In weakly supervised medical image segmentation, the absence of structural priors and the discreteness of class feature distribution present a challenge, i.e., how to accurately propagate supervision signals from local to global regions without excessively spreading them to other irrelevant regions? To address this, we propose a novel weakly supervised medical image segmentation framework named PCLMix, comprising dynamic mix augmentation, pixel-level contrastive learning, and consistency regularization strategies. Specifically, PCLMix is built upon a heterogeneous dual-decoder backbone, addressing the absence of structural priors through a strategy of dynamic mix augmentation during training. To handle the discrete distribution of class features, PCLMix incorporates pixel-level contrastive learning based on prediction uncertainty, effectively enhancing the model's ability to differentiate inter-class pixel differences and intra-class consistency. Furthermore, to reinforce segmentation consistency and robustness, PCLMix employs an auxiliary decoder for dual consistency regularization. In the inference phase, the auxiliary decoder will be dropped and no computation complexity is increased. Extensive experiments on the ACDC dataset demonstrate that PCLMix appropriately propagates local supervision signals to the global scale, further narrowing the gap between weakly supervised and fully supervised segmentation methods. Our code is available at //github.com/Torpedo2648/PCLMix.
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Weakly-supervised medical image segmentation is a challenging task that aims to reduce the annotation cost while keep the segmentation performance. In this paper, we present a novel framework, SimTxtSeg, that leverages simple text cues to generate high-quality pseudo-labels and study the cross-modal fusion in training segmentation models, simultaneously. Our contribution consists of two key components: an effective Textual-to-Visual Cue Converter that produces visual prompts from text prompts on medical images, and a text-guided segmentation model with Text-Vision Hybrid Attention that fuses text and image features. We evaluate our framework on two medical image segmentation tasks: colonic polyp segmentation and MRI brain tumor segmentation, and achieve consistent state-of-the-art performance.
We present PhysioLLM, an interactive system that leverages large language models (LLMs) to provide personalized health understanding and exploration by integrating physiological data from wearables with contextual information. Unlike commercial health apps for wearables, our system offers a comprehensive statistical analysis component that discovers correlations and trends in user data, allowing users to ask questions in natural language and receive generated personalized insights, and guides them to develop actionable goals. As a case study, we focus on improving sleep quality, given its measurability through physiological data and its importance to general well-being. Through a user study with 24 Fitbit watch users, we demonstrate that PhysioLLM outperforms both the Fitbit App alone and a generic LLM chatbot in facilitating a deeper, personalized understanding of health data and supporting actionable steps toward personal health goals.
Early detection of myocardial infarction (MI), a critical condition arising from coronary artery disease (CAD), is vital to prevent further myocardial damage. This study introduces a novel method for early MI detection using a one-class classification (OCC) algorithm in echocardiography. Our study overcomes the challenge of limited echocardiography data availability by adopting a novel approach based on Multi-modal Subspace Support Vector Data Description. The proposed technique involves a specialized MI detection framework employing multi-view echocardiography incorporating a composite kernel in the non-linear projection trick, fusing Gaussian and Laplacian sigmoid functions. Additionally, we enhance the update strategy of the projection matrices by adapting maximization for both or one of the modalities in the optimization process. Our method boosts MI detection capability by efficiently transforming features extracted from echocardiography data into an optimized lower-dimensional subspace. The OCC model trained specifically on target class instances from the comprehensive HMC-QU dataset that includes multiple echocardiography views indicates a marked improvement in MI detection accuracy. Our findings reveal that our proposed multi-view approach achieves a geometric mean of 71.24%, signifying a substantial advancement in echocardiography-based MI diagnosis and offering more precise and efficient diagnostic tools.
In the context of medical decision making, counterfactual prediction enables clinicians to predict treatment outcomes of interest under alternative courses of therapeutic actions given observed patient history. Prior machine learning approaches for counterfactual predictions under time-varying treatments focus on static time-varying treatment regimes where treatments do not depend on previous covariate history. In this work, we present G-Transformer, a Transformer-based framework supporting g-computation for counterfactual prediction under dynamic and time-varying treatment strategies. G-Transfomer captures complex, long-range dependencies in time-varying covariates using a Transformer architecture. G-Transformer estimates the conditional distribution of relevant covariates given covariate and treatment history at each time point using an encoder architecture, then produces Monte Carlo estimates of counterfactual outcomes by simulating forward patient trajectories under treatment strategies of interest. We evaluate G-Transformer extensively using two simulated longitudinal datasets from mechanistic models, and a real-world sepsis ICU dataset from MIMIC-IV. G-Transformer outperforms both classical and state-of-the-art counterfactual prediction models in these settings. To the best of our knowledge, this is the first Transformer-based architecture for counterfactual outcome prediction under dynamic and time-varying treatment strategies.
