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Medical image segmentation is a crucial task that relies on the ability to accurately identify and isolate regions of interest in images. Thereby, generative approaches allow to capture the statistical properties of segmentation masks that are dependent on the respective medical images. In this work we propose a conditional score-based generative modeling framework that leverages the signed distance function to represent an implicit and smoother distribution of segmentation masks. The score function of the conditional distribution of segmentation masks is learned in a conditional denoising process, which can be effectively used to generate accurate segmentation masks. Moreover, uncertainty maps can be generated, which can aid in further analysis and thus enhance the predictive robustness. We qualitatively and quantitatively illustrate competitive performance of the proposed method on a public nuclei and gland segmentation data set, highlighting its potential utility in medical image segmentation applications.

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Score-based diffusion models (SBDM) have recently emerged as state-of-the-art approaches for image generation. Existing SBDMs are typically formulated in a finite-dimensional setting, where images are considered as tensors of a finite size. This papers develops SBDMs in the infinite-dimensional setting, that is, we model the training data as functions supported on a rectangular domain. Besides the quest for generating images at ever higher resolution our primary motivation is to create a well-posed infinite-dimensional learning problem so that we can discretize it consistently on multiple resolution levels. We thereby hope to obtain diffusion models that generalize across different resolution levels and improve the efficiency of the training process. We demonstrate how to overcome two shortcomings of current SBDM approaches in the infinite-dimensional setting. First, we modify the forward process to ensure that the latent distribution is well-defined in the infinite-dimensional setting using the notion of trace class operators. Second, we illustrate that approximating the score function with an operator network, in our case Fourier neural operators (FNOs), is beneficial for multilevel training. After deriving the forward process in the infinite-dimensional setting and reverse processes for finite approximations, we show their well-posedness, derive adequate discretizations, and investigate the role of the latent distributions. We provide first promising numerical results on two datasets, MNIST and material structures. In particular, we show that multilevel training is feasible within this framework.

The Segment Anything Model (SAM) is the first foundation model for general image segmentation. It designed a novel promotable segmentation task, ensuring zero-shot image segmentation using the pre-trained model via two main modes including automatic everything and manual prompt. SAM has achieved impressive results on various natural image segmentation tasks. However, medical image segmentation (MIS) is more challenging due to the complex modalities, fine anatomical structures, uncertain and complex object boundaries, and wide-range object scales. SAM has achieved impressive results on various natural image segmentation tasks. Meanwhile, zero-shot and efficient MIS can well reduce the annotation time and boost the development of medical image analysis. Hence, SAM seems to be a potential tool and its performance on large medical datasets should be further validated. We collected and sorted 52 open-source datasets, and build a large medical segmentation dataset with 16 modalities, 68 objects, and 553K slices. We conducted a comprehensive analysis of different SAM testing strategies on the so-called COSMOS 553K dataset. Extensive experiments validate that SAM performs better with manual hints like points and boxes for object perception in medical images, leading to better performance in prompt mode compared to everything mode. Additionally, SAM shows remarkable performance in some specific objects and modalities, but is imperfect or even totally fails in other situations. Finally, we analyze the influence of different factors (e.g., the Fourier-based boundary complexity and size of the segmented objects) on SAM's segmentation performance. Extensive experiments validate that SAM's zero-shot segmentation capability is not sufficient to ensure its direct application to the MIS.

Text-conditioned image generation has made significant progress in recent years with generative adversarial networks and more recently, diffusion models. While diffusion models conditioned on text prompts have produced impressive and high-quality images, accurately representing complex text prompts such as the number of instances of a specific object remains challenging. To address this limitation, we propose a novel guidance approach for the sampling process in the diffusion model that leverages bounding box and segmentation map information at inference time without additional training data. Through a novel loss in the sampling process, our approach guides the model with semantic features from CLIP embeddings and enforces geometric constraints, leading to high-resolution images that accurately represent the scene. To obtain bounding box and segmentation map information, we structure the text prompt as a scene graph and enrich the nodes with CLIP embeddings. Our proposed model achieves state-of-the-art performance on two public benchmarks for image generation from scene graphs, surpassing both scene graph to image and text-based diffusion models in various metrics. Our results demonstrate the effectiveness of incorporating bounding box and segmentation map guidance in the diffusion model sampling process for more accurate text-to-image generation.

