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Mar 14

Exploring the Effect of Dataset Diversity in Self-Supervised Learning for Surgical Computer Vision

Over the past decade, computer vision applications in minimally invasive surgery have rapidly increased. Despite this growth, the impact of surgical computer vision remains limited compared to other medical fields like pathology and radiology, primarily due to the scarcity of representative annotated data. Whereas transfer learning from large annotated datasets such as ImageNet has been conventionally the norm to achieve high-performing models, recent advancements in self-supervised learning (SSL) have demonstrated superior performance. In medical image analysis, in-domain SSL pretraining has already been shown to outperform ImageNet-based initialization. Although unlabeled data in the field of surgical computer vision is abundant, the diversity within this data is limited. This study investigates the role of dataset diversity in SSL for surgical computer vision, comparing procedure-specific datasets against a more heterogeneous general surgical dataset across three different downstream surgical applications. The obtained results show that using solely procedure-specific data can lead to substantial improvements of 13.8%, 9.5%, and 36.8% compared to ImageNet pretraining. However, extending this data with more heterogeneous surgical data further increases performance by an additional 5.0%, 5.2%, and 2.5%, suggesting that increasing diversity within SSL data is beneficial for model performance. The code and pretrained model weights are made publicly available at https://github.com/TimJaspers0801/SurgeNet.

Scaling up self-supervised learning for improved surgical foundation models

Foundation models have revolutionized computer vision by achieving vastly superior performance across diverse tasks through large-scale pretraining on extensive datasets. However, their application in surgical computer vision has been limited. This study addresses this gap by introducing SurgeNetXL, a novel surgical foundation model that sets a new benchmark in surgical computer vision. Trained on the largest reported surgical dataset to date, comprising over 4.7 million video frames, SurgeNetXL achieves consistent top-tier performance across six datasets spanning four surgical procedures and three tasks, including semantic segmentation, phase recognition, and critical view of safety (CVS) classification. Compared with the best-performing surgical foundation models, SurgeNetXL shows mean improvements of 2.4, 9.0, and 12.6 percent for semantic segmentation, phase recognition, and CVS classification, respectively. Additionally, SurgeNetXL outperforms the best-performing ImageNet-based variants by 14.4, 4.0, and 1.6 percent in the respective tasks. In addition to advancing model performance, this study provides key insights into scaling pretraining datasets, extending training durations, and optimizing model architectures specifically for surgical computer vision. These findings pave the way for improved generalizability and robustness in data-scarce scenarios, offering a comprehensive framework for future research in this domain. All models and a subset of the SurgeNetXL dataset, including over 2 million video frames, are publicly available at: https://github.com/TimJaspers0801/SurgeNet.

MedShapeNet -- A Large-Scale Dataset of 3D Medical Shapes for Computer Vision

Prior to the deep learning era, shape was commonly used to describe the objects. Nowadays, state-of-the-art (SOTA) algorithms in medical imaging are predominantly diverging from computer vision, where voxel grids, meshes, point clouds, and implicit surface models are used. This is seen from numerous shape-related publications in premier vision conferences as well as the growing popularity of ShapeNet (about 51,300 models) and Princeton ModelNet (127,915 models). For the medical domain, we present a large collection of anatomical shapes (e.g., bones, organs, vessels) and 3D models of surgical instrument, called MedShapeNet, created to facilitate the translation of data-driven vision algorithms to medical applications and to adapt SOTA vision algorithms to medical problems. As a unique feature, we directly model the majority of shapes on the imaging data of real patients. As of today, MedShapeNet includes 23 dataset with more than 100,000 shapes that are paired with annotations (ground truth). Our data is freely accessible via a web interface and a Python application programming interface (API) and can be used for discriminative, reconstructive, and variational benchmarks as well as various applications in virtual, augmented, or mixed reality, and 3D printing. Exemplary, we present use cases in the fields of classification of brain tumors, facial and skull reconstructions, multi-class anatomy completion, education, and 3D printing. In future, we will extend the data and improve the interfaces. The project pages are: https://medshapenet.ikim.nrw/ and https://github.com/Jianningli/medshapenet-feedback

EndoNet: A Deep Architecture for Recognition Tasks on Laparoscopic Videos

Surgical workflow recognition has numerous potential medical applications, such as the automatic indexing of surgical video databases and the optimization of real-time operating room scheduling, among others. As a result, phase recognition has been studied in the context of several kinds of surgeries, such as cataract, neurological, and laparoscopic surgeries. In the literature, two types of features are typically used to perform this task: visual features and tool usage signals. However, the visual features used are mostly handcrafted. Furthermore, the tool usage signals are usually collected via a manual annotation process or by using additional equipment. In this paper, we propose a novel method for phase recognition that uses a convolutional neural network (CNN) to automatically learn features from cholecystectomy videos and that relies uniquely on visual information. In previous studies, it has been shown that the tool signals can provide valuable information in performing the phase recognition task. Thus, we present a novel CNN architecture, called EndoNet, that is designed to carry out the phase recognition and tool presence detection tasks in a multi-task manner. To the best of our knowledge, this is the first work proposing to use a CNN for multiple recognition tasks on laparoscopic videos. Extensive experimental comparisons to other methods show that EndoNet yields state-of-the-art results for both tasks.

PitVis-2023 Challenge: Workflow Recognition in videos of Endoscopic Pituitary Surgery

The field of computer vision applied to videos of minimally invasive surgery is ever-growing. Workflow recognition pertains to the automated recognition of various aspects of a surgery: including which surgical steps are performed; and which surgical instruments are used. This information can later be used to assist clinicians when learning the surgery; during live surgery; and when writing operation notes. The Pituitary Vision (PitVis) 2023 Challenge tasks the community to step and instrument recognition in videos of endoscopic pituitary surgery. This is a unique task when compared to other minimally invasive surgeries due to the smaller working space, which limits and distorts vision; and higher frequency of instrument and step switching, which requires more precise model predictions. Participants were provided with 25-videos, with results presented at the MICCAI-2023 conference as part of the Endoscopic Vision 2023 Challenge in Vancouver, Canada, on 08-Oct-2023. There were 18-submissions from 9-teams across 6-countries, using a variety of deep learning models. A commonality between the top performing models was incorporating spatio-temporal and multi-task methods, with greater than 50% and 10% macro-F1-score improvement over purely spacial single-task models in step and instrument recognition respectively. The PitVis-2023 Challenge therefore demonstrates state-of-the-art computer vision models in minimally invasive surgery are transferable to a new dataset, with surgery specific techniques used to enhance performance, progressing the field further. Benchmark results are provided in the paper, and the dataset is publicly available at: https://doi.org/10.5522/04/26531686.

OphNet: A Large-Scale Video Benchmark for Ophthalmic Surgical Workflow Understanding

Surgical scene perception via videos are critical for advancing robotic surgery, telesurgery, and AI-assisted surgery, particularly in ophthalmology. However, the scarcity of diverse and richly annotated video datasets has hindered the development of intelligent systems for surgical workflow analysis. Existing datasets for surgical workflow analysis, which typically face challenges such as small scale, a lack of diversity in surgery and phase categories, and the absence of time-localized annotations, limit the requirements for action understanding and model generalization validation in complex and diverse real-world surgical scenarios. To address this gap, we introduce OphNet, a large-scale, expert-annotated video benchmark for ophthalmic surgical workflow understanding. OphNet features: 1) A diverse collection of 2,278 surgical videos spanning 66 types of cataract, glaucoma, and corneal surgeries, with detailed annotations for 102 unique surgical phases and 150 granular operations; 2) It offers sequential and hierarchical annotations for each surgery, phase, and operation, enabling comprehensive understanding and improved interpretability; 3) Moreover, OphNet provides time-localized annotations, facilitating temporal localization and prediction tasks within surgical workflows. With approximately 205 hours of surgical videos, OphNet is about 20 times larger than the largest existing surgical workflow analysis benchmark. Our dataset and code have been made available at: https://github.com/minghu0830/OphNet-benchmark.

SuPRA: Surgical Phase Recognition and Anticipation for Intra-Operative Planning

Intra-operative recognition of surgical phases holds significant potential for enhancing real-time contextual awareness in the operating room. However, we argue that online recognition, while beneficial, primarily lends itself to post-operative video analysis due to its limited direct impact on the actual surgical decisions and actions during ongoing procedures. In contrast, we contend that the prediction and anticipation of surgical phases are inherently more valuable for intra-operative assistance, as they can meaningfully influence a surgeon's immediate and long-term planning by providing foresight into future steps. To address this gap, we propose a dual approach that simultaneously recognises the current surgical phase and predicts upcoming ones, thus offering comprehensive intra-operative assistance and guidance on the expected remaining workflow. Our novel method, Surgical Phase Recognition and Anticipation (SuPRA), leverages past and current information for accurate intra-operative phase recognition while using future segments for phase prediction. This unified approach challenges conventional frameworks that treat these objectives separately. We have validated SuPRA on two reputed datasets, Cholec80 and AutoLaparo21, where it demonstrated state-of-the-art performance with recognition accuracies of 91.8% and 79.3%, respectively. Additionally, we introduce and evaluate our model using new segment-level evaluation metrics, namely Edit and F1 Overlap scores, for a more temporal assessment of segment classification. In conclusion, SuPRA presents a new multi-task approach that paves the way for improved intra-operative assistance through surgical phase recognition and prediction of future events.

ORacle: Large Vision-Language Models for Knowledge-Guided Holistic OR Domain Modeling

Every day, countless surgeries are performed worldwide, each within the distinct settings of operating rooms (ORs) that vary not only in their setups but also in the personnel, tools, and equipment used. This inherent diversity poses a substantial challenge for achieving a holistic understanding of the OR, as it requires models to generalize beyond their initial training datasets. To reduce this gap, we introduce ORacle, an advanced vision-language model designed for holistic OR domain modeling, which incorporates multi-view and temporal capabilities and can leverage external knowledge during inference, enabling it to adapt to previously unseen surgical scenarios. This capability is further enhanced by our novel data augmentation framework, which significantly diversifies the training dataset, ensuring ORacle's proficiency in applying the provided knowledge effectively. In rigorous testing, in scene graph generation, and downstream tasks on the 4D-OR dataset, ORacle not only demonstrates state-of-the-art performance but does so requiring less data than existing models. Furthermore, its adaptability is displayed through its ability to interpret unseen views, actions, and appearances of tools and equipment. This demonstrates ORacle's potential to significantly enhance the scalability and affordability of OR domain modeling and opens a pathway for future advancements in surgical data science. We will release our code and data upon acceptance.

Surgical Gym: A high-performance GPU-based platform for reinforcement learning with surgical robots

Recent advances in robot-assisted surgery have resulted in progressively more precise, efficient, and minimally invasive procedures, sparking a new era of robotic surgical intervention. This enables doctors, in collaborative interaction with robots, to perform traditional or minimally invasive surgeries with improved outcomes through smaller incisions. Recent efforts are working toward making robotic surgery more autonomous which has the potential to reduce variability of surgical outcomes and reduce complication rates. Deep reinforcement learning methodologies offer scalable solutions for surgical automation, but their effectiveness relies on extensive data acquisition due to the absence of prior knowledge in successfully accomplishing tasks. Due to the intensive nature of simulated data collection, previous works have focused on making existing algorithms more efficient. In this work, we focus on making the simulator more efficient, making training data much more accessible than previously possible. We introduce Surgical Gym, an open-source high performance platform for surgical robot learning where both the physics simulation and reinforcement learning occur directly on the GPU. We demonstrate between 100-5000x faster training times compared with previous surgical learning platforms. The code is available at: https://github.com/SamuelSchmidgall/SurgicalGym.

Multi-Modal Self-Supervised Learning for Surgical Feedback Effectiveness Assessment

During surgical training, real-time feedback from trainers to trainees is important for preventing errors and enhancing long-term skill acquisition. Accurately predicting the effectiveness of this feedback, specifically whether it leads to a change in trainee behavior, is crucial for developing methods for improving surgical training and education. However, relying on human annotations to assess feedback effectiveness is laborious and prone to biases, underscoring the need for an automated, scalable, and objective method. Creating such an automated system poses challenges, as it requires an understanding of both the verbal feedback delivered by the trainer and the visual context of the real-time surgical scene. To address this, we propose a method that integrates information from transcribed verbal feedback and corresponding surgical video to predict feedback effectiveness. Our findings show that both transcribed feedback and surgical video are individually predictive of trainee behavior changes, and their combination achieves an AUROC of 0.70+/-0.02, improving prediction accuracy by up to 6.6%. Additionally, we introduce self-supervised fine-tuning as a strategy for enhancing surgical video representation learning, which is scalable and further enhances prediction performance. Our results demonstrate the potential of multi-modal learning to advance the automated assessment of surgical feedback.

A Temporal Convolutional Network-Based Approach and a Benchmark Dataset for Colonoscopy Video Temporal Segmentation

Following recent advancements in computer-aided detection and diagnosis systems for colonoscopy, the automated reporting of colonoscopy procedures is set to further revolutionize clinical practice. A crucial yet underexplored aspect in the development of these systems is the creation of computer vision models capable of autonomously segmenting full-procedure colonoscopy videos into anatomical sections and procedural phases. In this work, we aim to create the first open-access dataset for this task and propose a state-of-the-art approach, benchmarked against competitive models. We annotated the publicly available REAL-Colon dataset, consisting of 2.7 million frames from 60 complete colonoscopy videos, with frame-level labels for anatomical locations and colonoscopy phases across nine categories. We then present ColonTCN, a learning-based architecture that employs custom temporal convolutional blocks designed to efficiently capture long temporal dependencies for the temporal segmentation of colonoscopy videos. We also propose a dual k-fold cross-validation evaluation protocol for this benchmark, which includes model assessment on unseen, multi-center data.ColonTCN achieves state-of-the-art performance in classification accuracy while maintaining a low parameter count when evaluated using the two proposed k-fold cross-validation settings, outperforming competitive models. We report ablation studies to provide insights into the challenges of this task and highlight the benefits of the custom temporal convolutional blocks, which enhance learning and improve model efficiency. We believe that the proposed open-access benchmark and the ColonTCN approach represent a significant advancement in the temporal segmentation of colonoscopy procedures, fostering further open-access research to address this clinical need.

SAM 2 in Robotic Surgery: An Empirical Evaluation for Robustness and Generalization in Surgical Video Segmentation

The recent Segment Anything Model (SAM) 2 has demonstrated remarkable foundational competence in semantic segmentation, with its memory mechanism and mask decoder further addressing challenges in video tracking and object occlusion, thereby achieving superior results in interactive segmentation for both images and videos. Building upon our previous empirical studies, we further explore the zero-shot segmentation performance of SAM 2 in robot-assisted surgery based on prompts, alongside its robustness against real-world corruption. For static images, we employ two forms of prompts: 1-point and bounding box, while for video sequences, the 1-point prompt is applied to the initial frame. Through extensive experimentation on the MICCAI EndoVis 2017 and EndoVis 2018 benchmarks, SAM 2, when utilizing bounding box prompts, outperforms state-of-the-art (SOTA) methods in comparative evaluations. The results with point prompts also exhibit a substantial enhancement over SAM's capabilities, nearing or even surpassing existing unprompted SOTA methodologies. Besides, SAM 2 demonstrates improved inference speed and less performance degradation against various image corruption. Although slightly unsatisfactory results remain in specific edges or regions, SAM 2's robust adaptability to 1-point prompts underscores its potential for downstream surgical tasks with limited prompt requirements.

