Chest X-ray Foundation Model with Global and Local Representations Integration

Chest X-ray (CXR) is the most frequently ordered imaging test, supporting diverse clinical tasks from thoracic disease detection to postoperative monitoring. However, task-specific classification models are limited in scope, require costly labeled data, and lack generalizability to out-of-distribution datasets. To address these challenges, we introduce CheXFound, a self-supervised vision foundation model that learns robust CXR representations and generalizes effectively across a wide range of downstream tasks. We pretrain CheXFound on a curated CXR-1M dataset, comprising over one million unique CXRs from publicly available sources. We propose a Global and Local Representations Integration (GLoRI) module for downstream adaptations, by incorporating disease-specific local features with global image features for enhanced performance in multilabel classification. Our experimental results show that CheXFound outperforms state-of-the-art models in classifying 40 disease findings across different prevalence levels on the CXR-LT 24 dataset and exhibits superior label efficiency on downstream tasks with limited training data. Additionally, CheXFound achieved significant improvements on new tasks with out-of-distribution datasets, including opportunistic cardiovascular disease risk estimation and mortality prediction. These results highlight CheXFound's strong generalization capabilities, enabling diverse adaptations with improved label efficiency. The project source code is publicly available at https://github.com/RPIDIAL/CheXFound.

Integrating AI in College Education: Positive yet Mixed Experiences with ChatGPT

The integration of artificial intelligence (AI) chatbots into higher education marks a shift towards a new generation of pedagogical tools, mirroring the arrival of milestones like the internet. With the launch of ChatGPT-4 Turbo in November 2023, we developed a ChatGPT-based teaching application (https://chat.openai.com/g/g-1imx1py4K-chatge-medical-imaging) and integrated it into our undergraduate medical imaging course in the Spring 2024 semester. This study investigates the use of ChatGPT throughout a semester-long trial, providing insights into students' engagement, perception, and the overall educational effectiveness of the technology. We systematically collected and analyzed data concerning students' interaction with ChatGPT, focusing on their attitudes, concerns, and usage patterns. The findings indicate that ChatGPT offers significant advantages such as improved information access and increased interactivity, but its adoption is accompanied by concerns about the accuracy of the information provided and the necessity for well-defined guidelines to optimize its use.

Cardiovascular Disease Detection from Multi-View Chest X-rays with BI-Mamba

Accurate prediction of Cardiovascular disease (CVD) risk in medical imaging is central to effective patient health management. Previous studies have demonstrated that imaging features in computed tomography (CT) can help predict CVD risk. However, CT entails notable radiation exposure, which may result in adverse health effects for patients. In contrast, chest X-ray emits significantly lower levels of radiation, offering a safer option. This rationale motivates our investigation into the feasibility of using chest X-ray for predicting CVD risk. Convolutional Neural Networks (CNNs) and Transformers are two established network architectures for computer-aided diagnosis. However, they struggle to model very high resolution chest X-ray due to the lack of large context modeling power or quadratic time complexity. Inspired by state space sequence models (SSMs), a new class of network architectures with competitive sequence modeling power as Transfomers and linear time complexity, we propose Bidirectional Image Mamba (BI-Mamba) to complement the unidirectional SSMs with opposite directional information. BI-Mamba utilizes parallel forward and backwark blocks to encode longe-range dependencies of multi-view chest X-rays. We conduct extensive experiments on images from 10,395 subjects in National Lung Screening Trail (NLST). Results show that BI-Mamba outperforms ResNet-50 and ViT-S with comparable parameter size, and saves significant amount of GPU memory during training. Besides, BI-Mamba achieves promising performance compared with previous state of the art in CT, unraveling the potential of chest X-ray for CVD risk prediction.

Disease-informed Adaptation of Vision-Language Models

In medical image analysis, the expertise scarcity and the high cost of data annotation limits the development of large artificial intelligence models. This paper investigates the potential of transfer learning with pre-trained vision-language models (VLMs) in this domain. Currently, VLMs still struggle to transfer to the underrepresented diseases with minimal presence and new diseases entirely absent from the pretraining dataset. We argue that effective adaptation of VLMs hinges on the nuanced representation learning of disease concepts. By capitalizing on the joint visual-linguistic capabilities of VLMs, we introduce disease-informed contextual prompting in a novel disease prototype learning framework. This approach enables VLMs to grasp the concepts of new disease effectively and efficiently, even with limited data. Extensive experiments across multiple image modalities showcase notable enhancements in performance compared to existing techniques.

Spectral Adversarial MixUp for Few-Shot Unsupervised Domain Adaptation

Domain shift is a common problem in clinical applications, where the training images (source domain) and the test images (target domain) are under different distributions. Unsupervised Domain Adaptation (UDA) techniques have been proposed to adapt models trained in the source domain to the target domain. However, those methods require a large number of images from the target domain for model training. In this paper, we propose a novel method for Few-Shot Unsupervised Domain Adaptation (FSUDA), where only a limited number of unlabeled target domain samples are available for training. To accomplish this challenging task, first, a spectral sensitivity map is introduced to characterize the generalization weaknesses of models in the frequency domain. We then developed a Sensitivity-guided Spectral Adversarial MixUp (SAMix) method to generate target-style images to effectively suppresses the model sensitivity, which leads to improved model generalizability in the target domain. We demonstrated the proposed method and rigorously evaluated its performance on multiple tasks using several public datasets.

