

We introduce Deformable Convolution v4 (DCNv4), a highly efficient and effective operator designed for a broad spectrum of vision applications. DCNv4 addresses the limitations of its predecessor, DCNv3, with two key enhancements: 1. removing softmax normalization in spatial aggregation to enhance its dynamic property and expressive power and 2. optimizing memory access to minimize redundant operations for speedup. These improvements result in a significantly faster convergence compared to DCNv3 and a substantial increase in processing speed, with DCNv4 achieving more than three times the forward speed. DCNv4 demonstrates exceptional performance across various tasks, including image classification, instance and semantic segmentation, and notably, image generation. When integrated into generative models like U-Net in the latent diffusion model, DCNv4 outperforms its baseline, underscoring its possibility to enhance generative models. In practical applications, replacing DCNv3 with DCNv4 in the InternImage model to create FlashInternImage results in up to 80% speed increase and further performance improvement without further modifications. The advancements in speed and efficiency of DCNv4, combined with its robust performance across diverse vision tasks, show its potential as a foundational building block for future vision models.

Flow models are effective at progressively generating realistic images, but they generally struggle to capture long-range dependencies during the generation process as they compress all the information from previous time steps into a single corrupted image. To address this limitation, we propose integrating autoregressive modeling -- known for its excellence in modeling complex, high-dimensional joint probability distributions -- into flow models. During training, at each step, we construct causally-ordered sequences by sampling multiple images from the same semantic category and applying different levels of noise, where images with higher noise levels serve as causal predecessors to those with lower noise levels. This design enables the model to learn broader category-level variations while maintaining proper causal relationships in the flow process. During generation, the model autoregressively conditions the previously generated images from earlier denoising steps, forming a contextual and coherent generation trajectory. Additionally, we design a customized hybrid linear attention mechanism tailored to our modeling approach to enhance computational efficiency. Our approach, termed ARFlow, under 400k training steps, achieves 14.08 FID scores on ImageNet at 128 * 128 without classifier-free guidance, reaching 4.34 FID with classifier-free guidance 1.5, significantly outperforming the previous flow-based model SiT's 9.17 FID. Extensive ablation studies demonstrate the effectiveness of our modeling strategy and chunk-wise attention design.

Training convolutional neural networks (CNNs) for segmentation of pulmonary airway, artery, and vein is challenging due to sparse supervisory signals caused by the severe class imbalance between tubular targets and background. We present a CNNs-based method for accurate airway and artery-vein segmentation in non-contrast computed tomography. It enjoys superior sensitivity to tenuous peripheral bronchioles, arterioles, and venules. The method first uses a feature recalibration module to make the best use of features learned from the neural networks. Spatial information of features is properly integrated to retain relative priority of activated regions, which benefits the subsequent channel-wise recalibration. Then, attention distillation module is introduced to reinforce representation learning of tubular objects. Fine-grained details in high-resolution attention maps are passing down from one layer to its previous layer recursively to enrich context. Anatomy prior of lung context map and distance transform map is designed and incorporated for better artery-vein differentiation capacity. Extensive experiments demonstrated considerable performance gains brought by these components. Compared with state-of-the-art methods, our method extracted much more branches while maintaining competitive overall segmentation performance. Codes and models are available at http://www.pami.sjtu.edu.cn/News/56

In this paper we present a review of the Kornia differentiable data augmentation (DDA) module for both for spatial (2D) and volumetric (3D) tensors. This module leverages differentiable computer vision solutions from Kornia, with an aim of integrating data augmentation (DA) pipelines and strategies to existing PyTorch components (e.g. autograd for differentiability, optim for optimization). In addition, we provide a benchmark comparing different DA frameworks and a short review for a number of approaches that make use of Kornia DDA.

The success of Deep Learning applications critically depends on the quality and scale of the underlying training data. Generative adversarial networks (GANs) can generate arbitrary large datasets, but diversity and fidelity are limited, which has recently been addressed by denoising diffusion probabilistic models (DDPMs) whose superiority has been demonstrated on natural images. In this study, we propose Medfusion, a conditional latent DDPM for medical images. We compare our DDPM-based model against GAN-based models, which constitute the current state-of-the-art in the medical domain. Medfusion was trained and compared with (i) StyleGan-3 on n=101,442 images from the AIROGS challenge dataset to generate fundoscopies with and without glaucoma, (ii) ProGAN on n=191,027 from the CheXpert dataset to generate radiographs with and without cardiomegaly and (iii) wGAN on n=19,557 images from the CRCMS dataset to generate histopathological images with and without microsatellite stability. In the AIROGS, CRMCS, and CheXpert datasets, Medfusion achieved lower (=better) FID than the GANs (11.63 versus 20.43, 30.03 versus 49.26, and 17.28 versus 84.31). Also, fidelity (precision) and diversity (recall) were higher (=better) for Medfusion in all three datasets. Our study shows that DDPM are a superior alternative to GANs for image synthesis in the medical domain.

A major challenge in computational research in 3D medical imaging is the lack of comprehensive datasets. Addressing this issue, our study introduces CT-RATE, the first 3D medical imaging dataset that pairs images with textual reports. CT-RATE consists of 25,692 non-contrast chest CT volumes, expanded to 50,188 through various reconstructions, from 21,304 unique patients, along with corresponding radiology text reports. Leveraging CT-RATE, we developed CT-CLIP, a CT-focused contrastive language-image pre-training framework. As a versatile, self-supervised model, CT-CLIP is designed for broad application and does not require task-specific training. Remarkably, CT-CLIP outperforms state-of-the-art, fully supervised methods in multi-abnormality detection across all key metrics, thus eliminating the need for manual annotation. We also demonstrate its utility in case retrieval, whether using imagery or textual queries, thereby advancing knowledge dissemination. The open-source release of CT-RATE and CT-CLIP marks a significant advancement in medical AI, enhancing 3D imaging analysis and fostering innovation in healthcare.

We present an end-to-end deep learning segmentation method by combining a 3D UNet architecture with a graph neural network (GNN) model. In this approach, the convolutional layers at the deepest level of the UNet are replaced by a GNN-based module with a series of graph convolutions. The dense feature maps at this level are transformed into a graph input to the GNN module. The incorporation of graph convolutions in the UNet provides nodes in the graph with information that is based on node connectivity, in addition to the local features learnt through the downsampled paths. This information can help improve segmentation decisions. By stacking several graph convolution layers, the nodes can access higher order neighbourhood information without substantial increase in computational expense. We propose two types of node connectivity in the graph adjacency: i) one predefined and based on a regular node neighbourhood, and ii) one dynamically computed during training and using the nearest neighbour nodes in the feature space. We have applied this method to the task of segmenting the airway tree from chest CT scans. Experiments have been performed on 32 CTs from the Danish Lung Cancer Screening Trial dataset. We evaluate the performance of the UNet-GNN models with two types of graph adjacency and compare it with the baseline UNet.

Many clinical tasks require an understanding of specialized data, such as medical images and genomics, which is not typically found in general-purpose large multimodal models. Building upon Gemini's multimodal models, we develop several models within the new Med-Gemini family that inherit core capabilities of Gemini and are optimized for medical use via fine-tuning with 2D and 3D radiology, histopathology, ophthalmology, dermatology and genomic data. Med-Gemini-2D sets a new standard for AI-based chest X-ray (CXR) report generation based on expert evaluation, exceeding previous best results across two separate datasets by an absolute margin of 1% and 12%, where 57% and 96% of AI reports on normal cases, and 43% and 65% on abnormal cases, are evaluated as "equivalent or better" than the original radiologists' reports. We demonstrate the first ever large multimodal model-based report generation for 3D computed tomography (CT) volumes using Med-Gemini-3D, with 53% of AI reports considered clinically acceptable, although additional research is needed to meet expert radiologist reporting quality. Beyond report generation, Med-Gemini-2D surpasses the previous best performance in CXR visual question answering (VQA) and performs well in CXR classification and radiology VQA, exceeding SoTA or baselines on 17 of 20 tasks. In histopathology, ophthalmology, and dermatology image classification, Med-Gemini-2D surpasses baselines across 18 out of 20 tasks and approaches task-specific model performance. Beyond imaging, Med-Gemini-Polygenic outperforms the standard linear polygenic risk score-based approach for disease risk prediction and generalizes to genetically correlated diseases for which it has never been trained. Although further development and evaluation are necessary in the safety-critical medical domain, our results highlight the potential of Med-Gemini across a wide range of medical tasks.

The COVID-19 pandemic has spread globally for several months. Because its transmissibility and high pathogenicity seriously threaten people's lives, it is crucial to accurately and quickly detect COVID-19 infection. Many recent studies have shown that deep learning (DL) based solutions can help detect COVID-19 based on chest CT scans. However, most existing work focuses on 2D datasets, which may result in low quality models as the real CT scans are 3D images. Besides, the reported results span a broad spectrum on different datasets with a relatively unfair comparison. In this paper, we first use three state-of-the-art 3D models (ResNet3D101, DenseNet3D121, and MC3\_18) to establish the baseline performance on the three publicly available chest CT scan datasets. Then we propose a differentiable neural architecture search (DNAS) framework to automatically search for the 3D DL models for 3D chest CT scans classification with the Gumbel Softmax technique to improve the searching efficiency. We further exploit the Class Activation Mapping (CAM) technique on our models to provide the interpretability of the results. The experimental results show that our automatically searched models (CovidNet3D) outperform the baseline human-designed models on the three datasets with tens of times smaller model size and higher accuracy. Furthermore, the results also verify that CAM can be well applied in CovidNet3D for COVID-19 datasets to provide interpretability for medical diagnosis.

Multimodal large language models (MLLMs) have achieved significant success in the general field of image processing. Their emerging task generalization and freeform conversational capabilities can greatly facilitate medical diagnostic assistance, helping patients better understand their conditions and enhancing doctor-patient trust. Computed Tomography (CT) is a non-invasive imaging technique used to capture the internal mechanisms of a patient's condition and is widely utilized. However, in past research, the complex textural features of this imaging data have made accurate interpretation by algorithms challenging, impeding the performance of general LLMs in diagnostic assistance. To address this, we developed OrthoDoc, a MLLM designed for CT diagnostics. OrthoDoc is trained on 120,000 CT images and diagnostic reports and includes a Retrieval-Augmented Generation (RAG) module capable of effectively mitigating model hallucinations. This module is informed by extensive medical literature, textbooks, and explanatory data. Thus, OrthoDoc not only processes complex CT images but also stores, understands, and reasons over medical knowledge and language. In extensive experiments, OrthoDoc outperforms commercial models led by GPT-4, demonstrating superior diagnostic capabilities and accuracy. Specifically, OrthoDoc significantly surpasses existing models in the diagnosis of common orthopedic conditions such as fractures, arthritis, and tumors. Additionally, OrthoDoc exhibits robust generalization and stability when handling rare and complex cases.

X-ray images play a vital role in the intraoperative processes due to their high resolution and fast imaging speed and greatly promote the subsequent segmentation, registration and reconstruction. However, over-dosed X-rays superimpose potential risks to human health to some extent. Data-driven algorithms from volume scans to X-ray images are restricted by the scarcity of paired X-ray and volume data. Existing methods are mainly realized by modelling the whole X-ray imaging procedure. In this study, we propose a learning-based approach termed CT2X-GAN to synthesize the X-ray images in an end-to-end manner using the content and style disentanglement from three different image domains. Our method decouples the anatomical structure information from CT scans and style information from unpaired real X-ray images/ digital reconstructed radiography (DRR) images via a series of decoupling encoders. Additionally, we introduce a novel consistency regularization term to improve the stylistic resemblance between synthesized X-ray images and real X-ray images. Meanwhile, we also impose a supervised process by computing the similarity of computed real DRR and synthesized DRR images. We further develop a pose attention module to fully strengthen the comprehensive information in the decoupled content code from CT scans, facilitating high-quality multi-view image synthesis in the lower 2D space. Extensive experiments were conducted on the publicly available CTSpine1K dataset and achieved 97.8350, 0.0842 and 3.0938 in terms of FID, KID and defined user-scored X-ray similarity, respectively. In comparison with 3D-aware methods (pi-GAN, EG3D), CT2X-GAN is superior in improving the synthesis quality and realistic to the real X-ray images.

Recent advances in deep learning-based medical image segmentation studies achieve nearly human-level performance in fully supervised manner. However, acquiring pixel-level expert annotations is extremely expensive and laborious in medical imaging fields. Unsupervised domain adaptation (UDA) can alleviate this problem, which makes it possible to use annotated data in one imaging modality to train a network that can successfully perform segmentation on target imaging modality with no labels. In this work, we propose SDC-UDA, a simple yet effective volumetric UDA framework for slice-direction continuous cross-modality medical image segmentation which combines intra- and inter-slice self-attentive image translation, uncertainty-constrained pseudo-label refinement, and volumetric self-training. Our method is distinguished from previous methods on UDA for medical image segmentation in that it can obtain continuous segmentation in the slice direction, thereby ensuring higher accuracy and potential in clinical practice. We validate SDC-UDA with multiple publicly available cross-modality medical image segmentation datasets and achieve state-of-the-art segmentation performance, not to mention the superior slice-direction continuity of prediction compared to previous studies.

This paper introduces an innovative methodology for producing high-quality 3D lung CT images guided by textual information. While diffusion-based generative models are increasingly used in medical imaging, current state-of-the-art approaches are limited to low-resolution outputs and underutilize radiology reports' abundant information. The radiology reports can enhance the generation process by providing additional guidance and offering fine-grained control over the synthesis of images. Nevertheless, expanding text-guided generation to high-resolution 3D images poses significant memory and anatomical detail-preserving challenges. Addressing the memory issue, we introduce a hierarchical scheme that uses a modified UNet architecture. We start by synthesizing low-resolution images conditioned on the text, serving as a foundation for subsequent generators for complete volumetric data. To ensure the anatomical plausibility of the generated samples, we provide further guidance by generating vascular, airway, and lobular segmentation masks in conjunction with the CT images. The model demonstrates the capability to use textual input and segmentation tasks to generate synthesized images. The results of comparative assessments indicate that our approach exhibits superior performance compared to the most advanced models based on GAN and diffusion techniques, especially in accurately retaining crucial anatomical features such as fissure lines, airways, and vascular structures. This innovation introduces novel possibilities. This study focuses on two main objectives: (1) the development of a method for creating images based on textual prompts and anatomical components, and (2) the capability to generate new images conditioning on anatomical elements. The advancements in image generation can be applied to enhance numerous downstream tasks.

In this paper, we introduce DRR-RATE, a large-scale synthetic chest X-ray dataset derived from the recently released CT-RATE dataset. DRR-RATE comprises of 50,188 frontal Digitally Reconstructed Radiographs (DRRs) from 21,304 unique patients. Each image is paired with a corresponding radiology text report and binary labels for 18 pathology classes. Given the controllable nature of DRR generation, it facilitates the inclusion of lateral view images and images from any desired viewing position. This opens up avenues for research into new and novel multimodal applications involving paired CT, X-ray images from various views, text, and binary labels. We demonstrate the applicability of DRR-RATE alongside existing large-scale chest X-ray resources, notably the CheXpert dataset and CheXnet model. Experiments demonstrate that CheXnet, when trained and tested on the DRR-RATE dataset, achieves sufficient to high AUC scores for the six common pathologies cited in common literature: Atelectasis, Cardiomegaly, Consolidation, Lung Lesion, Lung Opacity, and Pleural Effusion. Additionally, CheXnet trained on the CheXpert dataset can accurately identify several pathologies, even when operating out of distribution. This confirms that the generated DRR images effectively capture the essential pathology features from CT images. The dataset and labels are publicly accessible at https://huggingface.co/datasets/farrell236/DRR-RATE.

Conditional normalizing flows can generate diverse image samples for solving inverse problems. Most normalizing flows for inverse problems in imaging employ the conditional affine coupling layer that can generate diverse images quickly. However, unintended severe artifacts are occasionally observed in the output of them. In this work, we address this critical issue by investigating the origins of these artifacts and proposing the conditions to avoid them. First of all, we empirically and theoretically reveal that these problems are caused by "exploding inverse" in the conditional affine coupling layer for certain out-of-distribution (OOD) conditional inputs. Then, we further validated that the probability of causing erroneous artifacts in pixels is highly correlated with a Mahalanobis distance-based OOD score for inverse problems in imaging. Lastly, based on our investigations, we propose a remark to avoid exploding inverse and then based on it, we suggest a simple remedy that substitutes the affine coupling layers with the modified rational quadratic spline coupling layers in normalizing flows, to encourage the robustness of generated image samples. Our experimental results demonstrated that our suggested methods effectively suppressed critical artifacts occurring in normalizing flows for super-resolution space generation and low-light image enhancement.

