HResFormer: Hybrid Residual Transformer for Volumetric Medical Image Segmentation

Vision Transformer shows great superiority in medical image segmentation due to the ability in learning long-range dependency. For medical image segmentation from 3D data, such as computed tomography (CT), existing methods can be broadly classified into 2D-based and 3D-based methods. One key limitation in 2D-based methods is that the intra-slice information is ignored, while the limitation in 3D-based methods is the high computation cost and memory consumption, resulting in a limited feature representation for inner-slice information. During the clinical examination, radiologists primarily use the axial plane and then routinely review both axial and coronal planes to form a 3D understanding of anatomy. Motivated by this fact, our key insight is to design a hybrid model which can first learn fine-grained inner-slice information and then generate a 3D understanding of anatomy by incorporating 3D information. We present a novel \textbf{H}ybrid \textbf{Res}idual trans\textbf{Former} \textbf{(HResFormer)} for 3D medical image segmentation. Building upon standard 2D and 3D Transformer backbones, HResFormer involves two novel key designs: \textbf{(1)} a \textbf{H}ybrid \textbf{L}ocal-\textbf{G}lobal fusion \textbf{M}odule \textbf{(HLGM)} to effectively and adaptively fuse inner-slice information from 2D Transformer and intra-slice information from 3D volumes for 3D Transformer with local fine-grained and global long-range representation. \textbf{(2)} a residual learning of the hybrid model, which can effectively leverage the inner-slice and intra-slice information for better 3D understanding of anatomy. Experiments show that our HResFormer outperforms prior art on widely-used medical image segmentation benchmarks. This paper sheds light on an important but neglected way to design Transformers for 3D medical image segmentation.

MultiEYE: Dataset and Benchmark for OCT-Enhanced Retinal Disease Recognition from Fundus Images

Existing multi-modal learning methods on fundus and OCT images mostly require both modalities to be available and strictly paired for training and testing, which appears less practical in clinical scenarios. To expand the scope of clinical applications, we formulate a novel setting, "OCT-enhanced disease recognition from fundus images", that allows for the use of unpaired multi-modal data during the training phase and relies on the widespread fundus photographs for testing. To benchmark this setting, we present the first large multi-modal multi-class dataset for eye disease diagnosis, MultiEYE, and propose an OCT-assisted Conceptual Distillation Approach (OCT-CoDA), which employs semantically rich concepts to extract disease-related knowledge from OCT images and leverage them into the fundus model. Specifically, we regard the image-concept relation as a link to distill useful knowledge from the OCT teacher model to the fundus student model, which considerably improves the diagnostic performance based on fundus images and formulates the cross-modal knowledge transfer into an explainable process. Through extensive experiments on the multi-disease classification task, our proposed OCT-CoDA demonstrates remarkable results and interpretability, showing great potential for clinical application. Our dataset and code are available at https://github.com/xmed-lab/MultiEYE.

Touchstone Benchmark: Are We on the Right Way for Evaluating AI Algorithms for Medical Segmentation?

How can we test AI performance? This question seems trivial, but it isn't. Standard benchmarks often have problems such as in-distribution and small-size test sets, oversimplified metrics, unfair comparisons, and short-term outcome pressure. As a consequence, good performance on standard benchmarks does not guarantee success in real-world scenarios. To address these problems, we present Touchstone, a large-scale collaborative segmentation benchmark of 9 types of abdominal organs. This benchmark is based on 5,195 training CT scans from 76 hospitals around the world and 5,903 testing CT scans from 11 additional hospitals. This diverse test set enhances the statistical significance of benchmark results and rigorously evaluates AI algorithms across various out-of-distribution scenarios. We invited 14 inventors of 19 AI algorithms to train their algorithms, while our team, as a third party, independently evaluated these algorithms on three test sets. In addition, we also evaluated pre-existing AI frameworks--which, differing from algorithms, are more flexible and can support different algorithms--including MONAI from NVIDIA, nnU-Net from DKFZ, and numerous other open-source frameworks. We are committed to expanding this benchmark to encourage more innovation of AI algorithms for the medical domain.

