FetalFlex: Anatomy-Guided Diffusion Model for Flexible Control on Fetal Ultrasound Image Synthesis

Fetal ultrasound (US) examinations require the acquisition of multiple planes, each providing unique diagnostic information to evaluate fetal development and screening for congenital anomalies. However, obtaining a comprehensive, multi-plane annotated fetal US dataset remains challenging, particularly for rare or complex anomalies owing to their low incidence and numerous subtypes. This poses difficulties in training novice radiologists and developing robust AI models, especially for detecting abnormal fetuses. In this study, we introduce a Flexible Fetal US image generation framework (FetalFlex) to address these challenges, which leverages anatomical structures and multimodal information to enable controllable synthesis of fetal US images across diverse planes. Specifically, FetalFlex incorporates a pre-alignment module to enhance controllability and introduces a repaint strategy to ensure consistent texture and appearance. Moreover, a two-stage adaptive sampling strategy is developed to progressively refine image quality from coarse to fine levels. We believe that FetalFlex is the first method capable of generating both in-distribution normal and out-of-distribution abnormal fetal US images, without requiring any abnormal data. Experiments on multi-center datasets demonstrate that FetalFlex achieved state-of-the-art performance across multiple image quality metrics. A reader study further confirms the close alignment of the generated results with expert visual assessments. Furthermore, synthetic images by FetalFlex significantly improve the performance of six typical deep models in downstream classification and anomaly detection tasks. Lastly, FetalFlex's anatomy-level controllable generation offers a unique advantage for anomaly simulation and creating paired or counterfactual data at the pixel level. The demo is available at: https://dyf1023.github.io/FetalFlex/.

MoEdit: On Learning Quantity Perception for Multi-object Image Editing

Multi-object images are prevalent in various real-world scenarios, including augmented reality, advertisement design, and medical imaging. Efficient and precise editing of these images is critical for these applications. With the advent of Stable Diffusion (SD), high-quality image generation and editing have entered a new era. However, existing methods often struggle to consider each object both individually and part of the whole image editing, both of which are crucial for ensuring consistent quantity perception, resulting in suboptimal perceptual performance. To address these challenges, we propose MoEdit, an auxiliary-free multi-object image editing framework. MoEdit facilitates high-quality multi-object image editing in terms of style transfer, object reinvention, and background regeneration, while ensuring consistent quantity perception between inputs and outputs, even with a large number of objects. To achieve this, we introduce the Feature Compensation (FeCom) module, which ensures the distinction and separability of each object attribute by minimizing the in-between interlacing. Additionally, we present the Quantity Attention (QTTN) module, which perceives and preserves quantity consistency by effective control in editing, without relying on auxiliary tools. By leveraging the SD model, MoEdit enables customized preservation and modification of specific concepts in inputs with high quality. Experimental results demonstrate that our MoEdit achieves State-Of-The-Art (SOTA) performance in multi-object image editing. Data and codes will be available at https://github.com/Tear-kitty/MoEdit.

ScribbleVS: Scribble-Supervised Medical Image Segmentation via Dynamic Competitive Pseudo Label Selection

In clinical medicine, precise image segmentation can provide substantial support to clinicians. However, achieving such precision often requires a large amount of finely annotated data, which can be costly. Scribble annotation presents a more efficient alternative, boosting labeling efficiency. However, utilizing such minimal supervision for medical image segmentation training, especially with scribble annotations, poses significant challenges. To address these challenges, we introduce ScribbleVS, a novel framework that leverages scribble annotations. We introduce a Regional Pseudo Labels Diffusion Module to expand the scope of supervision and reduce the impact of noise present in pseudo labels. Additionally, we propose a Dynamic Competitive Selection module for enhanced refinement in selecting pseudo labels. Experiments conducted on the ACDC and MSCMRseg datasets have demonstrated promising results, achieving performance levels that even exceed those of fully supervised methodologies. The codes of this study are available at https://github.com/ortonwang/ScribbleVS.