Limited-Angle Computed Tomography (LACT) is a non-destructive evaluation technique used in a variety of applications ranging from security to medicine. The limited angle coverage in LACT is often a dominant source of severe artifacts in the reconstructed images, making it a challenging inverse problem. We present DOLCE, a new deep model-based framework for LACT that uses a conditional diffusion model as an image prior. Diffusion models are a recent class of deep generative models that are relatively easy to train due to their implementation as image denoisers. DOLCE can form high-quality images from severely under-sampled data by integrating data-consistency updates with the sampling updates of a diffusion model, which is conditioned on the transformed limited-angle data. We show through extensive experimentation on several challenging real LACT datasets that, the same pre-trained DOLCE model achieves the SOTA performance on drastically different types of images. Additionally, we show that, unlike standard LACT reconstruction methods, DOLCE naturally enables the quantification of the reconstruction uncertainty by generating multiple samples consistent with the measured data.

Semantic segmentation is a key technology for autonomous vehicles to understand the surrounding scenes. The appealing performances of contemporary models usually come at the expense of heavy computations and lengthy inference time, which is intolerable for self-driving. Using light-weight architectures (encoder-decoder or two-pathway) or reasoning on low-resolution images, recent methods realize very fast scene parsing, even running at more than 100 FPS on a single 1080Ti GPU. However, there is still a significant gap in performance between these real-time methods and the models based on dilation backbones. To tackle this problem, we proposed a family of efficient backbones specially designed for real-time semantic segmentation. The proposed deep dual-resolution networks (DDRNets) are composed of two deep branches between which multiple bilateral fusions are performed. Additionally, we design a new contextual information extractor named Deep Aggregation Pyramid Pooling Module (DAPPM) to enlarge effective receptive fields and fuse multi-scale context based on low-resolution feature maps. Our method achieves a new state-of-the-art trade-off between accuracy and speed on both Cityscapes and CamVid dataset. In particular, on a single 2080Ti GPU, DDRNet-23-slim yields 77.4% mIoU at 102 FPS on Cityscapes test set and 74.7% mIoU at 230 FPS on CamVid test set. With widely used test augmentation, our method is superior to most state-of-the-art models and requires much less computation. Codes and trained models are available online.

Over 85 million computed tomography (CT) scans are performed annually in the US, of which approximately one quarter focus on the abdomen. Given the current radiologist shortage, there is a large impetus to use artificial intelligence to alleviate the burden of interpreting these complex imaging studies. Prior state-of-the-art approaches for automated medical image interpretation leverage vision language models (VLMs). However, current medical VLMs are generally limited to 2D images and short reports, and do not leverage electronic health record (EHR) data for supervision. We introduce Merlin - a 3D VLM that we train using paired CT scans (6+ million images from 15,331 CTs), EHR diagnosis codes (1.8+ million codes), and radiology reports (6+ million tokens). We evaluate Merlin on 6 task types and 752 individual tasks. The non-adapted (off-the-shelf) tasks include zero-shot findings classification (31 findings), phenotype classification (692 phenotypes), and zero-shot cross-modal retrieval (image to findings and image to impressions), while model adapted tasks include 5-year disease prediction (6 diseases), radiology report generation, and 3D semantic segmentation (20 organs). We perform internal validation on a test set of 5,137 CTs, and external validation on 7,000 clinical CTs and on two public CT datasets (VerSe, TotalSegmentator). Beyond these clinically-relevant evaluations, we assess the efficacy of various network architectures and training strategies to depict that Merlin has favorable performance to existing task-specific baselines. We derive data scaling laws to empirically assess training data needs for requisite downstream task performance. Furthermore, unlike conventional VLMs that require hundreds of GPUs for training, we perform all training on a single GPU.

Recent research in medical image analysis with deep learning almost exclusively focuses on grid- or voxel-based data representations. We challenge this common choice by introducing MedFuncta, a modality-agnostic continuous data representation based on neural fields. We demonstrate how to scale neural fields from single instances to large datasets by exploiting redundancy in medical signals and by applying an efficient meta-learning approach with a context reduction scheme. We further address the spectral bias in commonly used SIREN activations, by introducing an omega_0-schedule, improving reconstruction quality and convergence speed. We validate our proposed approach on a large variety of medical signals of different dimensions and modalities (1D: ECG; 2D: Chest X-ray, Retinal OCT, Fundus Camera, Dermatoscope, Colon Histopathology, Cell Microscopy; 3D: Brain MRI, Lung CT) and successfully demonstrate that we can solve relevant downstream tasks on these representations. We additionally release a large-scale dataset of > 550k annotated neural fields to promote research in this direction.

While models derived from Vision Transformers (ViTs) have been phonemically surging, pre-trained models cannot seamlessly adapt to arbitrary resolution images without altering the architecture and configuration, such as sampling the positional encoding, limiting their flexibility for various vision tasks. For instance, the Segment Anything Model (SAM) based on ViT-Huge requires all input images to be resized to 1024times1024. To overcome this limitation, we propose the Multi-Head Self-Attention Convolution (MSA-Conv) that incorporates Self-Attention within generalized convolutions, including standard, dilated, and depthwise ones. Enabling transformers to handle images of varying sizes without retraining or rescaling, the use of MSA-Conv further reduces computational costs compared to global attention in ViT, which grows costly as image size increases. Later, we present the Vision Transformer in Convolution (TiC) as a proof of concept for image classification with MSA-Conv, where two capacity enhancing strategies, namely Multi-Directional Cyclic Shifted Mechanism and Inter-Pooling Mechanism, have been proposed, through establishing long-distance connections between tokens and enlarging the effective receptive field. Extensive experiments have been carried out to validate the overall effectiveness of TiC. Additionally, ablation studies confirm the performance improvement made by MSA-Conv and the two capacity enhancing strategies separately. Note that our proposal aims at studying an alternative to the global attention used in ViT, while MSA-Conv meets our goal by making TiC comparable to state-of-the-art on ImageNet-1K. Code will be released at https://github.com/zs670980918/MSA-Conv.

We propose an adaptive training scheme for unsupervised medical image registration. Existing methods rely on image reconstruction as the primary supervision signal. However, nuisance variables (e.g. noise and covisibility), violation of the Lambertian assumption in physical waves (e.g. ultrasound), and inconsistent image acquisition can all cause a loss of correspondence between medical images. As the unsupervised learning scheme relies on intensity constancy between images to establish correspondence for reconstruction, this introduces spurious error residuals that are not modeled by the typical training objective. To mitigate this, we propose an adaptive framework that re-weights the error residuals with a correspondence scoring map during training, preventing the parametric displacement estimator from drifting away due to noisy gradients, which leads to performance degradation. To illustrate the versatility and effectiveness of our method, we tested our framework on three representative registration architectures across three medical image datasets along with other baselines. Our adaptive framework consistently outperforms other methods both quantitatively and qualitatively. Paired t-tests show that our improvements are statistically significant. Code available at: https://voldemort108x.github.io/AdaCS/.

Inspired by the long-range modeling ability of ViTs, large-kernel convolutions are widely studied and adopted recently to enlarge the receptive field and improve model performance, like the remarkable work ConvNeXt which employs 7x7 depthwise convolution. Although such depthwise operator only consumes a few FLOPs, it largely harms the model efficiency on powerful computing devices due to the high memory access costs. For example, ConvNeXt-T has similar FLOPs with ResNet-50 but only achieves 60% throughputs when trained on A100 GPUs with full precision. Although reducing the kernel size of ConvNeXt can improve speed, it results in significant performance degradation. It is still unclear how to speed up large-kernel-based CNN models while preserving their performance. To tackle this issue, inspired by Inceptions, we propose to decompose large-kernel depthwise convolution into four parallel branches along channel dimension, i.e. small square kernel, two orthogonal band kernels, and an identity mapping. With this new Inception depthwise convolution, we build a series of networks, namely IncepitonNeXt, which not only enjoy high throughputs but also maintain competitive performance. For instance, InceptionNeXt-T achieves 1.6x higher training throughputs than ConvNeX-T, as well as attains 0.2% top-1 accuracy improvement on ImageNet-1K. We anticipate InceptionNeXt can serve as an economical baseline for future architecture design to reduce carbon footprint. Code is available at https://github.com/sail-sg/inceptionnext.

The high cure rate of cancer is inextricably linked to physicians' accuracy in diagnosis and treatment, therefore a model that can accomplish high-precision tumor segmentation has become a necessity in many applications of the medical industry. It can effectively lower the rate of misdiagnosis while considerably lessening the burden on clinicians. However, fully automated target organ segmentation is problematic due to the irregular stereo structure of 3D volume organs. As a basic model for this class of real applications, U-Net excels. It can learn certain global and local features, but still lacks the capacity to grasp spatial long-range relationships and contextual information at multiple scales. This paper proposes a tumor segmentation model MPU-Net for patient volume CT images, which is inspired by Transformer with a global attention mechanism. By combining image serialization with the Position Attention Module, the model attempts to comprehend deeper contextual dependencies and accomplish precise positioning. Each layer of the decoder is also equipped with a multi-scale module and a cross-attention mechanism. The capability of feature extraction and integration at different levels has been enhanced, and the hybrid loss function developed in this study can better exploit high-resolution characteristic information. Moreover, the suggested architecture is tested and evaluated on the Liver Tumor Segmentation Challenge 2017 (LiTS 2017) dataset. Compared with the benchmark model U-Net, MPU-Net shows excellent segmentation results. The dice, accuracy, precision, specificity, IOU, and MCC metrics for the best model segmentation results are 92.17%, 99.08%, 91.91%, 99.52%, 85.91%, and 91.74%, respectively. Outstanding indicators in various aspects illustrate the exceptional performance of this framework in automatic medical image segmentation.

Low-light image enhancement (LLIE) restores the color and brightness of underexposed images. Supervised methods suffer from high costs in collecting low/normal-light image pairs. Unsupervised methods invest substantial effort in crafting complex loss functions. We address these two challenges through the proposed TroubleMaker Learning (TML) strategy, which employs normal-light images as inputs for training. TML is simple: we first dim the input and then increase its brightness. TML is based on two core components. First, the troublemaker model (TM) constructs pseudo low-light images from normal images to relieve the cost of pairwise data. Second, the predicting model (PM) enhances the brightness of pseudo low-light images. Additionally, we incorporate an enhancing model (EM) to further improve the visual performance of PM outputs. Moreover, in LLIE tasks, characterizing global element correlations is important because more information on the same object can be captured. CNN cannot achieve this well, and self-attention has high time complexity. Accordingly, we propose Global Dynamic Convolution (GDC) with O(n) time complexity, which essentially imitates the partial calculation process of self-attention to formulate elementwise correlations. Based on the GDC module, we build the UGDC model. Extensive quantitative and qualitative experiments demonstrate that UGDC trained with TML can achieve competitive performance against state-of-the-art approaches on public datasets. The code is available at https://github.com/Rainbowman0/TML_LLIE.

We propose Convolutional Block Attention Module (CBAM), a simple yet effective attention module for feed-forward convolutional neural networks. Given an intermediate feature map, our module sequentially infers attention maps along two separate dimensions, channel and spatial, then the attention maps are multiplied to the input feature map for adaptive feature refinement. Because CBAM is a lightweight and general module, it can be integrated into any CNN architectures seamlessly with negligible overheads and is end-to-end trainable along with base CNNs. We validate our CBAM through extensive experiments on ImageNet-1K, MS~COCO detection, and VOC~2007 detection datasets. Our experiments show consistent improvements in classification and detection performances with various models, demonstrating the wide applicability of CBAM. The code and models will be publicly available.

This paper presents innovative enhancements to diffusion models by integrating a novel multi-resolution network and time-dependent layer normalization. Diffusion models have gained prominence for their effectiveness in high-fidelity image generation. While conventional approaches rely on convolutional U-Net architectures, recent Transformer-based designs have demonstrated superior performance and scalability. However, Transformer architectures, which tokenize input data (via "patchification"), face a trade-off between visual fidelity and computational complexity due to the quadratic nature of self-attention operations concerning token length. While larger patch sizes enable attention computation efficiency, they struggle to capture fine-grained visual details, leading to image distortions. To address this challenge, we propose augmenting the Diffusion model with the Multi-Resolution network (DiMR), a framework that refines features across multiple resolutions, progressively enhancing detail from low to high resolution. Additionally, we introduce Time-Dependent Layer Normalization (TD-LN), a parameter-efficient approach that incorporates time-dependent parameters into layer normalization to inject time information and achieve superior performance. Our method's efficacy is demonstrated on the class-conditional ImageNet generation benchmark, where DiMR-XL variants outperform prior diffusion models, setting new state-of-the-art FID scores of 1.70 on ImageNet 256 x 256 and 2.89 on ImageNet 512 x 512. Project page: https://qihao067.github.io/projects/DiMR

Generating 3D images of complex objects conditionally from a few 2D views is a difficult synthesis problem, compounded by issues such as domain gap and geometric misalignment. For instance, a unified framework such as Generative Adversarial Networks cannot achieve this unless they explicitly define both a domain-invariant and geometric-invariant joint latent distribution, whereas Neural Radiance Fields are generally unable to handle both issues as they optimize at the pixel level. By contrast, we propose a simple and novel 2D to 3D synthesis approach based on conditional diffusion with vector-quantized codes. Operating in an information-rich code space enables high-resolution 3D synthesis via full-coverage attention across the views. Specifically, we generate the 3D codes (e.g. for CT images) conditional on previously generated 3D codes and the entire codebook of two 2D views (e.g. 2D X-rays). Qualitative and quantitative results demonstrate state-of-the-art performance over specialized methods across varied evaluation criteria, including fidelity metrics such as density, coverage, and distortion metrics for two complex volumetric imagery datasets from in real-world scenarios.

Sampling from diffusion probabilistic models (DPMs) is often expensive for high-quality image generation and typically requires many steps with a large model. In this paper, we introduce sampling Trajectory Stitching T-Stitch, a simple yet efficient technique to improve the sampling efficiency with little or no generation degradation. Instead of solely using a large DPM for the entire sampling trajectory, T-Stitch first leverages a smaller DPM in the initial steps as a cheap drop-in replacement of the larger DPM and switches to the larger DPM at a later stage. Our key insight is that different diffusion models learn similar encodings under the same training data distribution and smaller models are capable of generating good global structures in the early steps. Extensive experiments demonstrate that T-Stitch is training-free, generally applicable for different architectures, and complements most existing fast sampling techniques with flexible speed and quality trade-offs. On DiT-XL, for example, 40% of the early timesteps can be safely replaced with a 10x faster DiT-S without performance drop on class-conditional ImageNet generation. We further show that our method can also be used as a drop-in technique to not only accelerate the popular pretrained stable diffusion (SD) models but also improve the prompt alignment of stylized SD models from the public model zoo. Code is released at https://github.com/NVlabs/T-Stitch

Image registration is important for medical imaging, the estimation of the spatial transformation between different images. Many previous studies have used learning-based methods for coarse-to-fine registration to efficiently perform 3D image registration. The coarse-to-fine approach, however, is limited when dealing with the different motions of nearby objects. Here we propose a novel Motion-Aware (MA) structure that captures the different motions in a region. The MA structure incorporates a novel Residual Aligner (RA) module which predicts the multi-head displacement field used to disentangle the different motions of multiple neighbouring objects. Compared with other deep learning methods, the network based on the MA structure and RA module achieve one of the most accurate unsupervised inter-subject registration on the 9 organs of assorted sizes in abdominal CT scans, with the highest-ranked registration of the veins (Dice Similarity Coefficient / Average surface distance: 62\%/4.9mm for the vena cava and 34\%/7.9mm for the portal and splenic vein), with a half-sized structure and more efficient computation. Applied to the segmentation of lungs in chest CT scans, the new network achieves results which were indistinguishable from the best-ranked networks (94\%/3.0mm). Additionally, the theorem on predicted motion pattern and the design of MA structure are validated by further analysis.

The number of groups (g) in group convolution (GConv) is selected to boost the predictive performance of deep neural networks (DNNs) in a compute and parameter efficient manner. However, we show that naive selection of g in GConv creates an imbalance between the computational complexity and degree of data reuse, which leads to suboptimal energy efficiency in DNNs. We devise an optimum group size model, which enables a balance between computational cost and data movement cost, thus, optimize the energy-efficiency of DNNs. Based on the insights from this model, we propose an "energy-efficient group convolution" (E2GC) module where, unlike the previous implementations of GConv, the group size (G) remains constant. Further, to demonstrate the efficacy of the E2GC module, we incorporate this module in the design of MobileNet-V1 and ResNeXt-50 and perform experiments on two GPUs, P100 and P4000. We show that, at comparable computational complexity, DNNs with constant group size (E2GC) are more energy-efficient than DNNs with a fixed number of groups (FgGC). For example, on P100 GPU, the energy-efficiency of MobileNet-V1 and ResNeXt-50 is increased by 10.8% and 4.73% (respectively) when E2GC modules substitute the FgGC modules in both the DNNs. Furthermore, through our extensive experimentation with ImageNet-1K and Food-101 image classification datasets, we show that the E2GC module enables a trade-off between generalization ability and representational power of DNN. Thus, the predictive performance of DNNs can be optimized by selecting an appropriate G. The code and trained models are available at https://github.com/iithcandle/E2GC-release.

