Fuzzy Attention-based Border Rendering Network for Lung Organ Segmentation

Automatic lung organ segmentation on CT images is crucial for lung disease diagnosis. However, the unlimited voxel values and class imbalance of lung organs can lead to false-negative/positive and leakage issues in advanced methods. Additionally, some slender lung organs are easily lost during the recycled down/up-sample procedure, e.g., bronchioles & arterioles, causing severe discontinuity issue. Inspired by these, this paper introduces an effective lung organ segmentation method called Fuzzy Attention-based Border Rendering (FABR) network. Since fuzzy logic can handle the uncertainty in feature extraction, hence the fusion of deep networks and fuzzy sets should be a viable solution for better performance. Meanwhile, unlike prior top-tier methods that operate on all regular dense points, our FABR depicts lung organ regions as cube-trees, focusing only on recycle-sampled border vulnerable points, rendering the severely discontinuous, false-negative/positive organ regions with a novel Global-Local Cube-tree Fusion (GLCF) module. All experimental results, on four challenging datasets of airway & artery, demonstrate that our method can achieve the favorable performance significantly.

DeepUniUSTransformer: Towards A Universal UltraSound Model with Prompted Guidance

Ultrasound is a widely used imaging modality in clinical practice due to its low cost, portability, and safety. Current research in general AI for healthcare focuses on large language models and general segmentation models, with insufficient attention to solutions addressing both disease prediction and tissue segmentation. In this study, we propose a novel universal framework for ultrasound, namely DeepUniUSTransformer, which is a promptable model accommodating multiple clinical task. The universality of this model is derived from its versatility across various aspects. It proficiently manages any ultrasound nature, any anatomical position, any input type and excelling not only in segmentation tasks but also in computer-aided diagnosis tasks. We introduce a novel module that incorporates this information as a prompt and seamlessly embedding it within the model's learning process. To train and validate our proposed model, we curated a comprehensive ultrasound dataset from publicly accessible sources, encompassing up to 7 distinct anatomical positions with over 9.7K annotations. Experimental results demonstrate that our model surpasses both a model trained on a single dataset and an ablated version of the network lacking prompt guidance. We will continuously expand the dataset and optimize the task specific prompting mechanism towards the universality in medical ultrasound. Model weights, datasets, and code will be open source to the public.

Data and Physics driven Deep Learning Models for Fast MRI Reconstruction: Fundamentals and Methodologies

Magnetic Resonance Imaging (MRI) is a pivotal clinical diagnostic tool, yet its extended scanning times often compromise patient comfort and image quality, especially in volumetric, temporal and quantitative scans. This review elucidates recent advances in MRI acceleration via data and physics-driven models, leveraging techniques from algorithm unrolling models, enhancement-based models, and plug-and-play models to emergent full spectrum of generative models. We also explore the synergistic integration of data models with physics-based insights, encompassing the advancements in multi-coil hardware accelerations like parallel imaging and simultaneous multi-slice imaging, and the optimization of sampling patterns. We then focus on domain-specific challenges and opportunities, including image redundancy exploitation, image integrity, evaluation metrics, data heterogeneity, and model generalization. This work also discusses potential solutions and future research directions, emphasizing the role of data harmonization, and federated learning for further improving the general applicability and performance of these methods in MRI reconstruction.

Unsupervised Tissue Segmentation via Deep Constrained Gaussian Network

Tissue segmentation is the mainstay of pathological examination, whereas the manual delineation is unduly burdensome. To assist this time-consuming and subjective manual step, researchers have devised methods to automatically segment structures in pathological images. Recently, automated machine and deep learning based methods dominate tissue segmentation research studies. However, most machine and deep learning based approaches are supervised and developed using a large number of training samples, in which the pixelwise annotations are expensive and sometimes can be impossible to obtain. This paper introduces a novel unsupervised learning paradigm by integrating an end-to-end deep mixture model with a constrained indicator to acquire accurate semantic tissue segmentation. This constraint aims to centralise the components of deep mixture models during the calculation of the optimisation function. In so doing, the redundant or empty class issues, which are common in current unsupervised learning methods, can be greatly reduced. By validation on both public and in-house datasets, the proposed deep constrained Gaussian network achieves significantly (Wilcoxon signed-rank test) better performance (with the average Dice scores of 0.737 and 0.735, respectively) on tissue segmentation with improved stability and robustness, compared to other existing unsupervised segmentation approaches. Furthermore, the proposed method presents a similar performance (p-value > 0.05) compared to the fully supervised U-Net.

