3DGR-CAR: Coronary artery reconstruction from ultra-sparse 2D X-ray views with a 3D Gaussians representation

Reconstructing 3D coronary arteries is important for coronary artery disease diagnosis, treatment planning and operation navigation. Traditional reconstruction techniques often require many projections, while reconstruction from sparse-view X-ray projections is a potential way of reducing radiation dose. However, the extreme sparsity of coronary arteries in a 3D volume and ultra-limited number of projections pose significant challenges for efficient and accurate 3D reconstruction. To this end, we propose 3DGR-CAR, a 3D Gaussian Representation for Coronary Artery Reconstruction from ultra-sparse X-ray projections. We leverage 3D Gaussian representation to avoid the inefficiency caused by the extreme sparsity of coronary artery data and propose a Gaussian center predictor to overcome the noisy Gaussian initialization from ultra-sparse view projections. The proposed scheme enables fast and accurate 3D coronary artery reconstruction with only 2 views. Experimental results on two datasets indicate that the proposed approach significantly outperforms other methods in terms of voxel accuracy and visual quality of coronary arteries. The code will be available in https://github.com/windrise/3DGR-CAR.

MambaMIM: Pre-training Mamba with State Space Token-interpolation

Generative self-supervised learning demonstrates outstanding representation learning capabilities in both Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs). However, there are currently no generative pre-training methods related to selective state space models (Mamba) that can handle long-range dependencies effectively. To address this challenge, we introduce a generative self-supervised learning method for Mamba (MambaMIM) based on Selective Structure State Space Sequence Token-interpolation (S6T), a general-purpose pre-training method for arbitrary Mamba architectures. Our method, MambaMIM, incorporates a bottom-up 3D hybrid masking strategy in the encoder to maintain masking consistency across different architectures. Additionally, S6T is employed to learn causal relationships between the masked sequence in the state space. MambaMIM can be used on any single or hybrid Mamba architectures to enhance the Mamba long-range representation capability. Extensive downstream experiments reveal the feasibility and advancement of using Mamba for pre-training medical image tasks. The code is available at: https://github.com/FengheTan9/MambaMIM

HySparK: Hybrid Sparse Masking for Large Scale Medical Image Pre-Training

The generative self-supervised learning strategy exhibits remarkable learning representational capabilities. However, there is limited attention to end-to-end pre-training methods based on a hybrid architecture of CNN and Transformer, which can learn strong local and global representations simultaneously. To address this issue, we propose a generative pre-training strategy called Hybrid Sparse masKing (HySparK) based on masked image modeling and apply it to large-scale pre-training on medical images. First, we perform a bottom-up 3D hybrid masking strategy on the encoder to keep consistency masking. Then we utilize sparse convolution for the top CNNs and encode unmasked patches for the bottom vision Transformers. Second, we employ a simple hierarchical decoder with skip-connections to achieve dense multi-scale feature reconstruction. Third, we implement our pre-training method on a collection of multiple large-scale 3D medical imaging datasets. Extensive experiments indicate that our proposed pre-training strategy demonstrates robust transfer-ability in supervised downstream tasks and sheds light on HySparK's promising prospects. The code is available at https://github.com/FengheTan9/HySparK

APPLE: Adversarial Privacy-aware Perturbations on Latent Embedding for Unfairness Mitigation

Ensuring fairness in deep-learning-based segmentors is crucial for health equity. Much effort has been dedicated to mitigating unfairness in the training datasets or procedures. However, with the increasing prevalence of foundation models in medical image analysis, it is hard to train fair models from scratch while preserving utility. In this paper, we propose a novel method, Adversarial Privacy-aware Perturbations on Latent Embedding (APPLE), that can improve the fairness of deployed segmentors by introducing a small latent feature perturber without updating the weights of the original model. By adding perturbation to the latent vector, APPLE decorates the latent vector of segmentors such that no fairness-related features can be passed to the decoder of the segmentors while preserving the architecture and parameters of the segmentor. Experiments on two segmentation datasets and five segmentors (three U-Net-like and two SAM-like) illustrate the effectiveness of our proposed method compared to several unfairness mitigation methods.

Slide-SAM: Medical SAM Meets Sliding Window

The Segment Anything Model (SAM) has achieved a notable success in two-dimensional image segmentation in natural images. However, the substantial gap between medical and natural images hinders its direct application to medical image segmentation tasks. Particularly in 3D medical images, SAM struggles to learn contextual relationships between slices, limiting its practical applicability. Moreover, applying 2D SAM to 3D images requires prompting the entire volume, which is time- and label-consuming. To address these problems, we propose Slide-SAM, which treats a stack of three adjacent slices as a prediction window. It firstly takes three slices from a 3D volume and point- or bounding box prompts on the central slice as inputs to predict segmentation masks for all three slices. Subsequently, the masks of the top and bottom slices are then used to generate new prompts for adjacent slices. Finally, step-wise prediction can be achieved by sliding the prediction window forward or backward through the entire volume. Our model is trained on multiple public and private medical datasets and demonstrates its effectiveness through extensive 3D segmetnation experiments, with the help of minimal prompts. Code is available at \url{https://github.com/Curli-quan/Slide-SAM}.

