NERO: Explainable Out-of-Distribution Detection with Neuron-level Relevance

Ensuring reliability is paramount in deep learning, particularly within the domain of medical imaging, where diagnostic decisions often hinge on model outputs. The capacity to separate out-of-distribution (OOD) samples has proven to be a valuable indicator of a model's reliability in research. In medical imaging, this is especially critical, as identifying OOD inputs can help flag potential anomalies that might otherwise go undetected. While many OOD detection methods rely on feature or logit space representations, recent works suggest these approaches may not fully capture OOD diversity. To address this, we propose a novel OOD scoring mechanism, called NERO, that leverages neuron-level relevance at the feature layer. Specifically, we cluster neuron-level relevance for each in-distribution (ID) class to form representative centroids and introduce a relevance distance metric to quantify a new sample's deviation from these centroids, enhancing OOD separability. Additionally, we refine performance by incorporating scaled relevance in the bias term and combining feature norms. Our framework also enables explainable OOD detection. We validate its effectiveness across multiple deep learning architectures on the gastrointestinal imaging benchmarks Kvasir and GastroVision, achieving improvements over state-of-the-art OOD detection methods.

Federated Foundation Model for GI Endoscopy Images

Gastrointestinal (GI) endoscopy is essential in identifying GI tract abnormalities in order to detect diseases in their early stages and improve patient outcomes. Although deep learning has shown success in supporting GI diagnostics and decision-making, these models require curated datasets with labels that are expensive to acquire. Foundation models offer a promising solution by learning general-purpose representations, which can be finetuned for specific tasks, overcoming data scarcity. Developing foundation models for medical imaging holds significant potential, but the sensitive and protected nature of medical data presents unique challenges. Foundation model training typically requires extensive datasets, and while hospitals generate large volumes of data, privacy restrictions prevent direct data sharing, making foundation model training infeasible in most scenarios. In this work, we propose a FL framework for training foundation models for gastroendoscopy imaging, enabling data to remain within local hospital environments while contributing to a shared model. We explore several established FL algorithms, assessing their suitability for training foundation models without relying on task-specific labels, conducting experiments in both homogeneous and heterogeneous settings. We evaluate the trained foundation model on three critical downstream tasks--classification, detection, and segmentation--and demonstrate that it achieves improved performance across all tasks, highlighting the effectiveness of our approach in a federated, privacy-preserving setting.

Hallucination-Aware Multimodal Benchmark for Gastrointestinal Image Analysis with Large Vision-Language Models

Vision-Language Models (VLMs) are becoming increasingly popular in the medical domain, bridging the gap between medical images and clinical language. Existing VLMs demonstrate an impressive ability to comprehend medical images and text queries to generate detailed, descriptive diagnostic medical reports. However, hallucination--the tendency to generate descriptions that are inconsistent with the visual content--remains a significant issue in VLMs, with particularly severe implications in the medical field. To facilitate VLM research on gastrointestinal (GI) image analysis and study hallucination, we curate a multimodal image-text GI dataset: Gut-VLM. This dataset is created using a two-stage pipeline: first, descriptive medical reports of Kvasir-v2 images are generated using ChatGPT, which introduces some hallucinated or incorrect texts. In the second stage, medical experts systematically review these reports, and identify and correct potential inaccuracies to ensure high-quality, clinically reliable annotations. Unlike traditional datasets that contain only descriptive texts, our dataset also features tags identifying hallucinated sentences and their corresponding corrections. A common approach to reducing hallucination in VLM is to finetune the model on a small-scale, problem-specific dataset. However, we take a different strategy using our dataset. Instead of finetuning the VLM solely for generating textual reports, we finetune it to detect and correct hallucinations, an approach we call hallucination-aware finetuning. Our results show that this approach is better than simply finetuning for descriptive report generation. Additionally, we conduct an extensive evaluation of state-of-the-art VLMs across several metrics, establishing a benchmark. GitHub Repo: https://github.com/bhattarailab/Hallucination-Aware-VLM.

Surgical Vision World Model

Realistic and interactive surgical simulation has the potential to facilitate crucial applications, such as medical professional training and autonomous surgical agent training. In the natural visual domain, world models have enabled action-controlled data generation, demonstrating the potential to train autonomous agents in interactive simulated environments when large-scale real data acquisition is infeasible. However, such works in the surgical domain have been limited to simplified computer simulations, and lack realism. Furthermore, existing literature in world models has predominantly dealt with action-labeled data, limiting their applicability to real-world surgical data, where obtaining action annotation is prohibitively expensive. Inspired by the recent success of Genie in leveraging unlabeled video game data to infer latent actions and enable action-controlled data generation, we propose the first surgical vision world model. The proposed model can generate action-controllable surgical data and the architecture design is verified with extensive experiments on the unlabeled SurgToolLoc-2022 dataset. Codes and implementation details are available at https://github.com/bhattarailab/Surgical-Vision-World-Model

Prompt Augmentation for Self-supervised Text-guided Image Manipulation

Text-guided image editing finds applications in various creative and practical fields. While recent studies in image generation have advanced the field, they often struggle with the dual challenges of coherent image transformation and context preservation. In response, our work introduces prompt augmentation, a method amplifying a single input prompt into several target prompts, strengthening textual context and enabling localised image editing. Specifically, we use the augmented prompts to delineate the intended manipulation area. We propose a Contrastive Loss tailored to driving effective image editing by displacing edited areas and drawing preserved regions closer. Acknowledging the continuous nature of image manipulations, we further refine our approach by incorporating the similarity concept, creating a Soft Contrastive Loss. The new losses are incorporated to the diffusion model, demonstrating improved or competitive image editing results on public datasets and generated images over state-of-the-art approaches.

