Privacy-Preserving Federated Foundation Model for Generalist Ultrasound Artificial Intelligence

Ultrasound imaging is widely used in clinical diagnosis due to its non-invasive nature and real-time capabilities. However, conventional ultrasound diagnostics face several limitations, including high dependence on physician expertise and suboptimal image quality, which complicates interpretation and increases the likelihood of diagnostic errors. Artificial intelligence (AI) has emerged as a promising solution to enhance clinical diagnosis, particularly in detecting abnormalities across various biomedical imaging modalities. Nonetheless, current AI models for ultrasound imaging face critical challenges. First, these models often require large volumes of labeled medical data, raising concerns over patient privacy breaches. Second, most existing models are task-specific, which restricts their broader clinical utility. To overcome these challenges, we present UltraFedFM, an innovative privacy-preserving ultrasound foundation model. UltraFedFM is collaboratively pre-trained using federated learning across 16 distributed medical institutions in 9 countries, leveraging a dataset of over 1 million ultrasound images covering 19 organs and 10 ultrasound modalities. This extensive and diverse data, combined with a secure training framework, enables UltraFedFM to exhibit strong generalization and diagnostic capabilities. It achieves an average area under the receiver operating characteristic curve of 0.927 for disease diagnosis and a dice similarity coefficient of 0.878 for lesion segmentation. Notably, UltraFedFM surpasses the diagnostic accuracy of mid-level ultrasonographers and matches the performance of expert-level sonographers in the joint diagnosis of 8 common systemic diseases. These findings indicate that UltraFedFM can significantly enhance clinical diagnostics while safeguarding patient privacy, marking an advancement in AI-driven ultrasound imaging for future clinical applications.

An Empirical Study on Information Extraction using Large Language Models

Human-like large language models (LLMs), especially the most powerful and popular ones in OpenAI's GPT family, have proven to be very helpful for many natural language processing (NLP) related tasks. Therefore, various attempts have been made to apply LLMs to information extraction (IE), which is a fundamental NLP task that involves extracting information from unstructured plain text. To demonstrate the latest representative progress in LLMs' information extraction ability, we assess the information extraction ability of GPT-4 (the latest version of GPT at the time of writing this paper) from four perspectives: Performance, Evaluation Criteria, Robustness, and Error Types. Our results suggest a visible performance gap between GPT-4 and state-of-the-art (SOTA) IE methods. To alleviate this problem, considering the LLMs' human-like characteristics, we propose and analyze the effects of a series of simple prompt-based methods, which can be generalized to other LLMs and NLP tasks. Rich experiments show our methods' effectiveness and some of their remaining issues in improving GPT-4's information extraction ability.

Self-Instructed Derived Prompt Generation Meets In-Context Learning: Unlocking New Potential of Black-Box LLMs

Large language models (LLMs) have shown success in generating high-quality responses. In order to achieve better alignment with LLMs with human preference, various works are proposed based on specific optimization process, which, however, is not suitable to Black-Box LLMs like GPT-4, due to inaccessible parameters. In Black-Box LLMs case, their performance is highly dependent on the quality of the provided prompts. Existing methods to enhance response quality often involve a prompt refinement model, yet these approaches potentially suffer from semantic inconsistencies between the refined and original prompts, and typically overlook the relationship between them. To address these challenges, we introduce a self-instructed in-context learning framework that empowers LLMs to deliver more effective responses by generating reliable derived prompts to construct informative contextual environments. Our approach incorporates a self-instructed reinforcement learning mechanism, enabling direct interaction with the response model during derived prompt generation for better alignment. We then formulate querying as an in-context learning task, using responses from LLMs combined with the derived prompts to establish a contextual demonstration for the original prompt. This strategy ensures alignment with the original query, reduces discrepancies from refined prompts, and maximizes the LLMs' in-context learning capability. Extensive experiments demonstrate that the proposed method not only generates more reliable derived prompts but also significantly enhances LLMs' ability to deliver more effective responses, including Black-Box models such as GPT-4.

