Is Dataset Quality Still a Concern in Diagnosis Using Large Foundation Model?

Recent advancements in pre-trained large foundation models (LFM) have yielded significant breakthroughs across various domains, including natural language processing and computer vision. These models have been particularly impactful in the domain of medical diagnostic tasks. With abundant unlabeled data, an LFM has been developed for fundus images using the Vision Transformer (VIT) and a self-supervised learning framework. This LFM has shown promising performance in fundus disease diagnosis across multiple datasets. On the other hand, deep learning models have long been challenged by dataset quality issues, such as image quality and dataset bias. To investigate the influence of data quality on LFM, we conducted explorations in two fundus diagnosis tasks using datasets of varying quality. Specifically, we explored the following questions: Is LFM more robust to image quality? Is LFM affected by dataset bias? Can fine-tuning techniques alleviate these effects? Our investigation found that LFM exhibits greater resilience to dataset quality issues, including image quality and dataset bias, compared to typical convolutional networks. Furthermore, we discovered that overall fine-tuning is an effective adapter for LFM to mitigate the impact of dataset quality issues.

Enhancing and Adapting in the Clinic: Source-free Unsupervised Domain Adaptation for Medical Image Enhancement

Medical imaging provides many valuable clues involving anatomical structure and pathological characteristics. However, image degradation is a common issue in clinical practice, which can adversely impact the observation and diagnosis by physicians and algorithms. Although extensive enhancement models have been developed, these models require a well pre-training before deployment, while failing to take advantage of the potential value of inference data after deployment. In this paper, we raise an algorithm for source-free unsupervised domain adaptive medical image enhancement (SAME), which adapts and optimizes enhancement models using test data in the inference phase. A structure-preserving enhancement network is first constructed to learn a robust source model from synthesized training data. Then a teacher-student model is initialized with the source model and conducts source-free unsupervised domain adaptation (SFUDA) by knowledge distillation with the test data. Additionally, a pseudo-label picker is developed to boost the knowledge distillation of enhancement tasks. Experiments were implemented on ten datasets from three medical image modalities to validate the advantage of the proposed algorithm, and setting analysis and ablation studies were also carried out to interpret the effectiveness of SAME. The remarkable enhancement performance and benefits for downstream tasks demonstrate the potential and generalizability of SAME. The code is available at https://github.com/liamheng/Annotation-free-Medical-Image-Enhancement.