A diffusion model, which is formulated to produce an image using thousands of denoising steps, usually suffers from a slow inference speed. Existing acceleration algorithms simplify the sampling by skipping most steps yet exhibit considerable performance degradation. By viewing the generation of diffusion models as a discretized integrating process, we argue that the quality drop is partly caused by applying an inaccurate integral direction to a timestep interval. To rectify this issue, we propose a timestep aligner that helps find a more accurate integral direction for a particular interval at the minimum cost. Specifically, at each denoising step, we replace the original parameterization by conditioning the network on a new timestep, which is obtained by aligning the sampling distribution to the real distribution. Extensive experiments show that our plug-in design can be trained efficiently and boost the inference performance of various state-of-the-art acceleration methods, especially when there are few denoising steps. For example, when using 10 denoising steps on the popular LSUN Bedroom dataset, we improve the FID of DDIM from 9.65 to 6.07, simply by adopting our method for a more appropriate set of timesteps. Code will be made publicly available.

Convolution is the most time-consuming operation in deep neural network operations, so its performance is critical to the overall performance of the neural network. The commonly used methods for convolution on GPU include the general matrix multiplication (GEMM)-based convolution and the direct convolution. GEMM-based convolution relies on the im2col algorithm, which results in a large memory footprint and reduced performance. Direct convolution does not have the large memory footprint problem, but the performance is not on par with GEMM-based approach because of the discontinuous memory access. This paper proposes a window-order-based convolution paradigm on GPU, called im2win, which not only reduces memory footprint but also offers continuous memory accesses, resulting in improved performance. Furthermore, we apply a range of optimization techniques on the convolution CUDA kernel, including shared memory, tiling, micro-kernel, double buffer, and prefetching. We compare our implementation with the direct convolution, and PyTorch's GEMM-based convolution with cuBLAS and six cuDNN-based convolution implementations, with twelve state-of-the-art DNN benchmarks. The experimental results show that our implementation 1) uses less memory footprint by 23.1% and achieves 3.5times TFLOPS compared with cuBLAS, 2) uses less memory footprint by 32.8% and achieves up to 1.8times TFLOPS compared with the best performant convolutions in cuDNN, and 3) achieves up to 155times TFLOPS compared with the direct convolution. We further perform an ablation study on the applied optimization techniques and find that the micro-kernel has the greatest positive impact on performance.

This paper presents a new exploration into a category of diffusion models built upon state space architecture. We endeavor to train diffusion models for image data, wherein the traditional U-Net backbone is supplanted by a state space backbone, functioning on raw patches or latent space. Given its notable efficacy in accommodating long-range dependencies, Diffusion State Space Models (DiS) are distinguished by treating all inputs including time, condition, and noisy image patches as tokens. Our assessment of DiS encompasses both unconditional and class-conditional image generation scenarios, revealing that DiS exhibits comparable, if not superior, performance to CNN-based or Transformer-based U-Net architectures of commensurate size. Furthermore, we analyze the scalability of DiS, gauged by the forward pass complexity quantified in Gflops. DiS models with higher Gflops, achieved through augmentation of depth/width or augmentation of input tokens, consistently demonstrate lower FID. In addition to demonstrating commendable scalability characteristics, DiS-H/2 models in latent space achieve performance levels akin to prior diffusion models on class-conditional ImageNet benchmarks at the resolution of 256times256 and 512times512, while significantly reducing the computational burden. The code and models are available at: https://github.com/feizc/DiS.

Medical image analysis continues to hold interesting challenges given the subtle characteristics of certain diseases and the significant overlap in appearance between diseases. In this work, we explore the concept of self-attention for tackling such subtleties in and between diseases. To this end, we introduce MEDUSA, a multi-scale encoder-decoder self-attention mechanism tailored for medical image analysis. While self-attention deep convolutional neural network architectures in existing literature center around the notion of multiple isolated lightweight attention mechanisms with limited individual capacities being incorporated at different points in the network architecture, MEDUSA takes a significant departure from this notion by possessing a single, unified self-attention mechanism with significantly higher capacity with multiple attention heads feeding into different scales in the network architecture. To the best of the authors' knowledge, this is the first "single body, multi-scale heads" realization of self-attention and enables explicit global context amongst selective attention at different levels of representational abstractions while still enabling differing local attention context at individual levels of abstractions. With MEDUSA, we obtain state-of-the-art performance on multiple challenging medical image analysis benchmarks including COVIDx, RSNA RICORD, and RSNA Pneumonia Challenge when compared to previous work. Our MEDUSA model is publicly available.

Radiology report generation (RRG) is a challenging task, as it requires a thorough understanding of medical images, integration of multiple temporal inputs, and accurate report generation. Effective interpretation of medical images, such as chest X-rays (CXRs), demands sophisticated visual-language reasoning to map visual findings to structured reports. Recent studies have shown that multimodal large language models (MLLMs) can acquire multimodal capabilities by aligning with pre-trained vision encoders. However, current approaches predominantly focus on single-image analysis or utilise rule-based symbolic processing to handle multiple images, thereby overlooking the essential temporal information derived from comparing current images with prior ones. To overcome this critical limitation, we introduce Libra, a temporal-aware MLLM tailored for CXR report generation using temporal images. Libra integrates a radiology-specific image encoder with a MLLM and utilises a novel Temporal Alignment Connector to capture and synthesise temporal information of images across different time points with unprecedented precision. Extensive experiments show that Libra achieves new state-of-the-art performance among the same parameter scale MLLMs for RRG tasks on the MIMIC-CXR. Specifically, Libra improves the RadCliQ metric by 12.9% and makes substantial gains across all lexical metrics compared to previous models.

Convolutional neural networks (CNNs) have made resounding success in many computer vision tasks such as image classification and object detection. However, their performance degrades rapidly on tougher tasks where images are of low resolution or objects are small. In this paper, we point out that this roots in a defective yet common design in existing CNN architectures, namely the use of strided convolution and/or pooling layers, which results in a loss of fine-grained information and learning of less effective feature representations. To this end, we propose a new CNN building block called SPD-Conv in place of each strided convolution layer and each pooling layer (thus eliminates them altogether). SPD-Conv is comprised of a space-to-depth (SPD) layer followed by a non-strided convolution (Conv) layer, and can be applied in most if not all CNN architectures. We explain this new design under two most representative computer vision tasks: object detection and image classification. We then create new CNN architectures by applying SPD-Conv to YOLOv5 and ResNet, and empirically show that our approach significantly outperforms state-of-the-art deep learning models, especially on tougher tasks with low-resolution images and small objects. We have open-sourced our code at https://github.com/LabSAINT/SPD-Conv.

Accelerated magnetic resonance (MR) imaging attempts to reduce acquisition time by collecting data below the Nyquist rate. As an ill-posed inverse problem, many plausible solutions exist, yet the majority of deep learning approaches generate only a single solution. We instead focus on sampling from the posterior distribution, which provides more comprehensive information for downstream inference tasks. To do this, we design a novel conditional normalizing flow (CNF) that infers the signal component in the measurement operator's nullspace, which is later combined with measured data to form complete images. Using fastMRI brain and knee data, we demonstrate fast inference and accuracy that surpasses recent posterior sampling techniques for MRI. Code is available at https://github.com/jwen307/mri_cnf/

Interstitial lung diseases (ILD) present diagnostic challenges due to their varied manifestations and overlapping imaging features. To address this, we propose a machine learning approach that utilizes CLIP, a multimodal (image and text) self-supervised model, for ILD classification. We extensively integrate zero-shot CLIP throughout our workflow, starting from the initial extraction of image patches from volumetric CT scans and proceeding to ILD classification using "patch montages". Furthermore, we investigate how domain adaptive pretraining (DAPT) CLIP with task-specific images (CT "patch montages" extracted with ILD-specific prompts for CLIP) and/or text (lung-specific sections of radiology reports) affects downstream ILD classification performance. By leveraging CLIP-extracted "patch montages" and DAPT, we achieve strong zero-shot ILD classification results, including an AUROC of 0.893, without the need for any labeled training data. This work highlights the versatility and potential of multimodal models like CLIP for medical image classification tasks where labeled data is scarce.

Despite the ever-increasing interest in applying deep learning (DL) models to medical imaging, the typical scarcity and imbalance of medical datasets can severely impact the performance of DL models. The generation of synthetic data that might be freely shared without compromising patient privacy is a well-known technique for addressing these difficulties. Inpainting algorithms are a subset of DL generative models that can alter one or more regions of an input image while matching its surrounding context and, in certain cases, non-imaging input conditions. Although the majority of inpainting techniques for medical imaging data use generative adversarial networks (GANs), the performance of these algorithms is frequently suboptimal due to their limited output variety, a problem that is already well-known for GANs. Denoising diffusion probabilistic models (DDPMs) are a recently introduced family of generative networks that can generate results of comparable quality to GANs, but with diverse outputs. In this paper, we describe a DDPM to execute multiple inpainting tasks on 2D axial slices of brain MRI with various sequences, and present proof-of-concept examples of its performance in a variety of evaluation scenarios. Our model and a public online interface to try our tool are available at: https://github.com/Mayo-Radiology-Informatics-Lab/MBTI

In the domain of medical imaging, many supervised learning based methods for segmentation face several challenges such as high variability in annotations from multiple experts, paucity of labelled data and class imbalanced datasets. These issues may result in segmentations that lack the requisite precision for clinical analysis and can be misleadingly overconfident without associated uncertainty quantification. We propose the PULASki for biomedical image segmentation that accurately captures variability in expert annotations, even in small datasets. Our approach makes use of an improved loss function based on statistical distances in a conditional variational autoencoder structure (Probabilistic UNet), which improves learning of the conditional decoder compared to the standard cross-entropy particularly in class imbalanced problems. We analyse our method for two structurally different segmentation tasks (intracranial vessel and multiple sclerosis (MS) lesion) and compare our results to four well-established baselines in terms of quantitative metrics and qualitative output. Empirical results demonstrate the PULASKi method outperforms all baselines at the 5\% significance level. The generated segmentations are shown to be much more anatomically plausible than in the 2D case, particularly for the vessel task. Our method can also be applied to a wide range of multi-label segmentation tasks and and is useful for downstream tasks such as hemodynamic modelling (computational fluid dynamics and data assimilation), clinical decision making, and treatment planning.

Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs) stand as the two most popular foundation models for visual representation learning. While CNNs exhibit remarkable scalability with linear complexity w.r.t. image resolution, ViTs surpass them in fitting capabilities despite contending with quadratic complexity. A closer inspection reveals that ViTs achieve superior visual modeling performance through the incorporation of global receptive fields and dynamic weights. This observation motivates us to propose a novel architecture that inherits these components while enhancing computational efficiency. To this end, we draw inspiration from the recently introduced state space model and propose the Visual State Space Model (VMamba), which achieves linear complexity without sacrificing global receptive fields. To address the encountered direction-sensitive issue, we introduce the Cross-Scan Module (CSM) to traverse the spatial domain and convert any non-causal visual image into order patch sequences. Extensive experimental results substantiate that VMamba not only demonstrates promising capabilities across various visual perception tasks, but also exhibits more pronounced advantages over established benchmarks as the image resolution increases. Source code has been available at https://github.com/MzeroMiko/VMamba.

Learning visual representations of medical images (e.g., X-rays) is core to medical image understanding but its progress has been held back by the scarcity of human annotations. Existing work commonly relies on fine-tuning weights transferred from ImageNet pretraining, which is suboptimal due to drastically different image characteristics, or rule-based label extraction from the textual report data paired with medical images, which is inaccurate and hard to generalize. Meanwhile, several recent studies show exciting results from unsupervised contrastive learning from natural images, but we find these methods help little on medical images because of their high inter-class similarity. We propose ConVIRT, an alternative unsupervised strategy to learn medical visual representations by exploiting naturally occurring paired descriptive text. Our new method of pretraining medical image encoders with the paired text data via a bidirectional contrastive objective between the two modalities is domain-agnostic, and requires no additional expert input. We test ConVIRT by transferring our pretrained weights to 4 medical image classification tasks and 2 zero-shot retrieval tasks, and show that it leads to image representations that considerably outperform strong baselines in most settings. Notably, in all 4 classification tasks, our method requires only 10\% as much labeled training data as an ImageNet initialized counterpart to achieve better or comparable performance, demonstrating superior data efficiency.

To measure the difference between two probability distributions, referred to as the source and target, respectively, we exploit both the chain rule and Bayes' theorem to construct conditional transport (CT), which is constituted by both a forward component and a backward one. The forward CT is the expected cost of moving a source data point to a target one, with their joint distribution defined by the product of the source probability density function (PDF) and a source-dependent conditional distribution, which is related to the target PDF via Bayes' theorem. The backward CT is defined by reversing the direction. The CT cost can be approximated by replacing the source and target PDFs with their discrete empirical distributions supported on mini-batches, making it amenable to implicit distributions and stochastic gradient descent-based optimization. When applied to train a generative model, CT is shown to strike a good balance between mode-covering and mode-seeking behaviors and strongly resist mode collapse. On a wide variety of benchmark datasets for generative modeling, substituting the default statistical distance of an existing generative adversarial network with CT is shown to consistently improve the performance. PyTorch code is provided.

The objective of Radiology Report Generation (RRG) is to automatically generate coherent textual analyses of diseases based on radiological images, thereby alleviating the workload of radiologists. Current AI-based methods for RRG primarily focus on modifications to the encoder-decoder model architecture. To advance these approaches, this paper introduces an Organ-Regional Information Driven (ORID) framework which can effectively integrate multi-modal information and reduce the influence of noise from unrelated organs. Specifically, based on the LLaVA-Med, we first construct an RRG-related instruction dataset to improve organ-regional diagnosis description ability and get the LLaVA-Med-RRG. After that, we propose an organ-based cross-modal fusion module to effectively combine the information from the organ-regional diagnosis description and radiology image. To further reduce the influence of noise from unrelated organs on the radiology report generation, we introduce an organ importance coefficient analysis module, which leverages Graph Neural Network (GNN) to examine the interconnections of the cross-modal information of each organ region. Extensive experiments an1d comparisons with state-of-the-art methods across various evaluation metrics demonstrate the superior performance of our proposed method.

Domain generalization is critical for real-world applications of machine learning to microscopy images, including histopathology and fluorescence imaging. Artifacts in these modalities arise through a complex combination of factors relating to tissue collection and laboratory processing, as well as factors intrinsic to patient samples. In fluorescence imaging, these artifacts stem from variations across experimental batches. The complexity and subtlety of these artifacts make the enumeration of data domains intractable. Therefore, augmentation-based methods of domain generalization that require domain identifiers and manual fine-tuning are inadequate in this setting. To overcome this challenge, we introduce ContriMix, a domain generalization technique that learns to generate synthetic images by disentangling and permuting the biological content ("content") and technical variations ("attributes") in microscopy images. ContriMix does not rely on domain identifiers or handcrafted augmentations and makes no assumptions about the input characteristics of images. We assess the performance of ContriMix on two pathology datasets dealing with patch classification and Whole Slide Image label prediction tasks respectively (Camelyon17-WILDS and RCC subtyping), and one fluorescence microscopy dataset (RxRx1-WILDS). Without any access to domain identifiers at train or test time, ContriMix performs similar or better than current state-of-the-art methods in all these datasets, motivating its usage for microscopy image analysis in real-world settings where domain information is hard to come by. The code for ContriMix can be found at https://gitlab.com/huutan86/contrimix

Modular neural architectures are gaining increasing attention due to their powerful capability for generalization and sample-efficient adaptation to new domains. However, training modular models, particularly in the early stages, poses challenges due to the optimization difficulties arising from their intrinsic sparse connectivity. Leveraging the knowledge from monolithic models, using techniques such as knowledge distillation, is likely to facilitate the training of modular models and enable them to integrate knowledge from multiple models pretrained on diverse sources. Nevertheless, conventional knowledge distillation approaches are not tailored to modular models and can fail when directly applied due to the unique architectures and the enormous number of parameters involved. Motivated by these challenges, we propose a general module-to-module knowledge distillation (m2mKD) method for transferring knowledge between modules. Our approach involves teacher modules split from a pretrained monolithic model, and student modules of a modular model. m2mKD separately combines these modules with a shared meta model and encourages the student module to mimic the behaviour of the teacher module. We evaluate the effectiveness of m2mKD on two distinct modular neural architectures: Neural Attentive Circuits (NACs) and Vision Mixture-of-Experts (V-MoE). By applying m2mKD to NACs, we achieve significant improvements in IID accuracy on Tiny-ImageNet (up to 5.6%) and OOD robustness on Tiny-ImageNet-R (up to 4.2%). On average, we observe a 1% gain in both ImageNet and ImageNet-R. The V-MoE-Base model trained using m2mKD also achieves 3.5% higher accuracy than end-to-end training on ImageNet. The experimental results demonstrate that our method offers a promising solution for connecting modular networks with pretrained monolithic models. Code is available at https://github.com/kamanphoebe/m2mKD.