Over the past few years, the rapid development of deep learning technologies for computer vision has greatly promoted the performance of medical image segmentation (MedISeg). However, the recent MedISeg publications usually focus on presentations of the major contributions (e.g., network architectures, training strategies, and loss functions) while unwittingly ignoring some marginal implementation details (also known as "tricks"), leading to a potential problem of the unfair experimental result comparisons. In this paper, we collect a series of MedISeg tricks for different model implementation phases (i.e., pre-training model, data pre-processing, data augmentation, model implementation, model inference, and result post-processing), and experimentally explore the effectiveness of these tricks on the consistent baseline models. Compared to paper-driven surveys that only blandly focus on the advantages and limitation analyses of segmentation models, our work provides a large number of solid experiments and is more technically operable. With the extensive experimental results on both the representative 2D and 3D medical image datasets, we explicitly clarify the effect of these tricks. Moreover, based on the surveyed tricks, we also open-sourced a strong MedISeg repository, where each of its components has the advantage of plug-and-play. We believe that this milestone work not only completes a comprehensive and complementary survey of the state-of-the-art MedISeg approaches, but also offers a practical guide for addressing the future medical image processing challenges including but not limited to small dataset learning, class imbalance learning, multi-modality learning, and domain adaptation. The code has been released at: //github.com/hust-linyi/MedISeg

Deep learning-based semi-supervised learning (SSL) algorithms have led to promising results in medical images segmentation and can alleviate doctors' expensive annotations by leveraging unlabeled data. However, most of the existing SSL algorithms in literature tend to regularize the model training by perturbing networks and/or data. Observing that multi/dual-task learning attends to various levels of information which have inherent prediction perturbation, we ask the question in this work: can we explicitly build task-level regularization rather than implicitly constructing networks- and/or data-level perturbation-and-transformation for SSL? To answer this question, we propose a novel dual-task-consistency semi-supervised framework for the first time. Concretely, we use a dual-task deep network that jointly predicts a pixel-wise segmentation map and a geometry-aware level set representation of the target. The level set representation is converted to an approximated segmentation map through a differentiable task transform layer. Simultaneously, we introduce a dual-task consistency regularization between the level set-derived segmentation maps and directly predicted segmentation maps for both labeled and unlabeled data. Extensive experiments on two public datasets show that our method can largely improve the performance by incorporating the unlabeled data. Meanwhile, our framework outperforms the state-of-the-art semi-supervised medical image segmentation methods. Code is available at: //github.com/Luoxd1996/DTC

A key requirement for the success of supervised deep learning is a large labeled dataset - a condition that is difficult to meet in medical image analysis. Self-supervised learning (SSL) can help in this regard by providing a strategy to pre-train a neural network with unlabeled data, followed by fine-tuning for a downstream task with limited annotations. Contrastive learning, a particular variant of SSL, is a powerful technique for learning image-level representations. In this work, we propose strategies for extending the contrastive learning framework for segmentation of volumetric medical images in the semi-supervised setting with limited annotations, by leveraging domain-specific and problem-specific cues. Specifically, we propose (1) novel contrasting strategies that leverage structural similarity across volumetric medical images (domain-specific cue) and (2) a local version of the contrastive loss to learn distinctive representations of local regions that are useful for per-pixel segmentation (problem-specific cue). We carry out an extensive evaluation on three Magnetic Resonance Imaging (MRI) datasets. In the limited annotation setting, the proposed method yields substantial improvements compared to other self-supervision and semi-supervised learning techniques. When combined with a simple data augmentation technique, the proposed method reaches within 8% of benchmark performance using only two labeled MRI volumes for training, corresponding to only 4% (for ACDC) of the training data used to train the benchmark.

