Toward Modality Gap: Vision Prototype Learning for Weakly-supervised Semantic Segmentation with CLIP

The application of Contrastive Language-Image Pre-training (CLIP) in Weakly Supervised Semantic Segmentation (WSSS) research powerful cross-modal semantic understanding capabilities. Existing methods attempt to optimize input text prompts for improved alignment of images and text, by finely adjusting text prototypes to facilitate semantic matching. Nevertheless, given the modality gap between text and vision spaces, the text prototypes employed by these methods have not effectively established a close correspondence with pixel-level vision features. In this work, our theoretical analysis indicates that the inherent modality gap results in misalignment of text and region features, and that this gap cannot be sufficiently reduced by minimizing contrast loss in CLIP. To mitigate the impact of the modality gap, we propose a Vision Prototype Learning (VPL) framework, by introducing more representative vision prototypes. The core of this framework is to learn class-specific vision prototypes in vision space with the help of text prototypes, for capturing high-quality localization maps. Moreover, we propose a regional semantic contrast module that contrasts regions embedding with corresponding prototypes, leading to more comprehensive and robust feature learning. Experimental results show that our proposed framework achieves state-of-the-art performance on two benchmark datasets.

Neighbor Does Matter: Density-Aware Contrastive Learning for Medical Semi-supervised Segmentation

In medical image analysis, multi-organ semi-supervised segmentation faces challenges such as insufficient labels and low contrast in soft tissues. To address these issues, existing studies typically employ semi-supervised segmentation techniques using pseudo-labeling and consistency regularization. However, these methods mainly rely on individual data samples for training, ignoring the rich neighborhood information present in the feature space. In this work, we argue that supervisory information can be directly extracted from the geometry of the feature space. Inspired by the density-based clustering hypothesis, we propose using feature density to locate sparse regions within feature clusters. Our goal is to increase intra-class compactness by addressing sparsity issues. To achieve this, we propose a Density-Aware Contrastive Learning (DACL) strategy, pushing anchored features in sparse regions towards cluster centers approximated by high-density positive samples, resulting in more compact clusters. Specifically, our method constructs density-aware neighbor graphs using labeled and unlabeled data samples to estimate feature density and locate sparse regions. We also combine label-guided co-training with density-guided geometric regularization to form complementary supervision for unlabeled data. Experiments on the Multi-Organ Segmentation Challenge dataset demonstrate that our proposed method outperforms state-of-the-art methods, highlighting its efficacy in medical image segmentation tasks.

A General-Purpose Multimodal Foundation Model for Dermatology

Diagnosing and treating skin diseases require advanced visual skills across multiple domains and the ability to synthesize information from various imaging modalities. Current deep learning models, while effective at specific tasks such as diagnosing skin cancer from dermoscopic images, fall short in addressing the complex, multimodal demands of clinical practice. Here, we introduce PanDerm, a multimodal dermatology foundation model pretrained through self-supervised learning on a dataset of over 2 million real-world images of skin diseases, sourced from 11 clinical institutions across 4 imaging modalities. We evaluated PanDerm on 28 diverse datasets covering a range of clinical tasks, including skin cancer screening, phenotype assessment and risk stratification, diagnosis of neoplastic and inflammatory skin diseases, skin lesion segmentation, change monitoring, and metastasis prediction and prognosis. PanDerm achieved state-of-the-art performance across all evaluated tasks, often outperforming existing models even when using only 5-10% of labeled data. PanDerm's clinical utility was demonstrated through reader studies in real-world clinical settings across multiple imaging modalities. It outperformed clinicians by 10.2% in early-stage melanoma detection accuracy and enhanced clinicians' multiclass skin cancer diagnostic accuracy by 11% in a collaborative human-AI setting. Additionally, PanDerm demonstrated robust performance across diverse demographic factors, including different body locations, age groups, genders, and skin tones. The strong results in benchmark evaluations and real-world clinical scenarios suggest that PanDerm could enhance the management of skin diseases and serve as a model for developing multimodal foundation models in other medical specialties, potentially accelerating the integration of AI support in healthcare.

