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Universal segmentation models offer significant potential in addressing a wide range of tasks by effectively leveraging discrete annotations. As the scope of tasks and modalities expands, it becomes increasingly important to generate and strategically position task- and modal-specific priors within the universal model. However, existing universal models often overlook the correlations between different priors, and the optimal placement and frequency of these priors remain underexplored. In this paper, we introduce MedUniSeg, a prompt-driven universal segmentation model designed for 2D and 3D multi-task segmentation across diverse modalities and domains. MedUniSeg employs multiple modal-specific prompts alongside a universal task prompt to accurately characterize the modalities and tasks. To generate the related priors, we propose the modal map (MMap) and the fusion and selection (FUSE) modules, which transform modal and task prompts into corresponding priors. These modal and task priors are systematically introduced at the start and end of the encoding process. We evaluate MedUniSeg on a comprehensive multi-modal upstream dataset consisting of 17 sub-datasets. The results demonstrate that MedUniSeg achieves superior multi-task segmentation performance, attaining a 1.2% improvement in the mean Dice score across the 17 upstream tasks compared to nnUNet baselines, while using less than 1/10 of the parameters. For tasks that underperform during the initial multi-task joint training, we freeze MedUniSeg and introduce new modules to re-learn these tasks. This approach yields an enhanced version, MedUniSeg*, which consistently outperforms MedUniSeg across all tasks. Moreover, MedUniSeg surpasses advanced self-supervised and supervised pre-trained models on six downstream tasks, establishing itself as a high-quality, highly generalizable pre-trained segmentation model.

Chest pain symptoms are highly prevalent in emergency departments (EDs), where acute aortic syndrome (AAS) is a catastrophic cardiovascular emergency with a high fatality rate, especially when timely and accurate treatment is not administered. However, current triage practices in the ED can cause up to approximately half of patients with AAS to have an initially missed diagnosis or be misdiagnosed as having other acute chest pain conditions. Subsequently, these AAS patients will undergo clinically inaccurate or suboptimal differential diagnosis. Fortunately, even under these suboptimal protocols, nearly all these patients underwent non-contrast CT covering the aorta anatomy at the early stage of differential diagnosis. In this study, we developed an artificial intelligence model (DeepAAS) using non-contrast CT, which is highly accurate for identifying AAS and provides interpretable results to assist in clinical decision-making. Performance was assessed in two major phases: a multi-center retrospective study (n = 20,750) and an exploration in real-world emergency scenarios (n = 137,525). In the multi-center cohort, DeepAAS achieved a mean area under the receiver operating characteristic curve of 0.958 (95% CI 0.950-0.967). In the real-world cohort, DeepAAS detected 109 AAS patients with misguided initial suspicion, achieving 92.6% (95% CI 76.2%-97.5%) in mean sensitivity and 99.2% (95% CI 99.1%-99.3%) in mean specificity. Our AI model performed well on non-contrast CT at all applicable early stages of differential diagnosis workflows, effectively reduced the overall missed diagnosis and misdiagnosis rate from 48.8% to 4.8% and shortened the diagnosis time for patients with misguided initial suspicion from an average of 681.8 (74-11,820) mins to 68.5 (23-195) mins. DeepAAS could effectively fill the gap in the current clinical workflow without requiring additional tests.

Medical Vision-Language Pretraining (Med-VLP) establishes a connection between visual content from medical images and the relevant textual descriptions. Existing Med-VLP methods primarily focus on 2D images depicting a single body part, notably chest X-rays. In this paper, we extend the scope of Med-VLP to encompass 3D images, specifically targeting full-body scenarios, by using a multimodal dataset of CT images and reports. Compared with the 2D counterpart, 3D VLP is required to effectively capture essential semantics from significantly sparser representation in 3D imaging. In this paper, we introduce CT-GLIP (Grounded Language-Image Pretraining with CT scans), a novel method that constructs organ-level image-text pairs to enhance multimodal contrastive learning, aligning grounded visual features with precise diagnostic text. Additionally, we developed an abnormality dictionary to augment contrastive learning with diverse contrastive pairs. Our method, trained on a multimodal CT dataset comprising 44,011 organ-level vision-text pairs from 17,702 patients across 104 organs, demonstrates it can identify organs and abnormalities in a zero-shot manner using natural languages. The performance of CT-GLIP is validated on a separate test set of 1,130 patients, focusing on the 16 most frequent abnormalities across 7 organs. The experimental results show our model's superior performance over the standard CLIP framework across zero-shot and fine-tuning scenarios, using both CNN and ViT architectures., Comment: 12 pages, 5 figures, 3 tables

