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The performance of deep segmentation models often degrades due to distribution shifts in image intensities between the training and test data sets. This is particularly pronounced in multi-centre studies involving data acquired using multi-vendor scanners, with variations in acquisition protocols. It is challenging to address this degradation because the shift is often not known textit{a priori} and hence difficult to model. We propose a novel framework to ensure robust segmentation in the presence of such distribution shifts. Our contribution is three-fold. First, inspired by the spirit of curriculum learning, we design a novel style curriculum to train the segmentation models using an easy-to-hard mode. A style transfer model with style fusion is employed to generate the curriculum samples. Gradually focusing on complex and adversarial style samples can significantly boost the robustness of the models. Second, instead of subjectively defining the curriculum complexity, we adopt an automated gradient manipulation method to control the hard and adversarial sample generation process. Third, we propose the Local Gradient Sign strategy to aggregate the gradient locally and stabilise training during gradient manipulation. The proposed framework can generalise to unknown distribution without using any target data. Extensive experiments on the public M&Ms Challenge dataset demonstrate that our proposed framework can generalise deep models well to unknown distributions and achieve significant improvements in segmentation accuracy.
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Deep learning has successfully been leveraged for medical image segmentation. It employs convolutional neural networks (CNN) to learn distinctive image features from a defined pixel-wise objective function. However, this approach can lead to less output pixel interdependence producing incomplete and unrealistic segmentation results. In this paper, we present a fully automatic deep learning method for robust medical image segmentation by formulating the segmentation problem as a recurrent framework using two systems. The first one is a forward system of an encoder-decoder CNN that predicts the segmentation result from the input image. The predicted probabilistic output of the forward system is then encoded by a fully convolutional network (FCN)-based context feedback system. The encoded feature space of the FCN is then integrated back into the forward systems feed-forward learning process. Using the FCN-based context feedback loop allows the forward system to learn and extract more high-level image features and fix previous mistakes, thereby improving prediction accuracy over time. Experimental results, performed on four different clinical datasets, demonstrate our methods potential application for single and multi-structure medical image segmentation by outperforming the state of the art methods. With the feedback loop, deep learning methods can now produce results that are both anatomically plausible and robust to low contrast images. Therefore, formulating image segmentation as a recurrent framework of two interconnected networks via context feedback loop can be a potential method for robust and efficient medical image analysis.
Image segmentation is a fundamental topic in image processing and has been studied for many decades. Deep learning-based supervised segmentation models have achieved state-of-the-art performance but most of them are limited by using pixel-wise loss functions for training without geometrical constraints. Inspired by Eulers Elastica model and recent active contour models introduced into the field of deep learning, we propose a novel active contour with elastica (ACE) loss function incorporating Elastica (curvature and length) and region information as geometrically-natural constraints for the image segmentation tasks. We introduce the mean curvature i.e. the average of all principal curvatures, as a more effective image prior to representing curvature in our ACE loss function. Furthermore, based on the definition of the mean curvature, we propose a fast solution to approximate the ACE loss in three-dimensional (3D) by using Laplace operators for 3D image segmentation. We evaluate our ACE loss function on four 2D and 3D natural and biomedical image datasets. Our results show that the proposed loss function outperforms other mainstream loss functions on different segmentation networks. Our source code is available at https://github.com/HiLab-git/ACELoss.
Batch Normalization (BN) is one of the key components for accelerating network training, and has been widely adopted in the medical image analysis field. However, BN only calculates the global statistics at the batch level, and applies the same affine transformation uniformly across all spatial coordinates, which would suppress the image contrast of different semantic structures. In this paper, we propose to incorporate the semantic class information into normalization layers, so that the activations corresponding to different regions (i.e., classes) can be modulated differently. We thus develop a novel DualNorm-UNet, to concurrently incorporate both global image-level statistics and local region-wise statistics for network normalization. Specifically, the local statistics are integrated by adaptively modulating the activations along different class regions via the learned semantic masks in the normalization layer. Compared with existing methods, our approach exploits semantic knowledge at normalization and yields more discriminative features for robust segmentation results. More importantly, our network demonstrates superior abilities in capturing domain-invariant information from multiple domains (institutions) of medical data. Extensive experiments show that our proposed DualNorm-UNet consistently improves the performance on various segmentation tasks, even in the face of more complex and variable data distributions. Code is available at https://github.com/lambert-x/DualNorm-Unet.
Deep learning has been widely used for medical image segmentation and a large number of papers has been presented recording the success of deep learning in the field. In this paper, we present a comprehensive thematic survey on medical image segmentation using deep learning techniques. This paper makes two original contributions. Firstly, compared to traditional surveys that directly divide literatures of deep learning on medical image segmentation into many groups and introduce literatures in detail for each group, we classify currently popular literatures according to a multi-level structure from coarse to fine. Secondly, this paper focuses on supervised and weakly supervised learning approaches, without including unsupervised approaches since they have been introduced in many old surveys and they are not popular currently. For supervised learning approaches, we analyze literatures in three aspects: the selection of backbone networks, the design of network blocks, and the improvement of loss functions. For weakly supervised learning approaches, we investigate literature according to data augmentation, transfer learning, and interactive segmentation, separately. Compared to existing surveys, this survey classifies the literatures very differently from before and is more convenient for readers to understand the relevant rationale and will guide them to think of appropriate improvements in medical image segmentation based on deep learning approaches.
Accurate image segmentation is crucial for medical imaging applications. The prevailing deep learning approaches typically rely on very large training datasets with high-quality manual annotations, which are often not available in medical imaging. We introduce Annotation-effIcient Deep lEarning (AIDE) to handle imperfect datasets with an elaborately designed cross-model self-correcting mechanism. AIDE improves the segmentation Dice scores of conventional deep learning models on open datasets possessing scarce or noisy annotations by up to 30%. For three clinical datasets containing 11,852 breast images of 872 patients from three medical centers, AIDE consistently produces segmentation maps comparable to those generated by the fully supervised counterparts as well as the manual annotations of independent radiologists by utilizing only 10% training annotations. Such a 10-fold improvement of efficiency in utilizing experts labels has the potential to promote a wide range of biomedical applications.
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