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.

Embracing Massive Medical Data

As massive medical data become available with an increasing number of scans, expanding classes, and varying sources, prevalent training paradigms -- where AI is trained with multiple passes over fixed, finite datasets -- face significant challenges. First, training AI all at once on such massive data is impractical as new scans/sources/classes continuously arrive. Second, training AI continuously on new scans/sources/classes can lead to catastrophic forgetting, where AI forgets old data as it learns new data, and vice versa. To address these two challenges, we propose an online learning method that enables training AI from massive medical data. Instead of repeatedly training AI on randomly selected data samples, our method identifies the most significant samples for the current AI model based on their data uniqueness and prediction uncertainty, then trains the AI on these selective data samples. Compared with prevalent training paradigms, our method not only improves data efficiency by enabling training on continual data streams, but also mitigates catastrophic forgetting by selectively training AI on significant data samples that might otherwise be forgotten, outperforming by 15% in Dice score for multi-organ and tumor segmentation. The code is available at https://github.com/MrGiovanni/OnlineLearning

Acquiring Weak Annotations for Tumor Localization in Temporal and Volumetric Data

Creating large-scale and well-annotated datasets to train AI algorithms is crucial for automated tumor detection and localization. However, with limited resources, it is challenging to determine the best type of annotations when annotating massive amounts of unlabeled data. To address this issue, we focus on polyps in colonoscopy videos and pancreatic tumors in abdominal CT scans; both applications require significant effort and time for pixel-wise annotation due to the high dimensional nature of the data, involving either temporary or spatial dimensions. In this paper, we develop a new annotation strategy, termed Drag&Drop, which simplifies the annotation process to drag and drop. This annotation strategy is more efficient, particularly for temporal and volumetric imaging, than other types of weak annotations, such as per-pixel, bounding boxes, scribbles, ellipses, and points. Furthermore, to exploit our Drag&Drop annotations, we develop a novel weakly supervised learning method based on the watershed algorithm. Experimental results show that our method achieves better detection and localization performance than alternative weak annotations and, more importantly, achieves similar performance to that trained on detailed per-pixel annotations. Interestingly, we find that, with limited resources, allocating weak annotations from a diverse patient population can foster models more robust to unseen images than allocating per-pixel annotations for a small set of images. In summary, this research proposes an efficient annotation strategy for tumor detection and localization that is less accurate than per-pixel annotations but useful for creating large-scale datasets for screening tumors in various medical modalities.

Early Detection and Localization of Pancreatic Cancer by Label-Free Tumor Synthesis

Early detection and localization of pancreatic cancer can increase the 5-year survival rate for patients from 8.5% to 20%. Artificial intelligence (AI) can potentially assist radiologists in detecting pancreatic tumors at an early stage. Training AI models require a vast number of annotated examples, but the availability of CT scans obtaining early-stage tumors is constrained. This is because early-stage tumors may not cause any symptoms, which can delay detection, and the tumors are relatively small and may be almost invisible to human eyes on CT scans. To address this issue, we develop a tumor synthesis method that can synthesize enormous examples of small pancreatic tumors in the healthy pancreas without the need for manual annotation. Our experiments demonstrate that the overall detection rate of pancreatic tumors, measured by Sensitivity and Specificity, achieved by AI trained on synthetic tumors is comparable to that of real tumors. More importantly, our method shows a much higher detection rate for small tumors. We further investigate the per-voxel segmentation performance of pancreatic tumors if AI is trained on a combination of CT scans with synthetic tumors and CT scans with annotated large tumors at an advanced stage. Finally, we show that synthetic tumors improve AI generalizability in tumor detection and localization when processing CT scans from different hospitals. Overall, our proposed tumor synthesis method has immense potential to improve the early detection of pancreatic cancer, leading to better patient outcomes.

Deep Gradient Learning for Efficient Camouflaged Object Detection

This paper introduces DGNet, a novel deep framework that exploits object gradient supervision for camouflaged object detection (COD). It decouples the task into two connected branches, i.e., a context and a texture encoder. The essential connection is the gradient-induced transition, representing a soft grouping between context and texture features. Benefiting from the simple but efficient framework, DGNet outperforms existing state-of-the-art COD models by a large margin. Notably, our efficient version, DGNet-S, runs in real-time (80 fps) and achieves comparable results to the cutting-edge model JCSOD-CVPR$_{21}$ with only 6.82% parameters. Application results also show that the proposed DGNet performs well in polyp segmentation, defect detection, and transparent object segmentation tasks. Codes will be made available at https://github.com/GewelsJI/DGNet.

Video Polyp Segmentation: A Deep Learning Perspective

In the deep learning era, we present the first comprehensive video polyp segmentation (VPS) study. Over the years, developments in VPS are not moving forward with ease due to the lack of large-scale fine-grained segmentation annotations. To tackle this issue, we first introduce a high-quality per-frame annotated VPS dataset, named SUN-SEG, which includes 158,690 frames from the famous SUN dataset. We provide additional annotations with diverse types, i.e., attribute, object mask, boundary, scribble, and polygon. Second, we design a simple but efficient baseline, dubbed PNS+, consisting of a global encoder, a local encoder, and normalized self-attention (NS) blocks. The global and local encoders receive an anchor frame and multiple successive frames to extract long-term and short-term feature representations, which are then progressively updated by two NS blocks. Extensive experiments show that PNS+ achieves the best performance and real-time inference speed (170fps), making it a promising solution for the VPS task. Third, we extensively evaluate 13 representative polyp/object segmentation models on our SUN-SEG dataset and provide attribute-based comparisons. Benchmark results are available at https: //github.com/GewelsJI/VPS.

Guidance and Teaching Network for Video Salient Object Detection

Owing to the difficulties of mining spatial-temporal cues, the existing approaches for video salient object detection (VSOD) are limited in understanding complex and noisy scenarios, and often fail in inferring prominent objects. To alleviate such shortcomings, we propose a simple yet efficient architecture, termed Guidance and Teaching Network (GTNet), to independently distil effective spatial and temporal cues with implicit guidance and explicit teaching at feature- and decision-level, respectively. To be specific, we (a) introduce a temporal modulator to implicitly bridge features from motion into the appearance branch, which is capable of fusing cross-modal features collaboratively, and (b) utilise motion-guided mask to propagate the explicit cues during the feature aggregation. This novel learning strategy achieves satisfactory results via decoupling the complex spatial-temporal cues and mapping informative cues across different modalities. Extensive experiments on three challenging benchmarks show that the proposed method can run at ~28 fps on a single TITAN Xp GPU and perform competitively against 14 cutting-edge baselines.

Progressively Normalized Self-Attention Network for Video Polyp Segmentation

Existing video polyp segmentation (VPS) models typically employ convolutional neural networks (CNNs) to extract features. However, due to their limited receptive fields, CNNs can not fully exploit the global temporal and spatial information in successive video frames, resulting in false-positive segmentation results. In this paper, we propose the novel PNS-Net (Progressively Normalized Self-attention Network), which can efficiently learn representations from polyp videos with real-time speed (~140fps) on a single RTX 2080 GPU and no post-processing. Our PNS-Net is based solely on a basic normalized self-attention block, equipping with recurrence and CNNs entirely. Experiments on challenging VPS datasets demonstrate that the proposed PNS-Net achieves state-of-the-art performance. We also conduct extensive experiments to study the effectiveness of the channel split, soft-attention, and progressive learning strategy. We find that our PNS-Net works well under different settings, making it a promising solution to the VPS task.