MiniGPT-Pancreas: Multimodal Large Language Model for Pancreas Cancer Classification and Detection

Problem: Pancreas radiological imaging is challenging due to the small size, blurred boundaries, and variability of shape and position of the organ among patients. Goal: In this work we present MiniGPT-Pancreas, a Multimodal Large Language Model (MLLM), as an interactive chatbot to support clinicians in pancreas cancer diagnosis by integrating visual and textual information. Methods: MiniGPT-v2, a general-purpose MLLM, was fine-tuned in a cascaded way for pancreas detection, tumor classification, and tumor detection with multimodal prompts combining questions and computed tomography scans from the National Institute of Health (NIH), and Medical Segmentation Decathlon (MSD) datasets. The AbdomenCT-1k dataset was used to detect the liver, spleen, kidney, and pancreas. Results: MiniGPT-Pancreas achieved an Intersection over Union (IoU) of 0.595 and 0.550 for the detection of pancreas on NIH and MSD datasets, respectively. For the pancreas cancer classification task on the MSD dataset, accuracy, precision, and recall were 0.876, 0.874, and 0.878, respectively. When evaluating MiniGPT-Pancreas on the AbdomenCT-1k dataset for multi-organ detection, the IoU was 0.8399 for the liver, 0.722 for the kidney, 0.705 for the spleen, and 0.497 for the pancreas. For the pancreas tumor detection task, the IoU score was 0.168 on the MSD dataset. Conclusions: MiniGPT-Pancreas represents a promising solution to support clinicians in the classification of pancreas images with pancreas tumors. Future research is needed to improve the score on the detection task, especially for pancreas tumors.

Uncertainty-Error correlations in Evidential Deep Learning models for biomedical segmentation

In this work, we examine the effectiveness of an uncertainty quantification framework known as Evidential Deep Learning applied in the context of biomedical image segmentation. This class of models involves assigning Dirichlet distributions as priors for segmentation labels, and enables a few distinct definitions of model uncertainties. Using the cardiac and prostate MRI images available in the Medical Segmentation Decathlon for validation, we found that Evidential Deep Learning models with U-Net backbones generally yielded superior correlations between prediction errors and uncertainties relative to the conventional baseline equipped with Shannon entropy measure, Monte-Carlo Dropout and Deep Ensemble methods. We also examined these models' effectiveness in active learning, finding that relative to the standard Shannon entropy-based sampling, they yielded higher point-biserial uncertainty-error correlations while attaining similar performances in Dice-Sorensen coefficients. These superior features of EDL models render them well-suited for segmentation tasks that warrant a critical sensitivity in detecting large model errors.

Medical Image Segmentation with SAM-generated Annotations

The field of medical image segmentation is hindered by the scarcity of large, publicly available annotated datasets. Not all datasets are made public for privacy reasons, and creating annotations for a large dataset is time-consuming and expensive, as it requires specialized expertise to accurately identify regions of interest (ROIs) within the images. To address these challenges, we evaluate the performance of the Segment Anything Model (SAM) as an annotation tool for medical data by using it to produce so-called "pseudo labels" on the Medical Segmentation Decathlon (MSD) computed tomography (CT) tasks. The pseudo labels are then used in place of ground truth labels to train a UNet model in a weakly-supervised manner. We experiment with different prompt types on SAM and find that the bounding box prompt is a simple yet effective method for generating pseudo labels. This method allows us to develop a weakly-supervised model that performs comparably to a fully supervised model.

Expanding the Medical Decathlon dataset: segmentation of colon and colorectal cancer from computed tomography images

Colorectal cancer is the third-most common cancer in the Western Hemisphere. The segmentation of colorectal and colorectal cancer by computed tomography is an urgent problem in medicine. Indeed, a system capable of solving this problem will enable the detection of colorectal cancer at early stages of the disease, facilitate the search for pathology by the radiologist, and significantly accelerate the process of diagnosing the disease. However, scientific publications on medical image processing mostly use closed, non-public data. This paper presents an extension of the Medical Decathlon dataset with colorectal markups in order to improve the quality of segmentation algorithms. An experienced radiologist validated the data, categorized it into subsets by quality, and published it in the public domain. Based on the obtained results, we trained neural network models of the UNet architecture with 5-part cross-validation and achieved a Dice metric quality of $0.6988 \pm 0.3$. The published markups will improve the quality of colorectal cancer detection and simplify the radiologist's job for study description.

