Leveraging Semantic Asymmetry for Precise Gross Tumor Volume Segmentation of Nasopharyngeal Carcinoma in Planning CT

In the radiation therapy of nasopharyngeal carcinoma (NPC), clinicians typically delineate the gross tumor volume (GTV) using non-contrast planning computed tomography to ensure accurate radiation dose delivery. However, the low contrast between tumors and adjacent normal tissues necessitates that radiation oncologists manually delineate the tumors, often relying on diagnostic MRI for guidance. % In this study, we propose a novel approach to directly segment NPC gross tumors on non-contrast planning CT images, circumventing potential registration errors when aligning MRI or MRI-derived tumor masks to planning CT. To address the low contrast issues between tumors and adjacent normal structures in planning CT, we introduce a 3D Semantic Asymmetry Tumor segmentation (SATs) method. Specifically, we posit that a healthy nasopharyngeal region is characteristically bilaterally symmetric, whereas the emergence of nasopharyngeal carcinoma disrupts this symmetry. Then, we propose a Siamese contrastive learning segmentation framework that minimizes the voxel-wise distance between original and flipped areas without tumor and encourages a larger distance between original and flipped areas with tumor. Thus, our approach enhances the sensitivity of features to semantic asymmetries. % Extensive experiments demonstrate that the proposed SATs achieves the leading NPC GTV segmentation performance in both internal and external testing, \emph{e.g.}, with at least 2\% absolute Dice score improvement and 12\% average distance error reduction when compared to other state-of-the-art methods in the external testing.

Effective Lymph Nodes Detection in CT Scans Using Location Debiased Query Selection and Contrastive Query Representation in Transformer

Lymph node (LN) assessment is a critical, indispensable yet very challenging task in the routine clinical workflow of radiology and oncology. Accurate LN analysis is essential for cancer diagnosis, staging, and treatment planning. Finding scatteredly distributed, low-contrast clinically relevant LNs in 3D CT is difficult even for experienced physicians under high inter-observer variations. Previous automatic LN detection works typically yield limited recall and high false positives (FPs) due to adjacent anatomies with similar image intensities, shapes, or textures (vessels, muscles, esophagus, etc). In this work, we propose a new LN DEtection TRansformer, named LN-DETR, to achieve more accurate performance. By enhancing the 2D backbone with a multi-scale 2.5D feature fusion to incorporate 3D context explicitly, more importantly, we make two main contributions to improve the representation quality of LN queries. 1) Considering that LN boundaries are often unclear, an IoU prediction head and a location debiased query selection are proposed to select LN queries of higher localization accuracy as the decoder query's initialization. 2) To reduce FPs, query contrastive learning is employed to explicitly reinforce LN queries towards their best-matched ground-truth queries over unmatched query predictions. Trained and tested on 3D CT scans of 1067 patients (with 10,000+ labeled LNs) via combining seven LN datasets from different body parts (neck, chest, and abdomen) and pathologies/cancers, our method significantly improves the performance of previous leading methods by > 4-5% average recall at the same FP rates in both internal and external testing. We further evaluate on the universal lesion detection task using NIH DeepLesion benchmark, and our method achieves the top performance of 88.46% averaged recall across 0.5 to 4 FPs per image, compared with other leading reported results.

Improving and Benchmarking Offline Reinforcement Learning Algorithms

Recently, Offline Reinforcement Learning (RL) has achieved remarkable progress with the emergence of various algorithms and datasets. However, these methods usually focus on algorithmic advancements, ignoring that many low-level implementation choices considerably influence or even drive the final performance. As a result, it becomes hard to attribute the progress in Offline RL as these choices are not sufficiently discussed and aligned in the literature. In addition, papers focusing on a dataset (e.g., D4RL) often ignore algorithms proposed on another dataset (e.g., RL Unplugged), causing isolation among the algorithms, which might slow down the overall progress. Therefore, this work aims to bridge the gaps caused by low-level choices and datasets. To this end, we empirically investigate 20 implementation choices using three representative algorithms (i.e., CQL, CRR, and IQL) and present a guidebook for choosing implementations. Following the guidebook, we find two variants CRR+ and CQL+ , achieving new state-of-the-art on D4RL. Moreover, we benchmark eight popular offline RL algorithms across datasets under unified training and evaluation framework. The findings are inspiring: the success of a learning paradigm severely depends on the data distribution, and some previous conclusions are biased by the dataset used. Our code is available at https://github.com/sail-sg/offbench.

