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Deep models often struggle with out-of-distribution (OOD) generalization, limiting their real-world applicability beyond controlled laboratory settings. Invariant risk minimization (IRM) addresses this issue by learning invariant features and minimizing the risk across different domains. Thus, it avoids the pitfalls of pseudo-invariant features and spurious causality associated with empirical risk minimization (ERM). However, according to the support overlap theorem, ERM and IRM may fail to address the OOD problem when pseudo-invariant features have insufficient support overlap. To this end, we propose a novel method to enlarge feature support overlap for domain generalization. Specifically, we introduce Bayesian random semantic data augmentation to increase sample diversity and overcome the deficiency of IRM. Experiments on several challenging OOD generalization benchmarks demonstrate that our approach surpasses existing models, delivering superior performance and robustness. The code is available at \url{https://github.com/YaoyaoZhu19/BSDG}.

In recent years, Transformers have become the de-facto architecture for long-term sequence forecasting (LTSF), but faces challenges such as quadratic complexity and permutation invariant bias. A recent model, Mamba, based on selective state space models (SSMs), has emerged as a competitive alternative to Transformer, offering comparable performance with higher throughput and linear complexity related to sequence length. In this study, we analyze the limitations of current Mamba in LTSF and propose four targeted improvements, leading to MambaTS. We first introduce variable scan along time to arrange the historical information of all the variables together. We suggest that causal convolution in Mamba is not necessary for LTSF and propose the Temporal Mamba Block (TMB). We further incorporate a dropout mechanism for selective parameters of TMB to mitigate model overfitting. Moreover, we tackle the issue of variable scan order sensitivity by introducing variable permutation training. We further propose variable-aware scan along time to dynamically discover variable relationships during training and decode the optimal variable scan order by solving the shortest path visiting all nodes problem during inference. Extensive experiments conducted on eight public datasets demonstrate that MambaTS achieves new state-of-the-art performance.

Radiation therapy is crucial in cancer treatment. Experienced experts typically iteratively generate high-quality dose distribution maps, forming the basis for excellent radiation therapy plans. Therefore, automated prediction of dose distribution maps is significant in expediting the treatment process and providing a better starting point for developing radiation therapy plans. With the remarkable results of diffusion models in predicting high-frequency regions of dose distribution maps, dose prediction methods based on diffusion models have been extensively studied. However, existing methods mainly utilize CNNs or Transformers as denoising networks. CNNs lack the capture of global receptive fields, resulting in suboptimal prediction performance. Transformers excel in global modeling but face quadratic complexity with image size, resulting in significant computational overhead. To tackle these challenges, we introduce a novel diffusion model, MD-Dose, based on the Mamba architecture for predicting radiation therapy dose distribution in thoracic cancer patients. In the forward process, MD-Dose adds Gaussian noise to dose distribution maps to obtain pure noise images. In the backward process, MD-Dose utilizes a noise predictor based on the Mamba to predict the noise, ultimately outputting the dose distribution maps. Furthermore, We develop a Mamba encoder to extract structural information and integrate it into the noise predictor for localizing dose regions in the planning target volume (PTV) and organs at risk (OARs). Through extensive experiments on a dataset of 300 thoracic tumor patients, we showcase the superiority of MD-Dose in various metrics and time consumption.

Data augmentation is a crucial regularization technique for deep neural networks, particularly in medical image classification. Mainstream data augmentation (DA) methods are usually applied at the image level. Due to the specificity and diversity of medical imaging, expertise is often required to design effective DA strategies, and improper augmentation operations can degrade model performance. Although automatic augmentation methods exist, they are computationally intensive. Semantic data augmentation can implemented by translating features in feature space. However, over-translation may violate the image label. To address these issues, we propose \emph{Bayesian Random Semantic Data Augmentation} (BSDA), a computationally efficient and handcraft-free feature-level DA method. BSDA uses variational Bayesian to estimate the distribution of the augmentable magnitudes, and then a sample from this distribution is added to the original features to perform semantic data augmentation. We performed experiments on nine 2D and five 3D medical image datasets. Experimental results show that BSDA outperforms current DA methods. Additionally, BSDA can be easily assembled into CNNs or Transformers as a plug-and-play module, improving the network's performance. The code is available online at \url{https://github.com/YaoyaoZhu19/BSDA}.