Radiologists highly desire fully automated versatile AI for medical imaging interpretation. However, the lack of extensively annotated large-scale multi-disease datasets has hindered the achievement of this goal. In this paper, we explore the feasibility of leveraging language as a naturally high-quality supervision for chest CT imaging. In light of the limited availability of image-report pairs, we bootstrap the understanding of 3D chest CT images by distilling chest-related diagnostic knowledge from an extensively pre-trained 2D X-ray expert model. Specifically, we propose a language-guided retrieval method to match each 3D CT image with its semantically closest 2D X-ray image, and perform pair-wise and semantic relation knowledge distillation. Subsequently, we use contrastive learning to align images and reports within the same patient while distinguishing them from the other patients. However, the challenge arises when patients have similar semantic diagnoses, such as healthy patients, potentially confusing if treated as negatives. We introduce a robust contrastive learning that identifies and corrects these false negatives. We train our model with over 12,000 pairs of chest CT images and radiology reports. Extensive experiments across multiple scenarios, including zero-shot learning, report generation, and fine-tuning processes, demonstrate the model's feasibility in interpreting chest CT images., Comment: Accepted by CVPR 2024

Establishing dense anatomical correspondence across distinct imaging modalities is a foundational yet challenging procedure for numerous medical image analysis studies and image-guided radiotherapy. Existing multi-modality image registration algorithms rely on statistical-based similarity measures or local structural image representations. However, the former is sensitive to locally varying noise, while the latter is not discriminative enough to cope with complex anatomical structures in multimodal scans, causing ambiguity in determining the anatomical correspondence across scans with different modalities. In this paper, we propose a modality-agnostic structural representation learning method, which leverages Deep Neighbourhood Self-similarity (DNS) and anatomy-aware contrastive learning to learn discriminative and contrast-invariance deep structural image representations (DSIR) without the need for anatomical delineations or pre-aligned training images. We evaluate our method on multiphase CT, abdomen MR-CT, and brain MR T1w-T2w registration. Comprehensive results demonstrate that our method is superior to the conventional local structural representation and statistical-based similarity measures in terms of discriminability and accuracy., Comment: Accepted by CVPR2024

Lung cancer is a leading cause of death worldwide and early screening is critical for improving survival outcomes. In clinical practice, the contextual structure of nodules and the accumulated experience of radiologists are the two core elements related to the accuracy of identification of benign and malignant nodules. Contextual information provides comprehensive information about nodules such as location, shape, and peripheral vessels, and experienced radiologists can search for clues from previous cases as a reference to enrich the basis of decision-making. In this paper, we propose a radiologist-inspired method to simulate the diagnostic process of radiologists, which is composed of context parsing and prototype recalling modules. The context parsing module first segments the context structure of nodules and then aggregates contextual information for a more comprehensive understanding of the nodule. The prototype recalling module utilizes prototype-based learning to condense previously learned cases as prototypes for comparative analysis, which is updated online in a momentum way during training. Building on the two modules, our method leverages both the intrinsic characteristics of the nodules and the external knowledge accumulated from other nodules to achieve a sound diagnosis. To meet the needs of both low-dose and noncontrast screening, we collect a large-scale dataset of 12,852 and 4,029 nodules from low-dose and noncontrast CTs respectively, each with pathology- or follow-up-confirmed labels. Experiments on several datasets demonstrate that our method achieves advanced screening performance on both low-dose and noncontrast scenarios., Comment: MICCAI 2023

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., Comment: 34 pages, 12 figures