Accurate and Robust Lesion RECIST Diameter Prediction and Segmentation with Transformers

Automatically measuring lesion/tumor size with RECIST (Response Evaluation Criteria In Solid Tumors) diameters and segmentation is important for computer-aided diagnosis. Although it has been studied in recent years, there is still space to improve its accuracy and robustness, such as (1) enhancing features by incorporating rich contextual information while keeping a high spatial resolution and (2) involving new tasks and losses for joint optimization. To reach this goal, this paper proposes a transformer-based network (MeaFormer, Measurement transFormer) for lesion RECIST diameter prediction and segmentation (LRDPS). It is formulated as three correlative and complementary tasks: lesion segmentation, heatmap prediction, and keypoint regression. To the best of our knowledge, it is the first time to use keypoint regression for RECIST diameter prediction. MeaFormer can enhance high-resolution features by employing transformers to capture their long-range dependencies. Two consistency losses are introduced to explicitly build relationships among these tasks for better optimization. Experiments show that MeaFormer achieves the state-of-the-art performance of LRDPS on the large-scale DeepLesion dataset and produces promising results of two downstream clinic-relevant tasks, i.e., 3D lesion segmentation and RECIST assessment in longitudinal studies.

PieTrack: An MOT solution based on synthetic data training and self-supervised domain adaptation

In order to cope with the increasing demand for labeling data and privacy issues with human detection, synthetic data has been used as a substitute and showing promising results in human detection and tracking tasks. We participate in the 7th Workshop on Benchmarking Multi-Target Tracking (BMTT), themed on "How Far Can Synthetic Data Take us"? Our solution, PieTrack, is developed based on synthetic data without using any pre-trained weights. We propose a self-supervised domain adaptation method that enables mitigating the domain shift issue between the synthetic (e.g., MOTSynth) and real data (e.g., MOT17) without involving extra human labels. By leveraging the proposed multi-scale ensemble inference, we achieved a final HOTA score of 58.7 on the MOT17 testing set, ranked third place in the challenge.

Coherence Learning using Keypoint-based Pooling Network for Accurately Assessing Radiographic Knee Osteoarthritis

Knee osteoarthritis (OA) is a common degenerate joint disorder that affects a large population of elderly people worldwide. Accurate radiographic assessment of knee OA severity plays a critical role in chronic patient management. Current clinically-adopted knee OA grading systems are observer subjective and suffer from inter-rater disagreements. In this work, we propose a computer-aided diagnosis approach to provide more accurate and consistent assessments of both composite and fine-grained OA grades simultaneously. A novel semi-supervised learning method is presented to exploit the underlying coherence in the composite and fine-grained OA grades by learning from unlabeled data. By representing the grade coherence using the log-probability of a pre-trained Gaussian Mixture Model, we formulate an incoherence loss to incorporate unlabeled data in training. The proposed method also describes a keypoint-based pooling network, where deep image features are pooled from the disease-targeted keypoints (extracted along the knee joint) to provide more aligned and pathologically informative feature representations, for accurate OA grade assessments. The proposed method is comprehensively evaluated on the public Osteoarthritis Initiative (OAI) data, a multi-center ten-year observational study on 4,796 subjects. Experimental results demonstrate that our method leads to significant improvements over previous strong whole image-based deep classification network baselines (like ResNet-50).