Radiation therapy serves as an effective and standard method for cancer treatment. Excellent radiation therapy plans always rely on high-quality dose distribution maps obtained through repeated trial and error by experienced experts. However, due to individual differences and complex clinical situations, even seasoned expert teams may need help to achieve the best treatment plan every time quickly. Many automatic dose distribution prediction methods have been proposed recently to accelerate the radiation therapy planning process and have achieved good results. However, these results suffer from over-smoothing issues, with the obtained dose distribution maps needing more high-frequency details, limiting their clinical application. To address these limitations, we propose a dose prediction diffusion model based on SwinTransformer and a projector, SP-DiffDose. To capture the direct correlation between anatomical structure and dose distribution maps, SP-DiffDose uses a structural encoder to extract features from anatomical images, then employs a conditional diffusion process to blend noise and anatomical images at multiple scales and gradually map them to dose distribution maps. To enhance the dose prediction distribution for organs at risk, SP-DiffDose utilizes SwinTransformer in the deeper layers of the network to capture features at different scales in the image. To learn good representations from the fused features, SP-DiffDose passes the fused features through a designed projector, improving dose prediction accuracy. Finally, we evaluate SP-DiffDose on an internal dataset. The results show that SP-DiffDose outperforms existing methods on multiple evaluation metrics, demonstrating the superiority and generalizability of our method.

Cone Beam CT (CBCT) plays a crucial role in Adaptive Radiation Therapy (ART) by accurately providing radiation treatment when organ anatomy changes occur. However, CBCT images suffer from scatter noise and artifacts, making relying solely on CBCT for precise dose calculation and accurate tissue localization challenging. Therefore, there is a need to improve CBCT image quality and Hounsfield Unit (HU) accuracy while preserving anatomical structures. To enhance the role and application value of CBCT in ART, we propose an energy-guided diffusion model (EGDiff) and conduct experiments on a chest tumor dataset to generate synthetic CT (sCT) from CBCT. The experimental results demonstrate impressive performance with an average absolute error of 26.87$\pm$6.14 HU, a structural similarity index measurement of 0.850$\pm$0.03, a peak signal-to-noise ratio of the sCT of 19.83$\pm$1.39 dB, and a normalized cross-correlation of the sCT of 0.874$\pm$0.04. These results indicate that our method outperforms state-of-the-art unsupervised synthesis methods in accuracy and visual quality, producing superior sCT images.

Automated anesthesia promises to enable more precise and personalized anesthetic administration and free anesthesiologists from repetitive tasks, allowing them to focus on the most critical aspects of a patient's surgical care. Current research has typically focused on creating simulated environments from which agents can learn. These approaches have demonstrated good experimental results, but are still far from clinical application. In this paper, Policy Constraint Q-Learning (PCQL), a data-driven reinforcement learning algorithm for solving the problem of learning anesthesia strategies on real clinical datasets, is proposed. Conservative Q-Learning was first introduced to alleviate the problem of Q function overestimation in an offline context. A policy constraint term is added to agent training to keep the policy distribution of the agent and the anesthesiologist consistent to ensure safer decisions made by the agent in anesthesia scenarios. The effectiveness of PCQL was validated by extensive experiments on a real clinical anesthesia dataset. Experimental results show that PCQL is predicted to achieve higher gains than the baseline approach while maintaining good agreement with the reference dose given by the anesthesiologist, using less total dose, and being more responsive to the patient's vital signs. In addition, the confidence intervals of the agent were investigated, which were able to cover most of the clinical decisions of the anesthesiologist. Finally, an interpretable method, SHAP, was used to analyze the contributing components of the model predictions to increase the transparency of the model., Comment: 11 pages, 7 figures

In an unpaired setting, lacking sufficient content constraints for image-to-image translation (I2I) tasks, GAN-based approaches are usually prone to model collapse. Current solutions can be divided into two categories, reconstruction-based and Siamese network-based. The former requires that the transformed or transforming image can be perfectly converted back to the original image, which is sometimes too strict and limits the generative performance. The latter involves feeding the original and generated images into a feature extractor and then matching their outputs. This is not efficient enough, and a universal feature extractor is not easily available. In this paper, we propose EnCo, a simple but efficient way to maintain the content by constraining the representational similarity in the latent space of patch-level features from the same stage of the \textbf{En}coder and de\textbf{Co}der of the generator. For the similarity function, we use a simple MSE loss instead of contrastive loss, which is currently widely used in I2I tasks. Benefits from the design, EnCo training is extremely efficient, while the features from the encoder produce a more positive effect on the decoding, leading to more satisfying generations. In addition, we rethink the role played by discriminators in sampling patches and propose a discriminative attention-guided (DAG) patch sampling strategy to replace random sampling. DAG is parameter-free and only requires negligible computational overhead, while significantly improving the performance of the model. Extensive experiments on multiple datasets demonstrate the effectiveness and advantages of EnCo, and we achieve multiple state-of-the-art compared to previous methods. Our code is available at https://github.com/XiudingCai/EnCo-pytorch., Comment: Accepted by AAAI 2024