SynFER: Towards Boosting Facial Expression Recognition with Synthetic Data

Facial expression datasets remain limited in scale due to privacy concerns, the subjectivity of annotations, and the labor-intensive nature of data collection. This limitation poses a significant challenge for developing modern deep learning-based facial expression analysis models, particularly foundation models, that rely on large-scale data for optimal performance. To tackle the overarching and complex challenge, we introduce SynFER (Synthesis of Facial Expressions with Refined Control), a novel framework for synthesizing facial expression image data based on high-level textual descriptions as well as more fine-grained and precise control through facial action units. To ensure the quality and reliability of the synthetic data, we propose a semantic guidance technique to steer the generation process and a pseudo-label generator to help rectify the facial expression labels for the synthetic images. To demonstrate the generation fidelity and the effectiveness of the synthetic data from SynFER, we conduct extensive experiments on representation learning using both synthetic data and real-world data. Experiment results validate the efficacy of the proposed approach and the synthetic data. Notably, our approach achieves a 67.23% classification accuracy on AffectNet when training solely with synthetic data equivalent to the AffectNet training set size, which increases to 69.84% when scaling up to five times the original size. Our code will be made publicly available.

MONICA: Benchmarking on Long-tailed Medical Image Classification

Long-tailed learning is considered to be an extremely challenging problem in data imbalance learning. It aims to train well-generalized models from a large number of images that follow a long-tailed class distribution. In the medical field, many diagnostic imaging exams such as dermoscopy and chest radiography yield a long-tailed distribution of complex clinical findings. Recently, long-tailed learning in medical image analysis has garnered significant attention. However, the field currently lacks a unified, strictly formulated, and comprehensive benchmark, which often leads to unfair comparisons and inconclusive results. To help the community improve the evaluation and advance, we build a unified, well-structured codebase called Medical OpeN-source Long-taIled ClassifiCAtion (MONICA), which implements over 30 methods developed in relevant fields and evaluated on 12 long-tailed medical datasets covering 6 medical domains. Our work provides valuable practical guidance and insights for the field, offering detailed analysis and discussion on the effectiveness of individual components within the inbuilt state-of-the-art methodologies. We hope this codebase serves as a comprehensive and reproducible benchmark, encouraging further advancements in long-tailed medical image learning. The codebase is publicly available on https://github.com/PyJulie/MONICA.

Adaptive Transformer Modelling of Density Function for Nonparametric Survival Analysis

Survival analysis holds a crucial role across diverse disciplines, such as economics, engineering and healthcare. It empowers researchers to analyze both time-invariant and time-varying data, encompassing phenomena like customer churn, material degradation and various medical outcomes. Given the complexity and heterogeneity of such data, recent endeavors have demonstrated successful integration of deep learning methodologies to address limitations in conventional statistical approaches. However, current methods typically involve cluttered probability distribution function (PDF), have lower sensitivity in censoring prediction, only model static datasets, or only rely on recurrent neural networks for dynamic modelling. In this paper, we propose a novel survival regression method capable of producing high-quality unimodal PDFs without any prior distribution assumption, by optimizing novel Margin-Mean-Variance loss and leveraging the flexibility of Transformer to handle both temporal and non-temporal data, coined UniSurv. Extensive experiments on several datasets demonstrate that UniSurv places a significantly higher emphasis on censoring compared to other methods.

Fundus2Video: Cross-Modal Angiography Video Generation from Static Fundus Photography with Clinical Knowledge Guidance

Fundus Fluorescein Angiography (FFA) is a critical tool for assessing retinal vascular dynamics and aiding in the diagnosis of eye diseases. However, its invasive nature and less accessibility compared to Color Fundus (CF) images pose significant challenges. Current CF to FFA translation methods are limited to static generation. In this work, we pioneer dynamic FFA video generation from static CF images. We introduce an autoregressive GAN for smooth, memory-saving frame-by-frame FFA synthesis. To enhance the focus on dynamic lesion changes in FFA regions, we design a knowledge mask based on clinical experience. Leveraging this mask, our approach integrates innovative knowledge mask-guided techniques, including knowledge-boosted attention, knowledge-aware discriminators, and mask-enhanced patchNCE loss, aimed at refining generation in critical areas and addressing the pixel misalignment challenge. Our method achieves the best FVD of 1503.21 and PSNR of 11.81 compared to other common video generation approaches. Human assessment by an ophthalmologist confirms its high generation quality. Notably, our knowledge mask surpasses supervised lesion segmentation masks, offering a promising non-invasive alternative to traditional FFA for research and clinical applications. The code is available at https://github.com/Michi-3000/Fundus2Video.