Efficiently quantifying renal structures can provide distinct spatial context and facilitate biomarker discovery for kidney morphology. However, the development and evaluation of the transformer model to segment the renal cortex, medulla, and collecting system remains challenging due to data inefficiency. Inspired by the hierarchical structures in vision transformer, we propose a novel method using a 3D block aggregation transformer for segmenting kidney components on contrast-enhanced CT scans. We construct the first cohort of renal substructures segmentation dataset with 116 subjects under institutional review board (IRB) approval. Our method yields the state-of-the-art performance (Dice of 0.8467) against the baseline approach of 0.8308 with the data-efficient design. The Pearson R achieves 0.9891 between the proposed method and manual standards and indicates the strong correlation and reproducibility for volumetric analysis. We extend the proposed method to the public KiTS dataset, the method leads to improved accuracy compared to transformer-based approaches. We show that the 3D block aggregation transformer can achieve local communication between sequence representations without modifying self-attention, and it can serve as an accurate and efficient quantification tool for characterizing renal structures.

Model-based reconstruction employing the time separation technique (TST) was found to improve dynamic perfusion imaging of the liver using C-arm cone-beam computed tomography (CBCT). To apply TST using prior knowledge extracted from CT perfusion data, the liver should be accurately segmented from the CT scans. Reconstructions of primary and model-based CBCT data need to be segmented for proper visualisation and interpretation of perfusion maps. This research proposes Turbolift learning, which trains a modified version of the multi-scale Attention UNet on different liver segmentation tasks serially, following the order of the trainings CT, CBCT, CBCT TST - making the previous trainings act as pre-training stages for the subsequent ones - addressing the problem of limited number of datasets for training. For the final task of liver segmentation from CBCT TST, the proposed method achieved an overall Dice scores of 0.874pm0.031 and 0.905pm0.007 in 6-fold and 4-fold cross-validation experiments, respectively - securing statistically significant improvements over the model, which was trained only for that task. Experiments revealed that Turbolift not only improves the overall performance of the model but also makes it robust against artefacts originating from the embolisation materials and truncation artefacts. Additionally, in-depth analyses confirmed the order of the segmentation tasks. This paper shows the potential of segmenting the liver from CT, CBCT, and CBCT TST, learning from the available limited training data, which can possibly be used in the future for the visualisation and evaluation of the perfusion maps for the treatment evaluation of liver diseases.

Recent advances in Vision Transformers (ViTs) have significantly enhanced medical image segmentation by facilitating the learning of global relationships. However, these methods face a notable challenge in capturing diverse local and global long-range sequential feature representations, particularly evident in whole-body CT (WBCT) scans. To overcome this limitation, we introduce Swin Soft Mixture Transformer (Swin SMT), a novel architecture based on Swin UNETR. This model incorporates a Soft Mixture-of-Experts (Soft MoE) to effectively handle complex and diverse long-range dependencies. The use of Soft MoE allows for scaling up model parameters maintaining a balance between computational complexity and segmentation performance in both training and inference modes. We evaluate Swin SMT on the publicly available TotalSegmentator-V2 dataset, which includes 117 major anatomical structures in WBCT images. Comprehensive experimental results demonstrate that Swin SMT outperforms several state-of-the-art methods in 3D anatomical structure segmentation, achieving an average Dice Similarity Coefficient of 85.09%. The code and pre-trained weights of Swin SMT are publicly available at https://github.com/MI2DataLab/SwinSMT.

Automated medical image analysis systems often require large amounts of training data with high quality labels, which are difficult and time consuming to generate. This paper introduces Radiology Object in COntext version 2 (ROCOv2), a multimodal dataset consisting of radiological images and associated medical concepts and captions extracted from the PMC Open Access subset. It is an updated version of the ROCO dataset published in 2018, and adds 35,705 new images added to PMC since 2018. It further provides manually curated concepts for imaging modalities with additional anatomical and directional concepts for X-rays. The dataset consists of 79,789 images and has been used, with minor modifications, in the concept detection and caption prediction tasks of ImageCLEFmedical Caption 2023. The dataset is suitable for training image annotation models based on image-caption pairs, or for multi-label image classification using Unified Medical Language System (UMLS) concepts provided with each image. In addition, it can serve for pre-training of medical domain models, and evaluation of deep learning models for multi-task learning.

Recent progress in weakly supervised object detection is featured by a combination of multiple instance detection networks (MIDN) and ordinal online refinement. However, with only image-level annotation, MIDN inevitably assigns high scores to some unexpected region proposals when generating pseudo labels. These inaccurate high-scoring region proposals will mislead the training of subsequent refinement modules and thus hamper the detection performance. In this work, we explore how to ameliorate the quality of pseudo-labeling in MIDN. Formally, we devise Cyclic-Bootstrap Labeling (CBL), a novel weakly supervised object detection pipeline, which optimizes MIDN with rank information from a reliable teacher network. Specifically, we obtain this teacher network by introducing a weighted exponential moving average strategy to take advantage of various refinement modules. A novel class-specific ranking distillation algorithm is proposed to leverage the output of weighted ensembled teacher network for distilling MIDN with rank information. As a result, MIDN is guided to assign higher scores to accurate proposals among their neighboring ones, thus benefiting the subsequent pseudo labeling. Extensive experiments on the prevalent PASCAL VOC 2007 \& 2012 and COCO datasets demonstrate the superior performance of our CBL framework. Code will be available at https://github.com/Yinyf0804/WSOD-CBL/.

Diffusion models are powerful generative models that simulate the reverse of diffusion processes using score functions to synthesize data from noise. The sampling process of diffusion models can be interpreted as solving the reverse stochastic differential equation (SDE) or the ordinary differential equation (ODE) of the diffusion process, which often requires up to thousands of discretization steps to generate a single image. This has sparked a great interest in developing efficient integration techniques for reverse-S/ODEs. Here, we propose an orthogonal approach to accelerating score-based sampling: Denoising MCMC (DMCMC). DMCMC first uses MCMC to produce samples in the product space of data and variance (or diffusion time). Then, a reverse-S/ODE integrator is used to denoise the MCMC samples. Since MCMC traverses close to the data manifold, the computation cost of producing a clean sample for DMCMC is much less than that of producing a clean sample from noise. To verify the proposed concept, we show that Denoising Langevin Gibbs (DLG), an instance of DMCMC, successfully accelerates all six reverse-S/ODE integrators considered in this work on the tasks of CIFAR10 and CelebA-HQ-256 image generation. Notably, combined with integrators of Karras et al. (2022) and pre-trained score models of Song et al. (2021b), DLG achieves SOTA results. In the limited number of score function evaluation (NFE) settings on CIFAR10, we have 3.86 FID with approx 10 NFE and 2.63 FID with approx 20 NFE. On CelebA-HQ-256, we have 6.99 FID with approx 160 NFE, which beats the current best record of Kim et al. (2022) among score-based models, 7.16 FID with 4000 NFE. Code: https://github.com/1202kbs/DMCMC

In the radiation therapy of nasopharyngeal carcinoma (NPC), clinicians typically delineate the gross tumor volume (GTV) using non-contrast planning computed tomography to ensure accurate radiation dose delivery. However, the low contrast between tumors and adjacent normal tissues necessitates that radiation oncologists manually delineate the tumors, often relying on diagnostic MRI for guidance. % In this study, we propose a novel approach to directly segment NPC gross tumors on non-contrast planning CT images, circumventing potential registration errors when aligning MRI or MRI-derived tumor masks to planning CT. To address the low contrast issues between tumors and adjacent normal structures in planning CT, we introduce a 3D Semantic Asymmetry Tumor segmentation (SATs) method. Specifically, we posit that a healthy nasopharyngeal region is characteristically bilaterally symmetric, whereas the emergence of nasopharyngeal carcinoma disrupts this symmetry. Then, we propose a Siamese contrastive learning segmentation framework that minimizes the voxel-wise distance between original and flipped areas without tumor and encourages a larger distance between original and flipped areas with tumor. Thus, our approach enhances the sensitivity of features to semantic asymmetries. % Extensive experiments demonstrate that the proposed SATs achieves the leading NPC GTV segmentation performance in both internal and external testing, e.g., with at least 2\% absolute Dice score improvement and 12\% average distance error reduction when compared to other state-of-the-art methods in the external testing.

Automated brain structure segmentation is important to many clinical quantitative analysis and diagnoses. In this work, we introduce MixNet, a 2D semantic-wise deep convolutional neural network to segment brain structure in multi-modality MRI images. The network is composed of our modified deep residual learning units. In the unit, we replace the traditional convolution layer with the dilated convolutional layer, which avoids the use of pooling layers and deconvolutional layers, reducing the number of network parameters. Final predictions are made by aggregating information from multiple scales and modalities. A pyramid pooling module is used to capture spatial information of the anatomical structures at the output end. In addition, we test three architectures (MixNetv1, MixNetv2 and MixNetv3) which fuse the modalities differently to see the effect on the results. Our network achieves the state-of-the-art performance. MixNetv2 was submitted to the MRBrainS challenge at MICCAI 2018 and won the 3rd place in the 3-label task. On the MRBrainS2018 dataset, which includes subjects with a variety of pathologies, the overall DSC (Dice Coefficient) of 84.7% (gray matter), 87.3% (white matter) and 83.4% (cerebrospinal fluid) were obtained with only 7 subjects as training data.

In this work, we present efficient modulation, a novel design for efficient vision networks. We revisit the modulation mechanism, which operates input through convolutional context modeling and feature projection layers, and fuses features via element-wise multiplication and an MLP block. We demonstrate that the modulation mechanism is particularly well suited for efficient networks and further tailor the modulation design by proposing the efficient modulation (EfficientMod) block, which is considered the essential building block for our networks. Benefiting from the prominent representational ability of modulation mechanism and the proposed efficient design, our network can accomplish better trade-offs between accuracy and efficiency and set new state-of-the-art performance in the zoo of efficient networks. When integrating EfficientMod with the vanilla self-attention block, we obtain the hybrid architecture which further improves the performance without loss of efficiency. We carry out comprehensive experiments to verify EfficientMod's performance. With fewer parameters, our EfficientMod-s performs 0.6 top-1 accuracy better than EfficientFormerV2-s2 and is 25% faster on GPU, and 2.9 better than MobileViTv2-1.0 at the same GPU latency. Additionally, our method presents a notable improvement in downstream tasks, outperforming EfficientFormerV2-s by 3.6 mIoU on the ADE20K benchmark. Code and checkpoints are available at https://github.com/ma-xu/EfficientMod.

Inverse of an invertible convolution is an important operation that comes up in Normalizing Flows, Image Deblurring, etc. The naive algorithm for backpropagation of this operation using Gaussian elimination has running time O(n^3) where n is the number of pixels in the image. We give a fast parallel backpropagation algorithm with running time O(n) for a square image and provide a GPU implementation of the same. Inverse Convolutions are usually used in Normalizing Flows in the sampling pass, making them slow. We propose to use Inverse Convolutions in the forward (image to latent vector) pass of the Normalizing flow. Since the sampling pass is the inverse of the forward pass, it will use convolutions only, resulting in efficient sampling times. We use our parallel backpropagation algorithm for optimizing the inverse convolution layer resulting in fast training times also. We implement this approach in various Normalizing Flow backbones, resulting in our Inverse-Flow models. We benchmark Inverse-Flow on standard datasets and show significantly improved sampling times with similar bits per dimension compared to previous models.

We propose focal modulation networks (FocalNets in short), where self-attention (SA) is completely replaced by a focal modulation mechanism for modeling token interactions in vision. Focal modulation comprises three components: (i) hierarchical contextualization, implemented using a stack of depth-wise convolutional layers, to encode visual contexts from short to long ranges, (ii) gated aggregation to selectively gather contexts for each query token based on its content, and (iii) element-wise modulation or affine transformation to inject the aggregated context into the query. Extensive experiments show FocalNets outperform the state-of-the-art SA counterparts (e.g., Swin and Focal Transformers) with similar computational costs on the tasks of image classification, object detection, and segmentation. Specifically, FocalNets with tiny and base size achieve 82.3% and 83.9% top-1 accuracy on ImageNet-1K. After pretrained on ImageNet-22K in 224 resolution, it attains 86.5% and 87.3% top-1 accuracy when finetuned with resolution 224 and 384, respectively. When transferred to downstream tasks, FocalNets exhibit clear superiority. For object detection with Mask R-CNN, FocalNet base trained with 1\times outperforms the Swin counterpart by 2.1 points and already surpasses Swin trained with 3\times schedule (49.0 v.s. 48.5). For semantic segmentation with UPerNet, FocalNet base at single-scale outperforms Swin by 2.4, and beats Swin at multi-scale (50.5 v.s. 49.7). Using large FocalNet and Mask2former, we achieve 58.5 mIoU for ADE20K semantic segmentation, and 57.9 PQ for COCO Panoptic Segmentation. Using huge FocalNet and DINO, we achieved 64.3 and 64.4 mAP on COCO minival and test-dev, respectively, establishing new SoTA on top of much larger attention-based models like Swinv2-G and BEIT-3. Code and checkpoints are available at https://github.com/microsoft/FocalNet.

Medical images and radiology reports are crucial for diagnosing medical conditions, highlighting the importance of quantitative analysis for clinical decision-making. However, the diversity and cross-source heterogeneity of these data challenge the generalizability of current data-mining methods. Multimodal large language models (MLLMs) have recently transformed many domains, significantly affecting the medical field. Notably, Gemini-Vision-series (Gemini) and GPT-4-series (GPT-4) models have epitomized a paradigm shift in Artificial General Intelligence (AGI) for computer vision, showcasing their potential in the biomedical domain. In this study, we evaluated the performance of the Gemini, GPT-4, and 4 popular large models for an exhaustive evaluation across 14 medical imaging datasets, including 5 medical imaging categories (dermatology, radiology, dentistry, ophthalmology, and endoscopy), and 3 radiology report datasets. The investigated tasks encompass disease classification, lesion segmentation, anatomical localization, disease diagnosis, report generation, and lesion detection. Our experimental results demonstrated that Gemini-series models excelled in report generation and lesion detection but faces challenges in disease classification and anatomical localization. Conversely, GPT-series models exhibited proficiency in lesion segmentation and anatomical localization but encountered difficulties in disease diagnosis and lesion detection. Additionally, both the Gemini series and GPT series contain models that have demonstrated commendable generation efficiency. While both models hold promise in reducing physician workload, alleviating pressure on limited healthcare resources, and fostering collaboration between clinical practitioners and artificial intelligence technologies, substantial enhancements and comprehensive validations remain imperative before clinical deployment.

In this paper, we present UNet++, a new, more powerful architecture for medical image segmentation. Our architecture is essentially a deeply-supervised encoder-decoder network where the encoder and decoder sub-networks are connected through a series of nested, dense skip pathways. The re-designed skip pathways aim at reducing the semantic gap between the feature maps of the encoder and decoder sub-networks. We argue that the optimizer would deal with an easier learning task when the feature maps from the decoder and encoder networks are semantically similar. We have evaluated UNet++ in comparison with U-Net and wide U-Net architectures across multiple medical image segmentation tasks: nodule segmentation in the low-dose CT scans of chest, nuclei segmentation in the microscopy images, liver segmentation in abdominal CT scans, and polyp segmentation in colonoscopy videos. Our experiments demonstrate that UNet++ with deep supervision achieves an average IoU gain of 3.9 and 3.4 points over U-Net and wide U-Net, respectively.

High-quality, large-scale data is essential for robust deep learning models in medical applications, particularly ultrasound image analysis. Diffusion models facilitate high-fidelity medical image generation, reducing the costs associated with acquiring and annotating new images. This paper utilizes recent vision-language models to produce diverse and realistic synthetic echocardiography image data, preserving key features of the original images guided by textual and semantic label maps. Specifically, we investigate three potential avenues: unconditional generation, generation guided by text, and a hybrid approach incorporating both textual and semantic supervision. We show that the rich contextual information present in the synthesized data potentially enhances the accuracy and interpretability of downstream tasks, such as echocardiography segmentation and classification with improved metrics and faster convergence. Our implementation with checkpoints, prompts, and the created synthetic dataset will be publicly available at https://github.com/Pooria90/DiffEcho{GitHub}.

