SAM Fewshot Finetuning for Anatomical Segmentation in Medical Images

We propose a straightforward yet highly effective few-shot fine-tuning strategy for adapting the Segment Anything (SAM) to anatomical segmentation tasks in medical images. Our novel approach revolves around reformulating the mask decoder within SAM, leveraging few-shot embeddings derived from a limited set of labeled images (few-shot collection) as prompts for querying anatomical objects captured in image embeddings. This innovative reformulation greatly reduces the need for time-consuming online user interactions for labeling volumetric images, such as exhaustively marking points and bounding boxes to provide prompts slice by slice. With our method, users can manually segment a few 2D slices offline, and the embeddings of these annotated image regions serve as effective prompts for online segmentation tasks. Our method prioritizes the efficiency of the fine-tuning process by exclusively training the mask decoder through caching mechanisms while keeping the image encoder frozen. Importantly, this approach is not limited to volumetric medical images, but can generically be applied to any 2D/3D segmentation task. To thoroughly evaluate our method, we conducted extensive validation on four datasets, covering six anatomical segmentation tasks across two modalities. Furthermore, we conducted a comparative analysis of different prompting options within SAM and the fully-supervised nnU-Net. The results demonstrate the superior performance of our method compared to SAM employing only point prompts (approximately 50% improvement in IoU) and performs on-par with fully supervised methods whilst reducing the requirement of labeled data by at least an order of magnitude.

Contrastive Self-Supervised Learning for Spatio-Temporal Analysis of Lung Ultrasound Videos

Self-supervised learning (SSL) methods have shown promise for medical imaging applications by learning meaningful visual representations, even when the amount of labeled data is limited. Here, we extend state-of-the-art contrastive learning SSL methods to 2D+time medical ultrasound video data by introducing a modified encoder and augmentation method capable of learning meaningful spatio-temporal representations, without requiring constraints on the input data. We evaluate our method on the challenging clinical task of identifying lung consolidations (an important pathological feature) in ultrasound videos. Using a multi-center dataset of over 27k lung ultrasound videos acquired from over 500 patients, we show that our method can significantly improve performance on downstream localization and classification of lung consolidation. Comparisons against baseline models trained without SSL show that the proposed methods are particularly advantageous when the size of labeled training data is limited (e.g., as little as 5% of the training set).

Weakly Semi-Supervised Detection in Lung Ultrasound Videos

Frame-by-frame annotation of bounding boxes by clinical experts is often required to train fully supervised object detection models on medical video data. We propose a method for improving object detection in medical videos through weak supervision from video-level labels. More concretely, we aggregate individual detection predictions into video-level predictions and extend a teacher-student training strategy to provide additional supervision via a video-level loss. We also introduce improvements to the underlying teacher-student framework, including methods to improve the quality of pseudo-labels based on weak supervision and adaptive schemes to optimize knowledge transfer between the student and teacher networks. We apply this approach to the clinically important task of detecting lung consolidations (seen in respiratory infections such as COVID-19 pneumonia) in medical ultrasound videos. Experiments reveal that our framework improves detection accuracy and robustness compared to baseline semi-supervised models, and improves efficiency in data and annotation usage.