RaD: A Metric for Medical Image Distribution Comparison in Out-of-Domain Detection and Other Applications

Determining whether two sets of images belong to the same or different domain is a crucial task in modern medical image analysis and deep learning, where domain shift is a common problem that commonly results in decreased model performance. This determination is also important to evaluate the output quality of generative models, e.g., image-to-image translation models used to mitigate domain shift. Current metrics for this either rely on the (potentially biased) choice of some downstream task such as segmentation, or adopt task-independent perceptual metrics (e.g., FID) from natural imaging which insufficiently capture anatomical consistency and realism in medical images. We introduce a new perceptual metric tailored for medical images: Radiomic Feature Distance (RaD), which utilizes standardized, clinically meaningful and interpretable image features. We show that RaD is superior to other metrics for out-of-domain (OOD) detection in a variety of experiments. Furthermore, RaD outperforms previous perceptual metrics (FID, KID, etc.) for image-to-image translation by correlating more strongly with downstream task performance as well as anatomical consistency and realism, and shows similar utility for evaluating unconditional image generation. RaD also offers additional benefits such as interpretability, as well as stability and computational efficiency at low sample sizes. Our results are supported by broad experiments spanning four multi-domain medical image datasets, nine downstream tasks, six image translation models, and other factors, highlighting the broad potential of RaD for medical image analysis.

Touchstone Benchmark: Are We on the Right Way for Evaluating AI Algorithms for Medical Segmentation?

How can we test AI performance? This question seems trivial, but it isn't. Standard benchmarks often have problems such as in-distribution and small-size test sets, oversimplified metrics, unfair comparisons, and short-term outcome pressure. As a consequence, good performance on standard benchmarks does not guarantee success in real-world scenarios. To address these problems, we present Touchstone, a large-scale collaborative segmentation benchmark of 9 types of abdominal organs. This benchmark is based on 5,195 training CT scans from 76 hospitals around the world and 5,903 testing CT scans from 11 additional hospitals. This diverse test set enhances the statistical significance of benchmark results and rigorously evaluates AI algorithms across various out-of-distribution scenarios. We invited 14 inventors of 19 AI algorithms to train their algorithms, while our team, as a third party, independently evaluated these algorithms on three test sets. In addition, we also evaluated pre-existing AI frameworks--which, differing from algorithms, are more flexible and can support different algorithms--including MONAI from NVIDIA, nnU-Net from DKFZ, and numerous other open-source frameworks. We are committed to expanding this benchmark to encourage more innovation of AI algorithms for the medical domain.

Table-LLM-Specialist: Language Model Specialists for Tables using Iterative Generator-Validator Fine-tuning

In this work, we propose Table-LLM-Specialist, or Table-Specialist for short, as a new self-trained fine-tuning paradigm specifically designed for table tasks. Our insight is that for each table task, there often exist two dual versions of the same task, one generative and one classification in nature. Leveraging their duality, we propose a Generator-Validator paradigm, to iteratively generate-then-validate training data from language-models, to fine-tune stronger \sys models that can specialize in a given task, without requiring manually-labeled data. Our extensive evaluations suggest that our Table-Specialist has (1) \textit{strong performance} on diverse table tasks over vanilla language-models -- for example, Table-Specialist fine-tuned on GPT-3.5 not only outperforms vanilla GPT-3.5, but can often match or surpass GPT-4 level quality, (2) \textit{lower cost} to deploy, because when Table-Specialist fine-tuned on GPT-3.5 achieve GPT-4 level quality, it becomes possible to deploy smaller models with lower latency and inference cost, with comparable quality, and (3) \textit{better generalizability} when evaluated across multiple benchmarks, since \sys is fine-tuned on a broad range of training data systematically generated from diverse real tables. Our code and data will be available at https://github.com/microsoft/Table-LLM-Specialist.

