Search

Multimodal learning leverages complementary information derived from different modalities, thereby enhancing performance in medical image segmentation. However, prevailing multimodal learning methods heavily rely on extensive well-annotated data from various modalities to achieve accurate segmentation performance. This dependence often poses a challenge in clinical settings due to limited availability of such data. Moreover, the inherent anatomical misalignment between different imaging modalities further complicates the endeavor to enhance segmentation performance. To address this problem, we propose a novel semi-supervised multimodal segmentation framework that is robust to scarce labeled data and misaligned modalities. Our framework employs a novel cross modality collaboration strategy to distill modality-independent knowledge, which is inherently associated with each modality, and integrates this information into a unified fusion layer for feature amalgamation. With a channel-wise semantic consistency loss, our framework ensures alignment of modality-independent information from a feature-wise perspective across modalities, thereby fortifying it against misalignments in multimodal scenarios. Furthermore, our framework effectively integrates contrastive consistent learning to regulate anatomical structures, facilitating anatomical-wise prediction alignment on unlabeled data in semi-supervised segmentation tasks. Our method achieves competitive performance compared to other multimodal methods across three tasks: cardiac, abdominal multi-organ, and thyroid-associated orbitopathy segmentations. It also demonstrates outstanding robustness in scenarios involving scarce labeled data and misaligned modalities.

Fatty acid can potentially serve as biomarker for evaluating metabolic disorder and inflammation condition, and quantifying the double bonds is the key for revealing fatty acid information. This study presents an assessment of a deep learning approach utilizing Deep Image Prior (DIP) for the quantification of double bonds and methylene-interrupted double bonds of triglyceride derived from chemical-shift encoded multi-echo gradient echo images, all achieved without the necessity for network training. The methodology implemented a cost function grounded in signal constraints to continually refine the neural network's parameters on a single slice of images through iterative processes. Validation procedures encompassed both phantom experiments and in-vivo scans. The outcomes evidenced a concordance between the quantified values and the established reference standards, notably exemplified by a Pearson correlation coefficient of 0.96 (p = 0.0005) derived from the phantom experiments. The results in water-oil phantom also demonstrate the quantification reliability of the DIP method under the condition of having a relatively low-fat signal. Furthermore, the in-vivo assessments showcased the method's competency by showcasing consistent quantification results that closely mirrored previously published findings concerning subcutaneous fat. In summary, the study underscores the potential of Deep Image Prior in enabling the quantification of double bonds and methylene-interrupted double bonds from chemical-shift encoded multi-echo magnetic resonance imaging (MRI) data, suggesting potential avenues for future research and clinical applications in the field., Comment: This technical note is accepted by Quantitative Imaging in Medicine and Surgery as a breif report

The current clinical gold standard for evaluating adolescent idiopathic scoliosis (AIS) is X-ray radiography, using Cobb angle measurement. However, the frequent monitoring of the AIS progression using X-rays poses a challenge due to the cumulative radiation exposure. Although 3D ultrasound has been validated as a reliable and radiation-free alternative for scoliosis assessment, the process of measuring spinal curvature is still carried out manually. Consequently, there is a considerable demand for a fully automatic system that can locate bony landmarks and perform angle measurements. To this end, we introduce an estimation model for automatic ultrasound curve angle (UCA) measurement. The model employs a dual-branch network to detect candidate landmarks and perform vertebra segmentation on ultrasound coronal images. An affinity clustering strategy is utilized within the vertebral segmentation area to illustrate the affinity relationship between candidate landmarks. Subsequently, we can efficiently perform line delineation from a clustered affinity map for UCA measurement. As our method is specifically designed for UCA calculation, this method outperforms other state-of-the-art methods for landmark and line detection tasks. The high correlation between the automatic UCA and Cobb angle (R$^2$=0.858) suggests that our proposed method can potentially replace manual UCA measurement in ultrasound scoliosis assessment.

