Automated brain tumor segmentation methods are well established, reaching performance levels with clear clinical utility. Most algorithms require four input magnetic resonance imaging (MRI) modalities, typically T1-weighted images with and without contrast enhancement, T2-weighted images, and FLAIR images. However, some of these sequences are often missing in clinical practice, e.g., because of time constraints and/or image artifacts (such as patient motion). Therefore, substituting missing modalities to recover segmentation performance in these scenarios is highly desirable and necessary for the more widespread adoption of such algorithms in clinical routine. In this work, we report the set-up of the Brain MR Image Synthesis Benchmark (BraSyn), organized in conjunction with the Medical Image Computing and Computer-Assisted Intervention (MICCAI) 2023. The objective of the challenge is to benchmark image synthesis methods that realistically synthesize missing MRI modalities given multiple available images to facilitate automated brain tumor segmentation pipelines. The image dataset is multi-modal and diverse, created in collaboration with various hospitals and research institutions.
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The electron microscope (EM) remains the predominant technique for elucidating intricate details of the animal nervous system at the nanometer scale. However, accurately reconstructing the complex morphology of axons and myelin sheaths poses a significant challenge. Furthermore, the absence of publicly available, large-scale EM datasets encompassing complete cross sections of the corpus callosum, with dense ground truth segmentation for axons and myelin sheaths, hinders the advancement and evaluation of holistic corpus callosum reconstructions. To surmount these obstacles, we introduce the AxonCallosumEM dataset, comprising a 1.83 times 5.76mm EM image captured from the corpus callosum of the Rett Syndrome (RTT) mouse model, which entail extensive axon bundles. We meticulously proofread over 600,000 patches at a resolution of 1024 times 1024, thus providing a comprehensive ground truth for myelinated axons and myelin sheaths. Additionally, we extensively annotated three distinct regions within the dataset for the purposes of training, testing, and validation. Utilizing this dataset, we develop a fine-tuning methodology that adapts Segment Anything Model (SAM) to EM images segmentation tasks, called EM-SAM, enabling outperforms other state-of-the-art methods. Furthermore, we present the evaluation results of EM-SAM as a baseline.
This paper presents the challenge report for the 2021 Kidney and Kidney Tumor Segmentation Challenge (KiTS21) held in conjunction with the 2021 international conference on Medical Image Computing and Computer Assisted Interventions (MICCAI). KiTS21 is a sequel to its first edition in 2019, and it features a variety of innovations in how the challenge was designed, in addition to a larger dataset. A novel annotation method was used to collect three separate annotations for each region of interest, and these annotations were performed in a fully transparent setting using a web-based annotation tool. Further, the KiTS21 test set was collected from an outside institution, challenging participants to develop methods that generalize well to new populations. Nonetheless, the top-performing teams achieved a significant improvement over the state of the art set in 2019, and this performance is shown to inch ever closer to human-level performance. An in-depth meta-analysis is presented describing which methods were used and how they faired on the leaderboard, as well as the characteristics of which cases generally saw good performance, and which did not. Overall KiTS21 facilitated a significant advancement in the state of the art in kidney tumor segmentation, and provides useful insights that are applicable to the field of semantic segmentation as a whole.
Zero-shot medical image classification is a critical process in real-world scenarios where we have limited access to all possible diseases or large-scale annotated data. It involves computing similarity scores between a query medical image and possible disease categories to determine the diagnostic result. Recent advances in pretrained vision-language models (VLMs) such as CLIP have shown great performance for zero-shot natural image recognition and exhibit benefits in medical applications. However, an explainable zero-shot medical image recognition framework with promising performance is yet under development. In this paper, we propose a novel CLIP-based zero-shot medical image classification framework supplemented with ChatGPT for explainable diagnosis, mimicking the diagnostic process performed by human experts. The key idea is to query large language models (LLMs) with category names to automatically generate additional cues and knowledge, such as disease symptoms or descriptions other than a single category name, to help provide more accurate and explainable diagnosis in CLIP. We further design specific prompts to enhance the quality of generated texts by ChatGPT that describe visual medical features. Extensive results on one private dataset and four public datasets along with detailed analysis demonstrate the effectiveness and explainability of our training-free zero-shot diagnosis pipeline, corroborating the great potential of VLMs and LLMs for medical applications.
According to the 2021 World Health Organization (WHO) Classification scheme for gliomas, glioma segmentation is a very important basis for diagnosis and genotype prediction. In general, 3D multimodal brain MRI is an effective diagnostic tool. In the past decade, there has been an increase in the use of machine learning, particularly deep learning, for medical images processing. Thanks to the development of foundation models, models pre-trained with large-scale datasets have achieved better results on a variety of tasks. However, for medical images with small dataset sizes, deep learning methods struggle to achieve better results on real-world image datasets. In this paper, we propose a cross-modality attention adapter based on multimodal fusion to fine-tune the foundation model to accomplish the task of glioma segmentation in multimodal MRI brain images with better results. The effectiveness of the proposed method is validated via our private glioma data set from the First Affiliated Hospital of Zhengzhou University (FHZU) in Zhengzhou, China. Our proposed method is superior to current state-of-the-art methods with a Dice of 88.38% and Hausdorff distance of 10.64, thereby exhibiting a 4% increase in Dice to segment the glioma region for glioma treatment.