Unpaired medical image synthesis aims to provide complementary information for an accurate clinical diagnostics, and address challenges in obtaining aligned multi-modal medical scans. Transformer-based models excel in imaging translation tasks thanks to their ability to capture long-range dependencies. Although effective in supervised training settings, their performance falters in unpaired image synthesis, particularly in synthesizing structural details. This paper empirically demonstrates that, lacking strong inductive biases, Transformer can converge to non-optimal solutions in the absence of paired data. To address this, we introduce UNet Structured Transformer (UNest), a novel architecture incorporating structural inductive biases for unpaired medical image synthesis. We leverage the foundational Segment-Anything Model to precisely extract the foreground structure and perform structural attention within the main anatomy. This guides the model to learn key anatomical regions, thus improving structural synthesis under the lack of supervision in unpaired training. Evaluated on two public datasets, spanning three modalities, i.e., MR, CT, and PET, UNest improves recent methods by up to 19.30% across six medical image synthesis tasks. Our code is released at //github.com/HieuPhan33/MICCAI2024-UNest.
In the field of medical imaging, particularly in tasks related to early disease detection and prognosis, understanding the reasoning behind AI model predictions is imperative for assessing their reliability. Conventional explanation methods encounter challenges in identifying decisive features in medical image classifications, especially when discriminative features are subtle or not immediately evident. To address this limitation, we propose an agent model capable of generating counterfactual images that prompt different decisions when plugged into a black box model. By employing this agent model, we can uncover influential image patterns that impact the black model's final predictions. Through our methodology, we efficiently identify features that influence decisions of the deep black box. We validated our approach in the rigorous domain of medical prognosis tasks, showcasing its efficacy and potential to enhance the reliability of deep learning models in medical image classification compared to existing interpretation methods. The code will be publicly available at //github.com/ayanglab/DiffExplainer.
Binary malware summarization aims to automatically generate human-readable descriptions of malware behaviors from executable files, facilitating tasks like malware cracking and detection. Previous methods based on Large Language Models (LLMs) have shown great promise. However, they still face significant issues, including poor usability, inaccurate explanations, and incomplete summaries, primarily due to the obscure pseudocode structure and the lack of malware training summaries. Further, calling relationships between functions, which involve the rich interactions within a binary malware, remain largely underexplored. To this end, we propose MALSIGHT, a novel code summarization framework that can iteratively generate descriptions of binary malware by exploring malicious source code and benign pseudocode. Specifically, we construct the first malware summaries, MalS and MalP, using an LLM and manually refine this dataset with human effort. At the training stage, we tune our proposed MalT5, a novel LLM-based code model, on the MalS dataset and a benign pseudocode dataset. Then, at the test stage, we iteratively feed the pseudocode functions into MalT5 to obtain the summary. Such a procedure facilitates the understanding of pseudocode structure and captures the intricate interactions between functions, thereby benefiting the usability, accuracy, and completeness of summaries. Additionally, we propose a novel evaluation benchmark, BLEURT-sum, to measure the quality of summaries. Experiments on three datasets show the effectiveness of the proposed MALSIGHT. Notably, our proposed MalT5, with only 0.77B parameters, delivers comparable performance to much larger ChatGPT3.5.
The usage of medical image data for the training of large-scale machine learning approaches is particularly challenging due to its scarce availability and the costly generation of data annotations, typically requiring the engagement of medical professionals. The rapid development of generative models allows towards tackling this problem by leveraging large amounts of realistic synthetically generated data for the training process. However, randomly choosing synthetic samples, might not be an optimal strategy. In this work, we investigate the targeted generation of synthetic training data, in order to improve the accuracy and robustness of image classification. Therefore, our approach aims to guide the generative model to synthesize data with high epistemic uncertainty, since large measures of epistemic uncertainty indicate underrepresented data points in the training set. During the image generation we feed images reconstructed by an auto encoder into the classifier and compute the mutual information over the class-probability distribution as a measure for uncertainty.We alter the feature space of the autoencoder through an optimization process with the objective of maximizing the classifier uncertainty on the decoded image. By training on such data we improve the performance and robustness against test time data augmentations and adversarial attacks on several classifications tasks.
Learning disentanglement aims at finding a low dimensional representation which consists of multiple explanatory and generative factors of the observational data. The framework of variational autoencoder (VAE) is commonly used to disentangle independent factors from observations. However, in real scenarios, factors with semantics are not necessarily independent. Instead, there might be an underlying causal structure which renders these factors dependent. We thus propose a new VAE based framework named CausalVAE, which includes a Causal Layer to transform independent exogenous factors into causal endogenous ones that correspond to causally related concepts in data. We further analyze the model identifiabitily, showing that the proposed model learned from observations recovers the true one up to a certain degree. Experiments are conducted on various datasets, including synthetic and real word benchmark CelebA. Results show that the causal representations learned by CausalVAE are semantically interpretable, and their causal relationship as a Directed Acyclic Graph (DAG) is identified with good accuracy. Furthermore, we demonstrate that the proposed CausalVAE model is able to generate counterfactual data through "do-operation" to the causal factors.
Applying artificial intelligence techniques in medical imaging is one of the most promising areas in medicine. However, most of the recent success in this area highly relies on large amounts of carefully annotated data, whereas annotating medical images is a costly process. In this paper, we propose a novel method, called FocalMix, which, to the best of our knowledge, is the first to leverage recent advances in semi-supervised learning (SSL) for 3D medical image detection. We conducted extensive experiments on two widely used datasets for lung nodule detection, LUNA16 and NLST. Results show that our proposed SSL methods can achieve a substantial improvement of up to 17.3% over state-of-the-art supervised learning approaches with 400 unlabeled CT scans.
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