VILA-M3: Enhancing Vision-Language Models with Medical Expert Knowledge

Generalist vision language models (VLMs) have made significant strides in computer vision, but they fall short in specialized fields like healthcare, where expert knowledge is essential. In traditional computer vision tasks, creative or approximate answers may be acceptable, but in healthcare, precision is paramount.Current large multimodal models like Gemini and GPT-4o are insufficient for medical tasks due to their reliance on memorized internet knowledge rather than the nuanced expertise required in healthcare. VLMs are usually trained in three stages: vision pre-training, vision-language pre-training, and instruction fine-tuning (IFT). IFT has been typically applied using a mixture of generic and healthcare data. In contrast, we propose that for medical VLMs, a fourth stage of specialized IFT is necessary, which focuses on medical data and includes information from domain expert models. Domain expert models developed for medical use are crucial because they are specifically trained for certain clinical tasks, e.g. to detect tumors and classify abnormalities through segmentation and classification, which learn fine-grained features of medical data-features that are often too intricate for a VLM to capture effectively especially in radiology. This paper introduces a new framework, VILA-M3, for medical VLMs that utilizes domain knowledge via expert models. Through our experiments, we show an improved state-of-the-art (SOTA) performance with an average improvement of ~9% over the prior SOTA model Med-Gemini and ~6% over models trained on the specific tasks. Our approach emphasizes the importance of domain expertise in creating precise, reliable VLMs for medical applications.

D-Former: A U-shaped Dilated Transformer for 3D Medical Image Segmentation

Computer-aided medical image segmentation has been applied widely in diagnosis and treatment to obtain clinically useful information of shapes and volumes of target organs and tissues. In the past several years, convolutional neural network (CNN) based methods (e.g., U-Net) have dominated this area, but still suffered from inadequate long-range information capturing. Hence, recent work presented computer vision Transformer variants for medical image segmentation tasks and obtained promising performances. Such Transformers model long-range dependency by computing pair-wise patch relations. However, they incur prohibitive computational costs, especially on 3D medical images (e.g., CT and MRI). In this paper, we propose a new method called Dilated Transformer, which conducts self-attention for pair-wise patch relations captured alternately in local and global scopes. Inspired by dilated convolution kernels, we conduct the global self-attention in a dilated manner, enlarging receptive fields without increasing the patches involved and thus reducing computational costs. Based on this design of Dilated Transformer, we construct a U-shaped encoder-decoder hierarchical architecture called D-Former for 3D medical image segmentation. Experiments on the Synapse and ACDC datasets show that our D-Former model, trained from scratch, outperforms various competitive CNN-based or Transformer-based segmentation models at a low computational cost without time-consuming per-training process.

Merlin: A Vision Language Foundation Model for 3D Computed Tomography

Over 85 million computed tomography (CT) scans are performed annually in the US, of which approximately one quarter focus on the abdomen. Given the current radiologist shortage, there is a large impetus to use artificial intelligence to alleviate the burden of interpreting these complex imaging studies. Prior state-of-the-art approaches for automated medical image interpretation leverage vision language models (VLMs). However, current medical VLMs are generally limited to 2D images and short reports, and do not leverage electronic health record (EHR) data for supervision. We introduce Merlin - a 3D VLM that we train using paired CT scans (6+ million images from 15,331 CTs), EHR diagnosis codes (1.8+ million codes), and radiology reports (6+ million tokens). We evaluate Merlin on 6 task types and 752 individual tasks. The non-adapted (off-the-shelf) tasks include zero-shot findings classification (31 findings), phenotype classification (692 phenotypes), and zero-shot cross-modal retrieval (image to findings and image to impressions), while model adapted tasks include 5-year disease prediction (6 diseases), radiology report generation, and 3D semantic segmentation (20 organs). We perform internal validation on a test set of 5,137 CTs, and external validation on 7,000 clinical CTs and on two public CT datasets (VerSe, TotalSegmentator). Beyond these clinically-relevant evaluations, we assess the efficacy of various network architectures and training strategies to depict that Merlin has favorable performance to existing task-specific baselines. We derive data scaling laws to empirically assess training data needs for requisite downstream task performance. Furthermore, unlike conventional VLMs that require hundreds of GPUs for training, we perform all training on a single GPU.

Surgical tool classification and localization: results and methods from the MICCAI 2022 SurgToolLoc challenge

The ability to automatically detect and track surgical instruments in endoscopic videos can enable transformational interventions. Assessing surgical performance and efficiency, identifying skilled tool use and choreography, and planning operational and logistical aspects of OR resources are just a few of the applications that could benefit. Unfortunately, obtaining the annotations needed to train machine learning models to identify and localize surgical tools is a difficult task. Annotating bounding boxes frame-by-frame is tedious and time-consuming, yet large amounts of data with a wide variety of surgical tools and surgeries must be captured for robust training. Moreover, ongoing annotator training is needed to stay up to date with surgical instrument innovation. In robotic-assisted surgery, however, potentially informative data like timestamps of instrument installation and removal can be programmatically harvested. The ability to rely on tool installation data alone would significantly reduce the workload to train robust tool-tracking models. With this motivation in mind we invited the surgical data science community to participate in the challenge, SurgToolLoc 2022. The goal was to leverage tool presence data as weak labels for machine learning models trained to detect tools and localize them in video frames with bounding boxes. We present the results of this challenge along with many of the team's efforts. We conclude by discussing these results in the broader context of machine learning and surgical data science. The training data used for this challenge consisting of 24,695 video clips with tool presence labels is also being released publicly and can be accessed at https://console.cloud.google.com/storage/browser/isi-surgtoolloc-2022.

Rethinking Surgical Instrument Segmentation: A Background Image Can Be All You Need

Data diversity and volume are crucial to the success of training deep learning models, while in the medical imaging field, the difficulty and cost of data collection and annotation are especially huge. Specifically in robotic surgery, data scarcity and imbalance have heavily affected the model accuracy and limited the design and deployment of deep learning-based surgical applications such as surgical instrument segmentation. Considering this, we rethink the surgical instrument segmentation task and propose a one-to-many data generation solution that gets rid of the complicated and expensive process of data collection and annotation from robotic surgery. In our method, we only utilize a single surgical background tissue image and a few open-source instrument images as the seed images and apply multiple augmentations and blending techniques to synthesize amounts of image variations. In addition, we also introduce the chained augmentation mixing during training to further enhance the data diversities. The proposed approach is evaluated on the real datasets of the EndoVis-2018 and EndoVis-2017 surgical scene segmentation. Our empirical analysis suggests that without the high cost of data collection and annotation, we can achieve decent surgical instrument segmentation performance. Moreover, we also observe that our method can deal with novel instrument prediction in the deployment domain. We hope our inspiring results will encourage researchers to emphasize data-centric methods to overcome demanding deep learning limitations besides data shortage, such as class imbalance, domain adaptation, and incremental learning. Our code is available at https://github.com/lofrienger/Single_SurgicalScene_For_Segmentation.

ChatCAD: Interactive Computer-Aided Diagnosis on Medical Image using Large Language Models

Large language models (LLMs) have recently demonstrated their potential in clinical applications, providing valuable medical knowledge and advice. For example, a large dialog LLM like ChatGPT has successfully passed part of the US medical licensing exam. However, LLMs currently have difficulty processing images, making it challenging to interpret information from medical images, which are rich in information that supports clinical decisions. On the other hand, computer-aided diagnosis (CAD) networks for medical images have seen significant success in the medical field by using advanced deep-learning algorithms to support clinical decision-making. This paper presents a method for integrating LLMs into medical-image CAD networks. The proposed framework uses LLMs to enhance the output of multiple CAD networks, such as diagnosis networks, lesion segmentation networks, and report generation networks, by summarizing and reorganizing the information presented in natural language text format. The goal is to merge the strengths of LLMs' medical domain knowledge and logical reasoning with the vision understanding capability of existing medical-image CAD models to create a more user-friendly and understandable system for patients compared to conventional CAD systems. In the future, LLM's medical knowledge can be also used to improve the performance of vision-based medical-image CAD models.

Cross-D Conv: Cross-Dimensional Transferable Knowledge Base via Fourier Shifting Operation

In biomedical imaging analysis, the dichotomy between 2D and 3D data presents a significant challenge. While 3D volumes offer superior real-world applicability, they are less available for each modality and not easy to train in large scale, whereas 2D samples are abundant but less comprehensive. This paper introduces the Cross-D Conv operation, a novel approach that bridges the dimensional gap by learning the phase shifting in the Fourier domain. Our method enables seamless weight transfer between 2D and 3D convolution operations, effectively facilitating cross-dimensional learning. The proposed architecture leverages the abundance of 2D training data to enhance 3D model performance, offering a practical solution to the multimodal data scarcity challenge in 3D medical model pretraining. Experimental validation on the RadImagenet (2D) and multimodal (3D) sets demonstrates that our approach achieves comparable or superior performance in feature quality assessment comparable to conventional methods. The enhanced convolution operation presents new opportunities for developing efficient classification and segmentation models in medical imaging. This work represents an advancement in cross-dimensional and multi-modal medical image analysis, offering a robust framework for utilizing 2D priors in 3D model pretraining or vice versa while maintaining computational efficiency.

Interactive segmentation of medical images through fully convolutional neural networks

Image segmentation plays an essential role in medicine for both diagnostic and interventional tasks. Segmentation approaches are either manual, semi-automated or fully-automated. Manual segmentation offers full control over the quality of the results, but is tedious, time consuming and prone to operator bias. Fully automated methods require no human effort, but often deliver sub-optimal results without providing users with the means to make corrections. Semi-automated approaches keep users in control of the results by providing means for interaction, but the main challenge is to offer a good trade-off between precision and required interaction. In this paper we present a deep learning (DL) based semi-automated segmentation approach that aims to be a "smart" interactive tool for region of interest delineation in medical images. We demonstrate its use for segmenting multiple organs on computed tomography (CT) of the abdomen. Our approach solves some of the most pressing clinical challenges: (i) it requires only one to a few user clicks to deliver excellent 2D segmentations in a fast and reliable fashion; (ii) it can generalize to previously unseen structures and "corner cases"; (iii) it delivers results that can be corrected quickly in a smart and intuitive way up to an arbitrary degree of precision chosen by the user and (iv) ensures high accuracy. We present our approach and compare it to other techniques and previous work to show the advantages brought by our method.

LSMS: Language-guided Scale-aware MedSegmentor for Medical Image Referring Segmentation

Conventional medical image segmentation methods have been found inadequate in facilitating physicians with the identification of specific lesions for diagnosis and treatment. Given the utility of text as an instructional format, we introduce a novel task termed Medical Image Referring Segmentation (MIRS), which requires segmenting specified lesions in images based on the given language expressions. Due to the varying object scales in medical images, MIRS demands robust vision-language modeling and comprehensive multi-scale interaction for precise localization and segmentation under linguistic guidance. However, existing medical image segmentation methods fall short in meeting these demands, resulting in insufficient segmentation accuracy. In response, we propose an approach named Language-guided Scale-aware MedSegmentor (LSMS), incorporating two appealing designs: (1)~a Scale-aware Vision-Language Attention module that leverages diverse convolutional kernels to acquire rich visual knowledge and interact closely with linguistic features, thereby enhancing lesion localization capability; (2)~a Full-Scale Decoder that globally models multi-modal features across various scales, capturing complementary information between scales to accurately outline lesion boundaries. Addressing the lack of suitable datasets for MIRS, we constructed a vision-language medical dataset called Reference Hepatic Lesion Segmentation (RefHL-Seg). This dataset comprises 2,283 abdominal CT slices from 231 cases, with corresponding textual annotations and segmentation masks for various liver lesions in images. We validated the performance of LSMS for MIRS and conventional medical image segmentation tasks across various datasets. Our LSMS consistently outperforms on all datasets with lower computational costs. The code and datasets will be released.

BodySLAM: A Generalized Monocular Visual SLAM Framework for Surgical Applications

Endoscopic surgery relies on two-dimensional views, posing challenges for surgeons in depth perception and instrument manipulation. While Monocular Visual Simultaneous Localization and Mapping (MVSLAM) has emerged as a promising solution, its implementation in endoscopic procedures faces significant challenges due to hardware limitations, such as the use of a monocular camera and the absence of odometry sensors. This study presents BodySLAM, a robust deep learning-based MVSLAM approach that addresses these challenges through three key components: CycleVO, a novel unsupervised monocular pose estimation module; the integration of the state-of-the-art Zoe architecture for monocular depth estimation; and a 3D reconstruction module creating a coherent surgical map. The approach is rigorously evaluated using three publicly available datasets (Hamlyn, EndoSLAM, and SCARED) spanning laparoscopy, gastroscopy, and colonoscopy scenarios, and benchmarked against four state-of-the-art methods. Results demonstrate that CycleVO exhibited competitive performance with the lowest inference time among pose estimation methods, while maintaining robust generalization capabilities, whereas Zoe significantly outperformed existing algorithms for depth estimation in endoscopy. BodySLAM's strong performance across diverse endoscopic scenarios demonstrates its potential as a viable MVSLAM solution for endoscopic applications.

Medical Image Classification with KAN-Integrated Transformers and Dilated Neighborhood Attention

Convolutional networks, transformers, hybrid models, and Mamba-based architectures have demonstrated strong performance across various medical image classification tasks. However, these methods were primarily designed to classify clean images using labeled data. In contrast, real-world clinical data often involve image corruptions that are unique to multi-center studies and stem from variations in imaging equipment across manufacturers. In this paper, we introduce the Medical Vision Transformer (MedViTV2), a novel architecture incorporating Kolmogorov-Arnold Network (KAN) layers into the transformer architecture for the first time, aiming for generalized medical image classification. We have developed an efficient KAN block to reduce computational load while enhancing the accuracy of the original MedViT. Additionally, to counteract the fragility of our MedViT when scaled up, we propose an enhanced Dilated Neighborhood Attention (DiNA), an adaptation of the efficient fused dot-product attention kernel capable of capturing global context and expanding receptive fields to scale the model effectively and addressing feature collapse issues. Moreover, a hierarchical hybrid strategy is introduced to stack our Local Feature Perception and Global Feature Perception blocks in an efficient manner, which balances local and global feature perceptions to boost performance. Extensive experiments on 17 medical image classification datasets and 12 corrupted medical image datasets demonstrate that MedViTV2 achieved state-of-the-art results in 27 out of 29 experiments with reduced computational complexity. MedViTV2 is 44\% more computationally efficient than the previous version and significantly enhances accuracy, achieving improvements of 4.6\% on MedMNIST, 5.8\% on NonMNIST, and 13.4\% on the MedMNIST-C benchmark.

Intensive Vision-guided Network for Radiology Report Generation

Automatic radiology report generation is booming due to its huge application potential for the healthcare industry. However, existing computer vision and natural language processing approaches to tackle this problem are limited in two aspects. First, when extracting image features, most of them neglect multi-view reasoning in vision and model single-view structure of medical images, such as space-view or channel-view. However, clinicians rely on multi-view imaging information for comprehensive judgment in daily clinical diagnosis. Second, when generating reports, they overlook context reasoning with multi-modal information and focus on pure textual optimization utilizing retrieval-based methods. We aim to address these two issues by proposing a model that better simulates clinicians' perspectives and generates more accurate reports. Given the above limitation in feature extraction, we propose a Globally-intensive Attention (GIA) module in the medical image encoder to simulate and integrate multi-view vision perception. GIA aims to learn three types of vision perception: depth view, space view, and pixel view. On the other hand, to address the above problem in report generation, we explore how to involve multi-modal signals to generate precisely matched reports, i.e., how to integrate previously predicted words with region-aware visual content in next word prediction. Specifically, we design a Visual Knowledge-guided Decoder (VKGD), which can adaptively consider how much the model needs to rely on visual information and previously predicted text to assist next word prediction. Hence, our final Intensive Vision-guided Network (IVGN) framework includes a GIA-guided Visual Encoder and the VKGD. Experiments on two commonly-used datasets IU X-Ray and MIMIC-CXR demonstrate the superior ability of our method compared with other state-of-the-art approaches.