Medical image segmentation plays an important role in computer-aided diagnosis. Attention mechanisms that distinguish important parts from irrelevant parts have been widely used in medical image segmentation tasks. This paper systematically reviews the basic principles of attention mechanisms and their applications in medical image segmentation. First, we review the basic concepts of attention mechanism and formulation. Second, we surveyed over 300 articles related to medical image segmentation, and divided them into two groups based on their attention mechanisms, non-Transformer attention and Transformer attention. In each group, we deeply analyze the attention mechanisms from three aspects based on the current literature work, i.e., the principle of the mechanism (what to use), implementation methods (how to use), and application tasks (where to use). We also thoroughly analyzed the advantages and limitations of their applications to different tasks. Finally, we summarize the current state of research and shortcomings in the field, and discuss the potential challenges in the future, including task specificity, robustness, standard evaluation, etc. We hope that this review can showcase the overall research context of traditional and Transformer attention methods, provide a clear reference for subsequent research, and inspire more advanced attention research, not only in medical image segmentation, but also in other image analysis scenarios., Comment: Submitted to Medical Image Analysis, survey paper, 34 pages, over 300 references

The universal model emerges as a promising trend for medical image segmentation, paving up the way to build medical imaging large model (MILM). One popular strategy to build universal models is to encode each task as a one-hot vector and generate dynamic convolutional layers at the end of the decoder to extract the interested target. Although successful, it ignores the correlations among tasks and meanwhile is too late to make the model 'aware' of the ongoing task. To address both issues, we propose a prompt-driven Universal Segmentation model (UniSeg) for multi-task medical image segmentation using diverse modalities and domains. We first devise a learnable universal prompt to describe the correlations among all tasks and then convert this prompt and image features into a task-specific prompt, which is fed to the decoder as a part of its input. Thus, we make the model 'aware' of the ongoing task early and boost the task-specific training of the whole decoder. Our results indicate that the proposed UniSeg outperforms other universal models and single-task models on 11 upstream tasks. Moreover, UniSeg also beats other pre-trained models on two downstream datasets, providing the community with a high-quality pre-trained model for 3D medical image segmentation. Code and model are available at https://github.com/yeerwen/UniSeg., Comment: 13 pages, 4 figures

Human readers or radiologists routinely perform full-body multi-organ multi-disease detection and diagnosis in clinical practice, while most medical AI systems are built to focus on single organs with a narrow list of a few diseases. This might severely limit AI's clinical adoption. A certain number of AI models need to be assembled non-trivially to match the diagnostic process of a human reading a CT scan. In this paper, we construct a Unified Tumor Transformer (CancerUniT) model to jointly detect tumor existence & location and diagnose tumor characteristics for eight major cancers in CT scans. CancerUniT is a query-based Mask Transformer model with the output of multi-tumor prediction. We decouple the object queries into organ queries, tumor detection queries and tumor diagnosis queries, and further establish hierarchical relationships among the three groups. This clinically-inspired architecture effectively assists inter- and intra-organ representation learning of tumors and facilitates the resolution of these complex, anatomically related multi-organ cancer image reading tasks. CancerUniT is trained end-to-end using a curated large-scale CT images of 10,042 patients including eight major types of cancers and occurring non-cancer tumors (all are pathology-confirmed with 3D tumor masks annotated by radiologists). On the test set of 631 patients, CancerUniT has demonstrated strong performance under a set of clinically relevant evaluation metrics, substantially outperforming both multi-disease methods and an assembly of eight single-organ expert models in tumor detection, segmentation, and diagnosis. This moves one step closer towards a universal high performance cancer screening tool., Comment: ICCV 2023 Camera Ready Version

The number of international benchmarking competitions is steadily increasing in various fields of machine learning (ML) research and practice. So far, however, little is known about the common practice as well as bottlenecks faced by the community in tackling the research questions posed. To shed light on the status quo of algorithm development in the specific field of biomedical imaging analysis, we designed an international survey that was issued to all participants of challenges conducted in conjunction with the IEEE ISBI 2021 and MICCAI 2021 conferences (80 competitions in total). The survey covered participants' expertise and working environments, their chosen strategies, as well as algorithm characteristics. A median of 72% challenge participants took part in the survey. According to our results, knowledge exchange was the primary incentive (70%) for participation, while the reception of prize money played only a minor role (16%). While a median of 80 working hours was spent on method development, a large portion of participants stated that they did not have enough time for method development (32%). 25% perceived the infrastructure to be a bottleneck. Overall, 94% of all solutions were deep learning-based. Of these, 84% were based on standard architectures. 43% of the respondents reported that the data samples (e.g., images) were too large to be processed at once. This was most commonly addressed by patch-based training (69%), downsampling (37%), and solving 3D analysis tasks as a series of 2D tasks. K-fold cross-validation on the training set was performed by only 37% of the participants and only 50% of the participants performed ensembling based on multiple identical models (61%) or heterogeneous models (39%). 48% of the respondents applied postprocessing steps.