Swin Deformable Attention U-Net Transformer (SDAUT) for Explainable Fast MRI

Fast MRI aims to reconstruct a high fidelity image from partially observed measurements. Exuberant development in fast MRI using deep learning has been witnessed recently. Meanwhile, novel deep learning paradigms, e.g., Transformer based models, are fast-growing in natural language processing and promptly developed for computer vision and medical image analysis due to their prominent performance. Nevertheless, due to the complexity of the Transformer, the application of fast MRI may not be straightforward. The main obstacle is the computational cost of the self-attention layer, which is the core part of the Transformer, can be expensive for high resolution MRI inputs. In this study, we propose a new Transformer architecture for solving fast MRI that coupled Shifted Windows Transformer with U-Net to reduce the network complexity. We incorporate deformable attention to construe the explainability of our reconstruction model. We empirically demonstrate that our method achieves consistently superior performance on the fast MRI task. Besides, compared to state-of-the-art Transformer models, our method has fewer network parameters while revealing explainability. The code is publicly available at https://github.com/ayanglab/SDAUT.

CS$^2$: A Controllable and Simultaneous Synthesizer of Images and Annotations with Minimal Human Intervention

The destitution of image data and corresponding expert annotations limit the training capacities of AI diagnostic models and potentially inhibit their performance. To address such a problem of data and label scarcity, generative models have been developed to augment the training datasets. Previously proposed generative models usually require manually adjusted annotations (e.g., segmentation masks) or need pre-labeling. However, studies have found that these pre-labeling based methods can induce hallucinating artifacts, which might mislead the downstream clinical tasks, while manual adjustment could be onerous and subjective. To avoid manual adjustment and pre-labeling, we propose a novel controllable and simultaneous synthesizer (dubbed CS$^2$) in this study to generate both realistic images and corresponding annotations at the same time. Our CS$^2$ model is trained and validated using high resolution CT (HRCT) data collected from COVID-19 patients to realize an efficient infections segmentation with minimal human intervention. Our contributions include 1) a conditional image synthesis network that receives both style information from reference CT images and structural information from unsupervised segmentation masks, and 2) a corresponding segmentation mask synthesis network to automatically segment these synthesized images simultaneously. Our experimental studies on HRCT scans collected from COVID-19 patients demonstrate that our CS$^2$ model can lead to realistic synthesized datasets and promising segmentation results of COVID infections compared to the state-of-the-art nnUNet trained and fine-tuned in a fully supervised manner.

Data and Physics Driven Learning Models for Fast MRI -- Fundamentals and Methodologies from CNN, GAN to Attention and Transformers

Research studies have shown no qualms about using data driven deep learning models for downstream tasks in medical image analysis, e.g., anatomy segmentation and lesion detection, disease diagnosis and prognosis, and treatment planning. However, deep learning models are not the sovereign remedy for medical image analysis when the upstream imaging is not being conducted properly (with artefacts). This has been manifested in MRI studies, where the scanning is typically slow, prone to motion artefacts, with a relatively low signal to noise ratio, and poor spatial and/or temporal resolution. Recent studies have witnessed substantial growth in the development of deep learning techniques for propelling fast MRI. This article aims to (1) introduce the deep learning based data driven techniques for fast MRI including convolutional neural network and generative adversarial network based methods, (2) survey the attention and transformer based models for speeding up MRI reconstruction, and (3) detail the research in coupling physics and data driven models for MRI acceleration. Finally, we will demonstrate through a few clinical applications, explain the importance of data harmonisation and explainable models for such fast MRI techniques in multicentre and multi-scanner studies, and discuss common pitfalls in current research and recommendations for future research directions.