The scarcity of annotations poses a significant challenge in medical image analysis. Large-scale pre-training has emerged as a promising label-efficient solution, owing to the utilization of large-scale data, large models, and advanced pre-training techniques. However, its development in medical images remains underexplored. The primary challenge lies in harnessing large-scale unlabeled data and learning high-level semantics without annotations. We observe that 3D medical images exhibit consistent geometric context, i.e., consistent geometric relations between different organs, which leads to a promising way for learning consistent representations. Motivated by this, we introduce a simple-yet-effective Volume Contrast (VoCo) framework to leverage geometric context priors for self-supervision. Given an input volume, we extract base crops from different regions to construct positive and negative pairs for contrastive learning. Then we predict the contextual position of a random crop by contrasting its similarity to the base crops. In this way, VoCo encodes the inherent geometric context into model representations, facilitating high-level semantic learning without annotations. Specifically, we (1) introduce the largest medical pre-training dataset PreCT-160K; (2) investigate scaling laws and propose guidelines for tailoring different model sizes to various medical tasks; (3) build a benchmark encompassing 48 medical tasks. Extensive experiments highlight the superiority of VoCo. Codes at https://github.com/Luffy03/Large-Scale-Medical.

Diffusion models have garnered significant interest from the community for their great generative ability across various applications. However, their typical multi-step sequential-denoising nature gives rise to high cumulative latency, thereby precluding the possibilities of parallel computation. To address this, we introduce AsyncDiff, a universal and plug-and-play acceleration scheme that enables model parallelism across multiple devices. Our approach divides the cumbersome noise prediction model into multiple components, assigning each to a different device. To break the dependency chain between these components, it transforms the conventional sequential denoising into an asynchronous process by exploiting the high similarity between hidden states in consecutive diffusion steps. Consequently, each component is facilitated to compute in parallel on separate devices. The proposed strategy significantly reduces inference latency while minimally impacting the generative quality. Specifically, for the Stable Diffusion v2.1, AsyncDiff achieves a 2.7x speedup with negligible degradation and a 4.0x speedup with only a slight reduction of 0.38 in CLIP Score, on four NVIDIA A5000 GPUs. Our experiments also demonstrate that AsyncDiff can be readily applied to video diffusion models with encouraging performances. The code is available at https://github.com/czg1225/AsyncDiff.

Whole slide image (WSI) analysis has become increasingly important in the medical imaging community, enabling automated and objective diagnosis, prognosis, and therapeutic-response prediction. However, in clinical practice, the ever-evolving environment hamper the utility of WSI analysis models. In this paper, we propose the FIRST continual learning framework for WSI analysis, named ConSlide, to tackle the challenges of enormous image size, utilization of hierarchical structure, and catastrophic forgetting by progressive model updating on multiple sequential datasets. Our framework contains three key components. The Hierarchical Interaction Transformer (HIT) is proposed to model and utilize the hierarchical structural knowledge of WSI. The Breakup-Reorganize (BuRo) rehearsal method is developed for WSI data replay with efficient region storing buffer and WSI reorganizing operation. The asynchronous updating mechanism is devised to encourage the network to learn generic and specific knowledge respectively during the replay stage, based on a nested cross-scale similarity learning (CSSL) module. We evaluated the proposed ConSlide on four public WSI datasets from TCGA projects. It performs best over other state-of-the-art methods with a fair WSI-based continual learning setting and achieves a better trade-off of the overall performance and forgetting on previous task

As convolution has empowered many smart applications, dynamic convolution further equips it with the ability to adapt to diverse inputs. However, the static and dynamic convolutions are either layout-agnostic or computation-heavy, making it inappropriate for layout-specific applications, e.g., face recognition and medical image segmentation. We observe that these applications naturally exhibit the characteristics of large intra-image (spatial) variance and small cross-image variance. This observation motivates our efficient translation variant convolution (TVConv) for layout-aware visual processing. Technically, TVConv is composed of affinity maps and a weight-generating block. While affinity maps depict pixel-paired relationships gracefully, the weight-generating block can be explicitly overparameterized for better training while maintaining efficient inference. Although conceptually simple, TVConv significantly improves the efficiency of the convolution and can be readily plugged into various network architectures. Extensive experiments on face recognition show that TVConv reduces the computational cost by up to 3.1x and improves the corresponding throughput by 2.3x while maintaining a high accuracy compared to the depthwise convolution. Moreover, for the same computation cost, we boost the mean accuracy by up to 4.21%. We also conduct experiments on the optic disc/cup segmentation task and obtain better generalization performance, which helps mitigate the critical data scarcity issue. Code is available at https://github.com/JierunChen/TVConv.

Purpose: To introduce a deep learning model capable of multi-organ segmentation in MRI scans, offering a solution to the current limitations in MRI analysis due to challenges in resolution, standardized intensity values, and variability in sequences. Materials and Methods: he model was trained on 1,200 manually annotated MRI scans from the UK Biobank, 221 in-house MRI scans and 1228 CT scans, leveraging cross-modality transfer learning from CT segmentation models. A human-in-the-loop annotation workflow was employed to efficiently create high-quality segmentations. The model's performance was evaluated on NAKO and the AMOS22 dataset containing 600 and 60 MRI examinations. Dice Similarity Coefficient (DSC) and Hausdorff Distance (HD) was used to assess segmentation accuracy. The model will be open sourced. Results: The model showcased high accuracy in segmenting well-defined organs, achieving Dice Similarity Coefficient (DSC) scores of 0.97 for the right and left lungs, and 0.95 for the heart. It also demonstrated robustness in organs like the liver (DSC: 0.96) and kidneys (DSC: 0.95 left, 0.95 right), which present more variability. However, segmentation of smaller and complex structures such as the portal and splenic veins (DSC: 0.54) and adrenal glands (DSC: 0.65 left, 0.61 right) revealed the need for further model optimization. Conclusion: The proposed model is a robust, tool for accurate segmentation of 40 anatomical structures in MRI and CT images. By leveraging cross-modality learning and interactive annotation, the model achieves strong performance and generalizability across diverse datasets, making it a valuable resource for researchers and clinicians. It is open source and can be downloaded from https://github.com/hhaentze/MRSegmentator.

Foundation models have revolutionized computer vision by achieving vastly superior performance across diverse tasks through large-scale pretraining on extensive datasets. However, their application in surgical computer vision has been limited. This study addresses this gap by introducing SurgeNetXL, a novel surgical foundation model that sets a new benchmark in surgical computer vision. Trained on the largest reported surgical dataset to date, comprising over 4.7 million video frames, SurgeNetXL achieves consistent top-tier performance across six datasets spanning four surgical procedures and three tasks, including semantic segmentation, phase recognition, and critical view of safety (CVS) classification. Compared with the best-performing surgical foundation models, SurgeNetXL shows mean improvements of 2.4, 9.0, and 12.6 percent for semantic segmentation, phase recognition, and CVS classification, respectively. Additionally, SurgeNetXL outperforms the best-performing ImageNet-based variants by 14.4, 4.0, and 1.6 percent in the respective tasks. In addition to advancing model performance, this study provides key insights into scaling pretraining datasets, extending training durations, and optimizing model architectures specifically for surgical computer vision. These findings pave the way for improved generalizability and robustness in data-scarce scenarios, offering a comprehensive framework for future research in this domain. All models and a subset of the SurgeNetXL dataset, including over 2 million video frames, are publicly available at: https://github.com/TimJaspers0801/SurgeNet.

In this work, we investigate the capability of generating images from pre-trained diffusion models at much higher resolutions than the training image sizes. In addition, the generated images should have arbitrary image aspect ratios. When generating images directly at a higher resolution, 1024 x 1024, with the pre-trained Stable Diffusion using training images of resolution 512 x 512, we observe persistent problems of object repetition and unreasonable object structures. Existing works for higher-resolution generation, such as attention-based and joint-diffusion approaches, cannot well address these issues. As a new perspective, we examine the structural components of the U-Net in diffusion models and identify the crucial cause as the limited perception field of convolutional kernels. Based on this key observation, we propose a simple yet effective re-dilation that can dynamically adjust the convolutional perception field during inference. We further propose the dispersed convolution and noise-damped classifier-free guidance, which can enable ultra-high-resolution image generation (e.g., 4096 x 4096). Notably, our approach does not require any training or optimization. Extensive experiments demonstrate that our approach can address the repetition issue well and achieve state-of-the-art performance on higher-resolution image synthesis, especially in texture details. Our work also suggests that a pre-trained diffusion model trained on low-resolution images can be directly used for high-resolution visual generation without further tuning, which may provide insights for future research on ultra-high-resolution image and video synthesis.

Deep learning is currently the state-of-the-art for automated detection of referable diabetic retinopathy (DR) from color fundus photographs (CFP). While the general interest is put on improving results through methodological innovations, it is not clear how good these approaches perform compared to standard deep classification models trained with the appropriate settings. In this paper we propose to model a strong baseline for this task based on a simple and standard ResNet-18 architecture. To this end, we built on top of prior art by training the model with a standard preprocessing strategy but using images from several public sources and an empirically calibrated data augmentation setting. To evaluate its performance, we covered multiple clinically relevant perspectives, including image and patient level DR screening, discriminating responses by input quality and DR grade, assessing model uncertainties and analyzing its results in a qualitative manner. With no other methodological innovation than a carefully designed training, our ResNet model achieved an AUC = 0.955 (0.953 - 0.956) on a combined test set of 61007 test images from different public datasets, which is in line or even better than what other more complex deep learning models reported in the literature. Similar AUC values were obtained in 480 images from two separate in-house databases specially prepared for this study, which emphasize its generalization ability. This confirms that standard networks can still be strong baselines for this task if properly trained.

Feature pyramid networks (FPN) are widely exploited for multi-scale feature fusion in existing advanced object detection frameworks. Numerous previous works have developed various structures for bidirectional feature fusion, all of which are shown to improve the detection performance effectively. We observe that these complicated network structures require feature pyramids to be stacked in a fixed order, which introduces longer pipelines and reduces the inference speed. Moreover, semantics from non-adjacent levels are diluted in the feature pyramid since only features at adjacent pyramid levels are merged by the local fusion operation in a sequence manner. To address these issues, we propose a novel architecture named RCNet, which consists of Reverse Feature Pyramid (RevFP) and Cross-scale Shift Network (CSN). RevFP utilizes local bidirectional feature fusion to simplify the bidirectional pyramid inference pipeline. CSN directly propagates representations to both adjacent and non-adjacent levels to enable multi-scale features more correlative. Extensive experiments on the MS COCO dataset demonstrate RCNet can consistently bring significant improvements over both one-stage and two-stage detectors with subtle extra computational overhead. In particular, RetinaNet is boosted to 40.2 AP, which is 3.7 points higher than baseline, by replacing FPN with our proposed model. On COCO test-dev, RCNet can achieve very competitive performance with a single-model single-scale 50.5 AP. Codes will be made available.

Transforming two-dimensional (2D) images into three-dimensional (3D) volumes is a well-known yet challenging problem for the computer vision community. In the medical domain, a few previous studies attempted to convert two or more input radiographs into computed tomography (CT) volumes. Following their effort, we introduce a diffusion model-based technology that can rotate the anatomical content of any input radiograph in 3D space, potentially enabling the visualization of the entire anatomical content of the radiograph from any viewpoint in 3D. Similar to previous studies, we used CT volumes to create Digitally Reconstructed Radiographs (DRRs) as the training data for our model. However, we addressed two significant limitations encountered in previous studies: 1. We utilized conditional diffusion models with classifier-free guidance instead of Generative Adversarial Networks (GANs) to achieve higher mode coverage and improved output image quality, with the only trade-off being slower inference time, which is often less critical in medical applications; and 2. We demonstrated that the unreliable output of style transfer deep learning (DL) models, such as Cycle-GAN, to transfer the style of actual radiographs to DRRs could be replaced with a simple yet effective training transformation that randomly changes the pixel intensity histograms of the input and ground-truth imaging data during training. This transformation makes the diffusion model agnostic to any distribution variations of the input data pixel intensity, enabling the reliable training of a DL model on input DRRs and applying the exact same model to conventional radiographs (or DRRs) during inference.

Consistency Training (CT) has recently emerged as a promising alternative to diffusion models, achieving competitive performance in image generation tasks. However, non-distillation consistency training often suffers from high variance and instability, and analyzing and improving its training dynamics is an active area of research. In this work, we propose a novel CT training approach based on the Flow Matching framework. Our main contribution is a trained noise-coupling scheme inspired by the architecture of Variational Autoencoders (VAE). By training a data-dependent noise emission model implemented as an encoder architecture, our method can indirectly learn the geometry of the noise-to-data mapping, which is instead fixed by the choice of the forward process in classical CT. Empirical results across diverse image datasets show significant generative improvements, with our model outperforming baselines and achieving the state-of-the-art (SoTA) non-distillation CT FID on CIFAR-10, and attaining FID on par with SoTA on ImageNet at 64 times 64 resolution in 2-step generation. Our code is available at https://github.com/sony/vct .

Many approaches such as Quine-McCluskey algorithm, Karnaugh map solving, Petrick's method and McBoole's method have been devised to simplify Boolean expressions in order to optimize hardware implementation of digital circuits. However, the algorithmic implementations of these methods are hard-coded and also their computation time is proportional to the number of minterms involved in the expression. In this paper, we propose KarNet, where the ability of Convolutional Neural Networks to model relationships between various cell locations and values by capturing spatial dependencies is exploited to solve Karnaugh maps. In order to do so, a Karnaugh map is represented as an image signal, where each cell is considered as a pixel. Experimental results show that the computation time of KarNet is independent of the number of minterms and is of the order of one-hundredth to one-tenth that of the rule-based methods. KarNet being a learned system is found to achieve nearly a hundred percent accuracy, precision, and recall. We train KarNet to solve four variable Karnaugh maps and also show that a similar method can be applied on Karnaugh maps with more variables. Finally, we show a way to build a fully accurate and computationally fast system using KarNet.

As lung cancer evolves, the presence of enlarged and potentially malignant lymph nodes must be assessed to properly estimate disease progression and select the best treatment strategy. Following the clinical guidelines, estimation of short-axis diameter and mediastinum station are paramount for correct diagnosis. A method for accurate and automatic segmentation is hence decisive for quantitatively describing lymph nodes. In this study, the use of 3D convolutional neural networks, either through slab-wise schemes or the leveraging of downsampled entire volumes, is investigated. Furthermore, the potential impact from simple ensemble strategies is considered. As lymph nodes have similar attenuation values to nearby anatomical structures, we suggest using the knowledge of other organs as prior information to guide the segmentation task. To assess the segmentation and instance detection performances, a 5-fold cross-validation strategy was followed over a dataset of 120 contrast-enhanced CT volumes. For the 1178 lymph nodes with a short-axis diameter geq10 mm, our best performing approach reached a patient-wise recall of 92%, a false positive per patient ratio of 5, and a segmentation overlap of 80.5%. The method performs similarly well across all stations. Fusing a slab-wise and a full volume approach within an ensemble scheme generated the best performances. The anatomical priors guiding strategy is promising, yet a larger set than four organs appears needed to generate an optimal benefit. A larger dataset is also mandatory, given the wide range of expressions a lymph node can exhibit (i.e., shape, location, and attenuation), and contrast uptake variations.

Contrastive learning based vision-language joint pre-training has emerged as a successful representation learning strategy. In this paper, we present a prototype representation learning framework incorporating both global and local alignment between medical images and reports. In contrast to standard global multi-modality alignment methods, we employ a local alignment module for fine-grained representation. Furthermore, a cross-modality conditional reconstruction module is designed to interchange information across modalities in the training phase by reconstructing masked images and reports. For reconstructing long reports, a sentence-wise prototype memory bank is constructed, enabling the network to focus on low-level localized visual and high-level clinical linguistic features. Additionally, a non-auto-regressive generation paradigm is proposed for reconstructing non-sequential reports. Experimental results on five downstream tasks, including supervised classification, zero-shot classification, image-to-text retrieval, semantic segmentation, and object detection, show the proposed method outperforms other state-of-the-art methods across multiple datasets and under different dataset size settings. The code is available at https://github.com/QtacierP/PRIOR.

Multiparametric magnetic resonance imaging (mpMRI) has demonstrated promising results in prostate cancer (PCa) detection using deep convolutional neural networks (CNNs). Recently, transformers have achieved competitive performance compared to CNNs in computer vision. Large-scale transformers need abundant annotated data for training, which are difficult to obtain in medical imaging. Self-supervised learning can effectively leverage unlabeled data to extract useful semantic representations without annotation and its associated costs. This can improve model performance on downstream tasks with limited labelled data and increase generalizability. We introduce a novel end-to-end Cross-Shaped windows (CSwin) transformer UNet model, CSwin UNet, to detect clinically significant prostate cancer (csPCa) in prostate bi-parametric MR imaging (bpMRI) and demonstrate the effectiveness of our proposed self-supervised pre-training framework. Using a large prostate bpMRI dataset with 1500 patients, we first pre-train CSwin transformer using multi-task self-supervised learning to improve data-efficiency and network generalizability. We then finetuned using lesion annotations to perform csPCa detection. Five-fold cross validation shows that self-supervised CSwin UNet achieves 0.888 AUC and 0.545 Average Precision (AP), significantly outperforming four state-of-the-art models (Swin UNETR, DynUNet, Attention UNet, UNet). Using a separate bpMRI dataset with 158 patients, we evaluated our model robustness to external hold-out data. Self-supervised CSwin UNet achieves 0.79 AUC and 0.45 AP, still outperforming all other comparable methods and demonstrating generalization to a dataset shift.