Dynamic Ensemble of Low-fidelity Experts: Mitigating NAS "Cold-Start"

Predictor-based Neural Architecture Search (NAS) employs an architecture performance predictor to improve the sample efficiency. However, predictor-based NAS suffers from the severe ``cold-start'' problem, since a large amount of architecture-performance data is required to get a working predictor. In this paper, we focus on exploiting information in cheaper-to-obtain performance estimations (i.e., low-fidelity information) to mitigate the large data requirements of predictor training. Despite the intuitiveness of this idea, we observe that using inappropriate low-fidelity information even damages the prediction ability and different search spaces have different preferences for low-fidelity information types. To solve the problem and better fuse beneficial information provided by different types of low-fidelity information, we propose a novel dynamic ensemble predictor framework that comprises two steps. In the first step, we train different sub-predictors on different types of available low-fidelity information to extract beneficial knowledge as low-fidelity experts. In the second step, we learn a gating network to dynamically output a set of weighting coefficients conditioned on each input neural architecture, which will be used to combine the predictions of different low-fidelity experts in a weighted sum. The overall predictor is optimized on a small set of actual architecture-performance data to fuse the knowledge from different low-fidelity experts to make the final prediction. We conduct extensive experiments across five search spaces with different architecture encoders under various experimental settings. Our method can easily be incorporated into existing predictor-based NAS frameworks to discover better architectures.

When Neural Networks Fail to Generalize? A Model Sensitivity Perspective

Domain generalization (DG) aims to train a model to perform well in unseen domains under different distributions. This paper considers a more realistic yet more challenging scenario,namely Single Domain Generalization (Single-DG), where only a single source domain is available for training. To tackle this challenge, we first try to understand when neural networks fail to generalize? We empirically ascertain a property of a model that correlates strongly with its generalization that we coin as "model sensitivity". Based on our analysis, we propose a novel strategy of Spectral Adversarial Data Augmentation (SADA) to generate augmented images targeted at the highly sensitive frequencies. Models trained with these hard-to-learn samples can effectively suppress the sensitivity in the frequency space, which leads to improved generalization performance. Extensive experiments on multiple public datasets demonstrate the superiority of our approach, which surpasses the state-of-the-art single-DG methods.

Regression Metric Loss: Learning a Semantic Representation Space for Medical Images

Regression plays an essential role in many medical imaging applications for estimating various clinical risk or measurement scores. While training strategies and loss functions have been studied for the deep neural networks in medical image classification tasks, options for regression tasks are very limited. One of the key challenges is that the high-dimensional feature representation learned by existing popular loss functions like Mean Squared Error or L1 loss is hard to interpret. In this paper, we propose a novel Regression Metric Loss (RM-Loss), which endows the representation space with the semantic meaning of the label space by finding a representation manifold that is isometric to the label space. Experiments on two regression tasks, i.e. coronary artery calcium score estimation and bone age assessment, show that RM-Loss is superior to the existing popular regression losses on both performance and interpretability. Code is available at https://github.com/DIAL-RPI/Regression-Metric-Loss.

Task-Oriented Low-Dose CT Image Denoising

The extensive use of medical CT has raised a public concern over the radiation dose to the patient. Reducing the radiation dose leads to increased CT image noise and artifacts, which can adversely affect not only the radiologists judgement but also the performance of downstream medical image analysis tasks. Various low-dose CT denoising methods, especially the recent deep learning based approaches, have produced impressive results. However, the existing denoising methods are all downstream-task-agnostic and neglect the diverse needs of the downstream applications. In this paper, we introduce a novel Task-Oriented Denoising Network (TOD-Net) with a task-oriented loss leveraging knowledge from the downstream tasks. Comprehensive empirical analysis shows that the task-oriented loss complements other task agnostic losses by steering the denoiser to enhance the image quality in the task related regions of interest. Such enhancement in turn brings general boosts on the performance of various methods for the downstream task. The presented work may shed light on the future development of context-aware image denoising methods.

Robustified Domain Adaptation

Unsupervised domain adaptation (UDA) is widely used to transfer a model trained in a labeled source domain to an unlabeled target domain. However, with extensive studies showing deep learning models being vulnerable under adversarial attacks, the adversarial robustness of models in domain adaptation application has largely been overlooked. In this paper, we first conducted an empirical analysis to show that severe inter-class mismatch is the key barrier against achieving a robust model with UDA. Then, we propose a novel approach, Class-consistent Unsupervised Robust Domain Adaptation (CURDA), for robustified unsupervised domain adaptation. With the introduced contrastive robust training and source anchored adversarial contrastive loss, our proposed CURDA is able to effectively conquer the challenge of inter-class mismatch. Experiments on two public benchmarks show that, compared with vanilla UDA, CURDA can significantly improve model robustness in target domains for up to 67.4% costing only 0% to 4.4% of accuracy on the clean data samples. This is one of the first works focusing on the new problem of robustifying unsupervised domain adaptation, which demonstrates that UDA models can be substantially robustified while maintaining competitive accuracy.