Interactive 3D Medical Image Segmentation with SAM 2

Interactive medical image segmentation (IMIS) has shown significant potential in enhancing segmentation accuracy by integrating iterative feedback from medical professionals. However, the limited availability of enough 3D medical data restricts the generalization and robustness of most IMIS methods. The Segment Anything Model (SAM), though effective for 2D images, requires expensive semi-auto slice-by-slice annotations for 3D medical images. In this paper, we explore the zero-shot capabilities of SAM 2, the next-generation Meta SAM model trained on videos, for 3D medical image segmentation. By treating sequential 2D slices of 3D images as video frames, SAM 2 can fully automatically propagate annotations from a single frame to the entire 3D volume. We propose a practical pipeline for using SAM 2 in 3D medical image segmentation and present key findings highlighting its efficiency and potential for further optimization. Concretely, numerical experiments on the BraTS2020 and the medical segmentation decathlon datasets demonstrate that SAM 2 still has a gap with supervised methods but can narrow the gap in specific settings and organ types, significantly reducing the annotation burden on medical professionals. Our code will be open-sourced and available at https://github.com/Chuyun-Shen/SAM_2_Medical_3D.

Progressive Growing of Patch Size: Resource-Efficient Curriculum Learning for Dense Prediction Tasks

In this work, we introduce Progressive Growing of Patch Size, a resource-efficient implicit curriculum learning approach for dense prediction tasks. Our curriculum approach is defined by growing the patch size during model training, which gradually increases the task's difficulty. We integrated our curriculum into the nnU-Net framework and evaluated the methodology on all 10 tasks of the Medical Segmentation Decathlon. With our approach, we are able to substantially reduce runtime, computational costs, and CO2 emissions of network training compared to classical constant patch size training. In our experiments, the curriculum approach resulted in improved convergence. We are able to outperform standard nnU-Net training, which is trained with constant patch size, in terms of Dice Score on 7 out of 10 MSD tasks while only spending roughly 50% of the original training runtime. To the best of our knowledge, our Progressive Growing of Patch Size is the first successful employment of a sample-length curriculum in the form of patch size in the field of computer vision. Our code is publicly available at https://github.com/compai-lab/2024-miccai-fischer.

Universal and Extensible Language-Vision Models for Organ Segmentation and Tumor Detection from Abdominal Computed Tomography

The advancement of artificial intelligence (AI) for organ segmentation and tumor detection is propelled by the growing availability of computed tomography (CT) datasets with detailed, per-voxel annotations. However, these AI models often struggle with flexibility for partially annotated datasets and extensibility for new classes due to limitations in the one-hot encoding, architectural design, and learning scheme. To overcome these limitations, we propose a universal, extensible framework enabling a single model, termed Universal Model, to deal with multiple public datasets and adapt to new classes (e.g., organs/tumors). Firstly, we introduce a novel language-driven parameter generator that leverages language embeddings from large language models, enriching semantic encoding compared with one-hot encoding. Secondly, the conventional output layers are replaced with lightweight, class-specific heads, allowing Universal Model to simultaneously segment 25 organs and six types of tumors and ease the addition of new classes. We train our Universal Model on 3,410 CT volumes assembled from 14 publicly available datasets and then test it on 6,173 CT volumes from four external datasets. Universal Model achieves first place on six CT tasks in the Medical Segmentation Decathlon (MSD) public leaderboard and leading performance on the Beyond The Cranial Vault (BTCV) dataset. In summary, Universal Model exhibits remarkable computational efficiency (6x faster than other dataset-specific models), demonstrates strong generalization across different hospitals, transfers well to numerous downstream tasks, and more importantly, facilitates the extensibility to new classes while alleviating the catastrophic forgetting of previously learned classes. Codes, models, and datasets are available at https://github.com/ljwztc/CLIP-Driven-Universal-Model