CardiacNet: Learning to Reconstruct Abnormalities for Cardiac Disease Assessment from Echocardiogram Videos

Echocardiogram video plays a crucial role in analysing cardiac function and diagnosing cardiac diseases. Current deep neural network methods primarily aim to enhance diagnosis accuracy by incorporating prior knowledge, such as segmenting cardiac structures or lesions annotated by human experts. However, diagnosing the inconsistent behaviours of the heart, which exist across both spatial and temporal dimensions, remains extremely challenging. For instance, the analysis of cardiac motion acquires both spatial and temporal information from the heartbeat cycle. To address this issue, we propose a novel reconstruction-based approach named CardiacNet to learn a better representation of local cardiac structures and motion abnormalities through echocardiogram videos. CardiacNet is accompanied by the Consistency Deformation Codebook (CDC) and the Consistency Deformed-Discriminator (CDD) to learn the commonalities across abnormal and normal samples by incorporating cardiac prior knowledge. In addition, we propose benchmark datasets named CardiacNet-PAH and CardiacNet-ASD to evaluate the effectiveness of cardiac disease assessment. In experiments, our CardiacNet can achieve state-of-the-art results in three different cardiac disease assessment tasks on public datasets CAMUS, EchoNet, and our datasets. The code and dataset are available at: https://github.com/xmed-lab/CardiacNet.

Collaborative Knowledge Fusion: A Novel Approach for Multi-task Recommender Systems via LLMs

Owing to the impressive general intelligence of large language models (LLMs), there has been a growing trend to integrate them into recommender systems to gain a more profound insight into human interests and intentions. Existing LLMs-based recommender systems primarily leverage item attributes and user interaction histories in textual format, improving the single task like rating prediction or explainable recommendation. Nevertheless, these approaches overlook the crucial contribution of traditional collaborative signals in discerning users' profound intentions and disregard the interrelatedness among tasks. To address these limitations, we introduce a novel framework known as CKF, specifically developed to boost multi-task recommendations via personalized collaborative knowledge fusion into LLMs. Specifically, our method synergizes traditional collaborative filtering models to produce collaborative embeddings, subsequently employing the meta-network to construct personalized mapping bridges tailored for each user. Upon mapped, the embeddings are incorporated into meticulously designed prompt templates and then fed into an advanced LLM to represent user interests. To investigate the intrinsic relationship among diverse recommendation tasks, we develop Multi-Lora, a new parameter-efficient approach for multi-task optimization, adept at distinctly segregating task-shared and task-specific information. This method forges a connection between LLMs and recommendation scenarios, while simultaneously enriching the supervisory signal through mutual knowledge transfer among various tasks. Extensive experiments and in-depth robustness analyses across four common recommendation tasks on four large public data sets substantiate the effectiveness and superiority of our framework.

Bidirectional Recurrence for Cardiac Motion Tracking with Gaussian Process Latent Coding

Quantitative analysis of cardiac motion is crucial for assessing cardiac function. This analysis typically uses imaging modalities such as MRI and Echocardiograms that capture detailed image sequences throughout the heartbeat cycle. Previous methods predominantly focused on the analysis of image pairs lacking consideration of the motion dynamics and spatial variability. Consequently, these methods often overlook the long-term relationships and regional motion characteristic of cardiac. To overcome these limitations, we introduce the \textbf{GPTrack}, a novel unsupervised framework crafted to fully explore the temporal and spatial dynamics of cardiac motion. The GPTrack enhances motion tracking by employing the sequential Gaussian Process in the latent space and encoding statistics by spatial information at each time stamp, which robustly promotes temporal consistency and spatial variability of cardiac dynamics. Also, we innovatively aggregate sequential information in a bidirectional recursive manner, mimicking the behavior of diffeomorphic registration to better capture consistent long-term relationships of motions across cardiac regions such as the ventricles and atria. Our GPTrack significantly improves the precision of motion tracking in both 3D and 4D medical images while maintaining computational efficiency. The code is available at: https://github.com/xmed-lab/GPTrack

Interpretable Bilingual Multimodal Large Language Model for Diverse Biomedical Tasks

Several medical Multimodal Large Languange Models (MLLMs) have been developed to address tasks involving visual images with textual instructions across various medical modalities, achieving impressive results. Most current medical generalist models are region-agnostic, treating the entire image as a holistic representation. However, they struggle to identify which specific regions they are focusing on when generating a sentence.To mimic the behavior of doctors, who typically begin by reviewing the entire image before concentrating on specific regions for a thorough evaluation, we aim to enhance the capability of medical MLLMs in understanding anatomical regions within entire medical scans. To achieve it, we first formulate Region-Centric tasks and construct a large-scale dataset, MedRegInstruct, to incorporate regional information into training. Combining our collected dataset with other medical multimodal corpora for training, we propose a Region-Aware medical MLLM, MedRegA, which is the first bilingual generalist medical AI system to simultaneously handle image-level and region-level medical vision-language tasks across a broad range of modalities. Our MedRegA not only enables three region-centric tasks, but also achieves the best performance for visual question answering, report generation and medical image classification over 8 modalities, showcasing significant versatility. Experiments demonstrate that our model can not only accomplish powerful performance across various medical vision-language tasks in bilingual settings, but also recognize and detect structures in multimodal medical scans, boosting the interpretability and user interactivity of medical MLLMs. Our project page is https://medrega.github.io.

