Cardiovascular Disease Detection from Multi-View Chest X-rays with BI-Mamba

Accurate prediction of Cardiovascular disease (CVD) risk in medical imaging is central to effective patient health management. Previous studies have demonstrated that imaging features in computed tomography (CT) can help predict CVD risk. However, CT entails notable radiation exposure, which may result in adverse health effects for patients. In contrast, chest X-ray emits significantly lower levels of radiation, offering a safer option. This rationale motivates our investigation into the feasibility of using chest X-ray for predicting CVD risk. Convolutional Neural Networks (CNNs) and Transformers are two established network architectures for computer-aided diagnosis. However, they struggle to model very high resolution chest X-ray due to the lack of large context modeling power or quadratic time complexity. Inspired by state space sequence models (SSMs), a new class of network architectures with competitive sequence modeling power as Transfomers and linear time complexity, we propose Bidirectional Image Mamba (BI-Mamba) to complement the unidirectional SSMs with opposite directional information. BI-Mamba utilizes parallel forward and backwark blocks to encode longe-range dependencies of multi-view chest X-rays. We conduct extensive experiments on images from 10,395 subjects in National Lung Screening Trail (NLST). Results show that BI-Mamba outperforms ResNet-50 and ViT-S with comparable parameter size, and saves significant amount of GPU memory during training. Besides, BI-Mamba achieves promising performance compared with previous state of the art in CT, unraveling the potential of chest X-ray for CVD risk prediction.

Recurrent Feature Propagation and Edge Skip-Connections for Automatic Abdominal Organ Segmentation

Automatic segmentation of abdominal organs in computed tomography (CT) images can support radiation therapy and image-guided surgery workflows. Developing of such automatic solutions remains challenging mainly owing to complex organ interactions and blurry boundaries in CT images. To address these issues, we focus on effective spatial context modeling and explicit edge segmentation priors. Accordingly, we propose a 3D network with four main components trained end-to-end including shared encoder, edge detector, decoder with edge skip-connections (ESCs) and recurrent feature propagation head (RFP-Head). To capture wide-range spatial dependencies, the RFP-Head propagates and harvests local features through directed acyclic graphs (DAGs) formulated with recurrent connections in an efficient slice-wise manner, with regard to spatial arrangement of image units. To leverage edge information, the edge detector learns edge prior knowledge specifically tuned for semantic segmentation by exploiting intermediate features from the encoder with the edge supervision. The ESCs then aggregate the edge knowledge with multi-level decoder features to learn a hierarchy of discriminative features explicitly modeling complementarity between organs' interiors and edges for segmentation. We conduct extensive experiments on two challenging abdominal CT datasets with eight annotated organs. Experimental results show that the proposed network outperforms several state-of-the-art models, especially for the segmentation of small and complicated structures (gallbladder, esophagus, stomach, pancreas and duodenum). The code will be publicly available.