DiffRect: Latent Diffusion Label Rectification for Semi-supervised Medical Image Segmentation

Semi-supervised medical image segmentation aims to leverage limited annotated data and rich unlabeled data to perform accurate segmentation. However, existing semi-supervised methods are highly dependent on the quality of self-generated pseudo labels, which are prone to incorrect supervision and confirmation bias. Meanwhile, they are insufficient in capturing the label distributions in latent space and suffer from limited generalization to unlabeled data. To address these issues, we propose a Latent Diffusion Label Rectification Model (DiffRect) for semi-supervised medical image segmentation. DiffRect first utilizes a Label Context Calibration Module (LCC) to calibrate the biased relationship between classes by learning the category-wise correlation in pseudo labels, then apply Latent Feature Rectification Module (LFR) on the latent space to formulate and align the pseudo label distributions of different levels via latent diffusion. It utilizes a denoising network to learn the coarse to fine and fine to precise consecutive distribution transportations. We evaluate DiffRect on three public datasets: ACDC, MS-CMRSEG 2019, and Decathlon Prostate. Experimental results demonstrate the effectiveness of DiffRect, e.g. it achieves 82.40\% Dice score on ACDC with only 1\% labeled scan available, outperforms the previous state-of-the-art by 4.60\% in Dice, and even rivals fully supervised performance. Code is released at \url{https://github.com/CUHK-AIM-Group/DiffRect}.

CycleINR: Cycle Implicit Neural Representation for Arbitrary-Scale Volumetric Super-Resolution of Medical Data

In the realm of medical 3D data, such as CT and MRI images, prevalent anisotropic resolution is characterized by high intra-slice but diminished inter-slice resolution. The lowered resolution between adjacent slices poses challenges, hindering optimal viewing experiences and impeding the development of robust downstream analysis algorithms. Various volumetric super-resolution algorithms aim to surmount these challenges, enhancing inter-slice resolution and overall 3D medical imaging quality. However, existing approaches confront inherent challenges: 1) often tailored to specific upsampling factors, lacking flexibility for diverse clinical scenarios; 2) newly generated slices frequently suffer from over-smoothing, degrading fine details, and leading to inter-slice inconsistency. In response, this study presents CycleINR, a novel enhanced Implicit Neural Representation model for 3D medical data volumetric super-resolution. Leveraging the continuity of the learned implicit function, the CycleINR model can achieve results with arbitrary up-sampling rates, eliminating the need for separate training. Additionally, we enhance the grid sampling in CycleINR with a local attention mechanism and mitigate over-smoothing by integrating cycle-consistent loss. We introduce a new metric, Slice-wise Noise Level Inconsistency (SNLI), to quantitatively assess inter-slice noise level inconsistency. The effectiveness of our approach is demonstrated through image quality evaluations on an in-house dataset and a downstream task analysis on the Medical Segmentation Decathlon liver tumor dataset.

Exploring UMAP in hybrid models of entropy-based and representativeness sampling for active learning in biomedical segmentation

In this work, we study various hybrid models of entropy-based and representativeness sampling techniques in the context of active learning in medical segmentation, in particular examining the role of UMAP (Uniform Manifold Approximation and Projection) as a technique for capturing representativeness. Although UMAP has been shown viable as a general purpose dimension reduction method in diverse areas, its role in deep learning-based medical segmentation has yet been extensively explored. Using the cardiac and prostate datasets in the Medical Segmentation Decathlon for validation, we found that a novel hybrid combination of Entropy-UMAP sampling technique achieved a statistically significant Dice score advantage over the random baseline ($3.2 \%$ for cardiac, $4.5 \%$ for prostate), and attained the highest Dice coefficient among the spectrum of 10 distinct active learning methodologies we examined. This provides preliminary evidence that there is an interesting synergy between entropy-based and UMAP methods when the former precedes the latter in a hybrid model of active learning.