A Quantitative Evaluation of Dense 3D Reconstruction of Sinus Anatomy from Monocular Endoscopic Video

Generating accurate 3D reconstructions from endoscopic video is a promising avenue for longitudinal radiation-free analysis of sinus anatomy and surgical outcomes. Several methods for monocular reconstruction have been proposed, yielding visually pleasant 3D anatomical structures by retrieving relative camera poses with structure-from-motion-type algorithms and fusion of monocular depth estimates. However, due to the complex properties of the underlying algorithms and endoscopic scenes, the reconstruction pipeline may perform poorly or fail unexpectedly. Further, acquiring medical data conveys additional challenges, presenting difficulties in quantitatively benchmarking these models, understanding failure cases, and identifying critical components that contribute to their precision. In this work, we perform a quantitative analysis of a self-supervised approach for sinus reconstruction using endoscopic sequences paired with optical tracking and high-resolution computed tomography acquired from nine ex-vivo specimens. Our results show that the generated reconstructions are in high agreement with the anatomy, yielding an average point-to-mesh error of 0.91 mm between reconstructions and CT segmentations. However, in a point-to-point matching scenario, relevant for endoscope tracking and navigation, we found average target registration errors of 6.58 mm. We identified that pose and depth estimation inaccuracies contribute equally to this error and that locally consistent sequences with shorter trajectories generate more accurate reconstructions. These results suggest that achieving global consistency between relative camera poses and estimated depths with the anatomy is essential. In doing so, we can ensure proper synergy between all components of the pipeline for improved reconstructions that will facilitate clinical application of this innovative technology.

Generative Medical Segmentation

Rapid advancements in medical image segmentation performance have been significantly driven by the development of Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs). These models follow the discriminative pixel-wise classification learning paradigm and often have limited ability to generalize across diverse medical imaging datasets. In this manuscript, we introduce Generative Medical Segmentation (GMS), a novel approach leveraging a generative model to perform image segmentation. Concretely, GMS employs a robust pre-trained vision foundation model to extract latent representations for images and corresponding ground truth masks, followed by a model that learns a mapping function from the image to the mask in the latent space. Once trained, the model generates an estimated segmentation mask using the pre-trained vision foundation model to decode the predicted latent representation back into the image space. The design of GMS leads to fewer trainable parameters in the model which reduces the risk of overfitting and enhances its generalization capability. Our experimental analysis across five public datasets in different medical imaging domains demonstrates GMS outperforms existing discriminative and generative segmentation models. Furthermore, GMS is able to generalize well across datasets from different centers within the same imaging modality. Our experiments suggest GMS offers a scalable and effective solution for medical image segmentation. GMS implementation and trained model weights are available at https://github.com/King-HAW/GMS.

Breast Cancer Detection and Diagnosis: A comparative study of state-of-the-arts deep learning architectures

Breast cancer is a prevalent form of cancer among women, with over 1.5 million women being diagnosed each year. Unfortunately, the survival rates for breast cancer patients in certain third-world countries, like South Africa, are alarmingly low, with only 40% of diagnosed patients surviving beyond five years. The inadequate availability of resources, including qualified pathologists, delayed diagnoses, and ineffective therapy planning, contribute to this low survival rate. To address this pressing issue, medical specialists and researchers have turned to domain-specific AI approaches, specifically deep learning models, to develop end-to-end solutions that can be integrated into computer-aided diagnosis (CAD) systems. By improving the workflow of pathologists, these AI models have the potential to enhance the detection and diagnosis of breast cancer. This research focuses on evaluating the performance of various cutting-edge convolutional neural network (CNN) architectures in comparison to a relatively new model called the Vision Trans-former (ViT). The objective is to determine the superiority of these models in terms of their accuracy and effectiveness. The experimental results reveal that the ViT models outperform the other selected state-of-the-art CNN architectures, achieving an impressive accuracy rate of 95.15%. This study signifies a significant advancement in the field, as it explores the utilization of data augmentation and other relevant preprocessing techniques in conjunction with deep learning models for the detection and diagnosis of breast cancer using datasets of Breast Cancer Histopathological Image Classification.

Classification of Brain Tumours in MR Images using Deep Spatiospatial Models

A brain tumour is a mass or cluster of abnormal cells in the brain, which has the possibility of becoming life-threatening because of its ability to invade neighbouring tissues and also form metastases. An accurate diagnosis is essential for successful treatment planning and magnetic resonance imaging is the principal imaging modality for diagnostic of brain tumours and their extent. Deep Learning methods in computer vision applications have shown significant improvement in recent years, most of which can be credited to the fact that a sizeable amount of data is available to train models on, and the improvements in the model architectures yielding better approximations in a supervised setting. Classifying tumours using such deep learning methods has made significant progress with the availability of open datasets with reliable annotations. Typically those methods are either 3D models, which use 3D volumetric MRIs or even 2D models considering each slice separately. However, by treating the slice spatial dimension separately, spatiotemporal models can be employed as spatiospatial models for this task. These models have the capabilities of learning specific spatial and temporal relationship, while reducing computational costs. This paper uses two spatiotemporal models, ResNet (2+1)D and ResNet Mixed Convolution, to classify different types of brain tumours. It was observed that both these models performed superior to the pure 3D convolutional model, ResNet18. Furthermore, it was also observed that pre-training the models on a different, even unrelated dataset before training them for the task of tumour classification improves the performance. Finally, Pre-trained ResNet Mixed Convolution was observed to be the best model in these experiments, achieving a macro F1-score of 0.93 and a test accuracy of 96.98\%, while at the same time being the model with the least computational cost.

A ResNet is All You Need? Modeling A Strong Baseline for Detecting Referable Diabetic Retinopathy in Fundus Images

Deep learning is currently the state-of-the-art for automated detection of referable diabetic retinopathy (DR) from color fundus photographs (CFP). While the general interest is put on improving results through methodological innovations, it is not clear how good these approaches perform compared to standard deep classification models trained with the appropriate settings. In this paper we propose to model a strong baseline for this task based on a simple and standard ResNet-18 architecture. To this end, we built on top of prior art by training the model with a standard preprocessing strategy but using images from several public sources and an empirically calibrated data augmentation setting. To evaluate its performance, we covered multiple clinically relevant perspectives, including image and patient level DR screening, discriminating responses by input quality and DR grade, assessing model uncertainties and analyzing its results in a qualitative manner. With no other methodological innovation than a carefully designed training, our ResNet model achieved an AUC = 0.955 (0.953 - 0.956) on a combined test set of 61007 test images from different public datasets, which is in line or even better than what other more complex deep learning models reported in the literature. Similar AUC values were obtained in 480 images from two separate in-house databases specially prepared for this study, which emphasize its generalization ability. This confirms that standard networks can still be strong baselines for this task if properly trained.

Align, Reason and Learn: Enhancing Medical Vision-and-Language Pre-training with Knowledge

Medical vision-and-language pre-training (Med-VLP) has received considerable attention owing to its applicability to extracting generic vision-and-language representations from medical images and texts. Most existing methods mainly contain three elements: uni-modal encoders (i.e., a vision encoder and a language encoder), a multi-modal fusion module, and pretext tasks, with few studies considering the importance of medical domain expert knowledge and explicitly exploiting such knowledge to facilitate Med-VLP. Although there exist knowledge-enhanced vision-and-language pre-training (VLP) methods in the general domain, most require off-the-shelf toolkits (e.g., object detectors and scene graph parsers), which are unavailable in the medical domain. In this paper, we propose a systematic and effective approach to enhance Med-VLP by structured medical knowledge from three perspectives. First, considering knowledge can be regarded as the intermediate medium between vision and language, we align the representations of the vision encoder and the language encoder through knowledge. Second, we inject knowledge into the multi-modal fusion model to enable the model to perform reasoning using knowledge as the supplementation of the input image and text. Third, we guide the model to put emphasis on the most critical information in images and texts by designing knowledge-induced pretext tasks. To perform a comprehensive evaluation and facilitate further research, we construct a medical vision-and-language benchmark including three tasks. Experimental results illustrate the effectiveness of our approach, where state-of-the-art performance is achieved on all downstream tasks. Further analyses explore the effects of different components of our approach and various settings of pre-training.

DCT-HistoTransformer: Efficient Lightweight Vision Transformer with DCT Integration for histopathological image analysis

In recent years, the integration of advanced imaging techniques and deep learning methods has significantly advanced computer-aided diagnosis (CAD) systems for breast cancer detection and classification. Transformers, which have shown great promise in computer vision, are now being applied to medical image analysis. However, their application to histopathological images presents challenges due to the need for extensive manual annotations of whole-slide images (WSIs), as these models require large amounts of data to work effectively, which is costly and time-consuming. Furthermore, the quadratic computational cost of Vision Transformers (ViTs) is particularly prohibitive for large, high-resolution histopathological images, especially on edge devices with limited computational resources. In this study, we introduce a novel lightweight breast cancer classification approach using transformers that operates effectively without large datasets. By incorporating parallel processing pathways for Discrete Cosine Transform (DCT) Attention and MobileConv, we convert image data from the spatial domain to the frequency domain to utilize the benefits such as filtering out high frequencies in the image, which reduces computational cost. This demonstrates the potential of our approach to improve breast cancer classification in histopathological images, offering a more efficient solution with reduced reliance on extensive annotated datasets. Our proposed model achieves an accuracy of 96.00% pm 0.48% for binary classification and 87.85% pm 0.93% for multiclass classification, which is comparable to state-of-the-art models while significantly reducing computational costs. This demonstrates the potential of our approach to improve breast cancer classification in histopathological images, offering a more efficient solution with reduced reliance on extensive annotated datasets.

3D Medical Image Segmentation based on multi-scale MPU-Net

The high cure rate of cancer is inextricably linked to physicians' accuracy in diagnosis and treatment, therefore a model that can accomplish high-precision tumor segmentation has become a necessity in many applications of the medical industry. It can effectively lower the rate of misdiagnosis while considerably lessening the burden on clinicians. However, fully automated target organ segmentation is problematic due to the irregular stereo structure of 3D volume organs. As a basic model for this class of real applications, U-Net excels. It can learn certain global and local features, but still lacks the capacity to grasp spatial long-range relationships and contextual information at multiple scales. This paper proposes a tumor segmentation model MPU-Net for patient volume CT images, which is inspired by Transformer with a global attention mechanism. By combining image serialization with the Position Attention Module, the model attempts to comprehend deeper contextual dependencies and accomplish precise positioning. Each layer of the decoder is also equipped with a multi-scale module and a cross-attention mechanism. The capability of feature extraction and integration at different levels has been enhanced, and the hybrid loss function developed in this study can better exploit high-resolution characteristic information. Moreover, the suggested architecture is tested and evaluated on the Liver Tumor Segmentation Challenge 2017 (LiTS 2017) dataset. Compared with the benchmark model U-Net, MPU-Net shows excellent segmentation results. The dice, accuracy, precision, specificity, IOU, and MCC metrics for the best model segmentation results are 92.17%, 99.08%, 91.91%, 99.52%, 85.91%, and 91.74%, respectively. Outstanding indicators in various aspects illustrate the exceptional performance of this framework in automatic medical image segmentation.

LVM-Med: Learning Large-Scale Self-Supervised Vision Models for Medical Imaging via Second-order Graph Matching

Obtaining large pre-trained models that can be fine-tuned to new tasks with limited annotated samples has remained an open challenge for medical imaging data. While pre-trained deep networks on ImageNet and vision-language foundation models trained on web-scale data are prevailing approaches, their effectiveness on medical tasks is limited due to the significant domain shift between natural and medical images. To bridge this gap, we introduce LVM-Med, the first family of deep networks trained on large-scale medical datasets. We have collected approximately 1.3 million medical images from 55 publicly available datasets, covering a large number of organs and modalities such as CT, MRI, X-ray, and Ultrasound. We benchmark several state-of-the-art self-supervised algorithms on this dataset and propose a novel self-supervised contrastive learning algorithm using a graph-matching formulation. The proposed approach makes three contributions: (i) it integrates prior pair-wise image similarity metrics based on local and global information; (ii) it captures the structural constraints of feature embeddings through a loss function constructed via a combinatorial graph-matching objective; and (iii) it can be trained efficiently end-to-end using modern gradient-estimation techniques for black-box solvers. We thoroughly evaluate the proposed LVM-Med on 15 downstream medical tasks ranging from segmentation and classification to object detection, and both for the in and out-of-distribution settings. LVM-Med empirically outperforms a number of state-of-the-art supervised, self-supervised, and foundation models. For challenging tasks such as Brain Tumor Classification or Diabetic Retinopathy Grading, LVM-Med improves previous vision-language models trained on 1 billion masks by 6-7% while using only a ResNet-50.

MetaFood3D: Large 3D Food Object Dataset with Nutrition Values

Food computing is both important and challenging in computer vision (CV). It significantly contributes to the development of CV algorithms due to its frequent presence in datasets across various applications, ranging from classification and instance segmentation to 3D reconstruction. The polymorphic shapes and textures of food, coupled with high variation in forms and vast multimodal information, including language descriptions and nutritional data, make food computing a complex and demanding task for modern CV algorithms. 3D food modeling is a new frontier for addressing food-related problems, due to its inherent capability to deal with random camera views and its straightforward representation for calculating food portion size. However, the primary hurdle in the development of algorithms for food object analysis is the lack of nutrition values in existing 3D datasets. Moreover, in the broader field of 3D research, there is a critical need for domain-specific test datasets. To bridge the gap between general 3D vision and food computing research, we propose MetaFood3D. This dataset consists of 637 meticulously labeled 3D food objects across 108 categories, featuring detailed nutrition information, weight, and food codes linked to a comprehensive nutrition database. The dataset emphasizes intra-class diversity and includes rich modalities such as textured mesh files, RGB-D videos, and segmentation masks. Experimental results demonstrate our dataset's significant potential for improving algorithm performance, highlight the challenging gap between video captures and 3D scanned data, and show the strength of the MetaFood3D dataset in high-quality data generation, simulation, and augmentation.

Visual Instruction Tuning towards General-Purpose Multimodal Model: A Survey

Traditional computer vision generally solves each single task independently by a dedicated model with the task instruction implicitly designed in the model architecture, arising two limitations: (1) it leads to task-specific models, which require multiple models for different tasks and restrict the potential synergies from diverse tasks; (2) it leads to a pre-defined and fixed model interface that has limited interactivity and adaptability in following user' task instructions. To address them, Visual Instruction Tuning (VIT) has been intensively studied recently, which finetunes a large vision model with language as task instructions, aiming to learn from a wide range of vision tasks described by language instructions a general-purpose multimodal model that can follow arbitrary instructions and thus solve arbitrary tasks specified by the user. This work aims to provide a systematic review of visual instruction tuning, covering (1) the background that presents computer vision task paradigms and the development of VIT; (2) the foundations of VIT that introduce commonly used network architectures, visual instruction tuning frameworks and objectives, and evaluation setups and tasks; (3) the commonly used datasets in visual instruction tuning and evaluation; (4) the review of existing VIT methods that categorizes them with a taxonomy according to both the studied vision task and the method design and highlights the major contributions, strengths, and shortcomings of them; (5) the comparison and discussion of VIT methods over various instruction-following benchmarks; (6) several challenges, open directions and possible future works in visual instruction tuning research.