DocTabQA: Answering Questions from Long Documents Using Tables

We study a new problem setting of question answering (QA), referred to as DocTabQA. Within this setting, given a long document, the goal is to respond to questions by organizing the answers into structured tables derived directly from the document's content. Unlike traditional QA approaches which predominantly rely on unstructured text to formulate responses, DocTabQA aims to leverage structured tables as answers to convey information clearly and systematically, thereby enhancing user comprehension and highlighting relationships between data points. To the best of our knowledge, this problem has not been previously explored. In this paper, we introduce the QTabA dataset, encompassing 300 financial documents, accompanied by manually annotated 1.5k question-table pairs. Initially, we leverage Large Language Models (LLMs) such as GPT-4 to establish a baseline. However, it is widely acknowledged that LLMs encounter difficulties when tasked with generating intricate, structured outputs from long input sequences. To overcome these challenges, we present a two-stage framework, called DocTabTalk, which initially retrieves relevant sentences from extensive documents and subsequently generates hierarchical tables based on these identified sentences. DocTabTalk incorporates two key technological innovations: AlignLLaMA and TabTalk, which are specifically tailored to assist GPT-4 in tackling DocTabQA, enabling it to generate well-structured, hierarchical tables with improved organization and clarity. Comprehensive experimental evaluations conducted on both QTabA and RotoWire datasets demonstrate that our DocTabTalk significantly enhances the performances of the GPT-4 in our proposed DocTabQA task and the table generation task. The code and dataset are available at https://github.com/SmileWHC/DocTabQA for further research.

Segment anything model 2: an application to 2D and 3D medical images

Segment Anything Model (SAM) has gained significant attention because of its ability to segment varous objects in images given a prompt. The recently developed SAM 2 has extended this ability to video inputs. This opens an opportunity to apply SAM to 3D images, one of the fundamental tasks in the medical imaging field. In this paper, we extensively evaluate SAM 2's ability to segment both 2D and 3D medical images by first collecting 18 medical imaging datasets, including common 3D modalities such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) as well as 2D modalities such as X-ray and ultrasound. Two evaluation pipelines of SAM 2 are considered: (1) multi-frame 3D segmentation, where prompts are provided to one or multiple slice(s) selected from the volume, and (2) single-frame 2D segmentation, where prompts are provided to each slice. The former is only applicable to 3D modalities, while the latter applies to both 2D and 3D modalities. Our results show that SAM 2 exhibits similar performance as SAM under single-frame 2D segmentation, and has variable performance under multi-frame 3D segmentation depending on the choices of slices to annotate, the direction of the propagation, the predictions utilized during the propagation, etc.

SpreadsheetLLM: Encoding Spreadsheets for Large Language Models

Spreadsheets, with their extensive two-dimensional grids, various layouts, and diverse formatting options, present notable challenges for large language models (LLMs). In response, we introduce SpreadsheetLLM, pioneering an efficient encoding method designed to unleash and optimize LLMs' powerful understanding and reasoning capability on spreadsheets. Initially, we propose a vanilla serialization approach that incorporates cell addresses, values, and formats. However, this approach was limited by LLMs' token constraints, making it impractical for most applications. To tackle this challenge, we develop SheetCompressor, an innovative encoding framework that compresses spreadsheets effectively for LLMs. It comprises three modules: structural-anchor-based compression, inverse index translation, and data-format-aware aggregation. It significantly improves performance in spreadsheet table detection task, outperforming the vanilla approach by 25.6% in GPT4's in-context learning setting. Moreover, fine-tuned LLM with SheetCompressor has an average compression ratio of 25 times, but achieves a state-of-the-art 78.9% F1 score, surpassing the best existing models by 12.3%. Finally, we propose Chain of Spreadsheet for downstream tasks of spreadsheet understanding and validate in a new and demanding spreadsheet QA task. We methodically leverage the inherent layout and structure of spreadsheets, demonstrating that SpreadsheetLLM is highly effective across a variety of spreadsheet tasks.

MMedAgent: Learning to Use Medical Tools with Multi-modal Agent

Multi-Modal Large Language Models (MLLMs), despite being successful, exhibit limited generality and often fall short when compared to specialized models. Recently, LLM-based agents have been developed to address these challenges by selecting appropriate specialized models as tools based on user inputs. However, such advancements have not been extensively explored within the medical domain. To bridge this gap, this paper introduces the first agent explicitly designed for the medical field, named \textbf{M}ulti-modal \textbf{Med}ical \textbf{Agent} (MMedAgent). We curate an instruction-tuning dataset comprising six medical tools solving seven tasks, enabling the agent to choose the most suitable tools for a given task. Comprehensive experiments demonstrate that MMedAgent achieves superior performance across a variety of medical tasks compared to state-of-the-art open-source methods and even the closed-source model, GPT-4o. Furthermore, MMedAgent exhibits efficiency in updating and integrating new medical tools.