Medical image benchmarks for the segmentation of organs and tumors suffer from the partially labeling issue due to its intensive cost of labor and expertise. Current mainstream approaches follow the practice of one network solving one task. With this pipeline, not only the performance is limited by the typically small dataset of a single task, but also the computation cost linearly increases with the number of tasks. To address this, we propose a Transformer based dynamic on-demand network (TransDoDNet) that learns to segment organs and tumors on multiple partially labeled datasets. Specifically, TransDoDNet has a hybrid backbone that is composed of the convolutional neural network and Transformer. A dynamic head enables the network to accomplish multiple segmentation tasks flexibly. Unlike existing approaches that fix kernels after training, the kernels in the dynamic head are generated adaptively by the Transformer, which employs the self-attention mechanism to model long-range organ-wise dependencies and decodes the organ embedding that can represent each organ. We create a large-scale partially labeled Multi-Organ and Tumor Segmentation benchmark, termed MOTS, and demonstrate the superior performance of our TransDoDNet over other competitors on seven organ and tumor segmentation tasks. This study also provides a general 3D medical image segmentation model, which has been pre-trained on the large-scale MOTS benchmark and has demonstrated advanced performance over BYOL, the current predominant self-supervised learning method. Code will be available at \url{https://git.io/DoDNet}., Comment: An extension of our CVPR2021 work 'DoDNet: Learning to segment multi-organ and tumors from multiple partially labeled datasets'. arXiv admin note: substantial text overlap with arXiv:2011.10217

Although Transformers have successfully transitioned from their language modelling origins to image-based applications, their quadratic computational complexity remains a challenge, particularly for dense prediction. In this paper we propose a content-based sparse attention method, as an alternative to dense self-attention, aiming to reduce the computation complexity while retaining the ability to model long-range dependencies. Specifically, we cluster and then aggregate key and value tokens, as a content-based method of reducing the total token count. The resulting clustered-token sequence retains the semantic diversity of the original signal, but can be processed at a lower computational cost. Besides, we further extend the clustering-guided attention from single-scale to multi-scale, which is conducive to dense prediction tasks. We label the proposed Transformer architecture ClusTR, and demonstrate that it achieves state-of-the-art performance on various vision tasks but at lower computational cost and with fewer parameters. For instance, our ClusTR small model with 22.7M parameters achieves 83.2\% Top-1 accuracy on ImageNet. Source code and ImageNet models will be made publicly available., Comment: 14 pages

Multi-modal learning focuses on training models by equally combining multiple input data modalities during the prediction process. However, this equal combination can be detrimental to the prediction accuracy because different modalities are usually accompanied by varying levels of uncertainty. Using such uncertainty to combine modalities has been studied by a couple of approaches, but with limited success because these approaches are either designed to deal with specific classification or segmentation problems and cannot be easily translated into other tasks, or suffer from numerical instabilities. In this paper, we propose a new Uncertainty-aware Multi-modal Learner that estimates uncertainty by measuring feature density via Cross-modal Random Network Prediction (CRNP). CRNP is designed to require little adaptation to translate between different prediction tasks, while having a stable training process. From a technical point of view, CRNP is the first approach to explore random network prediction to estimate uncertainty and to combine multi-modal data. Experiments on two 3D multi-modal medical image segmentation tasks and three 2D multi-modal computer vision classification tasks show the effectiveness, adaptability and robustness of CRNP. Also, we provide an extensive discussion on different fusion functions and visualization to validate the proposed model.

