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 affin
e 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.
Low dose computed tomography (LDCT) has attracted more and more attention in routine clinical diagnosis assessment, therapy planning, etc., which can reduce the dose of X-ray radiation to patients. However, the noise caused by low X-ray exposure degr
ades the CT image quality and then affects clinical diagnosis accuracy. In this paper, we train a transformer-based neural network to enhance the final CT image quality. To be specific, we first decompose the noisy LDCT image into two parts: high-frequency (HF) and low-frequency (LF) compositions. Then, we extract content features (X_{L_c}) and latent texture features (X_{L_t}) from the LF part, as well as HF embeddings (X_{H_f}) from the HF part. Further, we feed X_{L_t} and X_{H_f} into a modified transformer with three encoders and decoders to obtain well-refined HF texture features. After that, we combine these well-refined HF texture features with the pre-extracted X_{L_c} to encourage the restoration of high-quality LDCT images with the assistance of piecewise reconstruction. Extensive experiments on Mayo LDCT dataset show that our method produces superior results and outperforms other methods.
Annotation scarcity is a long-standing problem in medical image analysis area. To efficiently leverage limited annotations, abundant unlabeled data are additionally exploited in semi-supervised learning, while well-established cross-modality data are
investigated in domain adaptation. In this paper, we aim to explore the feasibility of concurrently leveraging both unlabeled data and cross-modality data for annotation-efficient cardiac segmentation. To this end, we propose a cutting-edge semi-supervised domain adaptation framework, namely Dual-Teacher++. Besides directly learning from limited labeled target domain data (e.g., CT) via a student model adopted by previous literature, we design novel dual teacher models, including an inter-domain teacher model to explore cross-modality priors from source domain (e.g., MR) and an intra-domain teacher model to investigate the knowledge beneath unlabeled target domain. In this way, the dual teacher models would transfer acquired inter- and intra-domain knowledge to the student model for further integration and exploitation. Moreover, to encourage reliable dual-domain knowledge transfer, we enhance the inter-domain knowledge transfer on the samples with higher similarity to target domain after appearance alignment, and also strengthen intra-domain knowledge transfer of unlabeled target data with higher prediction confidence. In this way, the student model can obtain reliable dual-domain knowledge and yield improved performance on target domain data. We extensively evaluated the feasibility of our method on the MM-WHS 2017 challenge dataset. The experiments have demonstrated the superiority of our framework over other semi-supervised learning and domain adaptation methods. Moreover, our performance gains could be yielded in bidirections,i.e., adapting from MR to CT, and from CT to MR.
The whole slide histopathology images (WSIs) play a critical role in gastric cancer diagnosis. However, due to the large scale of WSIs and various sizes of the abnormal area, how to select informative regions and analyze them are quite challenging du
ring the automatic diagnosis process. The multi-instance learning based on the most discriminative instances can be of great benefit for whole slide gastric image diagnosis. In this paper, we design a recalibrated multi-instance deep learning method (RMDL) to address this challenging problem. We first select the discriminative instances, and then utilize these instances to diagnose diseases based on the proposed RMDL approach. The designed RMDL network is capable of capturing instance-wise dependencies and recalibrating instance features according to the importance coefficient learned from the fused features. Furthermore, we build a large whole-slide gastric histopathology image dataset with detailed pixel-level annotations. Experimental results on the constructed gastric dataset demonstrate the significant improvement on the accuracy of our proposed framework compared with other state-of-the-art multi-instance learning methods. Moreover, our method is general and can be extended to other diagnosis tasks of different cancer types based on WSIs.
Deep convolutional neural networks have significantly boosted the performance of fundus image segmentation when test datasets have the same distribution as the training datasets. However, in clinical practice, medical images often exhibit variations
in appearance for various reasons, e.g., different scanner vendors and image quality. These distribution discrepancies could lead the deep networks to over-fit on the training datasets and lack generalization ability on the unseen test datasets. To alleviate this issue, we present a novel Domain-oriented Feature Embedding (DoFE) framework to improve the generalization ability of CNNs on unseen target domains by exploring the knowledge from multiple source domains. Our DoFE framework dynamically enriches the image features with additional domain prior knowledge learned from multi-source domains to make the semantic features more discriminative. Specifically, we introduce a Domain Knowledge Pool to learn and memorize the prior information extracted from multi-source domains. Then the original image features are augmented with domain-oriented aggregated features, which are induced from the knowledge pool based on the similarity between the input image and multi-source domain images. We further design a novel domain code prediction branch to infer this similarity and employ an attention-guided mechanism to dynamically combine the aggregated features with the semantic features. We comprehensively evaluate our DoFE framework on two fundus image segmentation tasks, including the optic cup and disc segmentation and vessel segmentation. Our DoFE framework generates satisfying segmentation results on unseen datasets and surpasses other domain generalization and network regularization methods.
