Autonomous Robotic Ultrasound System for Liver Follow-up Diagnosis: Pilot Phantom Study

The paper introduces a novel autonomous robot ultrasound (US) system targeting liver follow-up scans for outpatients in local communities. Given a computed tomography (CT) image with specific target regions of interest, the proposed system carries out the autonomous follow-up scan in three steps: (i) initial robot contact to surface, (ii) coordinate mapping between CT image and robot, and (iii) target US scan. Utilizing 3D US-CT registration and deep learning-based segmentation networks, we can achieve precise imaging of 3D hepatic veins, facilitating accurate coordinate mapping between CT and the robot. This enables the automatic localization of follow-up targets within the CT image, allowing the robot to navigate precisely to the target's surface. Evaluation of the ultrasound phantom confirms the quality of the US-CT registration and shows the robot reliably locates the targets in repeated trials. The proposed framework holds the potential to significantly reduce time and costs for healthcare providers, clinicians, and follow-up patients, thereby addressing the increasing healthcare burden associated with chronic disease in local communities.

Prompt-driven Universal Model for View-Agnostic Echocardiography Analysis

Echocardiography segmentation for cardiac analysis is time-consuming and resource-intensive due to the variability in image quality and the necessity to process scans from various standard views. While current automated segmentation methods in echocardiography show promising performance, they are trained on specific scan views to analyze corresponding data. However, this solution has a limitation as the number of required models increases with the number of standard views. To address this, in this paper, we present a prompt-driven universal method for view-agnostic echocardiography analysis. Considering the domain shift between standard views, we first introduce a method called prompt matching, aimed at learning prompts specific to different views by matching prompts and querying input embeddings using a pre-trained vision model. Then, we utilized a pre-trained medical language model to align textual information with pixel data for accurate segmentation. Extensive experiments on three standard views showed that our approach significantly outperforms the state-of-the-art universal methods and achieves comparable or even better performances over the segmentation model trained and tested on same views.

MediViSTA-SAM: Zero-shot Medical Video Analysis with Spatio-temporal SAM Adaptation

In recent years, the Segmentation Anything Model (SAM) has attracted considerable attention as a foundational model well-known for its robust generalization capabilities across various downstream tasks. However, SAM does not exhibit satisfactory performance in the realm of medical image analysis. In this study, we introduce the first study on adapting SAM on video segmentation, called MediViSTA-SAM, a novel approach designed for medical video segmentation. Given video data, MediViSTA, spatio-temporal adapter captures long and short range temporal attention with cross-frame attention mechanism effectively constraining it to consider the immediately preceding video frame as a reference, while also considering spatial information effectively. Additionally, it incorporates multi-scale fusion by employing a U-shaped encoder and a modified mask decoder to handle objects of varying sizes. To evaluate our approach, extensive experiments were conducted using state-of-the-art (SOTA) methods, assessing its generalization abilities on multi-vendor in-house echocardiography datasets. The results highlight the accuracy and effectiveness of our network in medical video segmentation.

DULDA: Dual-domain Unsupervised Learned Descent Algorithm for PET image reconstruction

Deep learning based PET image reconstruction methods have achieved promising results recently. However, most of these methods follow a supervised learning paradigm, which rely heavily on the availability of high-quality training labels. In particular, the long scanning time required and high radiation exposure associated with PET scans make obtaining this labels impractical. In this paper, we propose a dual-domain unsupervised PET image reconstruction method based on learned decent algorithm, which reconstructs high-quality PET images from sinograms without the need for image labels. Specifically, we unroll the proximal gradient method with a learnable l2,1 norm for PET image reconstruction problem. The training is unsupervised, using measurement domain loss based on deep image prior as well as image domain loss based on rotation equivariance property. The experimental results domonstrate the superior performance of proposed method compared with maximum likelihood expectation maximazation (MLEM), total-variation regularized EM (EM-TV) and deep image prior based method (DIP).

A Noise-level-aware Framework for PET Image Denoising

In PET, the amount of relative (signal-dependent) noise present in different body regions can be significantly different and is inherently related to the number of counts present in that region. The number of counts in a region depends, in principle and among other factors, on the total administered activity, scanner sensitivity, image acquisition duration, radiopharmaceutical tracer uptake in the region, and patient local body morphometry surrounding the region. In theory, less amount of denoising operations is needed to denoise a high-count (low relative noise) image than images a low-count (high relative noise) image, and vice versa. The current deep-learning-based methods for PET image denoising are predominantly trained on image appearance only and have no special treatment for images of different noise levels. Our hypothesis is that by explicitly providing the local relative noise level of the input image to a deep convolutional neural network (DCNN), the DCNN can outperform itself trained on image appearance only. To this end, we propose a noise-level-aware framework denoising framework that allows embedding of local noise level into a DCNN. The proposed is trained and tested on 30 and 15 patient PET images acquired on a GE Discovery MI PET/CT system. Our experiments showed that the increases in both PSNR and SSIM from our backbone network with relative noise level embedding (NLE) versus the same network without NLE were statistically significant with p<0.001, and the proposed method significantly outperformed a strong baseline method by a large margin.

