MLA-BIN: Model-level Attention and Batch-instance Style Normalization for Domain Generalization of Federated Learning on Medical Image Segmentation

The privacy protection mechanism of federated learning (FL) offers an effective solution for cross-center medical collaboration and data sharing. In multi-site medical image segmentation, each medical site serves as a client of FL, and its data naturally forms a domain. FL supplies the possibility to improve the performance of seen domains model. However, there is a problem of domain generalization (DG) in the actual de-ployment, that is, the performance of the model trained by FL in unseen domains will decrease. Hence, MLA-BIN is proposed to solve the DG of FL in this study. Specifically, the model-level attention module (MLA) and batch-instance style normalization (BIN) block were designed. The MLA represents the unseen domain as a linear combination of seen domain models. The atten-tion mechanism is introduced for the weighting coefficient to obtain the optimal coefficient ac-cording to the similarity of inter-domain data features. MLA enables the global model to gen-eralize to unseen domain. In the BIN block, batch normalization (BN) and instance normalization (IN) are combined to perform the shallow layers of the segmentation network for style normali-zation, solving the influence of inter-domain image style differences on DG. The extensive experimental results of two medical image seg-mentation tasks demonstrate that the proposed MLA-BIN outperforms state-of-the-art methods.

A novel method using machine learning to integrate features from lung and epicardial adipose tissue for detecting the severity of COVID-19 infection

Objectives: To investigate the value of radiomics features of epicardial adipose tissue (EAT) combined with lung for detecting the severity of Coronavirus Disease 2019 (COVID-19) infection. Methods: The retrospective study included data from 515 COVID-19 patients (Cohort1: 415, cohort2: 100) from the two centers between January 2020 and July 2020. A deep learning method was developed to extract the myocardium and visceral pericardium from chest CTs, and then a threshold was applied for automatic EAT extraction. Lung segmentation was achieved according to a published method. Radiomics features of both EAT and lung were extracted for the severity prediction. In a derivation cohort (290, cohort1), univariate analysis and Pearson correlation analysis were used to identify predictors of the severity of COVID-19. A generalized linear regression model for detecting the severity of COVID-19 was built in a derivation cohort and evaluated in internal (125, cohort1) and external (100, cohort2) validation cohorts. Results: For EAT extraction, the Dice similarity coefficients (DSC) of the two centers were 0.972 (0.011) and 0.968 (0.005), respectively. For severity detection, the AUC, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) of the model with radiomics features of both lung and EAT increased by 0.09 (p<0.001), 22.4%, and 17.0%, respectively, compared with the model with lung radiomics features, in the internal validation cohort. The AUC, NRI, and IDI increased by 0.04 (p<0.001), 11.1%, and 8.0%, respectively, in the external validation cohort. Conclusion: Radiomics features of EAT combined with lung have incremental value in detecting the severity of COVID-19.