Assessment of myocardial viability is essential in diagnosis and treatment management of patients suffering from myocardial infarction, and classification of pathology on myocardium is the key to this assessment. This work defines a new task of medical image analysis, i.e., to perform myocardial pathology segmentation (MyoPS) combining three-sequence cardiac magnetic resonance (CMR) images, which was first proposed in the MyoPS challenge, in conjunction with MICCAI 2020. The challenge provided 45 paired and pre-aligned CMR images, allowing algorithms to combine the complementary information from the three CMR sequences for pathology segmentation. In this article, we provide details of the challenge, survey the works from fifteen participants and interpret their methods according to five aspects, i.e., preprocessing, data augmentation, learning strategy, model architecture and post-processing. In addition, we analyze the results with respect to different factors, in order to examine the key obstacles and explore potential of solutions, as well as to provide a benchmark for future research. We conclude that while promising results have been reported, the research is still in the early stage, and more in-depth exploration is needed before a successful application to the clinics. Note that MyoPS data and evaluation tool continue to be publicly available upon registration via its homepage (www.sdspeople.fudan.edu.cn/zhuangxiahai/0/myops20/).

Self-supervised learning (SSL) opens up huge opportunities for medical image analysis that is well known for its lack of annotations. However, aggregating massive (unlabeled) 3D medical images like computerized tomography (CT) remains challenging due to its high imaging cost and privacy restrictions. In this paper, we advocate bringing a wealth of 2D images like chest X-rays as compensation for the lack of 3D data, aiming to build a universal medical self-supervised representation learning framework, called UniMiSS. The following problem is how to break the dimensionality barrier, \ie, making it possible to perform SSL with both 2D and 3D images? To achieve this, we design a pyramid U-like medical Transformer (MiT). It is composed of the switchable patch embedding (SPE) module and Transformers. The SPE module adaptively switches to either 2D or 3D patch embedding, depending on the input dimension. The embedded patches are converted into a sequence regardless of their original dimensions. The Transformers model the long-term dependencies in a sequence-to-sequence manner, thus enabling UniMiSS to learn representations from both 2D and 3D images. With the MiT as the backbone, we perform the UniMiSS in a self-distillation manner. We conduct expensive experiments on six 3D/2D medical image analysis tasks, including segmentation and classification. The results show that the proposed UniMiSS achieves promising performance on various downstream tasks, outperforming the ImageNet pre-training and other advanced SSL counterparts substantially. Code is available at \def\UrlFont{\rm\small\ttfamily} \url{https://github.com/YtongXie/UniMiSS-code}., Comment: Accepted by ECCV 2022

The domain gap caused mainly by variable medical image quality renders a major obstacle on the path between training a segmentation model in the lab and applying the trained model to unseen clinical data. To address this issue, domain generalization methods have been proposed, which however usually use static convolutions and are less flexible. In this paper, we propose a multi-source domain generalization model based on the domain and content adaptive convolution (DCAC) for the segmentation of medical images across different modalities. Specifically, we design the domain adaptive convolution (DAC) module and content adaptive convolution (CAC) module and incorporate both into an encoder-decoder backbone. In the DAC module, a dynamic convolutional head is conditioned on the predicted domain code of the input to make our model adapt to the unseen target domain. In the CAC module, a dynamic convolutional head is conditioned on the global image features to make our model adapt to the test image. We evaluated the DCAC model against the baseline and four state-of-the-art domain generalization methods on the prostate segmentation, COVID-19 lesion segmentation, and optic cup/optic disc segmentation tasks. Our results not only indicate that the proposed DCAC model outperforms all competing methods on each segmentation task but also demonstrate the effectiveness of the DAC and CAC modules. Code is available at \url{https://git.io/DCAC}., Comment: IEEE-TMI

Current deep image super-resolution (SR) approaches aim to restore high-resolution images from down-sampled images or by assuming degradation from simple Gaussian kernels and additive noises. However, these techniques only assume crude approximations of the real-world image degradation process, which should involve complex kernels and noise patterns that are difficult to model using simple assumptions. In this paper, we propose a more realistic process to synthesise low-resolution images for real-world image SR by introducing a new Kernel Adversarial Learning Super-resolution (KASR) framework. In the proposed framework, degradation kernels and noises are adaptively modelled rather than explicitly specified. Moreover, we also propose a high-frequency selective objective and an iterative supervision process to further boost the model SR reconstruction accuracy. Extensive experiments validate the effectiveness of the proposed framework on real-world datasets.