Detecting AI Flaws: Target-Driven Attacks on Internal Faults in Language Models

Large Language Models (LLMs) have become a focal point in the rapidly evolving field of artificial intelligence. However, a critical concern is the presence of toxic content within the pre-training corpus of these models, which can lead to the generation of inappropriate outputs. Investigating methods for detecting internal faults in LLMs can help us understand their limitations and improve their security. Existing methods primarily focus on jailbreaking attacks, which involve manually or automatically constructing adversarial content to prompt the target LLM to generate unexpected responses. These methods rely heavily on prompt engineering, which is time-consuming and usually requires specially designed questions. To address these challenges, this paper proposes a target-driven attack paradigm that focuses on directly eliciting the target response instead of optimizing the prompts. We introduce the use of another LLM as the detector for toxic content, referred to as ToxDet. Given a target toxic response, ToxDet can generate a possible question and a preliminary answer to provoke the target model into producing desired toxic responses with meanings equivalent to the provided one. ToxDet is trained by interacting with the target LLM and receiving reward signals from it, utilizing reinforcement learning for the optimization process. While the primary focus of the target models is on open-source LLMs, the fine-tuned ToxDet can also be transferred to attack black-box models such as GPT-4o, achieving notable results. Experimental results on AdvBench and HH-Harmless datasets demonstrate the effectiveness of our methods in detecting the tendencies of target LLMs to generate harmful responses. This algorithm not only exposes vulnerabilities but also provides a valuable resource for researchers to strengthen their models against such attacks.

Let Video Teaches You More: Video-to-Image Knowledge Distillation using DEtection TRansformer for Medical Video Lesion Detection

AI-assisted lesion detection models play a crucial role in the early screening of cancer. However, previous image-based models ignore the inter-frame contextual information present in videos. On the other hand, video-based models capture the inter-frame context but are computationally expensive. To mitigate this contradiction, we delve into Video-to-Image knowledge distillation leveraging DEtection TRansformer (V2I-DETR) for the task of medical video lesion detection. V2I-DETR adopts a teacher-student network paradigm. The teacher network aims at extracting temporal contexts from multiple frames and transferring them to the student network, and the student network is an image-based model dedicated to fast prediction in inference. By distilling multi-frame contexts into a single frame, the proposed V2I-DETR combines the advantages of utilizing temporal contexts from video-based models and the inference speed of image-based models. Through extensive experiments, V2I-DETR outperforms previous state-of-the-art methods by a large margin while achieving the real-time inference speed (30 FPS) as the image-based model.

Towards a Benchmark for Colorectal Cancer Segmentation in Endorectal Ultrasound Videos: Dataset and Model Development

Endorectal ultrasound (ERUS) is an important imaging modality that provides high reliability for diagnosing the depth and boundary of invasion in colorectal cancer. However, the lack of a large-scale ERUS dataset with high-quality annotations hinders the development of automatic ultrasound diagnostics. In this paper, we collected and annotated the first benchmark dataset that covers diverse ERUS scenarios, i.e. colorectal cancer segmentation, detection, and infiltration depth staging. Our ERUS-10K dataset comprises 77 videos and 10,000 high-resolution annotated frames. Based on this dataset, we further introduce a benchmark model for colorectal cancer segmentation, named the Adaptive Sparse-context TRansformer (ASTR). ASTR is designed based on three considerations: scanning mode discrepancy, temporal information, and low computational complexity. For generalizing to different scanning modes, the adaptive scanning-mode augmentation is proposed to convert between raw sector images and linear scan ones. For mining temporal information, the sparse-context transformer is incorporated to integrate inter-frame local and global features. For reducing computational complexity, the sparse-context block is introduced to extract contextual features from auxiliary frames. Finally, on the benchmark dataset, the proposed ASTR model achieves a 77.6% Dice score in rectal cancer segmentation, largely outperforming previous state-of-the-art methods.

Diffuse-UDA: Addressing Unsupervised Domain Adaptation in Medical Image Segmentation with Appearance and Structure Aligned Diffusion Models