NCDD: Nearest Centroid Distance Deficit for Out-Of-Distribution Detection in Gastrointestinal Vision

The integration of deep learning tools in gastrointestinal vision holds the potential for significant advancements in diagnosis, treatment, and overall patient care. A major challenge, however, is these tools' tendency to make overconfident predictions, even when encountering unseen or newly emerging disease patterns, undermining their reliability. We address this critical issue of reliability by framing it as an out-of-distribution (OOD) detection problem, where previously unseen and emerging diseases are identified as OOD examples. However, gastrointestinal images pose a unique challenge due to the overlapping feature representations between in- Distribution (ID) and OOD examples. Existing approaches often overlook this characteristic, as they are primarily developed for natural image datasets, where feature distinctions are more apparent. Despite the overlap, we hypothesize that the features of an in-distribution example will cluster closer to the centroids of their ground truth class, resulting in a shorter distance to the nearest centroid. In contrast, OOD examples maintain an equal distance from all class centroids. Based on this observation, we propose a novel nearest-centroid distance deficit (NCCD) score in the feature space for gastrointestinal OOD detection. Evaluations across multiple deep learning architectures and two publicly available benchmarks, Kvasir2 and Gastrovision, demonstrate the effectiveness of our approach compared to several state-of-the-art methods. The code and implementation details are publicly available at: https://github.com/bhattarailab/NCDD

Guide3D: A Bi-planar X-ray Dataset for 3D Shape Reconstruction

Endovascular surgical tool reconstruction represents an important factor in advancing endovascular tool navigation, which is an important step in endovascular surgery. However, the lack of publicly available datasets significantly restricts the development and validation of novel machine learning approaches. Moreover, due to the need for specialized equipment such as biplanar scanners, most of the previous research employs monoplanar fluoroscopic technologies, hence only capturing the data from a single view and significantly limiting the reconstruction accuracy. To bridge this gap, we introduce Guide3D, a bi-planar X-ray dataset for 3D reconstruction. The dataset represents a collection of high resolution bi-planar, manually annotated fluoroscopic videos, captured in real-world settings. Validating our dataset within a simulated environment reflective of clinical settings confirms its applicability for real-world applications. Furthermore, we propose a new benchmark for guidewrite shape prediction, serving as a strong baseline for future work. Guide3D not only addresses an essential need by offering a platform for advancing segmentation and 3D reconstruction techniques but also aids the development of more accurate and efficient endovascular surgery interventions. Our project is available at https://airvlab.github.io/guide3d/.

CathAction: A Benchmark for Endovascular Intervention Understanding

Real-time visual feedback from catheterization analysis is crucial for enhancing surgical safety and efficiency during endovascular interventions. However, existing datasets are often limited to specific tasks, small scale, and lack the comprehensive annotations necessary for broader endovascular intervention understanding. To tackle these limitations, we introduce CathAction, a large-scale dataset for catheterization understanding. Our CathAction dataset encompasses approximately 500,000 annotated frames for catheterization action understanding and collision detection, and 25,000 ground truth masks for catheter and guidewire segmentation. For each task, we benchmark recent related works in the field. We further discuss the challenges of endovascular intentions compared to traditional computer vision tasks and point out open research questions. We hope that CathAction will facilitate the development of endovascular intervention understanding methods that can be applied to real-world applications. The dataset is available at https://airvlab.github.io/cathdata/.

TTA-OOD: Test-time Augmentation for Improving Out-of-Distribution Detection in Gastrointestinal Vision

Deep learning has significantly advanced the field of gastrointestinal vision, enhancing disease diagnosis capabilities. One major challenge in automating diagnosis within gastrointestinal settings is the detection of abnormal cases in endoscopic images. Due to the sparsity of data, this process of distinguishing normal from abnormal cases has faced significant challenges, particularly with rare and unseen conditions. To address this issue, we frame abnormality detection as an out-of-distribution (OOD) detection problem. In this setup, a model trained on In-Distribution (ID) data, which represents a healthy GI tract, can accurately identify healthy cases, while abnormalities are detected as OOD, regardless of their class. We introduce a test-time augmentation segment into the OOD detection pipeline, which enhances the distinction between ID and OOD examples, thereby improving the effectiveness of existing OOD methods with the same model. This augmentation shifts the pixel space, which translates into a more distinct semantic representation for OOD examples compared to ID examples. We evaluated our method against existing state-of-the-art OOD scores, showing improvements with test-time augmentation over the baseline approach.

CAR-MFL: Cross-Modal Augmentation by Retrieval for Multimodal Federated Learning with Missing Modalities

Multimodal AI has demonstrated superior performance over unimodal approaches by leveraging diverse data sources for more comprehensive analysis. However, applying this effectiveness in healthcare is challenging due to the limited availability of public datasets. Federated learning presents an exciting solution, allowing the use of extensive databases from hospitals and health centers without centralizing sensitive data, thus maintaining privacy and security. Yet, research in multimodal federated learning, particularly in scenarios with missing modalities a common issue in healthcare datasets remains scarce, highlighting a critical area for future exploration. Toward this, we propose a novel method for multimodal federated learning with missing modalities. Our contribution lies in a novel cross-modal data augmentation by retrieval, leveraging the small publicly available dataset to fill the missing modalities in the clients. Our method learns the parameters in a federated manner, ensuring privacy protection and improving performance in multiple challenging multimodal benchmarks in the medical domain, surpassing several competitive baselines. Code Available: https://github.com/bhattarailab/CAR-MFL