Cross-Shaped Windows Transformer with Self-supervised Pretraining for Clinically Significant Prostate Cancer Detection in Bi-parametric MRI

Multiparametric magnetic resonance imaging (mpMRI) has demonstrated promising results in prostate cancer (PCa) detection using deep convolutional neural networks (CNNs). Recently, transformers have achieved competitive performance compared to CNNs in computer vision. Large-scale transformers need abundant annotated data for training, which are difficult to obtain in medical imaging. Self-supervised learning can effectively leverage unlabeled data to extract useful semantic representations without annotation and its associated costs. This can improve model performance on downstream tasks with limited labelled data and increase generalizability. We introduce a novel end-to-end Cross-Shaped windows (CSwin) transformer UNet model, CSwin UNet, to detect clinically significant prostate cancer (csPCa) in prostate bi-parametric MR imaging (bpMRI) and demonstrate the effectiveness of our proposed self-supervised pre-training framework. Using a large prostate bpMRI dataset with 1500 patients, we first pre-train CSwin transformer using multi-task self-supervised learning to improve data-efficiency and network generalizability. We then finetuned using lesion annotations to perform csPCa detection. Five-fold cross validation shows that self-supervised CSwin UNet achieves 0.888 AUC and 0.545 Average Precision (AP), significantly outperforming four state-of-the-art models (Swin UNETR, DynUNet, Attention UNet, UNet). Using a separate bpMRI dataset with 158 patients, we evaluated our model robustness to external hold-out data. Self-supervised CSwin UNet achieves 0.79 AUC and 0.45 AP, still outperforming all other comparable methods and demonstrating generalization to a dataset shift.

MulModSeg: Enhancing Unpaired Multi-Modal Medical Image Segmentation with Modality-Conditioned Text Embedding and Alternating Training

In the diverse field of medical imaging, automatic segmentation has numerous applications and must handle a wide variety of input domains, such as different types of Computed Tomography (CT) scans and Magnetic Resonance (MR) images. This heterogeneity challenges automatic segmentation algorithms to maintain consistent performance across different modalities due to the requirement for spatially aligned and paired images. Typically, segmentation models are trained using a single modality, which limits their ability to generalize to other types of input data without employing transfer learning techniques. Additionally, leveraging complementary information from different modalities to enhance segmentation precision often necessitates substantial modifications to popular encoder-decoder designs, such as introducing multiple branched encoding or decoding paths for each modality. In this work, we propose a simple Multi-Modal Segmentation (MulModSeg) strategy to enhance medical image segmentation across multiple modalities, specifically CT and MR. It incorporates two key designs: a modality-conditioned text embedding framework via a frozen text encoder that adds modality awareness to existing segmentation frameworks without significant structural modifications or computational overhead, and an alternating training procedure that facilitates the integration of essential features from unpaired CT and MR inputs. Through extensive experiments with both Fully Convolutional Network and Transformer-based backbones, MulModSeg consistently outperforms previous methods in segmenting abdominal multi-organ and cardiac substructures for both CT and MR modalities. The code is available in this {https://github.com/ChengyinLee/MulModSeg_2024{link}}.

Towards a Single Unified Model for Effective Detection, Segmentation, and Diagnosis of Eight Major Cancers Using a Large Collection of CT Scans

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 (UniT) model to detect (tumor existence and location) and diagnose (tumor characteristics) eight major cancer-prevalent organs in CT scans. UniT is a query-based Mask Transformer model with the output of multi-organ and multi-tumor semantic segmentation. We decouple the object queries into organ queries, detection queries and 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. UniT 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, UniT has demonstrated strong performance under a set of clinically relevant evaluation metrics, substantially outperforming both multi-organ segmentation methods and an assembly of eight single-organ expert models in tumor detection, segmentation, and diagnosis. Such a unified multi-cancer image reading model (UniT) can significantly reduce the number of false positives produced by combined multi-system models. This moves one step closer towards a universal high-performance cancer screening tool.

Enhancing Abnormality Grounding for Vision Language Models with Knowledge Descriptions

Visual Language Models (VLMs) have demonstrated impressive capabilities in visual grounding tasks. However, their effectiveness in the medical domain, particularly for abnormality detection and localization within medical images, remains underexplored. A major challenge is the complex and abstract nature of medical terminology, which makes it difficult to directly associate pathological anomaly terms with their corresponding visual features. In this work, we introduce a novel approach to enhance VLM performance in medical abnormality detection and localization by leveraging decomposed medical knowledge. Instead of directly prompting models to recognize specific abnormalities, we focus on breaking down medical concepts into fundamental attributes and common visual patterns. This strategy promotes a stronger alignment between textual descriptions and visual features, improving both the recognition and localization of abnormalities in medical images.We evaluate our method on the 0.23B Florence-2 base model and demonstrate that it achieves comparable performance in abnormality grounding to significantly larger 7B LLaVA-based medical VLMs, despite being trained on only 1.5% of the data used for such models. Experimental results also demonstrate the effectiveness of our approach in both known and previously unseen abnormalities, suggesting its strong generalization capabilities.

UniMed-CLIP: Towards a Unified Image-Text Pretraining Paradigm for Diverse Medical Imaging Modalities

Vision-Language Models (VLMs) trained via contrastive learning have achieved notable success in natural image tasks. However, their application in the medical domain remains limited due to the scarcity of openly accessible, large-scale medical image-text datasets. Existing medical VLMs either train on closed-source proprietary or relatively small open-source datasets that do not generalize well. Similarly, most models remain specific to a single or limited number of medical imaging domains, again restricting their applicability to other modalities. To address this gap, we introduce UniMed, a large-scale, open-source multi-modal medical dataset comprising over 5.3 million image-text pairs across six diverse imaging modalities: X-ray, CT, MRI, Ultrasound, Pathology, and Fundus. UniMed is developed using a data-collection framework that leverages Large Language Models (LLMs) to transform modality-specific classification datasets into image-text formats while incorporating existing image-text data from the medical domain, facilitating scalable VLM pretraining. Using UniMed, we trained UniMed-CLIP, a unified VLM for six modalities that significantly outperforms existing generalist VLMs and matches modality-specific medical VLMs, achieving notable gains in zero-shot evaluations. For instance, UniMed-CLIP improves over BiomedCLIP (trained on proprietary data) by an absolute gain of +12.61, averaged over 21 datasets, while using 3x less training data. To facilitate future research, we release UniMed dataset, training codes, and models at https://github.com/mbzuai-oryx/UniMed-CLIP.

SAM-UNet:Enhancing Zero-Shot Segmentation of SAM for Universal Medical Images

Segment Anything Model (SAM) has demonstrated impressive performance on a wide range of natural image segmentation tasks. However, its performance significantly deteriorates when directly applied to medical domain, due to the remarkable differences between natural images and medical images. Some researchers have attempted to train SAM on large scale medical datasets. However, poor zero-shot performance is observed from the experimental results. In this context, inspired by the superior performance of U-Net-like models in medical image segmentation, we propose SAMUNet, a new foundation model which incorporates U-Net to the original SAM, to fully leverage the powerful contextual modeling ability of convolutions. To be specific, we parallel a convolutional branch in the image encoder, which is trained independently with the vision Transformer branch frozen. Additionally, we employ multi-scale fusion in the mask decoder, to facilitate accurate segmentation of objects with different scales. We train SAM-UNet on SA-Med2D-16M, the largest 2-dimensional medical image segmentation dataset to date, yielding a universal pretrained model for medical images. Extensive experiments are conducted to evaluate the performance of the model, and state-of-the-art result is achieved, with a dice similarity coefficient score of 0.883 on SA-Med2D-16M dataset. Specifically, in zero-shot segmentation experiments, our model not only significantly outperforms previous large medical SAM models across all modalities, but also substantially mitigates the performance degradation seen on unseen modalities. It should be highlighted that SAM-UNet is an efficient and extensible foundation model, which can be further fine-tuned for other downstream tasks in medical community. The code is available at https://github.com/Hhankyangg/sam-unet.

Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images

Semantic segmentation of brain tumors is a fundamental medical image analysis task involving multiple MRI imaging modalities that can assist clinicians in diagnosing the patient and successively studying the progression of the malignant entity. In recent years, Fully Convolutional Neural Networks (FCNNs) approaches have become the de facto standard for 3D medical image segmentation. The popular "U-shaped" network architecture has achieved state-of-the-art performance benchmarks on different 2D and 3D semantic segmentation tasks and across various imaging modalities. However, due to the limited kernel size of convolution layers in FCNNs, their performance of modeling long-range information is sub-optimal, and this can lead to deficiencies in the segmentation of tumors with variable sizes. On the other hand, transformer models have demonstrated excellent capabilities in capturing such long-range information in multiple domains, including natural language processing and computer vision. Inspired by the success of vision transformers and their variants, we propose a novel segmentation model termed Swin UNEt TRansformers (Swin UNETR). Specifically, the task of 3D brain tumor semantic segmentation is reformulated as a sequence to sequence prediction problem wherein multi-modal input data is projected into a 1D sequence of embedding and used as an input to a hierarchical Swin transformer as the encoder. The swin transformer encoder extracts features at five different resolutions by utilizing shifted windows for computing self-attention and is connected to an FCNN-based decoder at each resolution via skip connections. We have participated in BraTS 2021 segmentation challenge, and our proposed model ranks among the top-performing approaches in the validation phase. Code: https://monai.io/research/swin-unetr

CC-SAM: SAM with Cross-feature Attention and Context for Ultrasound Image Segmentation

The Segment Anything Model (SAM) has achieved remarkable successes in the realm of natural image segmentation, but its deployment in the medical imaging sphere has encountered challenges. Specifically, the model struggles with medical images that feature low contrast, faint boundaries, intricate morphologies, and small-sized objects. To address these challenges and enhance SAM's performance in the medical domain, we introduce a comprehensive modification. Firstly, we incorporate a frozen Convolutional Neural Network (CNN) branch as an image encoder, which synergizes with SAM's original Vision Transformer (ViT) encoder through a novel variational attention fusion module. This integration bolsters the model's capability to capture local spatial information, which is often paramount in medical imagery. Moreover, to further optimize SAM for medical imaging, we introduce feature and position adapters within the ViT branch, refining the encoder's representations. We see that compared to current prompting strategies to fine-tune SAM for ultrasound medical segmentation, the use of text descriptions that serve as text prompts for SAM helps significantly improve the performance. Leveraging ChatGPT's natural language understanding capabilities, we generate prompts that offer contextual information and guidance to SAM, enabling it to better understand the nuances of ultrasound medical images and improve its segmentation accuracy. Our method, in its entirety, represents a significant stride towards making universal image segmentation models more adaptable and efficient in the medical domain.

Preference Fine-Tuning for Factuality in Chest X-Ray Interpretation Models Without Human Feedback

Radiologists play a crucial role by translating medical images into medical reports. However, the field faces staffing shortages and increasing workloads. While automated approaches using vision-language models (VLMs) show promise as assistants, they require exceptionally high accuracy. Most current VLMs in radiology rely solely on supervised fine-tuning (SFT). Meanwhile, in the general domain, additional preference fine-tuning has become standard practice. The challenge in radiology lies in the prohibitive cost of obtaining radiologist feedback. We propose a scalable automated preference alignment technique for VLMs in radiology, focusing on chest X-ray (CXR) report generation. Our method leverages publicly available datasets with an LLM-as-a-Judge mechanism, eliminating the need for additional expert radiologist feedback. We evaluate and benchmark five direct alignment algorithms (DAAs). Our results show up to a 57.4% improvement in average GREEN scores, a LLM-based metric for evaluating CXR reports, and a 9.2% increase in an average across six metrics (domain specific and general), compared to the SFT baseline. We study reward overoptimization via length exploitation, with reports lengthening by up to 3.2x. To assess a potential alignment tax, we benchmark on six additional diverse tasks, finding no significant degradations. A reader study involving four board-certified radiologists indicates win rates of up to 0.62 over the SFT baseline, while significantly penalizing verbosity. Our analysis provides actionable insights for the development of VLMs in high-stakes fields like radiology.

A Comprehensive Survey of Mamba Architectures for Medical Image Analysis: Classification, Segmentation, Restoration and Beyond

Mamba, a special case of the State Space Model, is gaining popularity as an alternative to template-based deep learning approaches in medical image analysis. While transformers are powerful architectures, they have drawbacks, including quadratic computational complexity and an inability to address long-range dependencies efficiently. This limitation affects the analysis of large and complex datasets in medical imaging, where there are many spatial and temporal relationships. In contrast, Mamba offers benefits that make it well-suited for medical image analysis. It has linear time complexity, which is a significant improvement over transformers. Mamba processes longer sequences without attention mechanisms, enabling faster inference and requiring less memory. Mamba also demonstrates strong performance in merging multimodal data, improving diagnosis accuracy and patient outcomes. The organization of this paper allows readers to appreciate the capabilities of Mamba in medical imaging step by step. We begin by defining core concepts of SSMs and models, including S4, S5, and S6, followed by an exploration of Mamba architectures such as pure Mamba, U-Net variants, and hybrid models with convolutional neural networks, transformers, and Graph Neural Networks. We also cover Mamba optimizations, techniques and adaptations, scanning, datasets, applications, experimental results, and conclude with its challenges and future directions in medical imaging. This review aims to demonstrate the transformative potential of Mamba in overcoming existing barriers within medical imaging while paving the way for innovative advancements in the field. A comprehensive list of Mamba architectures applied in the medical field, reviewed in this work, is available at Github.

BEHAVIOR Vision Suite: Customizable Dataset Generation via Simulation

The systematic evaluation and understanding of computer vision models under varying conditions require large amounts of data with comprehensive and customized labels, which real-world vision datasets rarely satisfy. While current synthetic data generators offer a promising alternative, particularly for embodied AI tasks, they often fall short for computer vision tasks due to low asset and rendering quality, limited diversity, and unrealistic physical properties. We introduce the BEHAVIOR Vision Suite (BVS), a set of tools and assets to generate fully customized synthetic data for systematic evaluation of computer vision models, based on the newly developed embodied AI benchmark, BEHAVIOR-1K. BVS supports a large number of adjustable parameters at the scene level (e.g., lighting, object placement), the object level (e.g., joint configuration, attributes such as "filled" and "folded"), and the camera level (e.g., field of view, focal length). Researchers can arbitrarily vary these parameters during data generation to perform controlled experiments. We showcase three example application scenarios: systematically evaluating the robustness of models across different continuous axes of domain shift, evaluating scene understanding models on the same set of images, and training and evaluating simulation-to-real transfer for a novel vision task: unary and binary state prediction. Project website: https://behavior-vision-suite.github.io/

CACTUS: An Open Dataset and Framework for Automated Cardiac Assessment and Classification of Ultrasound Images Using Deep Transfer Learning

Cardiac ultrasound (US) scanning is a commonly used techniques in cardiology to diagnose the health of the heart and its proper functioning. Therefore, it is necessary to consider ways to automate these tasks and assist medical professionals in classifying and assessing cardiac US images. Machine learning (ML) techniques are regarded as a prominent solution due to their success in numerous applications aimed at enhancing the medical field, including addressing the shortage of echography technicians. However, the limited availability of medical data presents a significant barrier to applying ML in cardiology, particularly regarding US images of the heart. This paper addresses this challenge by introducing the first open graded dataset for Cardiac Assessment and ClassificaTion of UltraSound (CACTUS), which is available online. This dataset contains images obtained from scanning a CAE Blue Phantom and representing various heart views and different quality levels, exceeding the conventional cardiac views typically found in the literature. Additionally, the paper introduces a Deep Learning (DL) framework consisting of two main components. The first component classifies cardiac US images based on the heart view using a Convolutional Neural Network (CNN). The second component uses Transfer Learning (TL) to fine-tune the knowledge from the first component and create a model for grading and assessing cardiac images. The framework demonstrates high performance in both classification and grading, achieving up to 99.43% accuracy and as low as 0.3067 error, respectively. To showcase its robustness, the framework is further fine-tuned using new images representing additional cardiac views and compared to several other state-of-the-art architectures. The framework's outcomes and performance in handling real-time scans were also assessed using a questionnaire answered by cardiac experts.