TP-DRSeg: Improving Diabetic Retinopathy Lesion Segmentation with Explicit Text-Prompts Assisted SAM

Recent advances in large foundation models, such as the Segment Anything Model (SAM), have demonstrated considerable promise across various tasks. Despite their progress, these models still encounter challenges in specialized medical image analysis, especially in recognizing subtle inter-class differences in Diabetic Retinopathy (DR) lesion segmentation. In this paper, we propose a novel framework that customizes SAM for text-prompted DR lesion segmentation, termed TP-DRSeg. Our core idea involves exploiting language cues to inject medical prior knowledge into the vision-only segmentation network, thereby combining the advantages of different foundation models and enhancing the credibility of segmentation. Specifically, to unleash the potential of vision-language models in the recognition of medical concepts, we propose an explicit prior encoder that transfers implicit medical concepts into explicit prior knowledge, providing explainable clues to excavate low-level features associated with lesions. Furthermore, we design a prior-aligned injector to inject explicit priors into the segmentation process, which can facilitate knowledge sharing across multi-modality features and allow our framework to be trained in a parameter-efficient fashion. Experimental results demonstrate the superiority of our framework over other traditional models and foundation model variants.

OphNet: A Large-Scale Video Benchmark for Ophthalmic Surgical Workflow Understanding

Surgical scene perception via videos are critical for advancing robotic surgery, telesurgery, and AI-assisted surgery, particularly in ophthalmology. However, the scarcity of diverse and richly annotated video datasets has hindered the development of intelligent systems for surgical workflow analysis. Existing datasets for surgical workflow analysis, which typically face challenges such as small scale, a lack of diversity in surgery and phase categories, and the absence of time-localized annotations, limit the requirements for action understanding and model generalization validation in complex and diverse real-world surgical scenarios. To address this gap, we introduce OphNet, a large-scale, expert-annotated video benchmark for ophthalmic surgical workflow understanding. OphNet features: 1) A diverse collection of 2,278 surgical videos spanning 66 types of cataract, glaucoma, and corneal surgeries, with detailed annotations for 102 unique surgical phases and 150 granular operations; 2) It offers sequential and hierarchical annotations for each surgery, phase, and operation, enabling comprehensive understanding and improved interpretability; 3) Moreover, OphNet provides time-localized annotations, facilitating temporal localization and prediction tasks within surgical workflows. With approximately 205 hours of surgical videos, OphNet is about 20 times larger than the largest existing surgical workflow analysis benchmark. Our dataset and code have been made available at: \url{https://github.com/minghu0830/OphNet-benchmark}.

CARES: A Comprehensive Benchmark of Trustworthiness in Medical Vision Language Models

Artificial intelligence has significantly impacted medical applications, particularly with the advent of Medical Large Vision Language Models (Med-LVLMs), sparking optimism for the future of automated and personalized healthcare. However, the trustworthiness of Med-LVLMs remains unverified, posing significant risks for future model deployment. In this paper, we introduce CARES and aim to comprehensively evaluate the Trustworthiness of Med-LVLMs across the medical domain. We assess the trustworthiness of Med-LVLMs across five dimensions, including trustfulness, fairness, safety, privacy, and robustness. CARES comprises about 41K question-answer pairs in both closed and open-ended formats, covering 16 medical image modalities and 27 anatomical regions. Our analysis reveals that the models consistently exhibit concerns regarding trustworthiness, often displaying factual inaccuracies and failing to maintain fairness across different demographic groups. Furthermore, they are vulnerable to attacks and demonstrate a lack of privacy awareness. We publicly release our benchmark and code in https://github.com/richard-peng-xia/CARES.