Coronary microvascular disease constitutes a substantial risk to human health. Employing computer-aided analysis and diagnostic systems, medical professionals can intervene early in disease progression, with 3D vessel segmentation serving as a crucial component. Nevertheless, conventional U-Net architectures tend to yield incoherent and imprecise segmentation outcomes, particularly for small vessel structures. While models with attention mechanisms, such as Transformers and large convolutional kernels, demonstrate superior performance, their extensive computational demands during training and inference lead to increased time complexity. In this study, we leverage Fourier domain learning as a substitute for multi-scale convolutional kernels in 3D hierarchical segmentation models, which can reduce computational expenses while preserving global receptive fields within the network. Furthermore, a zero-parameter frequency domain fusion method is designed to improve the skip connections in U-Net architecture. Experimental results on a public dataset and an in-house dataset indicate that our novel Fourier transformation-based network achieves remarkable dice performance (84.37\% on ASACA500 and 80.32\% on ImageCAS) in tubular vessel segmentation tasks and substantially reduces computational requirements without compromising global receptive fields.

We present OCTCube-M, a 3D OCT-based multi-modal foundation model for jointly analyzing OCT and en face images. OCTCube-M first developed OCTCube, a 3D foundation model pre-trained on 26,685 3D OCT volumes encompassing 1.62 million 2D OCT images. It then exploits a novel multi-modal contrastive learning framework COEP to integrate other retinal imaging modalities, such as fundus autofluorescence and infrared retinal imaging, into OCTCube, efficiently extending it into multi-modal foundation models. OCTCube achieves best performance on predicting 8 retinal diseases, demonstrating strong generalizability on cross-cohort, cross-device and cross-modality prediction. OCTCube can also predict cross-organ nodule malignancy (CT) and low cardiac ejection fraction as well as systemic diseases, such as diabetes and hypertension, revealing its wide applicability beyond retinal diseases. We further develop OCTCube-IR using COEP with 26,685 OCT and IR image pairs. OCTCube-IR can accurately retrieve between OCT and IR images, allowing joint analysis between 3D and 2D retinal imaging modalities. Finally, we trained a tri-modal foundation model OCTCube-EF from 4 million 2D OCT images and 400K en face retinal images. OCTCube-EF attains the best performance on predicting the growth rate of geographic atrophy (GA) across datasets collected from 6 multi-center global trials conducted in 23 countries. This improvement is statistically equivalent to running a clinical trial with more than double the size of the original study. Our analysis based on another retrospective case study reveals OCTCube-EF's ability to avoid false positive Phase-III results according to its accurate treatment effect estimation on the Phase-II results. In sum, OCTCube-M is a 3D multi-modal foundation model framework that integrates OCT and other retinal imaging modalities revealing substantial diagnostic and prognostic benefits.

Diffusion models have shown remarkable performance in image generation in recent years. However, due to a quadratic increase in memory during generating ultra-high-resolution images (e.g. 4096*4096), the resolution of generated images is often limited to 1024*1024. In this work. we propose a unidirectional block attention mechanism that can adaptively adjust the memory overhead during the inference process and handle global dependencies. Building on this module, we adopt the DiT structure for upsampling and develop an infinite super-resolution model capable of upsampling images of various shapes and resolutions. Comprehensive experiments show that our model achieves SOTA performance in generating ultra-high-resolution images in both machine and human evaluation. Compared to commonly used UNet structures, our model can save more than 5x memory when generating 4096*4096 images. The project URL is https://github.com/THUDM/Inf-DiT.

Precise image segmentation provides clinical study with meaningful and well-structured information. Despite the remarkable progress achieved in medical image segmentation, there is still an absence of foundation segmentation model that can segment a wide range of anatomical categories with easy user interaction. In this paper, we propose a universal and interactive volumetric medical image segmentation model, named SegVol. By training on 90k unlabeled Computed Tomography (CT) volumes and 6k labeled CTs, this foundation model supports the segmentation of over 200 anatomical categories using semantic and spatial prompts. Extensive experiments verify that SegVol outperforms the state of the art by a large margin on multiple segmentation benchmarks. Notably, on three challenging lesion datasets, our method achieves around 20% higher Dice score than nnU-Net. The model and data are publicly available at: https://github.com/BAAI-DCAI/SegVol.

Learning medical visual representations directly from paired radiology reports has become an emerging topic in representation learning. However, existing medical image-text joint learning methods are limited by instance or local supervision analysis, ignoring disease-level semantic correspondences. In this paper, we present a novel Multi-Granularity Cross-modal Alignment (MGCA) framework for generalized medical visual representation learning by harnessing the naturally exhibited semantic correspondences between medical image and radiology reports at three different levels, i.e., pathological region-level, instance-level, and disease-level. Specifically, we first incorporate the instance-wise alignment module by maximizing the agreement between image-report pairs. Further, for token-wise alignment, we introduce a bidirectional cross-attention strategy to explicitly learn the matching between fine-grained visual tokens and text tokens, followed by contrastive learning to align them. More important, to leverage the high-level inter-subject relationship semantic (e.g., disease) correspondences, we design a novel cross-modal disease-level alignment paradigm to enforce the cross-modal cluster assignment consistency. Extensive experimental results on seven downstream medical image datasets covering image classification, object detection, and semantic segmentation tasks demonstrate the stable and superior performance of our framework.

Existing domain adaptation (DA) methods often involve pre-training on the source domain and fine-tuning on the target domain. For multi-target domain adaptation, having a dedicated/separate fine-tuned network for each target domain, that retain all the pre-trained model parameters, is prohibitively expensive. To address this limitation, we propose Convolutional Low-Rank Adaptation (ConvLoRA). ConvLoRA freezes pre-trained model weights, adds trainable low-rank decomposition matrices to convolutional layers, and backpropagates the gradient through these matrices thus greatly reducing the number of trainable parameters. To further boost adaptation, we utilize Adaptive Batch Normalization (AdaBN) which computes target-specific running statistics and use it along with ConvLoRA. Our method has fewer trainable parameters and performs better or on-par with large independent fine-tuned networks (with less than 0.9% trainable parameters of the total base model) when tested on the segmentation of Calgary-Campinas dataset containing brain MRI images. Our approach is simple, yet effective and can be applied to any deep learning-based architecture which uses convolutional and batch normalization layers. Code is available at: https://github.com/aleemsidra/ConvLoRA.

Next-Token Prediction (NTP) is a de facto approach for autoregressive (AR) video generation, but it suffers from suboptimal unidirectional dependencies and slow inference speed. In this work, we propose a semi-autoregressive (semi-AR) framework, called Next-Block Prediction (NBP), for video generation. By uniformly decomposing video content into equal-sized blocks (e.g., rows or frames), we shift the generation unit from individual tokens to blocks, allowing each token in the current block to simultaneously predict the corresponding token in the next block. Unlike traditional AR modeling, our framework employs bidirectional attention within each block, enabling tokens to capture more robust spatial dependencies. By predicting multiple tokens in parallel, NBP models significantly reduce the number of generation steps, leading to faster and more efficient inference. Our model achieves FVD scores of 103.3 on UCF101 and 25.5 on K600, outperforming the vanilla NTP model by an average of 4.4. Furthermore, thanks to the reduced number of inference steps, the NBP model generates 8.89 frames (128x128 resolution) per second, achieving an 11x speedup. We also explored model scales ranging from 700M to 3B parameters, observing significant improvements in generation quality, with FVD scores dropping from 103.3 to 55.3 on UCF101 and from 25.5 to 19.5 on K600, demonstrating the scalability of our approach.

Segmentation of the coronary artery is an important task for the quantitative analysis of coronary computed tomography angiography (CCTA) images and is being stimulated by the field of deep learning. However, the complex structures with tiny and narrow branches of the coronary artery bring it a great challenge. Coupled with the medical image limitations of low resolution and poor contrast, fragmentations of segmented vessels frequently occur in the prediction. Therefore, a geometry-based cascaded segmentation method is proposed for the coronary artery, which has the following innovations: 1) Integrating geometric deformation networks, we design a cascaded network for segmenting the coronary artery and vectorizing results. The generated meshes of the coronary artery are continuous and accurate for twisted and sophisticated coronary artery structures, without fragmentations. 2) Different from mesh annotations generated by the traditional marching cube method from voxel-based labels, a finer vectorized mesh of the coronary artery is reconstructed with the regularized morphology. The novel mesh annotation benefits the geometry-based segmentation network, avoiding bifurcation adhesion and point cloud dispersion in intricate branches. 3) A dataset named CCA-200 is collected, consisting of 200 CCTA images with coronary artery disease. The ground truths of 200 cases are coronary internal diameter annotations by professional radiologists. Extensive experiments verify our method on our collected dataset CCA-200 and public ASOCA dataset, with a Dice of 0.778 on CCA-200 and 0.895 on ASOCA, showing superior results. Especially, our geometry-based model generates an accurate, intact and smooth coronary artery, devoid of any fragmentations of segmented vessels.

Even though convolutional neural networks (CNNs) are driving progress in medical image segmentation, standard models still have some drawbacks. First, the use of multi-scale approaches, i.e., encoder-decoder architectures, leads to a redundant use of information, where similar low-level features are extracted multiple times at multiple scales. Second, long-range feature dependencies are not efficiently modeled, resulting in non-optimal discriminative feature representations associated with each semantic class. In this paper we attempt to overcome these limitations with the proposed architecture, by capturing richer contextual dependencies based on the use of guided self-attention mechanisms. This approach is able to integrate local features with their corresponding global dependencies, as well as highlight interdependent channel maps in an adaptive manner. Further, the additional loss between different modules guides the attention mechanisms to neglect irrelevant information and focus on more discriminant regions of the image by emphasizing relevant feature associations. We evaluate the proposed model in the context of semantic segmentation on three different datasets: abdominal organs, cardiovascular structures and brain tumors. A series of ablation experiments support the importance of these attention modules in the proposed architecture. In addition, compared to other state-of-the-art segmentation networks our model yields better segmentation performance, increasing the accuracy of the predictions while reducing the standard deviation. This demonstrates the efficiency of our approach to generate precise and reliable automatic segmentations of medical images. Our code is made publicly available at https://github.com/sinAshish/Multi-Scale-Attention

Denoising Diffusion Probabilistic Models (DDPMs) can generate high-quality samples such as image and audio samples. However, DDPMs require hundreds to thousands of iterations to produce final samples. Several prior works have successfully accelerated DDPMs through adjusting the variance schedule (e.g., Improved Denoising Diffusion Probabilistic Models) or the denoising equation (e.g., Denoising Diffusion Implicit Models (DDIMs)). However, these acceleration methods cannot maintain the quality of samples and even introduce new noise at a high speedup rate, which limit their practicability. To accelerate the inference process while keeping the sample quality, we provide a fresh perspective that DDPMs should be treated as solving differential equations on manifolds. Under such a perspective, we propose pseudo numerical methods for diffusion models (PNDMs). Specifically, we figure out how to solve differential equations on manifolds and show that DDIMs are simple cases of pseudo numerical methods. We change several classical numerical methods to corresponding pseudo numerical methods and find that the pseudo linear multi-step method is the best in most situations. According to our experiments, by directly using pre-trained models on Cifar10, CelebA and LSUN, PNDMs can generate higher quality synthetic images with only 50 steps compared with 1000-step DDIMs (20x speedup), significantly outperform DDIMs with 250 steps (by around 0.4 in FID) and have good generalization on different variance schedules. Our implementation is available at https://github.com/luping-liu/PNDM.

Effectively modeling long spatiotemporal sequences is challenging due to the need to model complex spatial correlations and long-range temporal dependencies simultaneously. ConvLSTMs attempt to address this by updating tensor-valued states with recurrent neural networks, but their sequential computation makes them slow to train. In contrast, Transformers can process an entire spatiotemporal sequence, compressed into tokens, in parallel. However, the cost of attention scales quadratically in length, limiting their scalability to longer sequences. Here, we address the challenges of prior methods and introduce convolutional state space models (ConvSSM) that combine the tensor modeling ideas of ConvLSTM with the long sequence modeling approaches of state space methods such as S4 and S5. First, we demonstrate how parallel scans can be applied to convolutional recurrences to achieve subquadratic parallelization and fast autoregressive generation. We then establish an equivalence between the dynamics of ConvSSMs and SSMs, which motivates parameterization and initialization strategies for modeling long-range dependencies. The result is ConvS5, an efficient ConvSSM variant for long-range spatiotemporal modeling. ConvS5 significantly outperforms Transformers and ConvLSTM on a long horizon Moving-MNIST experiment while training 3X faster than ConvLSTM and generating samples 400X faster than Transformers. In addition, ConvS5 matches or exceeds the performance of state-of-the-art methods on challenging DMLab, Minecraft and Habitat prediction benchmarks and enables new directions for modeling long spatiotemporal sequences.

Convolution models with long filters have demonstrated state-of-the-art reasoning abilities in many long-sequence tasks but lag behind the most optimized Transformers in wall-clock time. A major bottleneck is the Fast Fourier Transform (FFT)--which allows long convolutions to run in O(N logN) time in sequence length N but has poor hardware utilization. In this paper, we study how to optimize the FFT convolution. We find two key bottlenecks: the FFT does not effectively use specialized matrix multiply units, and it incurs expensive I/O between layers of the memory hierarchy. In response, we propose FlashFFTConv. FlashFFTConv uses a matrix decomposition that computes the FFT using matrix multiply units and enables kernel fusion for long sequences, reducing I/O. We also present two sparse convolution algorithms--1) partial convolutions and 2) frequency-sparse convolutions--which can be implemented simply by skipping blocks in the matrix decomposition, enabling further opportunities for memory and compute savings. FlashFFTConv speeds up exact FFT convolutions by up to 7.93times over PyTorch and achieves up to 4.4times speedup end-to-end. Given the same compute budget, FlashFFTConv allows Hyena-GPT-s to achieve 2.3 points better perplexity on the PILE and M2-BERT-base to achieve 3.3 points higher GLUE score--matching models with twice the parameter count. FlashFFTConv also achieves 96.1% accuracy on Path-512, a high-resolution vision task where no model had previously achieved better than 50%. Furthermore, partial convolutions enable longer-sequence models--yielding the first DNA model that can process the longest human genes (2.3M base pairs)--and frequency-sparse convolutions speed up pretrained models while maintaining or improving model quality.

The Segment Anything Model (SAM) has demonstrated outstanding adaptation to medical image segmentation but still faces three major challenges. Firstly, the huge computational costs of SAM limit its real-world applicability. Secondly, SAM depends on manual annotations (e.g., points, boxes) as prompts, which are laborious and impractical in clinical scenarios. Thirdly, SAM handles all segmentation targets equally, which is suboptimal for diverse medical modalities with inherent heterogeneity. To address these issues, we propose an Efficient Self-Prompting SAM for universal medical image segmentation, named ESP-MedSAM. We devise a Multi-Modal Decoupled Knowledge Distillation (MMDKD) strategy to distil common image knowledge and domain-specific medical knowledge from the foundation model to train a lightweight image encoder and a modality controller. Further, they combine with the additionally introduced Self-Patch Prompt Generator (SPPG) and Query-Decoupled Modality Decoder (QDMD) to construct ESP-MedSAM. Specifically, SPPG aims to generate a set of patch prompts automatically and QDMD leverages a one-to-one strategy to provide an independent decoding channel for every modality. Extensive experiments indicate that ESP-MedSAM outperforms state-of-the-arts in diverse medical imaging segmentation takes, displaying superior zero-shot learning and modality transfer ability. Especially, our framework uses only 31.4% parameters compared to SAM-Base.

Face video restoration (FVR) is a challenging but important problem where one seeks to recover a perceptually realistic face videos from a low-quality input. While diffusion probabilistic models (DPMs) have been shown to achieve remarkable performance for face image restoration, they often fail to preserve temporally coherent, high-quality videos, compromising the fidelity of reconstructed faces. We present a new conditional diffusion framework called FLAIR for FVR. FLAIR ensures temporal consistency across frames in a computationally efficient fashion by converting a traditional image DPM into a video DPM. The proposed conversion uses a recurrent video refinement layer and a temporal self-attention at different scales. FLAIR also uses a conditional iterative refinement process to balance the perceptual and distortion quality during inference. This process consists of two key components: a data-consistency module that analytically ensures that the generated video precisely matches its degraded observation and a coarse-to-fine image enhancement module specifically for facial regions. Our extensive experiments show superiority of FLAIR over the current state-of-the-art (SOTA) for video super-resolution, deblurring, JPEG restoration, and space-time frame interpolation on two high-quality face video datasets.

