SAS: Segment Anything Small for Ultrasound -- A Non-Generative Data Augmentation Technique for Robust Deep Learning in Ultrasound Imaging

Accurate segmentation of anatomical structures in ultrasound (US) images, particularly small ones, is challenging due to noise and variability in imaging conditions (e.g., probe position, patient anatomy, tissue characteristics and pathology). To address this, we introduce Segment Anything Small (SAS), a simple yet effective scale- and texture-aware data augmentation technique designed to enhance the performance of deep learning models for segmenting small anatomical structures in ultrasound images. SAS employs a dual transformation strategy: (1) simulating diverse organ scales by resizing and embedding organ thumbnails into a black background, and (2) injecting noise into regions of interest to simulate varying tissue textures. These transformations generate realistic and diverse training data without introducing hallucinations or artifacts, improving the model's robustness to noise and variability. We fine-tuned a promptable foundation model on a controlled organ-specific medical imaging dataset and evaluated its performance on one internal and five external datasets. Experimental results demonstrate significant improvements in segmentation performance, with Dice score gains of up to 0.35 and an average improvement of 0.16 [95% CI 0.132,0.188]. Additionally, our iterative point prompts provide precise control and adaptive refinement, achieving performance comparable to bounding box prompts with just two points. SAS enhances model robustness and generalizability across diverse anatomical structures and imaging conditions, particularly for small structures, without compromising the accuracy of larger ones. By offering a computationally efficient solution that eliminates the need for extensive human labeling efforts, SAS emerges as a powerful tool for advancing medical image analysis, particularly in resource-constrained settings.

Adversarial Focal Loss: Asking Your Discriminator for Hard Examples

Focal Loss has reached incredible popularity as it uses a simple technique to identify and utilize hard examples to achieve better performance on classification. However, this method does not easily generalize outside of classification tasks, such as in keypoint detection. In this paper, we propose a novel adaptation of Focal Loss for keypoint detection tasks, called Adversarial Focal Loss (AFL). AFL not only is semantically analogous to Focal loss, but also works as a plug-and-chug upgrade for arbitrary loss functions. While Focal Loss requires output from a classifier, AFL leverages a separate adversarial network to produce a difficulty score for each input. This difficulty score can then be used to dynamically prioritize learning on hard examples, even in absence of a classifier. In this work, we show AFL's effectiveness in enhancing existing methods in keypoint detection and verify its capability to re-weigh examples based on difficulty.

FastEstimator: A Deep Learning Library for Fast Prototyping and Productization

As the complexity of state-of-the-art deep learning models increases by the month, implementation, interpretation, and traceability become ever-more-burdensome challenges for AI practitioners around the world. Several AI frameworks have risen in an effort to stem this tide, but the steady advance of the field has begun to test the bounds of their flexibility, expressiveness, and ease of use. To address these concerns, we introduce a radically flexible high-level open source deep learning framework for both research and industry. We introduce FastEstimator.