Convolutional neural networks (CNNs) have been the de facto standard for nowadays 3D medical image segmentation. The convolutional operations used in these networks, however, inevitably have limitations in modeling the long-range dependency due to their inductive bias of locality and weight sharing. Although Transformer was born to address this issue, it suffers from extreme computational and spatial complexities in processing high-resolution 3D feature maps. In this paper, we propose a novel framework that efficiently bridges a {\bf Co}nvolutional neural network and a {\bf Tr}ansformer {\bf (CoTr)} for accurate 3D medical image segmentation. Under this framework, the CNN is constructed to extract feature representations and an efficient deformable Transformer (DeTrans) is built to model the long-range dependency on the extracted feature maps. Different from the vanilla Transformer which treats all image positions equally, our DeTrans pays attention only to a small set of key positions by introducing the deformable self-attention mechanism. Thus, the computational and spatial complexities of DeTrans have been greatly reduced, making it possible to process the multi-scale and high-resolution feature maps, which are usually of paramount importance for image segmentation. We conduct an extensive evaluation on the Multi-Atlas Labeling Beyond the Cranial Vault (BCV) dataset that covers 11 major human organs. The results indicate that our CoTr leads to a substantial performance improvement over other CNN-based, transformer-based, and hybrid methods on the 3D multi-organ segmentation task. Code is available at \def\UrlFont{\rm\small\ttfamily} \url{https://github.com/YtongXie/CoTr}, Comment: 13 pages

Automated and accurate 3D medical image segmentation plays an essential role in assisting medical professionals to evaluate disease progresses and make fast therapeutic schedules. Although deep convolutional neural networks (DCNNs) have widely applied to this task, the accuracy of these models still need to be further improved mainly due to their limited ability to 3D context perception. In this paper, we propose the 3D context residual network (ConResNet) for the accurate segmentation of 3D medical images. This model consists of an encoder, a segmentation decoder, and a context residual decoder. We design the context residual module and use it to bridge both decoders at each scale. Each context residual module contains both context residual mapping and context attention mapping, the formal aims to explicitly learn the inter-slice context information and the latter uses such context as a kind of attention to boost the segmentation accuracy. We evaluated this model on the MICCAI 2018 Brain Tumor Segmentation (BraTS) dataset and NIH Pancreas Segmentation (Pancreas-CT) dataset. Our results not only demonstrate the effectiveness of the proposed 3D context residual learning scheme but also indicate that the proposed ConResNet is more accurate than six top-ranking methods in brain tumor segmentation and seven top-ranking methods in pancreas segmentation. Code is available at https://git.io/ConResNet, Comment: Accpeted by IEEE-TMI

It has been widely recognized that the success of deep learning in image segmentation relies overwhelmingly on a myriad amount of densely annotated training data, which, however, are difficult to obtain due to the tremendous labor and expertise required, particularly for annotating 3D medical images. Although self-supervised learning (SSL) has shown great potential to address this issue, most SSL approaches focus only on image-level global consistency, but ignore the local consistency which plays a pivotal role in capturing structural information for dense prediction tasks such as segmentation. In this paper, we propose a PriorGuided Local (PGL) self-supervised model that learns the region-wise local consistency in the latent feature space. Specifically, we use the spatial transformations, which produce different augmented views of the same image, as a prior to deduce the location relation between two views, which is then used to align the feature maps of the same local region but being extracted on two views. Next, we construct a local consistency loss to minimize the voxel-wise discrepancy between the aligned feature maps. Thus, our PGL model learns the distinctive representations of local regions, and hence is able to retain structural information. This ability is conducive to downstream segmentation tasks. We conducted an extensive evaluation on four public computerized tomography (CT) datasets that cover 11 kinds of major human organs and two tumors. The results indicate that using pre-trained PGL model to initialize a downstream network leads to a substantial performance improvement over both random initialization and the initialization with global consistency-based models. Code and pre-trained weights will be made available at: https://git.io/PGL., Comment: 13 pages