Synergy-Guided Regional Supervision of Pseudo Labels for Semi-Supervised Medical Image Segmentation

Semi-supervised learning has received considerable attention for its potential to leverage abundant unlabeled data to enhance model robustness. Pseudo labeling is a widely used strategy in semi supervised learning. However, existing methods often suffer from noise contamination, which can undermine model performance. To tackle this challenge, we introduce a novel Synergy-Guided Regional Supervision of Pseudo Labels (SGRS-Net) framework. Built upon the mean teacher network, we employ a Mix Augmentation module to enhance the unlabeled data. By evaluating the synergy before and after augmentation, we strategically partition the pseudo labels into distinct regions. Additionally, we introduce a Region Loss Evaluation module to assess the loss across each delineated area. Extensive experiments conducted on the LA dataset have demonstrated superior performance over state-of-the-art techniques, underscoring the efficiency and practicality of our framework.

PEAR: Position-Embedding-Agnostic Attention Re-weighting Enhances Retrieval-Augmented Generation with Zero Inference Overhead

Large language models (LLMs) enhanced with retrieval-augmented generation (RAG) have introduced a new paradigm for web search. However, the limited context awareness of LLMs degrades their performance on RAG tasks. Existing methods to enhance context awareness are often inefficient, incurring time or memory overhead during inference, and many are tailored to specific position embeddings. In this paper, we propose Position-Embedding-Agnostic attention Re-weighting (PEAR), which enhances the context awareness of LLMs with zero inference overhead. Specifically, on a proxy task focused on context copying, we first detect heads which suppress the models' context awareness thereby diminishing RAG performance. To weaken the impact of these heads, we re-weight their outputs with learnable coefficients. The LLM (with frozen parameters) is optimized by adjusting these coefficients to minimize loss on the proxy task. As a result, the coefficients are optimized to values less than one, thereby reducing their tendency to suppress RAG performance. During inference, the optimized coefficients are fixed to re-weight these heads, regardless of the specific task at hand. Our proposed PEAR offers two major advantages over previous approaches: (1) It introduces zero additional inference overhead in terms of memory usage or inference time, while outperforming competitive baselines in accuracy and efficiency across various RAG tasks. (2) It is independent of position embedding algorithms, ensuring broader applicability.

Ordinal Learning: Longitudinal Attention Alignment Model for Predicting Time to Future Breast Cancer Events from Mammograms

Precision breast cancer (BC) risk assessment is crucial for developing individualized screening and prevention. Despite the promising potential of recent mammogram (MG) based deep learning models in predicting BC risk, they mostly overlook the 'time-to-future-event' ordering among patients and exhibit limited explorations into how they track history changes in breast tissue, thereby limiting their clinical application. In this work, we propose a novel method, named OA-BreaCR, to precisely model the ordinal relationship of the time to and between BC events while incorporating longitudinal breast tissue changes in a more explainable manner. We validate our method on public EMBED and inhouse datasets, comparing with existing BC risk prediction and time prediction methods. Our ordinal learning method OA-BreaCR outperforms existing methods in both BC risk and time-to-future-event prediction tasks. Additionally, ordinal heatmap visualizations show the model's attention over time. Our findings underscore the importance of interpretable and precise risk assessment for enhancing BC screening and prevention efforts. The code will be accessible to the public.

Enhancing Test Time Adaptation with Few-shot Guidance

Deep neural networks often encounter significant performance drops while facing with domain shifts between training (source) and test (target) data. To address this issue, Test Time Adaptation (TTA) methods have been proposed to adapt pre-trained source model to handle out-of-distribution streaming target data. Although these methods offer some relief, they lack a reliable mechanism for domain shift correction, which can often be erratic in real-world applications. In response, we develop Few-Shot Test Time Adaptation (FS-TTA), a novel and practical setting that utilizes a few-shot support set on top of TTA. Adhering to the principle of few inputs, big gains, FS-TTA reduces blind exploration in unseen target domains. Furthermore, we propose a two-stage framework to tackle FS-TTA, including (i) fine-tuning the pre-trained source model with few-shot support set, along with using feature diversity augmentation module to avoid overfitting, (ii) implementing test time adaptation based on prototype memory bank guidance to produce high quality pseudo-label for model adaptation. Through extensive experiments on three cross-domain classification benchmarks, we demonstrate the superior performance and reliability of our FS-TTA and framework.