The scarcity and complexity of voxel-level annotations in 3D medical imaging present significant challenges, particularly due to the domain gap between labeled datasets from well-resourced centers and unlabeled datasets from less-resourced centers. This disparity affects the fairness of artificial intelligence algorithms in healthcare. We introduce Diffuse-UDA, a novel method leveraging diffusion models to tackle Unsupervised Domain Adaptation (UDA) in medical image segmentation. Diffuse-UDA generates high-quality image-mask pairs with target domain characteristics and various structures, thereby enhancing UDA tasks. Initially, pseudo labels for target domain samples are generated. Subsequently, a specially tailored diffusion model, incorporating deformable augmentations, is trained on image-label or image-pseudo-label pairs from both domains. Finally, source domain labels guide the diffusion model to generate image-label pairs for the target domain. Comprehensive evaluations on several benchmarks demonstrate that Diffuse-UDA outperforms leading UDA and semi-supervised strategies, achieving performance close to or even surpassing the theoretical upper bound of models trained directly on target domain data. Diffuse-UDA offers a pathway to advance the development and deployment of AI systems in medical imaging, addressing disparities between healthcare environments. This approach enables the exploration of innovative AI-driven diagnostic tools, improves outcomes, saves time, and reduces human error.

ToDER: Towards Colonoscopy Depth Estimation and Reconstruction with Geometry Constraint Adaptation

Visualizing colonoscopy is crucial for medical auxiliary diagnosis to prevent undetected polyps in areas that are not fully observed. Traditional feature-based and depth-based reconstruction approaches usually end up with undesirable results due to incorrect point matching or imprecise depth estimation in realistic colonoscopy videos. Modern deep-based methods often require a sufficient number of ground truth samples, which are generally hard to obtain in optical colonoscopy. To address this issue, self-supervised and domain adaptation methods have been explored. However, these methods neglect geometry constraints and exhibit lower accuracy in predicting detailed depth. We thus propose a novel reconstruction pipeline with a bi-directional adaptation architecture named ToDER to get precise depth estimations. Furthermore, we carefully design a TNet module in our adaptation architecture to yield geometry constraints and obtain better depth quality. Estimated depth is finally utilized to reconstruct a reliable colon model for visualization. Experimental results demonstrate that our approach can precisely predict depth maps in both realistic and synthetic colonoscopy videos compared with other self-supervised and domain adaptation methods. Our method on realistic colonoscopy also shows the great potential for visualizing unobserved regions and preventing misdiagnoses.

CoD, Towards an Interpretable Medical Agent using Chain of Diagnosis

The field of medical diagnosis has undergone a significant transformation with the advent of large language models (LLMs), yet the challenges of interpretability within these models remain largely unaddressed. This study introduces Chain-of-Diagnosis (CoD) to enhance the interpretability of LLM-based medical diagnostics. CoD transforms the diagnostic process into a diagnostic chain that mirrors a physician's thought process, providing a transparent reasoning pathway. Additionally, CoD outputs the disease confidence distribution to ensure transparency in decision-making. This interpretability makes model diagnostics controllable and aids in identifying critical symptoms for inquiry through the entropy reduction of confidences. With CoD, we developed DiagnosisGPT, capable of diagnosing 9604 diseases. Experimental results demonstrate that DiagnosisGPT outperforms other LLMs on diagnostic benchmarks. Moreover, DiagnosisGPT provides interpretability while ensuring controllability in diagnostic rigor.

Pilot-Based SFO Estimation for Bistatic Integrated Sensing and Communication

Enabling bistatic radar sensing within the context of integrated sensing and communication (ISAC) for future sixth generation mobile networks demands strict synchronization accuracy, which is particularly challenging to be achieved with over-the-air synchronization. Existing algorithms handle time and frequency offsets adequately, but provide insufficiently accurate sampling frequency offset (SFO) estimates that result in degradation of obtained radar images in the form of signal-to-noise ratio loss and migration of range and Doppler shift. This article introduces an SFO estimation algorithm named tilt inference of time offset (TITO) for orthogonal frequency-division multiplexing (OFDM)-based ISAC. Using available pilot subcarriers, TITO obtains channel impulse response estimates and extracts information on the SFO-induced delay migration to a dominant reference path with constant range, Doppler shift, and angle between transmit and receive ISAC nodes. TITO then adaptively selects the delay estimates that are only negligibly impaired by SFO-induced intersymbol interference, ultimately employing them to estimate the SFO. Assuming a scenario without a direct line-of-sight (LoS) between the aforementioned transmitting and receiving ISAC nodes, a system concept with a relay reflective intelligent surface (RIS) is used to create the aforementioned reference path is proposed. Besides a mathematical derivation of accuracy bounds, simulation and measurements at 26.2 GHz are presented to demonstrate TITO's superiority over existing methods in terms of SFO estimation accuracy and robustness.