Multi-sequence MRI is valuable in clinical settings for reliable diagnosis and treatment prognosis, but some sequences may be unusable or missing for various reasons. To address this issue, MRI synthesis is a potential solution. Recent deep learning-based methods have achieved good performance in combining multiple available sequences for missing sequence synthesis. Despite their success, these methods lack the ability to quantify the contributions of different input sequences and estimate the quality of generated images, making it hard to be practical. Hence, we propose an explainable task-specific synthesis network, which adapts weights automatically for specific sequence generation tasks and provides interpretability and reliability from two sides: (1) visualize the contribution of each input sequence in the fusion stage by a trainable task-specific weighted average module; (2) highlight the area the network tried to refine during synthesizing by a task-specific attention module. We conduct experiments on the BraTS2021 dataset of 1251 subjects, and results on arbitrary sequence synthesis indicate that the proposed method achieves better performance than the state-of-the-art methods. Our code is available at \url{//github.com/fiy2W/mri_seq2seq}.
Open-vocabulary image segmentation aims to partition an image into semantic regions according to arbitrary text descriptions. However, complex visual scenes can be naturally decomposed into simpler parts and abstracted at multiple levels of granularity, introducing inherent segmentation ambiguity. Unlike existing methods that typically sidestep this ambiguity and treat it as an external factor, our approach actively incorporates a hierarchical representation encompassing different semantic-levels into the learning process. We propose a decoupled text-image fusion mechanism and representation learning modules for both "things" and "stuff".1 Additionally, we systematically examine the differences that exist in the textual and visual features between these types of categories. Our resulting model, named HIPIE, tackles HIerarchical, oPen-vocabulary, and unIvErsal segmentation tasks within a unified framework. Benchmarked on over 40 datasets, e.g., ADE20K, COCO, Pascal-VOC Part, RefCOCO/RefCOCOg, ODinW and SeginW, HIPIE achieves the state-of-the-art results at various levels of image comprehension, including semantic-level (e.g., semantic segmentation), instance-level (e.g., panoptic/referring segmentation and object detection), as well as part-level (e.g., part/subpart segmentation) tasks. Our code is released at //github.com/berkeley-hipie/HIPIE.
Image segmentation is a key topic in image processing and computer vision with applications such as scene understanding, medical image analysis, robotic perception, video surveillance, augmented reality, and image compression, among many others. Various algorithms for image segmentation have been developed in the literature. Recently, due to the success of deep learning models in a wide range of vision applications, there has been a substantial amount of works aimed at developing image segmentation approaches using deep learning models. In this survey, we provide a comprehensive review of the literature at the time of this writing, covering a broad spectrum of pioneering works for semantic and instance-level segmentation, including fully convolutional pixel-labeling networks, encoder-decoder architectures, multi-scale and pyramid based approaches, recurrent networks, visual attention models, and generative models in adversarial settings. We investigate the similarity, strengths and challenges of these deep learning models, examine the most widely used datasets, report performances, and discuss promising future research directions in this area.
In this paper, we adopt 3D Convolutional Neural Networks to segment volumetric medical images. Although deep neural networks have been proven to be very effective on many 2D vision tasks, it is still challenging to apply them to 3D tasks due to the limited amount of annotated 3D data and limited computational resources. We propose a novel 3D-based coarse-to-fine framework to effectively and efficiently tackle these challenges. The proposed 3D-based framework outperforms the 2D counterpart to a large margin since it can leverage the rich spatial infor- mation along all three axes. We conduct experiments on two datasets which include healthy and pathological pancreases respectively, and achieve the current state-of-the-art in terms of Dice-S{\o}rensen Coefficient (DSC). On the NIH pancreas segmentation dataset, we outperform the previous best by an average of over 2%, and the worst case is improved by 7% to reach almost 70%, which indicates the reliability of our framework in clinical applications.
Convolutional networks (ConvNets) have achieved great successes in various challenging vision tasks. However, the performance of ConvNets would degrade when encountering the domain shift. The domain adaptation is more significant while challenging in the field of biomedical image analysis, where cross-modality data have largely different distributions. Given that annotating the medical data is especially expensive, the supervised transfer learning approaches are not quite optimal. In this paper, we propose an unsupervised domain adaptation framework with adversarial learning for cross-modality biomedical image segmentations. Specifically, our model is based on a dilated fully convolutional network for pixel-wise prediction. Moreover, we build a plug-and-play domain adaptation module (DAM) to map the target input to features which are aligned with source domain feature space. A domain critic module (DCM) is set up for discriminating the feature space of both domains. We optimize the DAM and DCM via an adversarial loss without using any target domain label. Our proposed method is validated by adapting a ConvNet trained with MRI images to unpaired CT data for cardiac structures segmentations, and achieved very promising results.
Recent advances in 3D fully convolutional networks (FCN) have made it feasible to produce dense voxel-wise predictions of volumetric images. In this work, we show that a multi-class 3D FCN trained on manually labeled CT scans of several anatomical structures (ranging from the large organs to thin vessels) can achieve competitive segmentation results, while avoiding the need for handcrafting features or training class-specific models. To this end, we propose a two-stage, coarse-to-fine approach that will first use a 3D FCN to roughly define a candidate region, which will then be used as input to a second 3D FCN. This reduces the number of voxels the second FCN has to classify to ~10% and allows it to focus on more detailed segmentation of the organs and vessels. We utilize training and validation sets consisting of 331 clinical CT images and test our models on a completely unseen data collection acquired at a different hospital that includes 150 CT scans, targeting three anatomical organs (liver, spleen, and pancreas). In challenging organs such as the pancreas, our cascaded approach improves the mean Dice score from 68.5 to 82.2%, achieving the highest reported average score on this dataset. We compare with a 2D FCN method on a separate dataset of 240 CT scans with 18 classes and achieve a significantly higher performance in small organs and vessels. Furthermore, we explore fine-tuning our models to different datasets. Our experiments illustrate the promise and robustness of current 3D FCN based semantic segmentation of medical images, achieving state-of-the-art results. Our code and trained models are available for download: //github.com/holgerroth/3Dunet_abdomen_cascade.
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