Multi-scale self-guided attention for medical image segmentation

Even though convolutional neural networks (CNNs) are driving progress in medical image segmentation, standard models still have some drawbacks. First, the use of multi-scale approaches, i.e., encoder-decoder architectures, leads to a redundant use of information, where similar low-level features are extracted multiple times at multiple scales. Second, long-range feature dependencies are not efficiently modeled, resulting in non-optimal discriminative feature representations associated with each semantic class. In this paper we attempt to overcome these limitations with the proposed architecture, by capturing richer contextual dependencies based on the use of guided self-attention mechanisms. This approach is able to integrate local features with their corresponding global dependencies, as well as highlight interdependent channel maps in an adaptive manner. Further, the additional loss between different modules guides the attention mechanisms to neglect irrelevant information and focus on more discriminant regions of the image by emphasizing relevant feature associations. We evaluate the proposed model in the context of semantic segmentation on three different datasets: abdominal organs, cardiovascular structures and brain tumors. A series of ablation experiments support the importance of these attention modules in the proposed architecture. In addition, compared to other state-of-the-art segmentation networks our model yields better segmentation performance, increasing the accuracy of the predictions while reducing the standard deviation. This demonstrates the efficiency of our approach to generate precise and reliable automatic segmentations of medical images. Our code is made publicly available at https://github.com/sinAshish/Multi-Scale-Attention

Preserving Tumor Volumes for Unsupervised Medical Image Registration

Medical image registration is a critical task that estimates the spatial correspondence between pairs of images. However, current traditional and deep-learning-based methods rely on similarity measures to generate a deforming field, which often results in disproportionate volume changes in dissimilar regions, especially in tumor regions. These changes can significantly alter the tumor size and underlying anatomy, which limits the practical use of image registration in clinical diagnosis. To address this issue, we have formulated image registration with tumors as a constraint problem that preserves tumor volumes while maximizing image similarity in other normal regions. Our proposed strategy involves a two-stage process. In the first stage, we use similarity-based registration to identify potential tumor regions by their volume change, generating a soft tumor mask accordingly. In the second stage, we propose a volume-preserving registration with a novel adaptive volume-preserving loss that penalizes the change in size adaptively based on the masks calculated from the previous stage. Our approach balances image similarity and volume preservation in different regions, i.e., normal and tumor regions, by using soft tumor masks to adjust the imposition of volume-preserving loss on each one. This ensures that the tumor volume is preserved during the registration process. We have evaluated our strategy on various datasets and network architectures, demonstrating that our method successfully preserves the tumor volume while achieving comparable registration results with state-of-the-art methods. Our codes is available at: https://dddraxxx.github.io/Volume-Preserving-Registration/.

UnifiedVisionGPT: Streamlining Vision-Oriented AI through Generalized Multimodal Framework

In the current landscape of artificial intelligence, foundation models serve as the bedrock for advancements in both language and vision domains. OpenAI GPT-4 has emerged as the pinnacle in large language models (LLMs), while the computer vision (CV) domain boasts a plethora of state-of-the-art (SOTA) models such as Meta's SAM and DINO, and YOLOS. However, the financial and computational burdens of training new models from scratch remain a significant barrier to progress. In response to this challenge, we introduce UnifiedVisionGPT, a novel framework designed to consolidate and automate the integration of SOTA vision models, thereby facilitating the development of vision-oriented AI. UnifiedVisionGPT distinguishes itself through four key features: (1) provides a versatile multimodal framework adaptable to a wide range of applications, building upon the strengths of multimodal foundation models; (2) seamlessly integrates various SOTA vision models to create a comprehensive multimodal platform, capitalizing on the best components of each model; (3) prioritizes vision-oriented AI, ensuring a more rapid progression in the CV domain compared to the current trajectory of LLMs; and (4) introduces automation in the selection of SOTA vision models, generating optimal results based on diverse multimodal inputs such as text prompts and images. This paper outlines the architecture and capabilities of UnifiedVisionGPT, demonstrating its potential to revolutionize the field of computer vision through enhanced efficiency, versatility, generalization, and performance. Our implementation, along with the unified multimodal framework and comprehensive dataset, is made publicly available at https://github.com/LHBuilder/SA-Segment-Anything.

ConceptCLIP: Towards Trustworthy Medical AI via Concept-Enhanced Contrastive Langauge-Image Pre-training

Trustworthiness is essential for the precise and interpretable application of artificial intelligence (AI) in medical imaging. Traditionally, precision and interpretability have been addressed as separate tasks, namely medical image analysis and explainable AI, each developing its own models independently. In this study, for the first time, we investigate the development of a unified medical vision-language pre-training model that can achieve both accurate analysis and interpretable understanding of medical images across various modalities. To build the model, we construct MedConcept-23M, a large-scale dataset comprising 23 million medical image-text pairs extracted from 6.2 million scientific articles, enriched with concepts from the Unified Medical Language System (UMLS). Based on MedConcept-23M, we introduce ConceptCLIP, a medical AI model utilizing concept-enhanced contrastive language-image pre-training. The pre-training of ConceptCLIP involves two primary components: image-text alignment learning (IT-Align) and patch-concept alignment learning (PC-Align). This dual alignment strategy enhances the model's capability to associate specific image regions with relevant concepts, thereby improving both the precision of analysis and the interpretability of the AI system. We conducted extensive experiments on 5 diverse types of medical image analysis tasks, spanning 51 subtasks across 10 image modalities, with the broadest range of downstream tasks. The results demonstrate the effectiveness of the proposed vision-language pre-training model. Further explainability analysis across 6 modalities reveals that ConceptCLIP achieves superior performance, underscoring its robust ability to advance explainable AI in medical imaging. These findings highlight ConceptCLIP's capability in promoting trustworthy AI in the field of medicine.

Bora: Biomedical Generalist Video Generation Model

Generative models hold promise for revolutionizing medical education, robot-assisted surgery, and data augmentation for medical AI development. Diffusion models can now generate realistic images from text prompts, while recent advancements have demonstrated their ability to create diverse, high-quality videos. However, these models often struggle with generating accurate representations of medical procedures and detailed anatomical structures. This paper introduces Bora, the first spatio-temporal diffusion probabilistic model designed for text-guided biomedical video generation. Bora leverages Transformer architecture and is pre-trained on general-purpose video generation tasks. It is fine-tuned through model alignment and instruction tuning using a newly established medical video corpus, which includes paired text-video data from various biomedical fields. To the best of our knowledge, this is the first attempt to establish such a comprehensive annotated biomedical video dataset. Bora is capable of generating high-quality video data across four distinct biomedical domains, adhering to medical expert standards and demonstrating consistency and diversity. This generalist video generative model holds significant potential for enhancing medical consultation and decision-making, particularly in resource-limited settings. Additionally, Bora could pave the way for immersive medical training and procedure planning. Extensive experiments on distinct medical modalities such as endoscopy, ultrasound, MRI, and cell tracking validate the effectiveness of our model in understanding biomedical instructions and its superior performance across subjects compared to state-of-the-art generation models.

Modelling Human Visual Motion Processing with Trainable Motion Energy Sensing and a Self-attention Network

Visual motion processing is essential for humans to perceive and interact with dynamic environments. Despite extensive research in cognitive neuroscience, image-computable models that can extract informative motion flow from natural scenes in a manner consistent with human visual processing have yet to be established. Meanwhile, recent advancements in computer vision (CV), propelled by deep learning, have led to significant progress in optical flow estimation, a task closely related to motion perception. Here we propose an image-computable model of human motion perception by bridging the gap between biological and CV models. Specifically, we introduce a novel two-stages approach that combines trainable motion energy sensing with a recurrent self-attention network for adaptive motion integration and segregation. This model architecture aims to capture the computations in V1-MT, the core structure for motion perception in the biological visual system, while providing the ability to derive informative motion flow for a wide range of stimuli, including complex natural scenes. In silico neurophysiology reveals that our model's unit responses are similar to mammalian neural recordings regarding motion pooling and speed tuning. The proposed model can also replicate human responses to a range of stimuli examined in past psychophysical studies. The experimental results on the Sintel benchmark demonstrate that our model predicts human responses better than the ground truth, whereas the state-of-the-art CV models show the opposite. Our study provides a computational architecture consistent with human visual motion processing, although the physiological correspondence may not be exact.

Machine Learning Modeling for Multi-order Human Visual Motion Processing

Our research aims to develop machines that learn to perceive visual motion as do humans. While recent advances in computer vision (CV) have enabled DNN-based models to accurately estimate optical flow in naturalistic images, a significant disparity remains between CV models and the biological visual system in both architecture and behavior. This disparity includes humans' ability to perceive the motion of higher-order image features (second-order motion), which many CV models fail to capture because of their reliance on the intensity conservation law. Our model architecture mimics the cortical V1-MT motion processing pathway, utilizing a trainable motion energy sensor bank and a recurrent graph network. Supervised learning employing diverse naturalistic videos allows the model to replicate psychophysical and physiological findings about first-order (luminance-based) motion perception. For second-order motion, inspired by neuroscientific findings, the model includes an additional sensing pathway with nonlinear preprocessing before motion energy sensing, implemented using a simple multilayer 3D CNN block. When exploring how the brain acquired the ability to perceive second-order motion in natural environments, in which pure second-order signals are rare, we hypothesized that second-order mechanisms were critical when estimating robust object motion amidst optical fluctuations, such as highlights on glossy surfaces. We trained our dual-pathway model on novel motion datasets with varying material properties of moving objects. We found that training to estimate object motion from non-Lambertian materials naturally endowed the model with the capacity to perceive second-order motion, as can humans. The resulting model effectively aligns with biological systems while generalizing to both first- and second-order motion phenomena in natural scenes.

XNect: Real-time Multi-Person 3D Motion Capture with a Single RGB Camera

We present a real-time approach for multi-person 3D motion capture at over 30 fps using a single RGB camera. It operates successfully in generic scenes which may contain occlusions by objects and by other people. Our method operates in subsequent stages. The first stage is a convolutional neural network (CNN) that estimates 2D and 3D pose features along with identity assignments for all visible joints of all individuals.We contribute a new architecture for this CNN, called SelecSLS Net, that uses novel selective long and short range skip connections to improve the information flow allowing for a drastically faster network without compromising accuracy. In the second stage, a fully connected neural network turns the possibly partial (on account of occlusion) 2Dpose and 3Dpose features for each subject into a complete 3Dpose estimate per individual. The third stage applies space-time skeletal model fitting to the predicted 2D and 3D pose per subject to further reconcile the 2D and 3D pose, and enforce temporal coherence. Our method returns the full skeletal pose in joint angles for each subject. This is a further key distinction from previous work that do not produce joint angle results of a coherent skeleton in real time for multi-person scenes. The proposed system runs on consumer hardware at a previously unseen speed of more than 30 fps given 512x320 images as input while achieving state-of-the-art accuracy, which we will demonstrate on a range of challenging real-world scenes.

I-MedSAM: Implicit Medical Image Segmentation with Segment Anything

With the development of Deep Neural Networks (DNNs), many efforts have been made to handle medical image segmentation. Traditional methods such as nnUNet train specific segmentation models on the individual datasets. Plenty of recent methods have been proposed to adapt the foundational Segment Anything Model (SAM) to medical image segmentation. However, they still focus on discrete representations to generate pixel-wise predictions, which are spatially inflexible and scale poorly to higher resolution. In contrast, implicit methods learn continuous representations for segmentation, which is crucial for medical image segmentation. In this paper, we propose I-MedSAM, which leverages the benefits of both continuous representations and SAM, to obtain better cross-domain ability and accurate boundary delineation. Since medical image segmentation needs to predict detailed segmentation boundaries, we designed a novel adapter to enhance the SAM features with high-frequency information during Parameter-Efficient Fine-Tuning (PEFT). To convert the SAM features and coordinates into continuous segmentation output, we utilize Implicit Neural Representation (INR) to learn an implicit segmentation decoder. We also propose an uncertainty-guided sampling strategy for efficient learning of INR. Extensive evaluations on 2D medical image segmentation tasks have shown that our proposed method with only 1.6M trainable parameters outperforms existing methods including discrete and implicit methods. The code will be available at: https://github.com/ucwxb/I-MedSAM.

A skeletonization algorithm for gradient-based optimization

The skeleton of a digital image is a compact representation of its topology, geometry, and scale. It has utility in many computer vision applications, such as image description, segmentation, and registration. However, skeletonization has only seen limited use in contemporary deep learning solutions. Most existing skeletonization algorithms are not differentiable, making it impossible to integrate them with gradient-based optimization. Compatible algorithms based on morphological operations and neural networks have been proposed, but their results often deviate from the geometry and topology of the true medial axis. This work introduces the first three-dimensional skeletonization algorithm that is both compatible with gradient-based optimization and preserves an object's topology. Our method is exclusively based on matrix additions and multiplications, convolutional operations, basic non-linear functions, and sampling from a uniform probability distribution, allowing it to be easily implemented in any major deep learning library. In benchmarking experiments, we prove the advantages of our skeletonization algorithm compared to non-differentiable, morphological, and neural-network-based baselines. Finally, we demonstrate the utility of our algorithm by integrating it with two medical image processing applications that use gradient-based optimization: deep-learning-based blood vessel segmentation, and multimodal registration of the mandible in computed tomography and magnetic resonance images.

3DSAM-adapter: Holistic Adaptation of SAM from 2D to 3D for Promptable Medical Image Segmentation

Despite that the segment anything model (SAM) achieved impressive results on general-purpose semantic segmentation with strong generalization ability on daily images, its demonstrated performance on medical image segmentation is less precise and not stable, especially when dealing with tumor segmentation tasks that involve objects of small sizes, irregular shapes, and low contrast. Notably, the original SAM architecture is designed for 2D natural images, therefore would not be able to extract the 3D spatial information from volumetric medical data effectively. In this paper, we propose a novel adaptation method for transferring SAM from 2D to 3D for promptable medical image segmentation. Through a holistically designed scheme for architecture modification, we transfer the SAM to support volumetric inputs while retaining the majority of its pre-trained parameters for reuse. The fine-tuning process is conducted in a parameter-efficient manner, wherein most of the pre-trained parameters remain frozen, and only a few lightweight spatial adapters are introduced and tuned. Regardless of the domain gap between natural and medical data and the disparity in the spatial arrangement between 2D and 3D, the transformer trained on natural images can effectively capture the spatial patterns present in volumetric medical images with only lightweight adaptations. We conduct experiments on four open-source tumor segmentation datasets, and with a single click prompt, our model can outperform domain state-of-the-art medical image segmentation models on 3 out of 4 tasks, specifically by 8.25%, 29.87%, and 10.11% for kidney tumor, pancreas tumor, colon cancer segmentation, and achieve similar performance for liver tumor segmentation. We also compare our adaptation method with existing popular adapters, and observed significant performance improvement on most datasets.

FusionVision: A comprehensive approach of 3D object reconstruction and segmentation from RGB-D cameras using YOLO and fast segment anything

In the realm of computer vision, the integration of advanced techniques into the processing of RGB-D camera inputs poses a significant challenge, given the inherent complexities arising from diverse environmental conditions and varying object appearances. Therefore, this paper introduces FusionVision, an exhaustive pipeline adapted for the robust 3D segmentation of objects in RGB-D imagery. Traditional computer vision systems face limitations in simultaneously capturing precise object boundaries and achieving high-precision object detection on depth map as they are mainly proposed for RGB cameras. To address this challenge, FusionVision adopts an integrated approach by merging state-of-the-art object detection techniques, with advanced instance segmentation methods. The integration of these components enables a holistic (unified analysis of information obtained from both color RGB and depth D channels) interpretation of RGB-D data, facilitating the extraction of comprehensive and accurate object information. The proposed FusionVision pipeline employs YOLO for identifying objects within the RGB image domain. Subsequently, FastSAM, an innovative semantic segmentation model, is applied to delineate object boundaries, yielding refined segmentation masks. The synergy between these components and their integration into 3D scene understanding ensures a cohesive fusion of object detection and segmentation, enhancing overall precision in 3D object segmentation. The code and pre-trained models are publicly available at https://github.com/safouaneelg/FusionVision/.

