Alleviating Class Imbalance in Semi-supervised Multi-organ Segmentation via Balanced Subclass Regularization

Semi-supervised learning (SSL) has shown notable potential in relieving the heavy demand of dense prediction tasks on large-scale well-annotated datasets, especially for the challenging multi-organ segmentation (MoS). However, the prevailing class-imbalance problem in MoS, caused by the substantial variations in organ size, exacerbates the learning difficulty of the SSL network. To alleviate this issue, we present a two-phase semi-supervised network (BSR-Net) with balanced subclass regularization for MoS. Concretely, in Phase I, we introduce a class-balanced subclass generation strategy based on balanced clustering to effectively generate multiple balanced subclasses from original biased ones according to their pixel proportions. Then, in Phase II, we design an auxiliary subclass segmentation (SCS) task within the multi-task framework of the main MoS task. The SCS task contributes a balanced subclass regularization to the main MoS task and transfers unbiased knowledge to the MoS network, thus alleviating the influence of the class-imbalance problem. Extensive experiments conducted on two publicly available datasets, i.e., the MICCAI FLARE 2022 dataset and the WORD dataset, verify the superior performance of our method compared with other methods.

S3PET: Semi-supervised Standard-dose PET Image Reconstruction via Dose-aware Token Swap

To acquire high-quality positron emission tomography (PET) images while reducing the radiation tracer dose, numerous efforts have been devoted to reconstructing standard-dose PET (SPET) images from low-dose PET (LPET). However, the success of current fully-supervised approaches relies on abundant paired LPET and SPET images, which are often unavailable in clinic. Moreover, these methods often mix the dose-invariant content with dose level-related dose-specific details during reconstruction, resulting in distorted images. To alleviate these problems, in this paper, we propose a two-stage Semi-Supervised SPET reconstruction framework, namely S3PET, to accommodate the training of abundant unpaired and limited paired SPET and LPET images. Our S3PET involves an un-supervised pre-training stage (Stage I) to extract representations from unpaired images, and a supervised dose-aware reconstruction stage (Stage II) to achieve LPET-to-SPET reconstruction by transferring the dose-specific knowledge between paired images. Specifically, in stage I, two independent dose-specific masked autoencoders (DsMAEs) are adopted to comprehensively understand the unpaired SPET and LPET images. Then, in Stage II, the pre-trained DsMAEs are further finetuned using paired images. To prevent distortions in both content and details, we introduce two elaborate modules, i.e., a dose knowledge decouple module to disentangle the respective dose-specific and dose-invariant knowledge of LPET and SPET, and a dose-specific knowledge learning module to transfer the dose-specific information from SPET to LPET, thereby achieving high-quality SPET reconstruction from LPET images. Experiments on two datasets demonstrate that our S3PET achieves state-of-the-art performance quantitatively and qualitatively.

MCAD: Multi-modal Conditioned Adversarial Diffusion Model for High-Quality PET Image Reconstruction

Radiation hazards associated with standard-dose positron emission tomography (SPET) images remain a concern, whereas the quality of low-dose PET (LPET) images fails to meet clinical requirements. Therefore, there is great interest in reconstructing SPET images from LPET images. However, prior studies focus solely on image data, neglecting vital complementary information from other modalities, e.g., patients' clinical tabular, resulting in compromised reconstruction with limited diagnostic utility. Moreover, they often overlook the semantic consistency between real SPET and reconstructed images, leading to distorted semantic contexts. To tackle these problems, we propose a novel Multi-modal Conditioned Adversarial Diffusion model (MCAD) to reconstruct SPET images from multi-modal inputs, including LPET images and clinical tabular. Specifically, our MCAD incorporates a Multi-modal conditional Encoder (Mc-Encoder) to extract multi-modal features, followed by a conditional diffusion process to blend noise with multi-modal features and gradually map blended features to the target SPET images. To balance multi-modal inputs, the Mc-Encoder embeds Optimal Multi-modal Transport co-Attention (OMTA) to narrow the heterogeneity gap between image and tabular while capturing their interactions, providing sufficient guidance for reconstruction. In addition, to mitigate semantic distortions, we introduce the Multi-Modal Masked Text Reconstruction (M3TRec), which leverages semantic knowledge extracted from denoised PET images to restore the masked clinical tabular, thereby compelling the network to maintain accurate semantics during reconstruction. To expedite the diffusion process, we further introduce an adversarial diffusive network with a reduced number of diffusion steps. Experiments show that our method achieves the state-of-the-art performance both qualitatively and quantitatively.

