Imaging foundation model for universal enhancement of non-ideal measurement CT

Non-ideal measurement computed tomography (NICT), which sacrifices optimal imaging standards for new advantages in CT imaging, is expanding the clinical application scope of CT images. However, with the reduction of imaging standards, the image quality has also been reduced, extremely limiting the clinical acceptability. Although numerous studies have demonstrated the feasibility of deep learning for the NICT enhancement in specific scenarios, their high data cost and limited generalizability have become large obstacles. The recent research on the foundation model has brought new opportunities for building a universal NICT enhancement model - bridging the image quality degradation with minimal data cost. However, owing to the challenges in the collection of large pre-training datasets and the compatibility of data variation, no success has been reported. In this paper, we propose a multi-scale integrated Transformer AMPlifier (TAMP), the first imaging foundation model for universal NICT enhancement. It has been pre-trained on a large-scale physical-driven simulation dataset with 3.6 million NICT-ICT image pairs, and is able to directly generalize to the NICT enhancement tasks with various non-ideal settings and body regions. Via the adaptation with few data, it can further achieve professional performance in real-world specific scenarios. Our extensive experiments have demonstrated that the proposed TAMP has significant potential for promoting the exploration and application of NICT and serving a wider range of medical scenarios.

Knowledge Boosting: Rethinking Medical Contrastive Vision-Language Pre-Training

The foundation models based on pre-training technology have significantly advanced artificial intelligence from theoretical to practical applications. These models have facilitated the feasibility of computer-aided diagnosis for widespread use. Medical contrastive vision-language pre-training, which does not require human annotations, is an effective approach for guiding representation learning using description information in diagnostic reports. However, the effectiveness of pre-training is limited by the large-scale semantic overlap and shifting problems in medical field. To address these issues, we propose the Knowledge-Boosting Contrastive Vision-Language Pre-training framework (KoBo), which integrates clinical knowledge into the learning of vision-language semantic consistency. The framework uses an unbiased, open-set sample-wise knowledge representation to measure negative sample noise and supplement the correspondence between vision-language mutual information and clinical knowledge. Extensive experiments validate the effect of our framework on eight tasks including classification, segmentation, retrieval, and semantic relatedness, achieving comparable or better performance with the zero-shot or few-shot settings. Our code is open on https://github.com/ChenXiaoFei-CS/KoBo.

JCCS-PFGM: A Novel Circle-Supervision based Poisson Flow Generative Model for Multiphase CECT Progressive Low-Dose Reconstruction with Joint Condition

Multiphase contrast-enhanced computed tomography (CECT) scan is clinically significant to demonstrate the anatomy at different phases. In practice, such a multiphase CECT scan inherently takes longer time and deposits much more radiation dose into a patient body than a regular CT scan, and reduction of the radiation dose typically compromise the CECT image quality and its diagnostic value. With Joint Condition and Circle-Supervision, here we propose a novel Poisson Flow Generative Model (JCCS-PFGM) to promote the progressive low-dose reconstruction for multiphase CECT. JCCS-PFGM is characterized by the following three aspects: a progressive low-dose reconstruction scheme, a circle-supervision strategy, and a joint condition mechanism. Our extensive experiments are performed on a clinical dataset consisting of 11436 images. The results show that our JCCS-PFGM achieves promising PSNR up to 46.3dB, SSIM up to 98.5%, and MAE down to 9.67 HU averagely on phases I, II and III, in quantitative evaluations, as well as gains high-quality readable visualizations in qualitative assessments. All of these findings reveal our method a great potential to be adapted for clinical CECT scans at a much-reduced radiation dose.

Geometric Visual Similarity Learning in 3D Medical Image Self-supervised Pre-training

Learning inter-image similarity is crucial for 3D medical images self-supervised pre-training, due to their sharing of numerous same semantic regions. However, the lack of the semantic prior in metrics and the semantic-independent variation in 3D medical images make it challenging to get a reliable measurement for the inter-image similarity, hindering the learning of consistent representation for same semantics. We investigate the challenging problem of this task, i.e., learning a consistent representation between images for a clustering effect of same semantic features. We propose a novel visual similarity learning paradigm, Geometric Visual Similarity Learning, which embeds the prior of topological invariance into the measurement of the inter-image similarity for consistent representation of semantic regions. To drive this paradigm, we further construct a novel geometric matching head, the Z-matching head, to collaboratively learn the global and local similarity of semantic regions, guiding the efficient representation learning for different scale-level inter-image semantic features. Our experiments demonstrate that the pre-training with our learning of inter-image similarity yields more powerful inner-scene, inter-scene, and global-local transferring ability on four challenging 3D medical image tasks. Our codes and pre-trained models will be publicly available on https://github.com/YutingHe-list/GVSL.

Low-Dose CT Denoising via Sinogram Inner-Structure Transformer

Low-Dose Computed Tomography (LDCT) technique, which reduces the radiation harm to human bodies, is now attracting increasing interest in the medical imaging field. As the image quality is degraded by low dose radiation, LDCT exams require specialized reconstruction methods or denoising algorithms. However, most of the recent effective methods overlook the inner-structure of the original projection data (sinogram) which limits their denoising ability. The inner-structure of the sinogram represents special characteristics of the data in the sinogram domain. By maintaining this structure while denoising, the noise can be obviously restrained. Therefore, we propose an LDCT denoising network namely Sinogram Inner-Structure Transformer (SIST) to reduce the noise by utilizing the inner-structure in the sinogram domain. Specifically, we study the CT imaging mechanism and statistical characteristics of sinogram to design the sinogram inner-structure loss including the global and local inner-structure for restoring high-quality CT images. Besides, we propose a sinogram transformer module to better extract sinogram features. The transformer architecture using a self-attention mechanism can exploit interrelations between projections of different view angles, which achieves an outstanding performance in sinogram denoising. Furthermore, in order to improve the performance in the image domain, we propose the image reconstruction module to complementarily denoise both in the sinogram and image domain.

EnMcGAN: Adversarial Ensemble Learning for 3D Complete Renal Structures Segmentation

3D complete renal structures(CRS) segmentation targets on segmenting the kidneys, tumors, renal arteries and veins in one inference. Once successful, it will provide preoperative plans and intraoperative guidance for laparoscopic partial nephrectomy(LPN), playing a key role in the renal cancer treatment. However, no success has been reported in 3D CRS segmentation due to the complex shapes of renal structures, low contrast and large anatomical variation. In this study, we utilize the adversarial ensemble learning and propose Ensemble Multi-condition GAN(EnMcGAN) for 3D CRS segmentation for the first time. Its contribution is three-fold. 1)Inspired by windowing, we propose the multi-windowing committee which divides CTA image into multiple narrow windows with different window centers and widths enhancing the contrast for salient boundaries and soft tissues. And then, it builds an ensemble segmentation model on these narrow windows to fuse the segmentation superiorities and improve whole segmentation quality. 2)We propose the multi-condition GAN which equips the segmentation model with multiple discriminators to encourage the segmented structures meeting their real shape conditions, thus improving the shape feature extraction ability. 3)We propose the adversarial weighted ensemble module which uses the trained discriminators to evaluate the quality of segmented structures, and normalizes these evaluation scores for the ensemble weights directed at the input image, thus enhancing the ensemble results. 122 patients are enrolled in this study and the mean Dice coefficient of the renal structures achieves 84.6%. Extensive experiments with promising results on renal structures reveal powerful segmentation accuracy and great clinical significance in renal cancer treatment.