The success of deep convolutional neural networks is partially attributed to the massive amount of annotated training data. However, in practice, medical data annotations are usually expensive and time-consuming to be obtained. Considering multi-moda
lity data with the same anatomic structures are widely available in clinic routine, in this paper, we aim to exploit the prior knowledge (e.g., shape priors) learned from one modality (aka., assistant modality) to improve the segmentation performance on another modality (aka., target modality) to make up annotation scarcity. To alleviate the learning difficulties caused by modality-specific appearance discrepancy, we first present an Image Alignment Module (IAM) to narrow the appearance gap between assistant and target modality data.We then propose a novel Mutual Knowledge Distillation (MKD) scheme to thoroughly exploit the modality-shared knowledge to facilitate the target-modality segmentation. To be specific, we formulate our framework as an integration of two individual segmentors. Each segmentor not only explicitly extracts one modality knowledge from corresponding annotations, but also implicitly explores another modality knowledge from its counterpart in mutual-guided manner. The ensemble of two segmentors would further integrate the knowledge from both modalities and generate reliable segmentation results on target modality. Experimental results on the public multi-class cardiac segmentation data, i.e., MMWHS 2017, show that our method achieves large improvements on CT segmentation by utilizing additional MRI data and outperforms other state-of-the-art multi-modality learning methods.
Computed tomography (CT) has been widely used for medical diagnosis, assessment, and therapy planning and guidance. In reality, CT images may be affected adversely in the presence of metallic objects, which could lead to severe metal artifacts and in
fluence clinical diagnosis or dose calculation in radiation therapy. In this paper, we propose a generalizable framework for metal artifact reduction (MAR) by simultaneously leveraging the advantages of image domain and sinogram domain-based MAR techniques. We formulate our framework as a sinogram completion problem and train a neural network (SinoNet) to restore the metal-affected projections. To improve the continuity of the completed projections at the boundary of metal trace and thus alleviate new artifacts in the reconstructed CT images, we train another neural network (PriorNet) to generate a good prior image to guide sinogram learning, and further design a novel residual sinogram learning strategy to effectively utilize the prior image information for better sinogram completion. The two networks are jointly trained in an end-to-end fashion with a differentiable forward projection (FP) operation so that the prior image generation and deep sinogram completion procedures can benefit from each other. Finally, the artifact-reduced CT images are reconstructed using the filtered backward projection (FBP) from the completed sinogram. Extensive experiments on simulated and real artifacts data demonstrate that our method produces superior artifact-reduced results while preserving the anatomical structures and outperforms other MAR methods.
The generalization capability of neural networks across domains is crucial for real-world applications. We argue that a generalized object recognition system should well understand the relationships among different images and also the images themselv
es at the same time. To this end, we present a new domain generalization framework that learns how to generalize across domains simultaneously from extrinsic relationship supervision and intrinsic self-supervision for images from multi-source domains. To be specific, we formulate our framework with feature embedding using a multi-task learning paradigm. Besides conducting the common supervised recognition task, we seamlessly integrate a momentum metric learning task and a self-supervised auxiliary task to collectively utilize the extrinsic supervision and intrinsic supervision. Also, we develop an effective momentum metric learning scheme with K-hard negative mining to boost the network to capture image relationship for domain generalization. We demonstrate the effectiveness of our approach on two standard object recognition benchmarks VLCS and PACS, and show that our methods achieve state-of-the-art performance.
Medical image annotations are prohibitively time-consuming and expensive to obtain. To alleviate annotation scarcity, many approaches have been developed to efficiently utilize extra information, e.g.,semi-supervised learning further exploring plenti
ful unlabeled data, domain adaptation including multi-modality learning and unsupervised domain adaptation resorting to the prior knowledge from additional modality. In this paper, we aim to investigate the feasibility of simultaneously leveraging abundant unlabeled data and well-established cross-modality data for annotation-efficient medical image segmentation. To this end, we propose a novel semi-supervised domain adaptation approach, namely Dual-Teacher, where the student model not only learns from labeled target data (e.g., CT), but also explores unlabeled target data and labeled source data (e.g., MR) by two teacher models. Specifically, the student model learns the knowledge of unlabeled target data from intra-domain teacher by encouraging prediction consistency, as well as the shape priors embedded in labeled source data from inter-domain teacher via knowledge distillation. Consequently, the student model can effectively exploit the information from all three data resources and comprehensively integrate them to achieve improved performance. We conduct extensive experiments on MM-WHS 2017 dataset and demonstrate that our approach is able to concurrently utilize unlabeled data and cross-modality data with superior performance, outperforming semi-supervised learning and domain adaptation methods with a large margin.
Deep learning approaches have demonstrated remarkable progress in automatic Chest X-ray analysis. The data-driven feature of deep models requires training data to cover a large distribution. Therefore, it is substantial to integrate knowledge from mu
ltiple datasets, especially for medical images. However, learning a disease classification model with extra Chest X-ray (CXR) data is yet challenging. Recent researches have demonstrated that performance bottleneck exists in joint training on different CXR datasets, and few made efforts to address the obstacle. In this paper, we argue that incorporating an external CXR dataset leads to imperfect training data, which raises the challenges. Specifically, the imperfect data is in two folds: domain discrepancy, as the image appearances vary across datasets; and label discrepancy, as different datasets are partially labeled. To this end, we formulate the multi-label thoracic disease classification problem as weighted independent binary tasks according to the categories. For common categories shared across domains, we adopt task-specific adversarial training to alleviate the feature differences. For categories existing in a single dataset, we present uncertainty-aware temporal ensembling of model predictions to mine the information from the missing labels further. In this way, our framework simultaneously models and tackles the domain and label discrepancies, enabling superior knowledge mining ability. We conduct extensive experiments on three datasets with more than 360,000 Chest X-ray images. Our method outperforms other competing models and sets state-of-the-art performance on the official NIH test set with 0.8349 AUC, demonstrating its effectiveness of utilizing the external dataset to improve the internal classification.