TRRG: Towards Truthful Radiology Report Generation With Cross-modal Disease Clue Enhanced Large Language Model

The vision-language modeling capability of multi-modal large language models has attracted wide attention from the community. However, in medical domain, radiology report generation using vision-language models still faces significant challenges due to the imbalanced data distribution caused by numerous negated descriptions in radiology reports and issues such as rough alignment between radiology reports and radiography. In this paper, we propose a truthful radiology report generation framework, namely TRRG, based on stage-wise training for cross-modal disease clue injection into large language models. In pre-training stage, During the pre-training phase, contrastive learning is employed to enhance the ability of visual encoder to perceive fine-grained disease details. In fine-tuning stage, the clue injection module we proposed significantly enhances the disease-oriented perception capability of the large language model by effectively incorporating the robust zero-shot disease perception. Finally, through the cross-modal clue interaction module, our model effectively achieves the multi-granular interaction of visual embeddings and an arbitrary number of disease clue embeddings. This significantly enhances the report generation capability and clinical effectiveness of multi-modal large language models in the field of radiology reportgeneration. Experimental results demonstrate that our proposed pre-training and fine-tuning framework achieves state-of-the-art performance in radiology report generation on datasets such as IU-Xray and MIMIC-CXR. Further analysis indicates that our proposed method can effectively enhance the model to perceive diseases and improve its clinical effectiveness.

DIffSteISR: Harnessing Diffusion Prior for Superior Real-world Stereo Image Super-Resolution

We introduce DiffSteISR, a pioneering framework for reconstructing real-world stereo images. DiffSteISR utilizes the powerful prior knowledge embedded in pre-trained text-to-image model to efficiently recover the lost texture details in low-resolution stereo images. Specifically, DiffSteISR implements a time-aware stereo cross attention with temperature adapter (TASCATA) to guide the diffusion process, ensuring that the generated left and right views exhibit high texture consistency thereby reducing disparity error between the super-resolved images and the ground truth (GT) images. Additionally, a stereo omni attention control network (SOA ControlNet) is proposed to enhance the consistency of super-resolved images with GT images in the pixel, perceptual, and distribution space. Finally, DiffSteISR incorporates a stereo semantic extractor (SSE) to capture unique viewpoint soft semantic information and shared hard tag semantic information, thereby effectively improving the semantic accuracy and consistency of the generated left and right images. Extensive experimental results demonstrate that DiffSteISR accurately reconstructs natural and precise textures from low-resolution stereo images while maintaining a high consistency of semantic and texture between the left and right views.

Fine-Tuning Medical Language Models for Enhanced Long-Contextual Understanding and Domain Expertise

Large Language Models (LLMs) have been widely applied in various professional fields. By fine-tuning the models using domain specific question and answer datasets, the professional domain knowledge and Q\&A abilities of these models have significantly improved, for example, medical professional LLMs that use fine-tuning of doctor-patient Q\&A data exhibit extraordinary disease diagnostic abilities. However, we observed that despite improvements in specific domain knowledge, the performance of medical LLM in long-context understanding has significantly declined, especially compared to general language models with similar parameters. The purpose of this study is to investigate the phenomenon of reduced performance in understanding long-context in medical LLM. We designed a series of experiments to conduct open-book professional knowledge exams on all models to evaluate their ability to read long-context. By adjusting the proportion and quantity of general data and medical data in the process of fine-tuning, we can determine the best data composition to optimize the professional model and achieve a balance between long-context performance and specific domain knowledge.