The self-attention mechanism utilizes large implicit weight matrices, programmed through dot product-based activations with very few trainable parameters, to enable long sequence modeling. In this paper, we investigate the possibility of discarding residual learning by employing large implicit kernels to achieve full context interaction at each layer of the network. To accomplish it, we introduce coordinate-based implicit MLPs as a slow network to generate hyper-kernels for another fast convolutional network. To get context-varying weights for fast dynamic encoding, we propose a HyperZ{cdotZ{cdot}W} operator that connects hyper-kernels (W) and hidden activations (Z) through simple elementwise multiplication, followed by convolution of Z using the context-dependent W. Based on this design, we present a novel Terminator architecture that integrates hyper-kernels of different sizes to produce multi-branch hidden representations for enhancing the feature extraction capability of each layer. Additionally, a bottleneck layer is employed to compress the concatenated channels, allowing only valuable information to propagate to the subsequent layers. Notably, our model incorporates several innovative components and exhibits excellent properties, such as introducing local feedback error for updating the slow network, stable zero-mean features, faster training convergence, and fewer model parameters. Extensive experimental results on pixel-level 1D and 2D image classification benchmarks demonstrate the superior performance of our architecture.

Non-uniformed 3D sparse data, e.g., point clouds or voxels in different spatial positions, make contribution to the task of 3D object detection in different ways. Existing basic components in sparse convolutional networks (Sparse CNNs) process all sparse data, regardless of regular or submanifold sparse convolution. In this paper, we introduce two new modules to enhance the capability of Sparse CNNs, both are based on making feature sparsity learnable with position-wise importance prediction. They are focal sparse convolution (Focals Conv) and its multi-modal variant of focal sparse convolution with fusion, or Focals Conv-F for short. The new modules can readily substitute their plain counterparts in existing Sparse CNNs and be jointly trained in an end-to-end fashion. For the first time, we show that spatially learnable sparsity in sparse convolution is essential for sophisticated 3D object detection. Extensive experiments on the KITTI, nuScenes and Waymo benchmarks validate the effectiveness of our approach. Without bells and whistles, our results outperform all existing single-model entries on the nuScenes test benchmark at the paper submission time. Code and models are at https://github.com/dvlab-research/FocalsConv.

State space models (SSMs) have high performance on long sequence modeling but require sophisticated initialization techniques and specialized implementations for high quality and runtime performance. We study whether a simple alternative can match SSMs in performance and efficiency: directly learning long convolutions over the sequence. We find that a key requirement to achieving high performance is keeping the convolution kernels smooth. We find that simple interventions--such as squashing the kernel weights--result in smooth kernels and recover SSM performance on a range of tasks including the long range arena, image classification, language modeling, and brain data modeling. Next, we develop FlashButterfly, an IO-aware algorithm to improve the runtime performance of long convolutions. FlashButterfly appeals to classic Butterfly decompositions of the convolution to reduce GPU memory IO and increase FLOP utilization. FlashButterfly speeds up convolutions by 2.2times, and allows us to train on Path256, a challenging task with sequence length 64K, where we set state-of-the-art by 29.1 points while training 7.2times faster than prior work. Lastly, we introduce an extension to FlashButterfly that learns the coefficients of the Butterfly decomposition, increasing expressivity without increasing runtime. Using this extension, we outperform a Transformer on WikiText103 by 0.2 PPL with 30% fewer parameters.

The objective for establishing dense correspondence between paired images consists of two terms: a data term and a prior term. While conventional techniques focused on defining hand-designed prior terms, which are difficult to formulate, recent approaches have focused on learning the data term with deep neural networks without explicitly modeling the prior, assuming that the model itself has the capacity to learn an optimal prior from a large-scale dataset. The performance improvement was obvious, however, they often fail to address inherent ambiguities of matching, such as textureless regions, repetitive patterns, and large displacements. To address this, we propose DiffMatch, a novel conditional diffusion-based framework designed to explicitly model both the data and prior terms. Unlike previous approaches, this is accomplished by leveraging a conditional denoising diffusion model. DiffMatch consists of two main components: conditional denoising diffusion module and cost injection module. We stabilize the training process and reduce memory usage with a stage-wise training strategy. Furthermore, to boost performance, we introduce an inference technique that finds a better path to the accurate matching field. Our experimental results demonstrate significant performance improvements of our method over existing approaches, and the ablation studies validate our design choices along with the effectiveness of each component. Project page is available at https://ku-cvlab.github.io/DiffMatch/.

Recent advances in autoregressive (AR) models with continuous tokens for image generation show promising results by eliminating the need for discrete tokenization. However, these models face efficiency challenges due to their sequential token generation nature and reliance on computationally intensive diffusion-based sampling. We present ECAR (Efficient Continuous Auto-Regressive Image Generation via Multistage Modeling), an approach that addresses these limitations through two intertwined innovations: (1) a stage-wise continuous token generation strategy that reduces computational complexity and provides progressively refined token maps as hierarchical conditions, and (2) a multistage flow-based distribution modeling method that transforms only partial-denoised distributions at each stage comparing to complete denoising in normal diffusion models. Holistically, ECAR operates by generating tokens at increasing resolutions while simultaneously denoising the image at each stage. This design not only reduces token-to-image transformation cost by a factor of the stage number but also enables parallel processing at the token level. Our approach not only enhances computational efficiency but also aligns naturally with image generation principles by operating in continuous token space and following a hierarchical generation process from coarse to fine details. Experimental results demonstrate that ECAR achieves comparable image quality to DiT Peebles & Xie [2023] while requiring 10times FLOPs reduction and 5times speedup to generate a 256times256 image.

Sparse-view computed tomography (CT) -- using a small number of projections for tomographic reconstruction -- enables much lower radiation dose to patients and accelerated data acquisition. The reconstructed images, however, suffer from strong artifacts, greatly limiting their diagnostic value. Current trends for sparse-view CT turn to the raw data for better information recovery. The resultant dual-domain methods, nonetheless, suffer from secondary artifacts, especially in ultra-sparse view scenarios, and their generalization to other scanners/protocols is greatly limited. A crucial question arises: have the image post-processing methods reached the limit? Our answer is not yet. In this paper, we stick to image post-processing methods due to great flexibility and propose global representation (GloRe) distillation framework for sparse-view CT, termed GloReDi. First, we propose to learn GloRe with Fourier convolution, so each element in GloRe has an image-wide receptive field. Second, unlike methods that only use the full-view images for supervision, we propose to distill GloRe from intermediate-view reconstructed images that are readily available but not explored in previous literature. The success of GloRe distillation is attributed to two key components: representation directional distillation to align the GloRe directions, and band-pass-specific contrastive distillation to gain clinically important details. Extensive experiments demonstrate the superiority of the proposed GloReDi over the state-of-the-art methods, including dual-domain ones. The source code is available at https://github.com/longzilicart/GloReDi.

We consider the problem of video snapshot compressive imaging (SCI), where sequential high-speed frames are modulated by different masks and captured by a single measurement. The underlying principle of reconstructing multi-frame images from only one single measurement is to solve an ill-posed problem. By combining optimization algorithms and neural networks, deep unfolding networks (DUNs) score tremendous achievements in solving inverse problems. In this paper, our proposed model is under the DUN framework and we propose a 3D Convolution-Transformer Mixture (CTM) module with a 3D efficient and scalable attention model plugged in, which helps fully learn the correlation between temporal and spatial dimensions by virtue of Transformer. To our best knowledge, this is the first time that Transformer is employed to video SCI reconstruction. Besides, to further investigate the high-frequency information during the reconstruction process which are neglected in previous studies, we introduce variance estimation characterizing the uncertainty on a pixel-by-pixel basis. Extensive experimental results demonstrate that our proposed method achieves state-of-the-art (SOTA) (with a 1.2dB gain in PSNR over previous SOTA algorithm) results. We will release the code.

Objective: To allow efficient learning using the Recurrent Inference Machine (RIM) for image reconstruction whereas not being strictly dependent on the training data distribution so that unseen modalities and pathologies are still accurately recovered. Methods: Theoretically, the RIM learns to solve the inverse problem of accelerated-MRI reconstruction whereas being robust to variable imaging conditions. The efficiency and generalization capabilities with different training datasets were studied, as well as recurrent network units with decreasing complexity: the Gated Recurrent Unit (GRU), the Minimal Gated Unit (MGU), and the Independently Recurrent Neural Network (IndRNN), to reduce inference times. Validation was performed against Compressed Sensing (CS) and further assessed based on data unseen during training. A pathology study was conducted by reconstructing simulated white matter lesions and prospectively undersampled data of a Multiple Sclerosis patient. Results: Training on a single modality of 3T T_1-weighted brain data appeared sufficient to also reconstruct 7T T_{2}^*-weighted brain and 3T T_2-weighted knee data. The IndRNN is an efficient recurrent unit, reducing inference time by 68\% compared to CS, whereas maintaining performance. The RIM was able to reconstruct lesions unseen during training more accurately than CS when trained on T_2-weighted knee data. Training on T_1-weighted brain data and on combined data slightly enhanced the signal compared to CS. Conclusion: The RIM is efficient when decreasing its complexity, which reduces the inference time, whereas still being able to reconstruct data and pathology that was unseen during training.

Intra-fraction motion in radiotherapy is commonly modeled using deformable image registration (DIR). However, existing methods often struggle to balance speed and accuracy, limiting their applicability in clinical scenarios. This study introduces a novel approach that harnesses Neural Graphics Primitives (NGP) to optimize the displacement vector field (DVF). Our method leverages learned primitives, processed as splats, and interpolates within space using a shallow neural network. Uniquely, it enables self-supervised optimization at an ultra-fast speed, negating the need for pre-training on extensive datasets and allowing seamless adaptation to new cases. We validated this approach on the 4D-CT lung dataset DIR-lab, achieving a target registration error (TRE) of 1.15\pm1.15 mm within a remarkable time of 1.77 seconds. Notably, our method also addresses the sliding boundary problem, a common challenge in conventional DIR methods.

Semantic segmentation has made significant progress in recent years thanks to deep neural networks, but the common objective of generating a single segmentation output that accurately matches the image's content may not be suitable for safety-critical domains such as medical diagnostics and autonomous driving. Instead, multiple possible correct segmentation maps may be required to reflect the true distribution of annotation maps. In this context, stochastic semantic segmentation methods must learn to predict conditional distributions of labels given the image, but this is challenging due to the typically multimodal distributions, high-dimensional output spaces, and limited annotation data. To address these challenges, we propose a conditional categorical diffusion model (CCDM) for semantic segmentation based on Denoising Diffusion Probabilistic Models. Our model is conditioned to the input image, enabling it to generate multiple segmentation label maps that account for the aleatoric uncertainty arising from divergent ground truth annotations. Our experimental results show that CCDM achieves state-of-the-art performance on LIDC, a stochastic semantic segmentation dataset, and outperforms established baselines on the classical segmentation dataset Cityscapes.

Anatomical segmentation is a fundamental task in medical image computing, generally tackled with fully convolutional neural networks which produce dense segmentation masks. These models are often trained with loss functions such as cross-entropy or Dice, which assume pixels to be independent of each other, thus ignoring topological errors and anatomical inconsistencies. We address this limitation by moving from pixel-level to graph representations, which allow to naturally incorporate anatomical constraints by construction. To this end, we introduce HybridGNet, an encoder-decoder neural architecture that leverages standard convolutions for image feature encoding and graph convolutional neural networks (GCNNs) to decode plausible representations of anatomical structures. We also propose a novel image-to-graph skip connection layer which allows localized features to flow from standard convolutional blocks to GCNN blocks, and show that it improves segmentation accuracy. The proposed architecture is extensively evaluated in a variety of domain shift and image occlusion scenarios, and audited considering different types of demographic domain shift. Our comprehensive experimental setup compares HybridGNet with other landmark and pixel-based models for anatomical segmentation in chest x-ray images, and shows that it produces anatomically plausible results in challenging scenarios where other models tend to fail.

Large-kernel convolutional neural networks (ConvNets) have recently received extensive research attention, but there are two unresolved and critical issues that demand further investigation. 1) The architectures of existing large-kernel ConvNets largely follow the design principles of conventional ConvNets or transformers, while the architectural design for large-kernel ConvNets remains under-addressed. 2) As transformers have dominated multiple modalities, it remains to be investigated whether ConvNets also have a strong universal perception ability in domains beyond vision. In this paper, we contribute from two aspects. 1) We propose four architectural guidelines for designing large-kernel ConvNets, the core of which is to exploit the essential characteristics of large kernels that distinguish them from small kernels - they can see wide without going deep. Following such guidelines, our proposed large-kernel ConvNet shows leading performance in image recognition. For example, our models achieve an ImageNet accuracy of 88.0%, ADE20K mIoU of 55.6%, and COCO box AP of 56.4%, demonstrating better performance and higher speed than a number of recently proposed powerful competitors. 2) We discover that large kernels are the key to unlocking the exceptional performance of ConvNets in domains where they were originally not proficient. With certain modality-related preprocessing approaches, the proposed model achieves state-of-the-art performance on time-series forecasting and audio recognition tasks even without modality-specific customization to the architecture. Code and all the models at https://github.com/AILab-CVC/UniRepLKNet.

Convolution-BatchNorm (ConvBN) blocks are integral components in various computer vision tasks and other domains. A ConvBN block can operate in three modes: Train, Eval, and Deploy. While the Train mode is indispensable for training models from scratch, the Eval mode is suitable for transfer learning and beyond, and the Deploy mode is designed for the deployment of models. This paper focuses on the trade-off between stability and efficiency in ConvBN blocks: Deploy mode is efficient but suffers from training instability; Eval mode is widely used in transfer learning but lacks efficiency. To solve the dilemma, we theoretically reveal the reason behind the diminished training stability observed in the Deploy mode. Subsequently, we propose a novel Tune mode to bridge the gap between Eval mode and Deploy mode. The proposed Tune mode is as stable as Eval mode for transfer learning, and its computational efficiency closely matches that of the Deploy mode. Through extensive experiments in object detection, classification, and adversarial example generation across 5 datasets and 12 model architectures, we demonstrate that the proposed Tune mode retains the performance while significantly reducing GPU memory footprint and training time, thereby contributing efficient ConvBN blocks for transfer learning and beyond. Our method has been integrated into both PyTorch (general machine learning framework) and MMCV/MMEngine (computer vision framework). Practitioners just need one line of code to enjoy our efficient ConvBN blocks thanks to PyTorch's builtin machine learning compilers.

In recent years, the use of large convolutional kernels has become popular in designing convolutional neural networks due to their ability to capture long-range dependencies and provide large receptive fields. However, the increase in kernel size also leads to a quadratic growth in the number of parameters, resulting in heavy computation and memory requirements. To address this challenge, we propose a neighborhood attention (NA) module that upgrades the standard convolution with a self-attention mechanism. The NA module efficiently extracts long-range dependencies in a sliding window pattern, thereby achieving similar performance to large convolutional kernels but with fewer parameters. Building upon the NA module, we propose a lightweight single image super-resolution (SISR) network named TCSR. Additionally, we introduce an enhanced feed-forward network (EFFN) in TCSR to improve the SISR performance. EFFN employs a parameter-free spatial-shift operation for efficient feature aggregation. Our extensive experiments and ablation studies demonstrate that TCSR outperforms existing lightweight SISR methods and achieves state-of-the-art performance. Our codes are available at https://github.com/Aitical/TCSR.

During their formative years, radiology trainees are required to interpret hundreds of mammograms per month, with the objective of becoming apt at discerning the subtle patterns differentiating benign from malignant lesions. Unfortunately, medico-legal and technical hurdles make it difficult to access and query medical images for training. In this paper we train a generative adversarial network (GAN) to synthesize 512 x 512 high-resolution mammograms. The resulting model leads to the unsupervised separation of high-level features (e.g. the standard mammography views and the nature of the breast lesions), with stochastic variation in the generated images (e.g. breast adipose tissue, calcification), enabling user-controlled global and local attribute-editing of the synthesized images. We demonstrate the model's ability to generate anatomically and medically relevant mammograms by achieving an average AUC of 0.54 in a double-blind study on four expert mammography radiologists to distinguish between generated and real images, ascribing to the high visual quality of the synthesized and edited mammograms, and to their potential use in advancing and facilitating medical education.

Efficiently capturing multi-scale information and building long-range dependencies among pixels are essential for medical image segmentation because of the various sizes and shapes of the lesion regions or organs. In this paper, we present Multi-scale Cross-axis Attention (MCA) to solve the above challenging issues based on the efficient axial attention. Instead of simply connecting axial attention along the horizontal and vertical directions sequentially, we propose to calculate dual cross attentions between two parallel axial attentions to capture global information better. To process the significant variations of lesion regions or organs in individual sizes and shapes, we also use multiple convolutions of strip-shape kernels with different kernel sizes in each axial attention path to improve the efficiency of the proposed MCA in encoding spatial information. We build the proposed MCA upon the MSCAN backbone, yielding our network, termed MCANet. Our MCANet with only 4M+ parameters performs even better than most previous works with heavy backbones (e.g., Swin Transformer) on four challenging tasks, including skin lesion segmentation, nuclei segmentation, abdominal multi-organ segmentation, and polyp segmentation. Code is available at https://github.com/haoshao-nku/medical_seg.