Channel Vision Transformers: An Image Is Worth C x 16 x 16 Words

Vision Transformer (ViT) has emerged as a powerful architecture in the realm of modern computer vision. However, its application in certain imaging fields, such as microscopy and satellite imaging, presents unique challenges. In these domains, images often contain multiple channels, each carrying semantically distinct and independent information. Furthermore, the model must demonstrate robustness to sparsity in input channels, as they may not be densely available during training or testing. In this paper, we propose a modification to the ViT architecture that enhances reasoning across the input channels and introduce Hierarchical Channel Sampling (HCS) as an additional regularization technique to ensure robustness when only partial channels are presented during test time. Our proposed model, ChannelViT, constructs patch tokens independently from each input channel and utilizes a learnable channel embedding that is added to the patch tokens, similar to positional embeddings. We evaluate the performance of ChannelViT on ImageNet, JUMP-CP (microscopy cell imaging), and So2Sat (satellite imaging). Our results show that ChannelViT outperforms ViT on classification tasks and generalizes well, even when a subset of input channels is used during testing. Across our experiments, HCS proves to be a powerful regularizer, independent of the architecture employed, suggesting itself as a straightforward technique for robust ViT training. Lastly, we find that ChannelViT generalizes effectively even when there is limited access to all channels during training, highlighting its potential for multi-channel imaging under real-world conditions with sparse sensors. Our code is available at https://github.com/insitro/ChannelViT.

Exploring Token Pruning in Vision State Space Models

State Space Models (SSMs) have the advantage of keeping linear computational complexity compared to attention modules in transformers, and have been applied to vision tasks as a new type of powerful vision foundation model. Inspired by the observations that the final prediction in vision transformers (ViTs) is only based on a subset of most informative tokens, we take the novel step of enhancing the efficiency of SSM-based vision models through token-based pruning. However, direct applications of existing token pruning techniques designed for ViTs fail to deliver good performance, even with extensive fine-tuning. To address this issue, we revisit the unique computational characteristics of SSMs and discover that naive application disrupts the sequential token positions. This insight motivates us to design a novel and general token pruning method specifically for SSM-based vision models. We first introduce a pruning-aware hidden state alignment method to stabilize the neighborhood of remaining tokens for performance enhancement. Besides, based on our detailed analysis, we propose a token importance evaluation method adapted for SSM models, to guide the token pruning. With efficient implementation and practical acceleration methods, our method brings actual speedup. Extensive experiments demonstrate that our approach can achieve significant computation reduction with minimal impact on performance across different tasks. Notably, we achieve 81.7\% accuracy on ImageNet with a 41.6\% reduction in the FLOPs for pruned PlainMamba-L3. Furthermore, our work provides deeper insights into understanding the behavior of SSM-based vision models for future research.

RadGPT: Constructing 3D Image-Text Tumor Datasets

With over 85 million CT scans performed annually in the United States, creating tumor-related reports is a challenging and time-consuming task for radiologists. To address this need, we present RadGPT, an Anatomy-Aware Vision-Language AI Agent for generating detailed reports from CT scans. RadGPT first segments tumors, including benign cysts and malignant tumors, and their surrounding anatomical structures, then transforms this information into both structured reports and narrative reports. These reports provide tumor size, shape, location, attenuation, volume, and interactions with surrounding blood vessels and organs. Extensive evaluation on unseen hospitals shows that RadGPT can produce accurate reports, with high sensitivity/specificity for small tumor (<2 cm) detection: 80/73% for liver tumors, 92/78% for kidney tumors, and 77/77% for pancreatic tumors. For large tumors, sensitivity ranges from 89% to 97%. The results significantly surpass the state-of-the-art in abdominal CT report generation. RadGPT generated reports for 17 public datasets. Through radiologist review and refinement, we have ensured the reports' accuracy, and created the first publicly available image-text 3D medical dataset, comprising over 1.8 million text tokens and 2.7 million images from 9,262 CT scans, including 2,947 tumor scans/reports of 8,562 tumor instances. Our reports can: (1) localize tumors in eight liver sub-segments and three pancreatic sub-segments annotated per-voxel; (2) determine pancreatic tumor stage (T1-T4) in 260 reports; and (3) present individual analyses of multiple tumors--rare in human-made reports. Importantly, 948 of the reports are for early-stage tumors.

Learning to Generate Images with Perceptual Similarity Metrics

Deep networks are increasingly being applied to problems involving image synthesis, e.g., generating images from textual descriptions and reconstructing an input image from a compact representation. Supervised training of image-synthesis networks typically uses a pixel-wise loss (PL) to indicate the mismatch between a generated image and its corresponding target image. We propose instead to use a loss function that is better calibrated to human perceptual judgments of image quality: the multiscale structural-similarity score (MS-SSIM). Because MS-SSIM is differentiable, it is easily incorporated into gradient-descent learning. We compare the consequences of using MS-SSIM versus PL loss on training deterministic and stochastic autoencoders. For three different architectures, we collected human judgments of the quality of image reconstructions. Observers reliably prefer images synthesized by MS-SSIM-optimized models over those synthesized by PL-optimized models, for two distinct PL measures (ell_1 and ell_2 distances). We also explore the effect of training objective on image encoding and analyze conditions under which perceptually-optimized representations yield better performance on image classification. Finally, we demonstrate the superiority of perceptually-optimized networks for super-resolution imaging. Just as computer vision has advanced through the use of convolutional architectures that mimic the structure of the mammalian visual system, we argue that significant additional advances can be made in modeling images through the use of training objectives that are well aligned to characteristics of human perception.

Potential of Multimodal Large Language Models for Data Mining of Medical Images and Free-text Reports

Medical images and radiology reports are crucial for diagnosing medical conditions, highlighting the importance of quantitative analysis for clinical decision-making. However, the diversity and cross-source heterogeneity of these data challenge the generalizability of current data-mining methods. Multimodal large language models (MLLMs) have recently transformed many domains, significantly affecting the medical field. Notably, Gemini-Vision-series (Gemini) and GPT-4-series (GPT-4) models have epitomized a paradigm shift in Artificial General Intelligence (AGI) for computer vision, showcasing their potential in the biomedical domain. In this study, we evaluated the performance of the Gemini, GPT-4, and 4 popular large models for an exhaustive evaluation across 14 medical imaging datasets, including 5 medical imaging categories (dermatology, radiology, dentistry, ophthalmology, and endoscopy), and 3 radiology report datasets. The investigated tasks encompass disease classification, lesion segmentation, anatomical localization, disease diagnosis, report generation, and lesion detection. Our experimental results demonstrated that Gemini-series models excelled in report generation and lesion detection but faces challenges in disease classification and anatomical localization. Conversely, GPT-series models exhibited proficiency in lesion segmentation and anatomical localization but encountered difficulties in disease diagnosis and lesion detection. Additionally, both the Gemini series and GPT series contain models that have demonstrated commendable generation efficiency. While both models hold promise in reducing physician workload, alleviating pressure on limited healthcare resources, and fostering collaboration between clinical practitioners and artificial intelligence technologies, substantial enhancements and comprehensive validations remain imperative before clinical deployment.

Machine Vision Therapy: Multimodal Large Language Models Can Enhance Visual Robustness via Denoising In-Context Learning

Although vision models such as Contrastive Language-Image Pre-Training (CLIP) show impressive generalization performance, their zero-shot robustness is still limited under Out-of-Distribution (OOD) scenarios without fine-tuning. Instead of undesirably providing human supervision as commonly done, it is possible to take advantage of Multi-modal Large Language Models (MLLMs) that hold powerful visual understanding abilities. However, MLLMs are shown to struggle with vision problems due to the incompatibility of tasks, thus hindering their utilization. In this paper, we propose to effectively leverage MLLMs to conduct Machine Vision Therapy which aims to rectify the noisy predictions from vision models. By fine-tuning with the denoised labels, the learning model performance can be boosted in an unsupervised manner. To solve the incompatibility issue, we propose a novel Denoising In-Context Learning (DICL) strategy to align vision tasks with MLLMs. Concretely, by estimating a transition matrix that captures the probability of one class being confused with another, an instruction containing a correct exemplar and an erroneous one from the most probable noisy class can be constructed. Such an instruction can help any MLLMs with ICL ability to detect and rectify incorrect predictions of vision models. Through extensive experiments on ImageNet, WILDS, DomainBed, and other OOD datasets, we carefully validate the quantitative and qualitative effectiveness of our method. Our code is available at https://github.com/tmllab/Machine_Vision_Therapy.

Masked Momentum Contrastive Learning for Zero-shot Semantic Understanding

Self-supervised pretraining (SSP) has emerged as a popular technique in machine learning, enabling the extraction of meaningful feature representations without labelled data. In the realm of computer vision, pretrained vision transformers (ViTs) have played a pivotal role in advancing transfer learning. Nonetheless, the escalating cost of finetuning these large models has posed a challenge due to the explosion of model size. This study endeavours to evaluate the effectiveness of pure self-supervised learning (SSL) techniques in computer vision tasks, obviating the need for finetuning, with the intention of emulating human-like capabilities in generalisation and recognition of unseen objects. To this end, we propose an evaluation protocol for zero-shot segmentation based on a prompting patch. Given a point on the target object as a prompt, the algorithm calculates the similarity map between the selected patch and other patches, upon that, a simple thresholding is applied to segment the target. Another evaluation is intra-object and inter-object similarity to gauge discriminatory ability of SSP ViTs. Insights from zero-shot segmentation from prompting and discriminatory abilities of SSP led to the design of a simple SSP approach, termed MMC. This approaches combines Masked image modelling for encouraging similarity of local features, Momentum based self-distillation for transferring semantics from global to local features, and global Contrast for promoting semantics of global features, to enhance discriminative representations of SSP ViTs. Consequently, our proposed method significantly reduces the overlap of intra-object and inter-object similarities, thereby facilitating effective object segmentation within an image. Our experiments reveal that MMC delivers top-tier results in zero-shot semantic segmentation across various datasets.

DVPT: Dynamic Visual Prompt Tuning of Large Pre-trained Models for Medical Image Analysis

Limited labeled data makes it hard to train models from scratch in medical domain, and an important paradigm is pre-training and then fine-tuning. Large pre-trained models contain rich representations, which can be adapted to downstream medical tasks. However, existing methods either tune all the parameters or the task-specific layers of the pre-trained models, ignoring the input variations of medical images, and thus they are not efficient or effective. In this work, we aim to study parameter-efficient fine-tuning (PEFT) for medical image analysis, and propose a dynamic visual prompt tuning method, named DVPT. It can extract knowledge beneficial to downstream tasks from large models with a few trainable parameters. Firstly, the frozen features are transformed by an lightweight bottleneck layer to learn the domain-specific distribution of downstream medical tasks, and then a few learnable visual prompts are used as dynamic queries and then conduct cross-attention with the transformed features, attempting to acquire sample-specific knowledge that are suitable for each sample. Finally, the features are projected to original feature dimension and aggregated with the frozen features. This DVPT module can be shared between different Transformer layers, further reducing the trainable parameters. To validate DVPT, we conduct extensive experiments with different pre-trained models on medical classification and segmentation tasks. We find such PEFT method can not only efficiently adapt the pre-trained models to the medical domain, but also brings data efficiency with partial labeled data. For example, with 0.5\% extra trainable parameters, our method not only outperforms state-of-the-art PEFT methods, even surpasses the full fine-tuning by more than 2.20\% Kappa score on medical classification task. It can saves up to 60\% labeled data and 99\% storage cost of ViT-B/16.

SCONE: Surface Coverage Optimization in Unknown Environments by Volumetric Integration

Next Best View computation (NBV) is a long-standing problem in robotics, and consists in identifying the next most informative sensor position(s) for reconstructing a 3D object or scene efficiently and accurately. Like most current methods, we consider NBV prediction from a depth sensor like Lidar systems. Learning-based methods relying on a volumetric representation of the scene are suitable for path planning, but have lower accuracy than methods using a surface-based representation. However, the latter do not scale well with the size of the scene and constrain the camera to a small number of poses. To obtain the advantages of both representations, we show that we can maximize surface metrics by Monte Carlo integration over a volumetric representation. In particular, we propose an approach, SCONE, that relies on two neural modules: The first module predicts occupancy probability in the entire volume of the scene. Given any new camera pose, the second module samples points in the scene based on their occupancy probability and leverages a self-attention mechanism to predict the visibility of the samples. Finally, we integrate the visibility to evaluate the gain in surface coverage for the new camera pose. NBV is selected as the pose that maximizes the gain in total surface coverage. Our method scales to large scenes and handles free camera motion: It takes as input an arbitrarily large point cloud gathered by a depth sensor as well as camera poses to predict NBV. We demonstrate our approach on a novel dataset made of large and complex 3D scenes.

MedImageInsight: An Open-Source Embedding Model for General Domain Medical Imaging

In this work, we present MedImageInsight, an open-source medical imaging embedding model. MedImageInsight is trained on medical images with associated text and labels across a diverse collection of domains, including X-Ray, CT, MRI, dermoscopy, OCT, fundus photography, ultrasound, histopathology, and mammography. Rigorous evaluations demonstrate MedImageInsight's ability to achieve state-of-the-art (SOTA) or human expert level performance across classification, image-image search, and fine-tuning tasks. Specifically, on public datasets, MedImageInsight achieves SOTA in CT 3D medical image retrieval, as well as SOTA in disease classification and search for chest X-ray, dermatology, and OCT imaging. Furthermore, MedImageInsight achieves human expert performance in bone age estimation (on both public and partner data), as well as AUC above 0.9 in most other domains. When paired with a text decoder, MedImageInsight achieves near SOTA level single image report findings generation with less than 10\% the parameters of other models. Compared to fine-tuning GPT-4o with only MIMIC-CXR data for the same task, MedImageInsight outperforms in clinical metrics, but underperforms on lexical metrics where GPT-4o sets a new SOTA. Importantly for regulatory purposes, MedImageInsight can generate ROC curves, adjust sensitivity and specificity based on clinical need, and provide evidence-based decision support through image-image search (which can also enable retrieval augmented generation). In an independent clinical evaluation of image-image search in chest X-ray, MedImageInsight outperformed every other publicly available foundation model evaluated by large margins (over 6 points AUC), and significantly outperformed other models in terms of AI fairness (across age and gender). We hope releasing MedImageInsight will help enhance collective progress in medical imaging AI research and development.

SegBook: A Simple Baseline and Cookbook for Volumetric Medical Image Segmentation

Computed Tomography (CT) is one of the most popular modalities for medical imaging. By far, CT images have contributed to the largest publicly available datasets for volumetric medical segmentation tasks, covering full-body anatomical structures. Large amounts of full-body CT images provide the opportunity to pre-train powerful models, e.g., STU-Net pre-trained in a supervised fashion, to segment numerous anatomical structures. However, it remains unclear in which conditions these pre-trained models can be transferred to various downstream medical segmentation tasks, particularly segmenting the other modalities and diverse targets. To address this problem, a large-scale benchmark for comprehensive evaluation is crucial for finding these conditions. Thus, we collected 87 public datasets varying in modality, target, and sample size to evaluate the transfer ability of full-body CT pre-trained models. We then employed a representative model, STU-Net with multiple model scales, to conduct transfer learning across modalities and targets. Our experimental results show that (1) there may be a bottleneck effect concerning the dataset size in fine-tuning, with more improvement on both small- and large-scale datasets than medium-size ones. (2) Models pre-trained on full-body CT demonstrate effective modality transfer, adapting well to other modalities such as MRI. (3) Pre-training on the full-body CT not only supports strong performance in structure detection but also shows efficacy in lesion detection, showcasing adaptability across target tasks. We hope that this large-scale open evaluation of transfer learning can direct future research in volumetric medical image segmentation.