Scalable Semi-supervised Landmark Localization for X-ray Images using Few-shot Deep Adaptive Graph

Landmark localization plays an important role in medical image analysis. Learning based methods, including CNN and GCN, have demonstrated the state-of-the-art performance. However, most of these methods are fully-supervised and heavily rely on manual labeling of a large training dataset. In this paper, based on a fully-supervised graph-based method, DAG, we proposed a semi-supervised extension of it, termed few-shot DAG, \ie five-shot DAG. It first trains a DAG model on the labeled data and then fine-tunes the pre-trained model on the unlabeled data with a teacher-student SSL mechanism. In addition to the semi-supervised loss, we propose another loss using JS divergence to regulate the consistency of the intermediate feature maps. We extensively evaluated our method on pelvis, hand and chest landmark detection tasks. Our experiment results demonstrate consistent and significant improvements over previous methods.

Opportunistic Screening of Osteoporosis Using Plain Film Chest X-ray

Osteoporosis is a common chronic metabolic bone disease that is often under-diagnosed and under-treated due to the limited access to bone mineral density (BMD) examinations, Dual-energy X-ray Absorptiometry (DXA). In this paper, we propose a method to predict BMD from Chest X-ray (CXR), one of the most common, accessible, and low-cost medical image examinations. Our method first automatically detects Regions of Interest (ROIs) of local and global bone structures from the CXR. Then a multi-ROI model is developed to exploit both local and global information in the chest X-ray image for accurate BMD estimation. Our method is evaluated on 329 CXR cases with ground truth BMD measured by DXA. The model predicted BMD has a strong correlation with the gold standard DXA BMD (Pearson correlation coefficient 0.840). When applied for osteoporosis screening, it achieves a high classification performance (AUC 0.936). As the first effort in the field to use CXR scans to predict the spine BMD, the proposed algorithm holds strong potential in enabling early osteoporosis screening through routine chest X-rays and contributing to the enhancement of public health.

Semi-Supervised Learning for Bone Mineral Density Estimation in Hip X-ray Images

Bone mineral density (BMD) is a clinically critical indicator of osteoporosis, usually measured by dual-energy X-ray absorptiometry (DEXA). Due to the limited accessibility of DEXA machines and examinations, osteoporosis is often under-diagnosed and under-treated, leading to increased fragility fracture risks. Thus it is highly desirable to obtain BMDs with alternative cost-effective and more accessible medical imaging examinations such as X-ray plain films. In this work, we formulate the BMD estimation from plain hip X-ray images as a regression problem. Specifically, we propose a new semi-supervised self-training algorithm to train the BMD regression model using images coupled with DEXA measured BMDs and unlabeled images with pseudo BMDs. Pseudo BMDs are generated and refined iteratively for unlabeled images during self-training. We also present a novel adaptive triplet loss to improve the model's regression accuracy. On an in-house dataset of 1,090 images (819 unique patients), our BMD estimation method achieves a high Pearson correlation coefficient of 0.8805 to ground-truth BMDs. It offers good feasibility to use the more accessible and cheaper X-ray imaging for opportunistic osteoporosis screening.

Scale-free Network-based Differential Evolution

Some recent research reveals that a topological structure in meta-heuristic algorithms can effectively enhance the interaction of population, and thus improve their performance. Inspired by it, we creatively investigate the effectiveness of using a scale-free network in differential evolution methods, and propose a scale-free network-based differential evolution method. The novelties of this paper include a scale-free network-based population structure and a new mutation operator designed to fully utilize the neighborhood information provided by a scale-free structure. The elite individuals and population at the latest generation are both employed to guide a global optimization process. In this manner, the proposed algorithm owns balanced exploration and exploitation capabilities to alleviate the drawbacks of premature convergence. Experimental and statistical analyses are performed on the CEC'17 benchmark function suite and three real world problems. Results demonstrate its superior effectiveness and efficiency in comparison with its competitive peers.