Inspecting Model Fairness in Ultrasound Segmentation Tasks

With the rapid expansion of machine learning and deep learning (DL), researchers are increasingly employing learning-based algorithms to alleviate diagnostic challenges across diverse medical tasks and applications. While advancements in diagnostic precision are notable, some researchers have identified a concerning trend: their models exhibit biased performance across subgroups characterized by different sensitive attributes. This bias not only infringes upon the rights of patients but also has the potential to lead to life-altering consequences. In this paper, we inspect a series of DL segmentation models using two ultrasound datasets, aiming to assess the presence of model unfairness in these specific tasks. Our findings reveal that even state-of-the-art DL algorithms demonstrate unfair behavior in ultrasound segmentation tasks. These results serve as a crucial warning, underscoring the necessity for careful model evaluation before their deployment in real-world scenarios. Such assessments are imperative to ensure ethical considerations and mitigate the risk of adverse impacts on patient outcomes.

MobileUtr: Revisiting the relationship between light-weight CNN and Transformer for efficient medical image segmentation

Due to the scarcity and specific imaging characteristics in medical images, light-weighting Vision Transformers (ViTs) for efficient medical image segmentation is a significant challenge, and current studies have not yet paid attention to this issue. This work revisits the relationship between CNNs and Transformers in lightweight universal networks for medical image segmentation, aiming to integrate the advantages of both worlds at the infrastructure design level. In order to leverage the inductive bias inherent in CNNs, we abstract a Transformer-like lightweight CNNs block (ConvUtr) as the patch embeddings of ViTs, feeding Transformer with denoised, non-redundant and highly condensed semantic information. Moreover, an adaptive Local-Global-Local (LGL) block is introduced to facilitate efficient local-to-global information flow exchange, maximizing Transformer's global context information extraction capabilities. Finally, we build an efficient medical image segmentation model (MobileUtr) based on CNN and Transformer. Extensive experiments on five public medical image datasets with three different modalities demonstrate the superiority of MobileUtr over the state-of-the-art methods, while boasting lighter weights and lower computational cost. Code is available at https://github.com/FengheTan9/MobileUtr.

SRSNetwork: Siamese Reconstruction-Segmentation Networks based on Dynamic-Parameter Convolution

In this paper, we present a high-performance deep neural network for weak target image segmentation, including medical image segmentation and infrared image segmentation. To this end, this work analyzes the existing dynamic convolutions and proposes dynamic parameter convolution (DPConv). Furthermore, it reevaluates the relationship between reconstruction tasks and segmentation tasks from the perspective of DPConv, leading to the proposal of a dual-network model called the Siamese Reconstruction-Segmentation Network (SRSNet). The proposed model is not only a universal network but also enhances the segmentation performance without altering its structure, leveraging the reconstruction task. Additionally, as the amount of training data for the reconstruction network increases, the performance of the segmentation network also improves synchronously. On seven datasets including five medical datasets and two infrared image datasets, our SRSNet consistently achieves the best segmentation results. The code is released at https://github.com/fidshu/SRSNet.

CMUNeXt: An Efficient Medical Image Segmentation Network based on Large Kernel and Skip Fusion

The U-shaped architecture has emerged as a crucial paradigm in the design of medical image segmentation networks. However, due to the inherent local limitations of convolution, a fully convolutional segmentation network with U-shaped architecture struggles to effectively extract global context information, which is vital for the precise localization of lesions. While hybrid architectures combining CNNs and Transformers can address these issues, their application in real medical scenarios is limited due to the computational resource constraints imposed by the environment and edge devices. In addition, the convolutional inductive bias in lightweight networks adeptly fits the scarce medical data, which is lacking in the Transformer based network. In order to extract global context information while taking advantage of the inductive bias, we propose CMUNeXt, an efficient fully convolutional lightweight medical image segmentation network, which enables fast and accurate auxiliary diagnosis in real scene scenarios. CMUNeXt leverages large kernel and inverted bottleneck design to thoroughly mix distant spatial and location information, efficiently extracting global context information. We also introduce the Skip-Fusion block, designed to enable smooth skip-connections and ensure ample feature fusion. Experimental results on multiple medical image datasets demonstrate that CMUNeXt outperforms existing heavyweight and lightweight medical image segmentation networks in terms of segmentation performance, while offering a faster inference speed, lighter weights, and a reduced computational cost. The code is available at https://github.com/FengheTan9/CMUNeXt.

Thinking Twice: Clinical-Inspired Thyroid Ultrasound Lesion Detection Based on Feature Feedback

Accurate detection of thyroid lesions is a critical aspect of computer-aided diagnosis. However, most existing detection methods perform only one feature extraction process and then fuse multi-scale features, which can be affected by noise and blurred features in ultrasound images. In this study, we propose a novel detection network based on a feature feedback mechanism inspired by clinical diagnosis. The mechanism involves first roughly observing the overall picture and then focusing on the details of interest. It comprises two parts: a feedback feature selection module and a feature feedback pyramid. The feedback feature selection module efficiently selects the features extracted in the first phase in both space and channel dimensions to generate high semantic prior knowledge, which is similar to coarse observation. The feature feedback pyramid then uses this high semantic prior knowledge to enhance feature extraction in the second phase and adaptively fuses the two features, similar to fine observation. Additionally, since radiologists often focus on the shape and size of lesions for diagnosis, we propose an adaptive detection head strategy to aggregate multi-scale features. Our proposed method achieves an AP of 70.3% and AP50 of 99.0% on the thyroid ultrasound dataset and meets the real-time requirement. The code is available at https://github.com/HIT-wanglingtao/Thinking-Twice.