ParaTransCNN: Parallelized TransCNN Encoder for Medical Image Segmentation

The convolutional neural network-based methods have become more and more popular for medical image segmentation due to their outstanding performance. However, they struggle with capturing long-range dependencies, which are essential for accurately modeling global contextual correlations. Thanks to the ability to model long-range dependencies by expanding the receptive field, the transformer-based methods have gained prominence. Inspired by this, we propose an advanced 2D feature extraction method by combining the convolutional neural network and Transformer architectures. More specifically, we introduce a parallelized encoder structure, where one branch uses ResNet to extract local information from images, while the other branch uses Transformer to extract global information. Furthermore, we integrate pyramid structures into the Transformer to extract global information at varying resolutions, especially in intensive prediction tasks. To efficiently utilize the different information in the parallelized encoder at the decoder stage, we use a channel attention module to merge the features of the encoder and propagate them through skip connections and bottlenecks. Intensive numerical experiments are performed on both aortic vessel tree, cardiac, and multi-organ datasets. By comparing with state-of-the-art medical image segmentation methods, our method is shown with better segmentation accuracy, especially on small organs. The code is publicly available on https://github.com/HongkunSun/ParaTransCNN.

MMed-RAG: Versatile Multimodal RAG System for Medical Vision Language Models

Artificial Intelligence (AI) has demonstrated significant potential in healthcare, particularly in disease diagnosis and treatment planning. Recent progress in Medical Large Vision-Language Models (Med-LVLMs) has opened up new possibilities for interactive diagnostic tools. However, these models often suffer from factual hallucination, which can lead to incorrect diagnoses. Fine-tuning and retrieval-augmented generation (RAG) have emerged as methods to address these issues. However, the amount of high-quality data and distribution shifts between training data and deployment data limit the application of fine-tuning methods. Although RAG is lightweight and effective, existing RAG-based approaches are not sufficiently general to different medical domains and can potentially cause misalignment issues, both between modalities and between the model and the ground truth. In this paper, we propose a versatile multimodal RAG system, MMed-RAG, designed to enhance the factuality of Med-LVLMs. Our approach introduces a domain-aware retrieval mechanism, an adaptive retrieved contexts selection method, and a provable RAG-based preference fine-tuning strategy. These innovations make the RAG process sufficiently general and reliable, significantly improving alignment when introducing retrieved contexts. Experimental results across five medical datasets (involving radiology, ophthalmology, pathology) on medical VQA and report generation demonstrate that MMed-RAG can achieve an average improvement of 43.8% in the factual accuracy of Med-LVLMs. Our data and code are available in https://github.com/richard-peng-xia/MMed-RAG.

One Eye is All You Need: Lightweight Ensembles for Gaze Estimation with Single Encoders

Gaze estimation has grown rapidly in accuracy in recent years. However, these models often fail to take advantage of different computer vision (CV) algorithms and techniques (such as small ResNet and Inception networks and ensemble models) that have been shown to improve results for other CV problems. Additionally, most current gaze estimation models require the use of either both eyes or an entire face, whereas real-world data may not always have both eyes in high resolution. Thus, we propose a gaze estimation model that implements the ResNet and Inception model architectures and makes predictions using only one eye image. Furthermore, we propose an ensemble calibration network that uses the predictions from several individual architectures for subject-specific predictions. With the use of lightweight architectures, we achieve high performance on the GazeCapture dataset with very low model parameter counts. When using two eyes as input, we achieve a prediction error of 1.591 cm on the test set without calibration and 1.439 cm with an ensemble calibration model. With just one eye as input, we still achieve an average prediction error of 2.312 cm on the test set without calibration and 1.951 cm with an ensemble calibration model. We also notice significantly lower errors on the right eye images in the test set, which could be important in the design of future gaze estimation-based tools.

Softmax-free Linear Transformers

Vision transformers (ViTs) have pushed the state-of-the-art for visual perception tasks. The self-attention mechanism underpinning the strength of ViTs has a quadratic complexity in both computation and memory usage. This motivates the development of approximating the self-attention at linear complexity. However, an in-depth analysis in this work reveals that existing methods are either theoretically flawed or empirically ineffective for visual recognition. We identify that their limitations are rooted in the inheritance of softmax-based self-attention during approximations, that is, normalizing the scaled dot-product between token feature vectors using the softmax function. As preserving the softmax operation challenges any subsequent linearization efforts. By this insight, a family of Softmax-Free Transformers (SOFT) are proposed. Specifically, a Gaussian kernel function is adopted to replace the dot-product similarity, enabling a full self-attention matrix to be approximated under low-rank matrix decomposition. For computational robustness, we estimate the Moore-Penrose inverse using an iterative Newton-Raphson method in the forward process only, while calculating its theoretical gradients only once in the backward process. To further expand applicability (e.g., dense prediction tasks), an efficient symmetric normalization technique is introduced. Extensive experiments on ImageNet, COCO, and ADE20K show that our SOFT significantly improves the computational efficiency of existing ViT variants. With linear complexity, much longer token sequences are permitted by SOFT, resulting in superior trade-off between accuracy and complexity. Code and models are available at https://github.com/fudan-zvg/SOFT.

Scattering Vision Transformer: Spectral Mixing Matters

Vision transformers have gained significant attention and achieved state-of-the-art performance in various computer vision tasks, including image classification, instance segmentation, and object detection. However, challenges remain in addressing attention complexity and effectively capturing fine-grained information within images. Existing solutions often resort to down-sampling operations, such as pooling, to reduce computational cost. Unfortunately, such operations are non-invertible and can result in information loss. In this paper, we present a novel approach called Scattering Vision Transformer (SVT) to tackle these challenges. SVT incorporates a spectrally scattering network that enables the capture of intricate image details. SVT overcomes the invertibility issue associated with down-sampling operations by separating low-frequency and high-frequency components. Furthermore, SVT introduces a unique spectral gating network utilizing Einstein multiplication for token and channel mixing, effectively reducing complexity. We show that SVT achieves state-of-the-art performance on the ImageNet dataset with a significant reduction in a number of parameters and FLOPS. SVT shows 2\% improvement over LiTv2 and iFormer. SVT-H-S reaches 84.2\% top-1 accuracy, while SVT-H-B reaches 85.2\% (state-of-art for base versions) and SVT-H-L reaches 85.7\% (again state-of-art for large versions). SVT also shows comparable results in other vision tasks such as instance segmentation. SVT also outperforms other transformers in transfer learning on standard datasets such as CIFAR10, CIFAR100, Oxford Flower, and Stanford Car datasets. The project page is available on this webpage.https://badripatro.github.io/svt/.

GMAI-MMBench: A Comprehensive Multimodal Evaluation Benchmark Towards General Medical AI

Large Vision-Language Models (LVLMs) are capable of handling diverse data types such as imaging, text, and physiological signals, and can be applied in various fields. In the medical field, LVLMs have a high potential to offer substantial assistance for diagnosis and treatment. Before that, it is crucial to develop benchmarks to evaluate LVLMs' effectiveness in various medical applications. Current benchmarks are often built upon specific academic literature, mainly focusing on a single domain, and lacking varying perceptual granularities. Thus, they face specific challenges, including limited clinical relevance, incomplete evaluations, and insufficient guidance for interactive LVLMs. To address these limitations, we developed the GMAI-MMBench, the most comprehensive general medical AI benchmark with well-categorized data structure and multi-perceptual granularity to date. It is constructed from 285 datasets across 39 medical image modalities, 18 clinical-related tasks, 18 departments, and 4 perceptual granularities in a Visual Question Answering (VQA) format. Additionally, we implemented a lexical tree structure that allows users to customize evaluation tasks, accommodating various assessment needs and substantially supporting medical AI research and applications. We evaluated 50 LVLMs, and the results show that even the advanced GPT-4o only achieves an accuracy of 52%, indicating significant room for improvement. Moreover, we identified five key insufficiencies in current cutting-edge LVLMs that need to be addressed to advance the development of better medical applications. We believe that GMAI-MMBench will stimulate the community to build the next generation of LVLMs toward GMAI. Project Page: https://uni-medical.github.io/GMAI-MMBench.github.io/

Swin Transformer V2: Scaling Up Capacity and Resolution

Large-scale NLP models have been shown to significantly improve the performance on language tasks with no signs of saturation. They also demonstrate amazing few-shot capabilities like that of human beings. This paper aims to explore large-scale models in computer vision. We tackle three major issues in training and application of large vision models, including training instability, resolution gaps between pre-training and fine-tuning, and hunger on labelled data. Three main techniques are proposed: 1) a residual-post-norm method combined with cosine attention to improve training stability; 2) A log-spaced continuous position bias method to effectively transfer models pre-trained using low-resolution images to downstream tasks with high-resolution inputs; 3) A self-supervised pre-training method, SimMIM, to reduce the needs of vast labeled images. Through these techniques, this paper successfully trained a 3 billion-parameter Swin Transformer V2 model, which is the largest dense vision model to date, and makes it capable of training with images of up to 1,536times1,536 resolution. It set new performance records on 4 representative vision tasks, including ImageNet-V2 image classification, COCO object detection, ADE20K semantic segmentation, and Kinetics-400 video action classification. Also note our training is much more efficient than that in Google's billion-level visual models, which consumes 40 times less labelled data and 40 times less training time. Code is available at https://github.com/microsoft/Swin-Transformer.

TransDAE: Dual Attention Mechanism in a Hierarchical Transformer for Efficient Medical Image Segmentation

In healthcare, medical image segmentation is crucial for accurate disease diagnosis and the development of effective treatment strategies. Early detection can significantly aid in managing diseases and potentially prevent their progression. Machine learning, particularly deep convolutional neural networks, has emerged as a promising approach to addressing segmentation challenges. Traditional methods like U-Net use encoding blocks for local representation modeling and decoding blocks to uncover semantic relationships. However, these models often struggle with multi-scale objects exhibiting significant variations in texture and shape, and they frequently fail to capture long-range dependencies in the input data. Transformers designed for sequence-to-sequence predictions have been proposed as alternatives, utilizing global self-attention mechanisms. Yet, they can sometimes lack precise localization due to insufficient granular details. To overcome these limitations, we introduce TransDAE: a novel approach that reimagines the self-attention mechanism to include both spatial and channel-wise associations across the entire feature space, while maintaining computational efficiency. Additionally, TransDAE enhances the skip connection pathway with an inter-scale interaction module, promoting feature reuse and improving localization accuracy. Remarkably, TransDAE outperforms existing state-of-the-art methods on the Synaps multi-organ dataset, even without relying on pre-trained weights.

A Pressure Ulcer Care System For Remote Medical Assistance: Residual U-Net with an Attention Model Based for Wound Area Segmentation

Increasing numbers of patients with disabilities or elderly people with mobility issues often suffer from a pressure ulcer. The affected areas need regular checks, but they have a difficulty in accessing a hospital. Some remote diagnosis systems are being used for them, but there are limitations in checking a patient's status regularly. In this paper, we present a remote medical assistant that can help pressure ulcer management with image processing techniques. The proposed system includes a mobile application with a deep learning model for wound segmentation and analysis. As there are not enough data to train the deep learning model, we make use of a pretrained model from a relevant domain and data augmentation that is appropriate for this task. First of all, an image preprocessing method using bilinear interpolation is used to resize images and normalize the images. Second, for data augmentation, we use rotation, reflection, and a watershed algorithm. Third, we use a pretrained deep learning model generated from skin wound images similar to pressure ulcer images. Finally, we added an attention module that can provide hints on the pressure ulcer image features. The resulting model provides an accuracy of 99.0%, an intersection over union (IoU) of 99.99%, and a dice similarity coefficient (DSC) of 93.4% for pressure ulcer segmentation, which is better than existing results.

Complex Network for Complex Problems: A comparative study of CNN and Complex-valued CNN

Neural networks, especially convolutional neural networks (CNN), are one of the most common tools these days used in computer vision. Most of these networks work with real-valued data using real-valued features. Complex-valued convolutional neural networks (CV-CNN) can preserve the algebraic structure of complex-valued input data and have the potential to learn more complex relationships between the input and the ground-truth. Although some comparisons of CNNs and CV-CNNs for different tasks have been performed in the past, a large-scale investigation comparing different models operating on different tasks has not been conducted. Furthermore, because complex features contain both real and imaginary components, CV-CNNs have double the number of trainable parameters as real-valued CNNs in terms of the actual number of trainable parameters. Whether or not the improvements in performance with CV-CNN observed in the past have been because of the complex features or just because of having double the number of trainable parameters has not yet been explored. This paper presents a comparative study of CNN, CNNx2 (CNN with double the number of trainable parameters as the CNN), and CV-CNN. The experiments were performed using seven models for two different tasks - brain tumour classification and segmentation in brain MRIs. The results have revealed that the CV-CNN models outperformed the CNN and CNNx2 models.

Multi-view X-ray Image Synthesis with Multiple Domain Disentanglement from CT Scans

X-ray images play a vital role in the intraoperative processes due to their high resolution and fast imaging speed and greatly promote the subsequent segmentation, registration and reconstruction. However, over-dosed X-rays superimpose potential risks to human health to some extent. Data-driven algorithms from volume scans to X-ray images are restricted by the scarcity of paired X-ray and volume data. Existing methods are mainly realized by modelling the whole X-ray imaging procedure. In this study, we propose a learning-based approach termed CT2X-GAN to synthesize the X-ray images in an end-to-end manner using the content and style disentanglement from three different image domains. Our method decouples the anatomical structure information from CT scans and style information from unpaired real X-ray images/ digital reconstructed radiography (DRR) images via a series of decoupling encoders. Additionally, we introduce a novel consistency regularization term to improve the stylistic resemblance between synthesized X-ray images and real X-ray images. Meanwhile, we also impose a supervised process by computing the similarity of computed real DRR and synthesized DRR images. We further develop a pose attention module to fully strengthen the comprehensive information in the decoupled content code from CT scans, facilitating high-quality multi-view image synthesis in the lower 2D space. Extensive experiments were conducted on the publicly available CTSpine1K dataset and achieved 97.8350, 0.0842 and 3.0938 in terms of FID, KID and defined user-scored X-ray similarity, respectively. In comparison with 3D-aware methods (pi-GAN, EG3D), CT2X-GAN is superior in improving the synthesis quality and realistic to the real X-ray images.

Revisiting Unreasonable Effectiveness of Data in Deep Learning Era

The success of deep learning in vision can be attributed to: (a) models with high capacity; (b) increased computational power; and (c) availability of large-scale labeled data. Since 2012, there have been significant advances in representation capabilities of the models and computational capabilities of GPUs. But the size of the biggest dataset has surprisingly remained constant. What will happen if we increase the dataset size by 10x or 100x? This paper takes a step towards clearing the clouds of mystery surrounding the relationship between `enormous data' and visual deep learning. By exploiting the JFT-300M dataset which has more than 375M noisy labels for 300M images, we investigate how the performance of current vision tasks would change if this data was used for representation learning. Our paper delivers some surprising (and some expected) findings. First, we find that the performance on vision tasks increases logarithmically based on volume of training data size. Second, we show that representation learning (or pre-training) still holds a lot of promise. One can improve performance on many vision tasks by just training a better base model. Finally, as expected, we present new state-of-the-art results for different vision tasks including image classification, object detection, semantic segmentation and human pose estimation. Our sincere hope is that this inspires vision community to not undervalue the data and develop collective efforts in building larger datasets.