Vision Language Models for Spreadsheet Understanding: Challenges and Opportunities

This paper explores capabilities of Vision Language Models on spreadsheet comprehension. We propose three self-supervised challenges with corresponding evaluation metrics to comprehensively evaluate VLMs on Optical Character Recognition (OCR), spatial perception, and visual format recognition. Additionally, we utilize the spreadsheet table detection task to assess the overall performance of VLMs by integrating these challenges. To probe VLMs more finely, we propose three spreadsheet-to-image settings: column width adjustment, style change, and address augmentation. We propose variants of prompts to address the above tasks in different settings. Notably, to leverage the strengths of VLMs in understanding text rather than two-dimensional positioning, we propose to decode cell values on the four boundaries of the table in spreadsheet boundary detection. Our findings reveal that VLMs demonstrate promising OCR capabilities but produce unsatisfactory results due to cell omission and misalignment, and they notably exhibit insufficient spatial and format recognition skills, motivating future work to enhance VLMs' spreadsheet data comprehension capabilities using our methods to generate extensive spreadsheet-image pairs in various settings.

KET-QA: A Dataset for Knowledge Enhanced Table Question Answering

Due to the concise and structured nature of tables, the knowledge contained therein may be incomplete or missing, posing a significant challenge for table question answering (TableQA) and data analysis systems. Most existing datasets either fail to address the issue of external knowledge in TableQA or only utilize unstructured text as supplementary information for tables. In this paper, we propose to use a knowledge base (KB) as the external knowledge source for TableQA and construct a dataset KET-QA with fine-grained gold evidence annotation. Each table in the dataset corresponds to a sub-graph of the entire KB, and every question requires the integration of information from both the table and the sub-graph to be answered. To extract pertinent information from the vast knowledge sub-graph and apply it to TableQA, we design a retriever-reasoner structured pipeline model. Experimental results demonstrate that our model consistently achieves remarkable relative performance improvements ranging from 1.9 to 6.5 times and absolute improvements of 11.66% to 44.64% on EM scores across three distinct settings (fine-tuning, zero-shot, and few-shot), in comparison with solely relying on table information in the traditional TableQA manner. However, even the best model achieves a 60.23% EM score, which still lags behind the human-level performance, highlighting the challenging nature of KET-QA for the question-answering community. We also provide a human evaluation of error cases to analyze further the aspects in which the model can be improved. Project page: https://ketqa.github.io/.

How to build the best medical image segmentation algorithm using foundation models: a comprehensive empirical study with Segment Anything Model

Automated segmentation is a fundamental medical image analysis task, which enjoys significant advances due to the advent of deep learning. While foundation models have been useful in natural language processing and some vision tasks for some time, the foundation model developed with image segmentation in mind - Segment Anything Model (SAM) - has been developed only recently and has shown similar promise. However, there are still no systematic analyses or ``best-practice'' guidelines for optimal fine-tuning of SAM for medical image segmentation. This work summarizes existing fine-tuning strategies with various backbone architectures, model components, and fine-tuning algorithms across 18 combinations, and evaluates them on 17 datasets covering all common radiology modalities. Our study reveals that (1) fine-tuning SAM leads to slightly better performance than previous segmentation methods, (2) fine-tuning strategies that use parameter-efficient learning in both the encoder and decoder are superior to other strategies, (3) network architecture has a small impact on final performance, (4) further training SAM with self-supervised learning can improve final model performance. We also demonstrate the ineffectiveness of some methods popular in the literature and further expand our experiments into few-shot and prompt-based settings. Lastly, we released our code and MRI-specific fine-tuned weights, which consistently obtained superior performance over the original SAM, at https://github.com/mazurowski-lab/finetune-SAM.