Swin Transformer for Fast MRI

Magnetic resonance imaging (MRI) is an important non-invasive clinical tool that can produce high-resolution and reproducible images. However, a long scanning time is required for high-quality MR images, which leads to exhaustion and discomfort of patients, inducing more artefacts due to voluntary movements of the patients and involuntary physiological movements. To accelerate the scanning process, methods by k-space undersampling and deep learning based reconstruction have been popularised. This work introduced SwinMR, a novel Swin transformer based method for fast MRI reconstruction. The whole network consisted of an input module (IM), a feature extraction module (FEM) and an output module (OM). The IM and OM were 2D convolutional layers and the FEM was composed of a cascaded of residual Swin transformer blocks (RSTBs) and 2D convolutional layers. The RSTB consisted of a series of Swin transformer layers (STLs). The shifted windows multi-head self-attention (W-MSA/SW-MSA) of STL was performed in shifted windows rather than the multi-head self-attention (MSA) of the original transformer in the whole image space. A novel multi-channel loss was proposed by using the sensitivity maps, which was proved to reserve more textures and details. We performed a series of comparative studies and ablation studies in the Calgary-Campinas public brain MR dataset and conducted a downstream segmentation experiment in the Multi-modal Brain Tumour Segmentation Challenge 2017 dataset. The results demonstrate our SwinMR achieved high-quality reconstruction compared with other benchmark methods, and it shows great robustness with different undersampling masks, under noise interruption and on different datasets. The code is publicly available at https://github.com/ayanglab/SwinMR.

Multi-domain Integrative Swin Transformer network for Sparse-View Tomographic Reconstruction

The deep learning-based tomographic image reconstruction methods have been attracting much attention among these years. The sparse-view data reconstruction is one of typical underdetermined inverse problems, how to reconstruct high-quality CT images from dozens of projections is still a challenge in practice. To address this challenge, in this article we proposed a Multi-domain Integrative Swin Transformer network (MIST-net). First, the proposed MIST-net incorporated lavish domain features from data, residual-data, image, and residual-image using flexible network architectures. Here, the residual-data and residual-image domains network components can be considered as data consistency module to eliminate interpolation errors in both residual data and image domains, and then further retain image details. Second, to detect image features and further protect image edge, the trainable edge enhancement filter was incorporated into sub-network to improve encode-decode ability. Third, with classical Swin Transformer, we further designed a high-quality reconstruction transformer (i.e., Recformer) to improve reconstruction performance. Recformer inherited the power of Swin transformer to capture global and local features of reconstructed image. The experiments on numerical datasets with 48 views demonstrated our proposed MIST-net provided higher reconstructed image quality with small feature recovery and edge protection than other competitors including advanced unrolled networks. The trained network was transferred to real cardiac CT dataset to further validate the advantages as well as good robustness of our MIST-net in clinical applications.

Simultaneous Left Atrium Anatomy and Scar Segmentations via Deep Learning in Multiview Information with Attention

Three-dimensional late gadolinium enhanced (LGE) cardiac MR (CMR) of left atrial scar in patients with atrial fibrillation (AF) has recently emerged as a promising technique to stratify patients, to guide ablation therapy and to predict treatment success. This requires a segmentation of the high intensity scar tissue and also a segmentation of the left atrium (LA) anatomy, the latter usually being derived from a separate bright-blood acquisition. Performing both segmentations automatically from a single 3D LGE CMR acquisition would eliminate the need for an additional acquisition and avoid subsequent registration issues. In this paper, we propose a joint segmentation method based on multiview two-task (MVTT) recursive attention model working directly on 3D LGE CMR images to segment the LA (and proximal pulmonary veins) and to delineate the scar on the same dataset. Using our MVTT recursive attention model, both the LA anatomy and scar can be segmented accurately (mean Dice score of 93% for the LA anatomy and 87% for the scar segmentations) and efficiently (~0.27 seconds to simultaneously segment the LA anatomy and scars directly from the 3D LGE CMR dataset with 60-68 2D slices). Compared to conventional unsupervised learning and other state-of-the-art deep learning based methods, the proposed MVTT model achieved excellent results, leading to an automatic generation of a patient-specific anatomical model combined with scar segmentation for patients in AF.