Two-Phase Multi-Dose-Level PET Image Reconstruction with Dose Level Awareness

To obtain high-quality positron emission tomography (PET) while minimizing radiation exposure, a range of methods have been designed to reconstruct standard-dose PET (SPET) from corresponding low-dose PET (LPET) images. However, most current methods merely learn the mapping between single-dose-level LPET and SPET images, but omit the dose disparity of LPET images in clinical scenarios. In this paper, to reconstruct high-quality SPET images from multi-dose-level LPET images, we design a novel two-phase multi-dose-level PET reconstruction algorithm with dose level awareness, containing a pre-training phase and a SPET prediction phase. Specifically, the pre-training phase is devised to explore both fine-grained discriminative features and effective semantic representation. The SPET prediction phase adopts a coarse prediction network utilizing pre-learned dose level prior to generate preliminary result, and a refinement network to precisely preserve the details. Experiments on MICCAI 2022 Ultra-low Dose PET Imaging Challenge Dataset have demonstrated the superiority of our method.

Dose Prediction Driven Radiotherapy Paramters Regression via Intra- and Inter-Relation Modeling

Deep learning has facilitated the automation of radiotherapy by predicting accurate dose distribution maps. However, existing methods fail to derive the desirable radiotherapy parameters that can be directly input into the treatment planning system (TPS), impeding the full automation of radiotherapy. To enable more thorough automatic radiotherapy, in this paper, we propose a novel two-stage framework to directly regress the radiotherapy parameters, including a dose map prediction stage and a radiotherapy parameters regression stage. In stage one, we combine transformer and convolutional neural network (CNN) to predict realistic dose maps with rich global and local information, providing accurate dosimetric knowledge for the subsequent parameters regression. In stage two, two elaborate modules, i.e., an intra-relation modeling (Intra-RM) module and an inter-relation modeling (Inter-RM) module, are designed to exploit the organ-specific and organ-shared features for precise parameters regression. Experimental results on a rectal cancer dataset demonstrate the effectiveness of our method.

Image2Points:A 3D Point-based Context Clusters GAN for High-Quality PET Image Reconstruction

To obtain high-quality Positron emission tomography (PET) images while minimizing radiation exposure, numerous methods have been proposed to reconstruct standard-dose PET (SPET) images from the corresponding low-dose PET (LPET) images. However, these methods heavily rely on voxel-based representations, which fall short of adequately accounting for the precise structure and fine-grained context, leading to compromised reconstruction. In this paper, we propose a 3D point-based context clusters GAN, namely PCC-GAN, to reconstruct high-quality SPET images from LPET. Specifically, inspired by the geometric representation power of points, we resort to a point-based representation to enhance the explicit expression of the image structure, thus facilitating the reconstruction with finer details. Moreover, a context clustering strategy is applied to explore the contextual relationships among points, which mitigates the ambiguities of small structures in the reconstructed images. Experiments on both clinical and phantom datasets demonstrate that our PCC-GAN outperforms the state-of-the-art reconstruction methods qualitatively and quantitatively. Code is available at https://github.com/gluucose/PCCGAN.

TriDo-Former: A Triple-Domain Transformer for Direct PET Reconstruction from Low-Dose Sinograms

To obtain high-quality positron emission tomography (PET) images while minimizing radiation exposure, various methods have been proposed for reconstructing standard-dose PET (SPET) images from low-dose PET (LPET) sinograms directly. However, current methods often neglect boundaries during sinogram-to-image reconstruction, resulting in high-frequency distortion in the frequency domain and diminished or fuzzy edges in the reconstructed images. Furthermore, the convolutional architectures, which are commonly used, lack the ability to model long-range non-local interactions, potentially leading to inaccurate representations of global structures. To alleviate these problems, we propose a transformer-based model that unites triple domains of sinogram, image, and frequency for direct PET reconstruction, namely TriDo-Former. Specifically, the TriDo-Former consists of two cascaded networks, i.e., a sinogram enhancement transformer (SE-Former) for denoising the input LPET sinograms and a spatial-spectral reconstruction transformer (SSR-Former) for reconstructing SPET images from the denoised sinograms. Different from the vanilla transformer that splits an image into 2D patches, based specifically on the PET imaging mechanism, our SE-Former divides the sinogram into 1D projection view angles to maintain its inner-structure while denoising, preventing the noise in the sinogram from prorogating into the image domain. Moreover, to mitigate high-frequency distortion and improve reconstruction details, we integrate global frequency parsers (GFPs) into SSR-Former. The GFP serves as a learnable frequency filter that globally adjusts the frequency components in the frequency domain, enforcing the network to restore high-frequency details resembling real SPET images. Validations on a clinical dataset demonstrate that our TriDo-Former outperforms the state-of-the-art methods qualitatively and quantitatively.