Federated Active Learning (F-AL): an Efficient Annotation Strategy for Federated Learning

Federated learning (FL) has been intensively investigated in terms of communication efficiency, privacy, and fairness. However, efficient annotation, which is a pain point in real-world FL applications, is less studied. In this project, we propose to apply active learning (AL) and sampling strategy into the FL framework to reduce the annotation workload. We expect that the AL and FL can improve the performance of each other complementarily. In our proposed federated active learning (F-AL) method, the clients collaboratively implement the AL to obtain the instances which are considered as informative to FL in a distributed optimization manner. We compare the test accuracies of the global FL models using the conventional random sampling strategy, client-level separate AL (S-AL), and the proposed F-AL. We empirically demonstrate that the F-AL outperforms baseline methods in image classification tasks.

Deep Metric Learning-based Image Retrieval System for Chest Radiograph and its Clinical Applications in COVID-19

In recent years, deep learning-based image analysis methods have been widely applied in computer-aided detection, diagnosis and prognosis, and has shown its value during the public health crisis of the novel coronavirus disease 2019 (COVID-19) pandemic. Chest radiograph (CXR) has been playing a crucial role in COVID-19 patient triaging, diagnosing and monitoring, particularly in the United States. Considering the mixed and unspecific signals in CXR, an image retrieval model of CXR that provides both similar images and associated clinical information can be more clinically meaningful than a direct image diagnostic model. In this work we develop a novel CXR image retrieval model based on deep metric learning. Unlike traditional diagnostic models which aims at learning the direct mapping from images to labels, the proposed model aims at learning the optimized embedding space of images, where images with the same labels and similar contents are pulled together. It utilizes multi-similarity loss with hard-mining sampling strategy and attention mechanism to learn the optimized embedding space, and provides similar images to the query image. The model is trained and validated on an international multi-site COVID-19 dataset collected from 3 different sources. Experimental results of COVID-19 image retrieval and diagnosis tasks show that the proposed model can serve as a robust solution for CXR analysis and patient management for COVID-19. The model is also tested on its transferability on a different clinical decision support task, where the pre-trained model is applied to extract image features from a new dataset without any further training. These results demonstrate our deep metric learning based image retrieval model is highly efficient in the CXR retrieval, diagnosis and prognosis, and thus has great clinical value for the treatment and management of COVID-19 patients.

Deep Learning-based Four-region Lung Segmentation in Chest Radiography for COVID-19 Diagnosis

Purpose. Imaging plays an important role in assessing severity of COVID 19 pneumonia. However, semantic interpretation of chest radiography (CXR) findings does not include quantitative description of radiographic opacities. Most current AI assisted CXR image analysis framework do not quantify for regional variations of disease. To address these, we proposed a four region lung segmentation method to assist accurate quantification of COVID 19 pneumonia. Methods. A segmentation model to separate left and right lung is firstly applied, and then a carina and left hilum detection network is used, which are the clinical landmarks to separate the upper and lower lungs. To improve the segmentation performance of COVID 19 images, ensemble strategy incorporating five models is exploited. Using each region, we evaluated the clinical relevance of the proposed method with the Radiographic Assessment of the Quality of Lung Edema (RALE). Results. The proposed ensemble strategy showed dice score of 0.900, which is significantly higher than conventional methods (0.854 0.889). Mean intensities of segmented four regions indicate positive correlation to the extent and density scores of pulmonary opacities under the RALE framework. Conclusion. A deep learning based model in CXR can accurately segment and quantify regional distribution of pulmonary opacities in patients with COVID 19 pneumonia.

Consensus Neural Network for Medical Imaging Denoising with Only Noisy Training Samples

Deep neural networks have been proved efficient for medical image denoising. Current training methods require both noisy and clean images. However, clean images cannot be acquired for many practical medical applications due to naturally noisy signal, such as dynamic imaging, spectral computed tomography, arterial spin labeling magnetic resonance imaging, etc. In this paper we proposed a training method which learned denoising neural networks from noisy training samples only. Training data in the acquisition domain was split to two subsets and the network was trained to map one noisy set to the other. A consensus loss function was further proposed to efficiently combine the outputs from both subsets. A mathematical proof was provided that the proposed training scheme was equivalent to training with noisy and clean samples when the noise in the two subsets was uncorrelated and zero-mean. The method was validated on Low-dose CT Challenge dataset and NYU MRI dataset and achieved improved performance compared to existing unsupervised methods.

End-to-end Lung Nodule Detection in Computed Tomography

Computer aided diagnostic (CAD) system is crucial for modern med-ical imaging. But almost all CAD systems operate on reconstructed images, which were optimized for radiologists. Computer vision can capture features that is subtle to human observers, so it is desirable to design a CAD system op-erating on the raw data. In this paper, we proposed a deep-neural-network-based detection system for lung nodule detection in computed tomography (CT). A primal-dual-type deep reconstruction network was applied first to convert the raw data to the image space, followed by a 3-dimensional convolutional neural network (3D-CNN) for the nodule detection. For efficient network training, the deep reconstruction network and the CNN detector was trained sequentially first, then followed by one epoch of end-to-end fine tuning. The method was evaluated on the Lung Image Database Consortium image collection (LIDC-IDRI) with simulated forward projections. With 144 multi-slice fanbeam pro-jections, the proposed end-to-end detector could achieve comparable sensitivity with the reference detector, which was trained and applied on the fully-sampled image data. It also demonstrated superior detection performance compared to detectors trained on the reconstructed images. The proposed method is general and could be expanded to most detection tasks in medical imaging.