Generalist foundation models (GFMs) are renowned for their exceptional capability and flexibility in effectively generalizing across diverse tasks and modalities. In the field of medicine, while GFMs exhibit superior generalizability based on their extensive intrinsic knowledge as well as proficiency in instruction following and in-context learning, specialist models excel in precision due to their domain knowledge. In this work, for the first time, we explore the synergy between the GFM and specialist models, to enable precise medical image analysis on a broader scope. Specifically, we propose a cooperative framework, Generalist-Specialist Collaboration (GSCo), which consists of two stages, namely the construction of GFM and specialists, and collaborative inference on downstream tasks. In the construction stage, we develop MedDr, the largest open-source GFM tailored for medicine, showcasing exceptional instruction-following and in-context learning capabilities. Meanwhile, a series of lightweight specialists are crafted for downstream tasks with low computational cost. In the collaborative inference stage, we introduce two cooperative mechanisms, Mixture-of-Expert Diagnosis and Retrieval-Augmented Diagnosis, to harvest the generalist's in-context learning abilities alongside the specialists' domain expertise. For a comprehensive evaluation, we curate a large-scale benchmark featuring 28 datasets and about 250,000 images. Extensive results demonstrate that MedDr consistently outperforms state-of-the-art GFMs on downstream datasets. Furthermore, GSCo exceeds both GFMs and specialists across all out-of-domain disease diagnosis datasets. These findings indicate a significant paradigm shift in the application of GFMs, transitioning from separate models for specific tasks to a collaborative approach between GFMs and specialists, thereby advancing the frontiers of generalizable AI in medicine.

Objective: Quantitative $T_1\rho$ imaging has potential for assessment of biochemical alterations of liver pathologies. Deep learning methods have been employed to accelerate quantitative $T_1\rho$ imaging. To employ artificial intelligence-based quantitative imaging methods in complicated clinical environment, it is valuable to estimate the uncertainty of the predicated $T_1\rho$ values to provide the confidence level of the quantification results. The uncertainty should also be utilized to aid the post-hoc quantitative analysis and model learning tasks. Approach: To address this need, we propose a parametric map refinement approach for learning-based $T_1\rho$ mapping and train the model in a probabilistic way to model the uncertainty. We also propose to utilize the uncertainty map to spatially weight the training of an improved $T_1\rho$ mapping network to further improve the mapping performance and to remove pixels with unreliable $T_1\rho$ values in the region of interest. The framework was tested on a dataset of 51 patients with different liver fibrosis stages. Main results: Our results indicate that the learning-based map refinement method leads to a relative mapping error of less than 3% and provides uncertainty estimation simultaneously. The estimated uncertainty reflects the actual error level, and it can be used to further reduce relative $T_1\rho$ mapping error to 2.60% as well as removing unreliable pixels in the region of interest effectively. Significance: Our studies demonstrate the proposed approach has potential to provide a learning-based quantitative MRI system for trustworthy $T_1\rho$ mapping of the liver.

$T_{1\rho}$ mapping is a promising quantitative MRI technique for the non-invasive assessment of tissue properties. Learning-based approaches can map $T_{1\rho}$ from a reduced number of $T_{1\rho}$ weighted images, but requires significant amounts of high quality training data. Moreover, existing methods do not provide the confidence level of the $T_{1\rho}$ estimation. To address these problems, we proposed a self-supervised learning neural network that learns a $T_{1\rho}$ mapping using the relaxation constraint in the learning process. Epistemic uncertainty and aleatoric uncertainty are modelled for the $T_{1\rho}$ quantification network to provide a Bayesian confidence estimation of the $T_{1\rho}$ mapping. The uncertainty estimation can also regularize the model to prevent it from learning imperfect data. We conducted experiments on $T_{1\rho}$ data collected from 52 patients with non-alcoholic fatty liver disease. The results showed that our method outperformed the existing methods for $T_{1\rho}$ quantification of the liver using as few as two $T_{1\rho}$-weighted images. Our uncertainty estimation provided a feasible way of modelling the confidence of the self-supervised learning based $T_{1\rho}$ estimation, which is consistent with the reality in liver $T_{1\rho}$ imaging., Comment: Provisionally accepted by Physics in Medicine and Biology