The U-Net was presented in 2015. With its straight-forward and successful architecture it quickly evolved to a commonly used benchmark in medical image segmentation. The adaptation of the U-Net to novel problems, however, comprises several degrees of freedom regarding the exact architecture, preprocessing, training and inference. These choices are not independent of each other and substantially impact the overall performance. The present paper introduces the nnU-Net ('no-new-Net'), which refers to a robust and self-adapting framework on the basis of 2D and 3D vanilla U-Nets. We argue the strong case for taking away superfluous bells and whistles of many proposed network designs and instead focus on the remaining aspects that make out the performance and generalizability of a method. We evaluate the nnU-Net in the context of the Medical Segmentation Decathlon challenge, which measures segmentation performance in ten disciplines comprising distinct entities, image modalities, image geometries and dataset sizes, with no manual adjustments between datasets allowed. At the time of manuscript submission, nnU-Net achieves the highest mean dice scores across all classes and seven phase 1 tasks (except class 1 in BrainTumour) in the online leaderboard of the challenge.

In this paper, we focus on three problems in deep learning based medical image segmentation. Firstly, U-net, as a popular model for medical image segmentation, is difficult to train when convolutional layers increase even though a deeper network usually has a better generalization ability because of more learnable parameters. Secondly, the exponential ReLU (ELU), as an alternative of ReLU, is not much different from ReLU when the network of interest gets deep. Thirdly, the Dice loss, as one of the pervasive loss functions for medical image segmentation, is not effective when the prediction is close to ground truth and will cause oscillation during training. To address the aforementioned three problems, we propose and validate a deeper network that can fit medical image datasets that are usually small in the sample size. Meanwhile, we propose a new loss function to accelerate the learning process and a combination of different activation functions to improve the network performance. Our experimental results suggest that our network is comparable or superior to state-of-the-art methods.

Medical image segmentation requires consensus ground truth segmentations to be derived from multiple expert annotations. A novel approach is proposed that obtains consensus segmentations from experts using graph cuts (GC) and semi supervised learning (SSL). Popular approaches use iterative Expectation Maximization (EM) to estimate the final annotation and quantify annotator's performance. Such techniques pose the risk of getting trapped in local minima. We propose a self consistency (SC) score to quantify annotator consistency using low level image features. SSL is used to predict missing annotations by considering global features and local image consistency. The SC score also serves as the penalty cost in a second order Markov random field (MRF) cost function optimized using graph cuts to derive the final consensus label. Graph cut obtains a global maximum without an iterative procedure. Experimental results on synthetic images, real data of Crohn's disease patients and retinal images show our final segmentation to be accurate and more consistent than competing methods.

Image segmentation is considered to be one of the critical tasks in hyperspectral remote sensing image processing. Recently, convolutional neural network (CNN) has established itself as a powerful model in segmentation and classification by demonstrating excellent performances. The use of a graphical model such as a conditional random field (CRF) contributes further in capturing contextual information and thus improving the segmentation performance. In this paper, we propose a method to segment hyperspectral images by considering both spectral and spatial information via a combined framework consisting of CNN and CRF. We use multiple spectral cubes to learn deep features using CNN, and then formulate deep CRF with CNN-based unary and pairwise potential functions to effectively extract the semantic correlations between patches consisting of three-dimensional data cubes. Effective piecewise training is applied in order to avoid the computationally expensive iterative CRF inference. Furthermore, we introduce a deep deconvolution network that improves the segmentation masks. We also introduce a new dataset and experimented our proposed method on it along with several widely adopted benchmark datasets to evaluate the effectiveness of our method. By comparing our results with those from several state-of-the-art models, we show the promising potential of our method.

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