PSFHS Challenge Report: Pubic Symphysis and Fetal Head Segmentation from Intrapartum Ultrasound Images

Segmentation of the fetal and maternal structures, particularly intrapartum ultrasound imaging as advocated by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) for monitoring labor progression, is a crucial first step for quantitative diagnosis and clinical decision-making. This requires specialized analysis by obstetrics professionals, in a task that i) is highly time- and cost-consuming and ii) often yields inconsistent results. The utility of automatic segmentation algorithms for biometry has been proven, though existing results remain suboptimal. To push forward advancements in this area, the Grand Challenge on Pubic Symphysis-Fetal Head Segmentation (PSFHS) was held alongside the 26th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI 2023). This challenge aimed to enhance the development of automatic segmentation algorithms at an international scale, providing the largest dataset to date with 5,101 intrapartum ultrasound images collected from two ultrasound machines across three hospitals from two institutions. The scientific community's enthusiastic participation led to the selection of the top 8 out of 179 entries from 193 registrants in the initial phase to proceed to the competition's second stage. These algorithms have elevated the state-of-the-art in automatic PSFHS from intrapartum ultrasound images. A thorough analysis of the results pinpointed ongoing challenges in the field and outlined recommendations for future work. The top solutions and the complete dataset remain publicly available, fostering further advancements in automatic segmentation and biometry for intrapartum ultrasound imaging.

Tri-Plane Mamba: Efficiently Adapting Segment Anything Model for 3D Medical Images

General networks for 3D medical image segmentation have recently undergone extensive exploration. Behind the exceptional performance of these networks lies a significant demand for a large volume of pixel-level annotated data, which is time-consuming and labor-intensive. The emergence of the Segment Anything Model (SAM) has enabled this model to achieve superior performance in 2D medical image segmentation tasks via parameter- and data-efficient feature adaptation. However, the introduction of additional depth channels in 3D medical images not only prevents the sharing of 2D pre-trained features but also results in a quadratic increase in the computational cost for adapting SAM. To overcome these challenges, we present the Tri-Plane Mamba (TP-Mamba) adapters tailored for the SAM, featuring two major innovations: 1) multi-scale 3D convolutional adapters, optimized for efficiently processing local depth-level information, 2) a tri-plane mamba module, engineered to capture long-range depth-level representation without significantly increasing computational costs. This approach achieves state-of-the-art performance in 3D CT organ segmentation tasks. Remarkably, this superior performance is maintained even with scarce training data. Specifically using only three CT training samples from the BTCV dataset, it surpasses conventional 3D segmentation networks, attaining a Dice score that is up to 12% higher.

Teach CLIP to Develop a Number Sense for Ordinal Regression

Ordinal regression is a fundamental problem within the field of computer vision, with customised well-trained models on specific tasks. While pre-trained vision-language models (VLMs) have exhibited impressive performance on various vision tasks, their potential for ordinal regression has received less exploration. In this study, we first investigate CLIP's potential for ordinal regression, from which we expect the model could generalise to different ordinal regression tasks and scenarios. Unfortunately, vanilla CLIP fails on this task, since current VLMs have a well-documented limitation of encapsulating compositional concepts such as number sense. We propose a simple yet effective method called NumCLIP to improve the quantitative understanding of VLMs. We disassemble the exact image to number-specific text matching problem into coarse classification and fine prediction stages. We discretize and phrase each numerical bin with common language concept to better leverage the available pre-trained alignment in CLIP. To consider the inherent continuous property of ordinal regression, we propose a novel fine-grained cross-modal ranking-based regularisation loss specifically designed to keep both semantic and ordinal alignment in CLIP's feature space. Experimental results on three general ordinal regression tasks demonstrate the effectiveness of NumCLIP, with 10% and 3.83% accuracy improvement on historical image dating and image aesthetics assessment task, respectively. Code is publicly available at https://github.com/xmed-lab/NumCLIP.