Due to the intensive cost of labor and expertise in annotating 3D medical images at a voxel level, most benchmark datasets are equipped with the annotations of only one type of organs and/or tumors, resulting in the so-called partially labeling issue. To address this, we propose a dynamic on-demand network (DoDNet) that learns to segment multiple organs and tumors on partially labeled datasets. DoDNet consists of a shared encoder-decoder architecture, a task encoding module, a controller for generating dynamic convolution filters, and a single but dynamic segmentation head. The information of the current segmentation task is encoded as a task-aware prior to tell the model what the task is expected to solve. Different from existing approaches which fix kernels after training, the kernels in dynamic head are generated adaptively by the controller, conditioned on both input image and assigned task. Thus, DoDNet is able to segment multiple organs and tumors, as done by multiple networks or a multi-head network, in a much efficient and flexible manner. We have created a large-scale partially labeled dataset, termed MOTS, and demonstrated the superior performance of our DoDNet over other competitors on seven organ and tumor segmentation tasks. We also transferred the weights pre-trained on MOTS to a downstream multi-organ segmentation task and achieved state-of-the-art performance. This study provides a general 3D medical image segmentation model that has been pre-trained on a large-scale partially labelled dataset and can be extended (after fine-tuning) to downstream volumetric medical data segmentation tasks. The dataset and code areavailableat: https://git.io/DoDNet

Accurate and automated gland segmentation on histology tissue images is an essential but challenging task in the computer-aided diagnosis of adenocarcinoma. Despite their prevalence, deep learning models always require a myriad number of densely annotated training images, which are difficult to obtain due to extensive labor and associated expert costs related to histology image annotations. In this paper, we propose the pairwise relation-based semi-supervised (PRS^2) model for gland segmentation on histology images. This model consists of a segmentation network (S-Net) and a pairwise relation network (PR-Net). The S-Net is trained on labeled data for segmentation, and PR-Net is trained on both labeled and unlabeled data in an unsupervised way to enhance its image representation ability via exploiting the semantic consistency between each pair of images in the feature space. Since both networks share their encoders, the image representation ability learned by PR-Net can be transferred to S-Net to improve its segmentation performance. We also design the object-level Dice loss to address the issues caused by touching glands and combine it with other two loss functions for S-Net. We evaluated our model against five recent methods on the GlaS dataset and three recent methods on the CRAG dataset. Our results not only demonstrate the effectiveness of the proposed PR-Net and object-level Dice loss, but also indicate that our PRS^2 model achieves the state-of-the-art gland segmentation performance on both benchmarks., Comment: Accepted by MICCAI2020

Cluster of viral pneumonia occurrences during a short period of time may be a harbinger of an outbreak or pandemic, like SARS, MERS, and recent COVID-19. Rapid and accurate detection of viral pneumonia using chest X-ray can be significantly useful in large-scale screening and epidemic prevention, particularly when other chest imaging modalities are less available. Viral pneumonia often have diverse causes and exhibit notably different visual appearances on X-ray images. The evolution of viruses and the emergence of novel mutated viruses further result in substantial dataset shift, which greatly limits the performance of classification approaches. In this paper, we formulate the task of differentiating viral pneumonia from non-viral pneumonia and healthy controls into an one-class classification-based anomaly detection problem, and thus propose the confidence-aware anomaly detection (CAAD) model, which consists of a shared feature extractor, an anomaly detection module, and a confidence prediction module. If the anomaly score produced by the anomaly detection module is large enough or the confidence score estimated by the confidence prediction module is small enough, we accept the input as an anomaly case (i.e., viral pneumonia). The major advantage of our approach over binary classification is that we avoid modeling individual viral pneumonia classes explicitly and treat all known viral pneumonia cases as anomalies to reinforce the one-class model. The proposed model outperforms binary classification models on the clinical X-VIRAL dataset that contains 5,977 viral pneumonia (no COVID-19) cases, 18,619 non-viral pneumonia cases, and 18,774 healthy controls., Comment: Accepted to IEEE Trans. Medical Imaging. 12 pages