We introduce a novel bilateral reference framework (BiRefNet) for high-resolution dichotomous image segmentation (DIS). It comprises two essential components: the localization module (LM) and the reconstruction module (RM) with our proposed bilateral reference (BiRef). The LM aids in object localization using global semantic information. Within the RM, we utilize BiRef for the reconstruction process, where hierarchical patches of images provide the source reference and gradient maps serve as the target reference. These components collaborate to generate the final predicted maps. We also introduce auxiliary gradient supervision to enhance focus on regions with finer details. Furthermore, we outline practical training strategies tailored for DIS to improve map quality and training process. To validate the general applicability of our approach, we conduct extensive experiments on four tasks to evince that BiRefNet exhibits remarkable performance, outperforming task-specific cutting-edge methods across all benchmarks. Our codes are available at https://github.com/ZhengPeng7/BiRefNet.

Diffusion models have found widespread adoption in various areas. However, their sampling process is slow because it requires hundreds to thousands of network evaluations to emulate a continuous process defined by differential equations. In this work, we use neural operators, an efficient method to solve the probability flow differential equations, to accelerate the sampling process of diffusion models. Compared to other fast sampling methods that have a sequential nature, we are the first to propose parallel decoding method that generates images with only one model forward pass. We propose diffusion model sampling with neural operator (DSNO) that maps the initial condition, i.e., Gaussian distribution, to the continuous-time solution trajectory of the reverse diffusion process. To model the temporal correlations along the trajectory, we introduce temporal convolution layers that are parameterized in the Fourier space into the given diffusion model backbone. We show our method achieves state-of-the-art FID of 4.12 for CIFAR-10 and 8.35 for ImageNet-64 in the one-model-evaluation setting.

The emergence of Kolmogorov-Arnold Networks (KANs) has sparked significant interest and debate within the scientific community. This paper explores the application of KANs in the domain of computer vision (CV). We examine the convolutional version of KANs, considering various nonlinearity options beyond splines, such as Wavelet transforms and a range of polynomials. We propose a parameter-efficient design for Kolmogorov-Arnold convolutional layers and a parameter-efficient finetuning algorithm for pre-trained KAN models, as well as KAN convolutional versions of self-attention and focal modulation layers. We provide empirical evaluations conducted on MNIST, CIFAR10, CIFAR100, Tiny ImageNet, ImageNet1k, and HAM10000 datasets for image classification tasks. Additionally, we explore segmentation tasks, proposing U-Net-like architectures with KAN convolutions, and achieving state-of-the-art results on BUSI, GlaS, and CVC datasets. We summarized all of our findings in a preliminary design guide of KAN convolutional models for computer vision tasks. Furthermore, we investigate regularization techniques for KANs. All experimental code and implementations of convolutional layers and models, pre-trained on ImageNet1k weights are available on GitHub via this https://github.com/IvanDrokin/torch-conv-kan

Due to the three-dimensional nature of CT- or MR-scans, generative modeling of medical images is a particularly challenging task. Existing approaches mostly apply patch-wise, slice-wise, or cascaded generation techniques to fit the high-dimensional data into the limited GPU memory. However, these approaches may introduce artifacts and potentially restrict the model's applicability for certain downstream tasks. This work presents WDM, a wavelet-based medical image synthesis framework that applies a diffusion model on wavelet decomposed images. The presented approach is a simple yet effective way of scaling diffusion models to high resolutions and can be trained on a single 40 GB GPU. Experimental results on BraTS and LIDC-IDRI unconditional image generation at a resolution of 128 times 128 times 128 show state-of-the-art image fidelity (FID) and sample diversity (MS-SSIM) scores compared to GANs, Diffusion Models, and Latent Diffusion Models. Our proposed method is the only one capable of generating high-quality images at a resolution of 256 times 256 times 256.

Rapid advancements in medical image segmentation performance have been significantly driven by the development of Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs). These models follow the discriminative pixel-wise classification learning paradigm and often have limited ability to generalize across diverse medical imaging datasets. In this manuscript, we introduce Generative Medical Segmentation (GMS), a novel approach leveraging a generative model to perform image segmentation. Concretely, GMS employs a robust pre-trained vision foundation model to extract latent representations for images and corresponding ground truth masks, followed by a model that learns a mapping function from the image to the mask in the latent space. Once trained, the model generates an estimated segmentation mask using the pre-trained vision foundation model to decode the predicted latent representation back into the image space. The design of GMS leads to fewer trainable parameters in the model which reduces the risk of overfitting and enhances its generalization capability. Our experimental analysis across five public datasets in different medical imaging domains demonstrates GMS outperforms existing discriminative and generative segmentation models. Furthermore, GMS is able to generalize well across datasets from different centers within the same imaging modality. Our experiments suggest GMS offers a scalable and effective solution for medical image segmentation. GMS implementation and trained model weights are available at https://github.com/King-HAW/GMS.

In this paper, we propose a novel text promptable surgical instrument segmentation approach to overcome challenges associated with diversity and differentiation of surgical instruments in minimally invasive surgeries. We redefine the task as text promptable, thereby enabling a more nuanced comprehension of surgical instruments and adaptability to new instrument types. Inspired by recent advancements in vision-language models, we leverage pretrained image and text encoders as our model backbone and design a text promptable mask decoder consisting of attention- and convolution-based prompting schemes for surgical instrument segmentation prediction. Our model leverages multiple text prompts for each surgical instrument through a new mixture of prompts mechanism, resulting in enhanced segmentation performance. Additionally, we introduce a hard instrument area reinforcement module to improve image feature comprehension and segmentation precision. Extensive experiments on EndoVis2017 and EndoVis2018 datasets demonstrate our model's superior performance and promising generalization capability. To our knowledge, this is the first implementation of a promptable approach to surgical instrument segmentation, offering significant potential for practical application in the field of robotic-assisted surgery.

Multi-modality magnetic resonance imaging data with various sequences facilitate the early diagnosis, tumor segmentation, and disease staging in the management of nasopharyngeal carcinoma (NPC). The lack of publicly available, comprehensive datasets limits advancements in diagnosis, treatment planning, and the development of machine learning algorithms for NPC. Addressing this critical need, we introduce the first comprehensive NPC MRI dataset, encompassing MR axial imaging of 277 primary NPC patients. This dataset includes T1-weighted, T2-weighted, and contrast-enhanced T1-weighted sequences, totaling 831 scans. In addition to the corresponding clinical data, manually annotated and labeled segmentations by experienced radiologists offer high-quality data resources from untreated primary NPC.

Trit-plane coding enables deep progressive image compression, but it cannot use autoregressive context models. In this paper, we propose the context-based trit-plane coding (CTC) algorithm to achieve progressive compression more compactly. First, we develop the context-based rate reduction module to estimate trit probabilities of latent elements accurately and thus encode the trit-planes compactly. Second, we develop the context-based distortion reduction module to refine partial latent tensors from the trit-planes and improve the reconstructed image quality. Third, we propose a retraining scheme for the decoder to attain better rate-distortion tradeoffs. Extensive experiments show that CTC outperforms the baseline trit-plane codec significantly in BD-rate on the Kodak lossless dataset, while increasing the time complexity only marginally. Our codes are available at https://github.com/seungminjeon-github/CTC.

Convolutional Neural Networks have demonstrated superior performance on single image depth estimation in recent years. These works usually use stacked spatial pooling or strided convolution to get high-level information which are common practices in classification task. However, depth estimation is a dense prediction problem and low-resolution feature maps usually generate blurred depth map which is undesirable in application. In order to produce high quality depth map, say clean and accurate, we propose a network consists of a Dense Feature Extractor (DFE) and a Depth Map Generator (DMG). The DFE combines ResNet and dilated convolutions. It extracts multi-scale information from input image while keeping the feature maps dense. As for DMG, we use attention mechanism to fuse multi-scale features produced in DFE. Our Network is trained end-to-end and does not need any post-processing. Hence, it runs fast and can predict depth map in about 15 fps. Experiment results show that our method is competitive with the state-of-the-art in quantitative evaluation, but can preserve better structural details of the scene depth.

Sparse attention as a efficient method can significantly decrease the computation cost, but current sparse attention tend to rely on window self attention which block the global information flow. For this problem, we present Shifted Cross Chunk Attention (SCCA), using different KV shifting strategy to extend respective field in each attention layer. Except, we combine Dilated Attention(DA) and Dilated Neighborhood Attention(DNA) to present Shifted Dilated Attention(SDA). Both SCCA and SDA can accumulate attention results in multi head attention to obtain approximate respective field in full attention. In this paper, we conduct language modeling experiments using different pattern of SCCA and combination of SCCA and SDA. The proposed shifted cross chunk attention (SCCA) can effectively extend large language models (LLMs) to longer context combined with Positional interpolation(PI) and LoRA than current sparse attention. Notably, SCCA adopts LLaMA2 7B from 4k context to 8k in single V100. This attention pattern can provide a Plug-and-play fine-tuning method to extend model context while retaining their original architectures, and is compatible with most existing techniques.

Convolutional Neural Networks (CNNs) and Transformers have been the most popular architectures for biomedical image segmentation, but both of them have limited ability to handle long-range dependencies because of inherent locality or computational complexity. To address this challenge, we introduce U-Mamba, a general-purpose network for biomedical image segmentation. Inspired by the State Space Sequence Models (SSMs), a new family of deep sequence models known for their strong capability in handling long sequences, we design a hybrid CNN-SSM block that integrates the local feature extraction power of convolutional layers with the abilities of SSMs for capturing the long-range dependency. Moreover, U-Mamba enjoys a self-configuring mechanism, allowing it to automatically adapt to various datasets without manual intervention. We conduct extensive experiments on four diverse tasks, including the 3D abdominal organ segmentation in CT and MR images, instrument segmentation in endoscopy images, and cell segmentation in microscopy images. The results reveal that U-Mamba outperforms state-of-the-art CNN-based and Transformer-based segmentation networks across all tasks. This opens new avenues for efficient long-range dependency modeling in biomedical image analysis. The code, models, and data are publicly available at https://wanglab.ai/u-mamba.html.

Self-supervised learning (SSL) has recently achieved promising performance for 3D medical image analysis tasks. Most current methods follow existing SSL paradigm originally designed for photographic or natural images, which cannot explicitly and thoroughly exploit the intrinsic similar anatomical structures across varying medical images. This may in fact degrade the quality of learned deep representations by maximizing the similarity among features containing spatial misalignment information and different anatomical semantics. In this work, we propose a new self-supervised learning framework, namely Alice, that explicitly fulfills Anatomical invariance modeling and semantic alignment via elaborately combining discriminative and generative objectives. Alice introduces a new contrastive learning strategy which encourages the similarity between views that are diversely mined but with consistent high-level semantics, in order to learn invariant anatomical features. Moreover, we design a conditional anatomical feature alignment module to complement corrupted embeddings with globally matched semantics and inter-patch topology information, conditioned by the distribution of local image content, which permits to create better contrastive pairs. Our extensive quantitative experiments on three 3D medical image analysis tasks demonstrate and validate the performance superiority of Alice, surpassing the previous best SSL counterpart methods and showing promising ability for united representation learning. Codes are available at https://github.com/alibaba-damo-academy/alice.

In the light of the COVID-19 pandemic, deep learning methods have been widely investigated in detecting COVID-19 from chest X-rays. However, a more pragmatic approach to applying AI methods to a medical diagnosis is designing a framework that facilitates human-machine interaction and expert decision making. Studies have shown that categorization can play an essential rule in accelerating real-world decision making. Inspired by descriptive document clustering, we propose a domain-independent explanatory clustering framework to group contextually related instances and support radiologists' decision making. While most descriptive clustering approaches employ domain-specific characteristics to form meaningful clusters, we focus on model-level explanation as a more general-purpose element of every learning process to achieve cluster homogeneity. We employ DeepSHAP to generate homogeneous clusters in terms of disease severity and describe the clusters using favorable and unfavorable saliency maps, which visualize the class discriminating regions of an image. These human-interpretable maps complement radiologist knowledge to investigate the whole cluster at once. Besides, as part of this study, we evaluate a model based on VGG-19, which can identify COVID and pneumonia cases with a positive predictive value of 95% and 97%, respectively, comparable to the recent explainable approaches for COVID diagnosis.

Blind image deconvolution (BID) is a classic yet challenging problem in the field of image processing. Recent advances in deep image prior (DIP) have motivated a series of DIP-based approaches, demonstrating remarkable success in BID. However, due to the high non-convexity of the inherent optimization process, these methods are notorious for their sensitivity to the initialized kernel. To alleviate this issue and further improve their performance, we propose a new framework for BID that better considers the prior modeling and the initialization for blur kernels, leveraging a deep generative model. The proposed approach pre-trains a generative adversarial network-based kernel generator that aptly characterizes the kernel priors and a kernel initializer that facilitates a well-informed initialization for the blur kernel through latent space encoding. With the pre-trained kernel generator and initializer, one can obtain a high-quality initialization of the blur kernel, and enable optimization within a compact latent kernel manifold. Such a framework results in an evident performance improvement over existing DIP-based BID methods. Extensive experiments on different datasets demonstrate the effectiveness of the proposed method.

Diffusion Probabilistic Models (DPM) have shown remarkable efficacy in the synthesis of high-quality images. However, their inference process characteristically requires numerous, potentially hundreds, of iterative steps, which could exaggerate the problem of exposure bias due to the training and inference discrepancy. Previous work has attempted to mitigate this issue by perturbing inputs during training, which consequently mandates the retraining of the DPM. In this work, we conduct a systematic study of exposure bias in DPM and, intriguingly, we find that the exposure bias could be alleviated with a novel sampling method that we propose, without retraining the model. We empirically and theoretically show that, during inference, for each backward time step t and corresponding state x_t, there might exist another time step t_s which exhibits superior coupling with x_t. Based on this finding, we introduce a sampling method named Time-Shift Sampler. Our framework can be seamlessly integrated to existing sampling algorithms, such as DDPM, DDIM and other high-order solvers, inducing merely minimal additional computations. Experimental results show our method brings significant and consistent improvements in FID scores on different datasets and sampling methods. For example, integrating Time-Shift Sampler to F-PNDM yields a FID=3.88, achieving 44.49\% improvements as compared to F-PNDM, on CIFAR-10 with 10 sampling steps, which is more performant than the vanilla DDIM with 100 sampling steps. Our code is available at https://github.com/Mingxiao-Li/TS-DPM.

Sequence modeling plays a vital role across various domains, with recurrent neural networks being historically the predominant method of performing these tasks. However, the emergence of transformers has altered this paradigm due to their superior performance. Built upon these advances, transformers have conjoined CNNs as two leading foundational models for learning visual representations. However, transformers are hindered by the O(N^2) complexity of their attention mechanisms, while CNNs lack global receptive fields and dynamic weight allocation. State Space Models (SSMs), specifically the \textbf{Mamba} model with selection mechanisms and hardware-aware architecture, have garnered immense interest lately in sequential modeling and visual representation learning, challenging the dominance of transformers by providing infinite context lengths and offering substantial efficiency maintaining linear complexity in the input sequence. Capitalizing on the advances in computer vision, medical imaging has heralded a new epoch with Mamba models. Intending to help researchers navigate the surge, this survey seeks to offer an encyclopedic review of Mamba models in medical imaging. Specifically, we start with a comprehensive theoretical review forming the basis of SSMs, including Mamba architecture and its alternatives for sequence modeling paradigms in this context. Next, we offer a structured classification of Mamba models in the medical field and introduce a diverse categorization scheme based on their application, imaging modalities, and targeted organs. Finally, we summarize key challenges, discuss different future research directions of the SSMs in the medical domain, and propose several directions to fulfill the demands of this field. In addition, we have compiled the studies discussed in this paper along with their open-source implementations on our GitHub repository.

We introduce Hybrid Autoregressive Transformer (HART), an autoregressive (AR) visual generation model capable of directly generating 1024x1024 images, rivaling diffusion models in image generation quality. Existing AR models face limitations due to the poor image reconstruction quality of their discrete tokenizers and the prohibitive training costs associated with generating 1024px images. To address these challenges, we present the hybrid tokenizer, which decomposes the continuous latents from the autoencoder into two components: discrete tokens representing the big picture and continuous tokens representing the residual components that cannot be represented by the discrete tokens. The discrete component is modeled by a scalable-resolution discrete AR model, while the continuous component is learned with a lightweight residual diffusion module with only 37M parameters. Compared with the discrete-only VAR tokenizer, our hybrid approach improves reconstruction FID from 2.11 to 0.30 on MJHQ-30K, leading to a 31% generation FID improvement from 7.85 to 5.38. HART also outperforms state-of-the-art diffusion models in both FID and CLIP score, with 4.5-7.7x higher throughput and 6.9-13.4x lower MACs. Our code is open sourced at https://github.com/mit-han-lab/hart.