DiNO-Diffusion. Scaling Medical Diffusion via Self-Supervised Pre-Training

Diffusion models (DMs) have emerged as powerful foundation models for a variety of tasks, with a large focus in synthetic image generation. However, their requirement of large annotated datasets for training limits their applicability in medical imaging, where datasets are typically smaller and sparsely annotated. We introduce DiNO-Diffusion, a self-supervised method for training latent diffusion models (LDMs) that conditions the generation process on image embeddings extracted from DiNO. By eliminating the reliance on annotations, our training leverages over 868k unlabelled images from public chest X-Ray (CXR) datasets. Despite being self-supervised, DiNO-Diffusion shows comprehensive manifold coverage, with FID scores as low as 4.7, and emerging properties when evaluated in downstream tasks. It can be used to generate semantically-diverse synthetic datasets even from small data pools, demonstrating up to 20% AUC increase in classification performance when used for data augmentation. Images were generated with different sampling strategies over the DiNO embedding manifold and using real images as a starting point. Results suggest, DiNO-Diffusion could facilitate the creation of large datasets for flexible training of downstream AI models from limited amount of real data, while also holding potential for privacy preservation. Additionally, DiNO-Diffusion demonstrates zero-shot segmentation performance of up to 84.4% Dice score when evaluating lung lobe segmentation. This evidences good CXR image-anatomy alignment, akin to segmenting using textual descriptors on vanilla DMs. Finally, DiNO-Diffusion can be easily adapted to other medical imaging modalities or state-of-the-art diffusion models, opening the door for large-scale, multi-domain image generation pipelines for medical imaging.

Towards Hierarchical Regional Transformer-based Multiple Instance Learning

The classification of gigapixel histopathology images with deep multiple instance learning models has become a critical task in digital pathology and precision medicine. In this work, we propose a Transformer-based multiple instance learning approach that replaces the traditional learned attention mechanism with a regional, Vision Transformer inspired self-attention mechanism. We present a method that fuses regional patch information to derive slide-level predictions and show how this regional aggregation can be stacked to hierarchically process features on different distance levels. To increase predictive accuracy, especially for datasets with small, local morphological features, we introduce a method to focus the image processing on high attention regions during inference. Our approach is able to significantly improve performance over the baseline on two histopathology datasets and points towards promising directions for further research.