DeepOrgan: Multi-level Deep Convolutional Networks for Automated Pancreas Segmentation

Automatic organ segmentation is an important yet challenging problem for medical image analysis. The pancreas is an abdominal organ with very high anatomical variability. This inhibits previous segmentation methods from achieving high accuracies, especially compared to other organs such as the liver, heart or kidneys. In this paper, we present a probabilistic bottom-up approach for pancreas segmentation in abdominal computed tomography (CT) scans, using multi-level deep convolutional networks (ConvNets). We propose and evaluate several variations of deep ConvNets in the context of hierarchical, coarse-to-fine classification on image patches and regions, i.e. superpixels. We first present a dense labeling of local image patches via P{-}ConvNet and nearest neighbor fusion. Then we describe a regional ConvNet (R_1{-}ConvNet) that samples a set of bounding boxes around each image superpixel at different scales of contexts in a "zoom-out" fashion. Our ConvNets learn to assign class probabilities for each superpixel region of being pancreas. Last, we study a stacked R_2{-}ConvNet leveraging the joint space of CT intensities and the P{-}ConvNet dense probability maps. Both 3D Gaussian smoothing and 2D conditional random fields are exploited as structured predictions for post-processing. We evaluate on CT images of 82 patients in 4-fold cross-validation. We achieve a Dice Similarity Coefficient of 83.6pm6.3% in training and 71.8pm10.7% in testing.

Multi-Scale VMamba: Hierarchy in Hierarchy Visual State Space Model

Despite the significant achievements of Vision Transformers (ViTs) in various vision tasks, they are constrained by the quadratic complexity. Recently, State Space Models (SSMs) have garnered widespread attention due to their global receptive field and linear complexity with respect to the input length, demonstrating substantial potential across fields including natural language processing and computer vision. To improve the performance of SSMs in vision tasks, a multi-scan strategy is widely adopted, which leads to significant redundancy of SSMs. For a better trade-off between efficiency and performance, we analyze the underlying reasons behind the success of the multi-scan strategy, where long-range dependency plays an important role. Based on the analysis, we introduce Multi-Scale Vision Mamba (MSVMamba) to preserve the superiority of SSMs in vision tasks with limited parameters. It employs a multi-scale 2D scanning technique on both original and downsampled feature maps, which not only benefits long-range dependency learning but also reduces computational costs. Additionally, we integrate a Convolutional Feed-Forward Network (ConvFFN) to address the lack of channel mixing. Our experiments demonstrate that MSVMamba is highly competitive, with the MSVMamba-Tiny model achieving 82.8% top-1 accuracy on ImageNet, 46.9% box mAP, and 42.2% instance mAP with the Mask R-CNN framework, 1x training schedule on COCO, and 47.6% mIoU with single-scale testing on ADE20K.Code is available at https://github.com/YuHengsss/MSVMamba.

Calculation of Femur Caput Collum Diaphyseal angle for X-Rays images using Semantic Segmentation

This paper investigates the use of deep learning approaches to estimate the femur caput-collum-diaphyseal (CCD) angle from X-ray images. The CCD angle is an important measurement in the diagnosis of hip problems, and correct prediction can help in the planning of surgical procedures. Manual measurement of this angle, on the other hand, can be time-intensive and vulnerable to inter-observer variability. In this paper, we present a deep-learning algorithm that can reliably estimate the femur CCD angle from X-ray images. To train and test the performance of our model, we employed an X-ray image dataset with associated femur CCD angle measurements. Furthermore, we built a prototype to display the resulting predictions and to allow the user to interact with the predictions. As this is happening in a sterile setting during surgery, we expanded our interface to the possibility of being used only by voice commands. Our results show that our deep learning model predicts the femur CCD angle on X-ray images with great accuracy, with a mean absolute error of 4.3 degrees on the left femur and 4.9 degrees on the right femur on the test dataset. Our results suggest that deep learning has the potential to give a more efficient and accurate technique for predicting the femur CCD angle, which might have substantial therapeutic implications for the diagnosis and management of hip problems.

A multi-path 2.5 dimensional convolutional neural network system for segmenting stroke lesions in brain MRI images

Automatic identification of brain lesions from magnetic resonance imaging (MRI) scans of stroke survivors would be a useful aid in patient diagnosis and treatment planning. We propose a multi-modal multi-path convolutional neural network system for automating stroke lesion segmentation. Our system has nine end-to-end UNets that take as input 2-dimensional (2D) slices and examines all three planes with three different normalizations. Outputs from these nine total paths are concatenated into a 3D volume that is then passed to a 3D convolutional neural network to output a final lesion mask. We trained and tested our method on datasets from three sources: Medical College of Wisconsin (MCW), Kessler Foundation (KF), and the publicly available Anatomical Tracings of Lesions After Stroke (ATLAS) dataset. Cross-study validation results (with independent training and validation datasets) were obtained to compare with previous methods based on naive Bayes, random forests, and three recently published convolutional neural networks. Model performance was quantified in terms of the Dice coefficient. Training on the KF and MCW images and testing on the ATLAS images yielded a mean Dice coefficient of 0.54. This was reliably better than the next best previous model, UNet, at 0.47. Reversing the train and test datasets yields a mean Dice of 0.47 on KF and MCW images, whereas the next best UNet reaches 0.45. With all three datasets combined, the current system compared to previous methods also attained a reliably higher cross-validation accuracy. It also achieved high Dice values for many smaller lesions that existing methods have difficulty identifying. Overall, our system is a clear improvement over previous methods for automating stroke lesion segmentation, bringing us an important step closer to the inter-rater accuracy level of human experts.

Attention-based Dynamic Subspace Learners for Medical Image Analysis

Learning similarity is a key aspect in medical image analysis, particularly in recommendation systems or in uncovering the interpretation of anatomical data in images. Most existing methods learn such similarities in the embedding space over image sets using a single metric learner. Images, however, have a variety of object attributes such as color, shape, or artifacts. Encoding such attributes using a single metric learner is inadequate and may fail to generalize. Instead, multiple learners could focus on separate aspects of these attributes in subspaces of an overarching embedding. This, however, implies the number of learners to be found empirically for each new dataset. This work, Dynamic Subspace Learners, proposes to dynamically exploit multiple learners by removing the need of knowing apriori the number of learners and aggregating new subspace learners during training. Furthermore, the visual interpretability of such subspace learning is enforced by integrating an attention module into our method. This integrated attention mechanism provides a visual insight of discriminative image features that contribute to the clustering of image sets and a visual explanation of the embedding features. The benefits of our attention-based dynamic subspace learners are evaluated in the application of image clustering, image retrieval, and weakly supervised segmentation. Our method achieves competitive results with the performances of multiple learners baselines and significantly outperforms the classification network in terms of clustering and retrieval scores on three different public benchmark datasets. Moreover, our attention maps offer a proxy-labels, which improves the segmentation accuracy up to 15% in Dice scores when compared to state-of-the-art interpretation techniques.

PA-LLaVA: A Large Language-Vision Assistant for Human Pathology Image Understanding

The previous advancements in pathology image understanding primarily involved developing models tailored to specific tasks. Recent studies has demonstrated that the large vision-language model can enhance the performance of various downstream tasks in medical image understanding. In this study, we developed a domain-specific large language-vision assistant (PA-LLaVA) for pathology image understanding. Specifically, (1) we first construct a human pathology image-text dataset by cleaning the public medical image-text data for domain-specific alignment; (2) Using the proposed image-text data, we first train a pathology language-image pretraining (PLIP) model as the specialized visual encoder for pathology image, and then we developed scale-invariant connector to avoid the information loss caused by image scaling; (3) We adopt two-stage learning to train PA-LLaVA, first stage for domain alignment, and second stage for end to end visual question \& answering (VQA) task. In experiments, we evaluate our PA-LLaVA on both supervised and zero-shot VQA datasets, our model achieved the best overall performance among multimodal models of similar scale. The ablation experiments also confirmed the effectiveness of our design. We posit that our PA-LLaVA model and the datasets presented in this work can promote research in field of computational pathology. All codes are available at: https://github.com/ddw2AIGROUP2CQUPT/PA-LLaVA}{https://github.com/ddw2AIGROUP2CQUPT/PA-LLaVA

LPViT: Low-Power Semi-structured Pruning for Vision Transformers

Vision transformers have emerged as a promising alternative to convolutional neural networks for various image analysis tasks, offering comparable or superior performance. However, one significant drawback of ViTs is their resource-intensive nature, leading to increased memory footprint, computation complexity, and power consumption. To democratize this high-performance technology and make it more environmentally friendly, it is essential to compress ViT models, reducing their resource requirements while maintaining high performance. In this paper, we introduce a new block-structured pruning to address the resource-intensive issue for ViTs, offering a balanced trade-off between accuracy and hardware acceleration. Unlike unstructured pruning or channel-wise structured pruning, block pruning leverages the block-wise structure of linear layers, resulting in more efficient matrix multiplications. To optimize this pruning scheme, our paper proposes a novel hardware-aware learning objective that simultaneously maximizes speedup and minimizes power consumption during inference, tailored to the block sparsity structure. This objective eliminates the need for empirical look-up tables and focuses solely on reducing parametrized layer connections. Moreover, our paper provides a lightweight algorithm to achieve post-training pruning for ViTs, utilizing second-order Taylor approximation and empirical optimization to solve the proposed hardware-aware objective. Extensive experiments on ImageNet are conducted across various ViT architectures, including DeiT-B and DeiT-S, demonstrating competitive performance with other pruning methods and achieving a remarkable balance between accuracy preservation and power savings. Especially, we achieve up to 3.93x and 1.79x speedups on dedicated hardware and GPUs respectively for DeiT-B, and also observe an inference power reduction by 1.4x on real-world GPUs.

CAS-ViT: Convolutional Additive Self-attention Vision Transformers for Efficient Mobile Applications

Vision Transformers (ViTs) mark a revolutionary advance in neural networks with their token mixer's powerful global context capability. However, the pairwise token affinity and complex matrix operations limit its deployment on resource-constrained scenarios and real-time applications, such as mobile devices, although considerable efforts have been made in previous works. In this paper, we introduce CAS-ViT: Convolutional Additive Self-attention Vision Transformers, to achieve a balance between efficiency and performance in mobile applications. Firstly, we argue that the capability of token mixers to obtain global contextual information hinges on multiple information interactions, such as spatial and channel domains. Subsequently, we construct a novel additive similarity function following this paradigm and present an efficient implementation named Convolutional Additive Token Mixer (CATM). This simplification leads to a significant reduction in computational overhead. We evaluate CAS-ViT across a variety of vision tasks, including image classification, object detection, instance segmentation, and semantic segmentation. Our experiments, conducted on GPUs, ONNX, and iPhones, demonstrate that CAS-ViT achieves a competitive performance when compared to other state-of-the-art backbones, establishing it as a viable option for efficient mobile vision applications. Our code and model are available at: https://github.com/Tianfang-Zhang/CAS-ViT

TorchEsegeta: Framework for Interpretability and Explainability of Image-based Deep Learning Models

Clinicians are often very sceptical about applying automatic image processing approaches, especially deep learning based methods, in practice. One main reason for this is the black-box nature of these approaches and the inherent problem of missing insights of the automatically derived decisions. In order to increase trust in these methods, this paper presents approaches that help to interpret and explain the results of deep learning algorithms by depicting the anatomical areas which influence the decision of the algorithm most. Moreover, this research presents a unified framework, TorchEsegeta, for applying various interpretability and explainability techniques for deep learning models and generate visual interpretations and explanations for clinicians to corroborate their clinical findings. In addition, this will aid in gaining confidence in such methods. The framework builds on existing interpretability and explainability techniques that are currently focusing on classification models, extending them to segmentation tasks. In addition, these methods have been adapted to 3D models for volumetric analysis. The proposed framework provides methods to quantitatively compare visual explanations using infidelity and sensitivity metrics. This framework can be used by data scientists to perform post-hoc interpretations and explanations of their models, develop more explainable tools and present the findings to clinicians to increase their faith in such models. The proposed framework was evaluated based on a use case scenario of vessel segmentation models trained on Time-of-fight (TOF) Magnetic Resonance Angiogram (MRA) images of the human brain. Quantitative and qualitative results of a comparative study of different models and interpretability methods are presented. Furthermore, this paper provides an extensive overview of several existing interpretability and explainability methods.

hSDB-instrument: Instrument Localization Database for Laparoscopic and Robotic Surgeries

Automated surgical instrument localization is an important technology to understand the surgical process and in order to analyze them to provide meaningful guidance during surgery or surgical index after surgery to the surgeon. We introduce a new dataset that reflects the kinematic characteristics of surgical instruments for automated surgical instrument localization of surgical videos. The hSDB(hutom Surgery DataBase)-instrument dataset consists of instrument localization information from 24 cases of laparoscopic cholecystecomy and 24 cases of robotic gastrectomy. Localization information for all instruments is provided in the form of a bounding box for object detection. To handle class imbalance problem between instruments, synthesized instruments modeled in Unity for 3D models are included as training data. Besides, for 3D instrument data, a polygon annotation is provided to enable instance segmentation of the tool. To reflect the kinematic characteristics of all instruments, they are annotated with head and body parts for laparoscopic instruments, and with head, wrist, and body parts for robotic instruments separately. Annotation data of assistive tools (specimen bag, needle, etc.) that are frequently used for surgery are also included. Moreover, we provide statistical information on the hSDB-instrument dataset and the baseline localization performances of the object detection networks trained by the MMDetection library and resulting analyses.

A Foundation LAnguage-Image model of the Retina (FLAIR): Encoding expert knowledge in text supervision

Foundation vision-language models are currently transforming computer vision, and are on the rise in medical imaging fueled by their very promising generalization capabilities. However, the initial attempts to transfer this new paradigm to medical imaging have shown less impressive performances than those observed in other domains, due to the significant domain shift and the complex, expert domain knowledge inherent to medical-imaging tasks. Motivated by the need for domain-expert foundation models, we present FLAIR, a pre-trained vision-language model for universal retinal fundus image understanding. To this end, we compiled 37 open-access, mostly categorical fundus imaging datasets from various sources, with up to 97 different target conditions and 284,660 images. We integrate the expert's domain knowledge in the form of descriptive textual prompts, during both pre-training and zero-shot inference, enhancing the less-informative categorical supervision of the data. Such a textual expert's knowledge, which we compiled from the relevant clinical literature and community standards, describes the fine-grained features of the pathologies as well as the hierarchies and dependencies between them. We report comprehensive evaluations, which illustrate the benefit of integrating expert knowledge and the strong generalization capabilities of FLAIR under difficult scenarios with domain shifts or unseen categories. When adapted with a lightweight linear probe, FLAIR outperforms fully-trained, dataset-focused models, more so in the few-shot regimes. Interestingly, FLAIR outperforms by a large margin more generalist, larger-scale image-language models, which emphasizes the potential of embedding experts' domain knowledge and the limitations of generalist models in medical imaging.

Algorithm-hardware Co-design for Deformable Convolution

FPGAs provide a flexible and efficient platform to accelerate rapidly-changing algorithms for computer vision. The majority of existing work focuses on accelerating image classification, while other fundamental vision problems, including object detection and instance segmentation, have not been adequately addressed. Compared with image classification, detection problems are more sensitive to the spatial variance of objects, and therefore, require specialized convolutions to aggregate spatial information. To address this, recent work proposes dynamic deformable convolution to augment regular convolutions. Regular convolutions process a fixed grid of pixels across all the spatial locations in an image, while dynamic deformable convolutions may access arbitrary pixels in the image and the access pattern is input-dependent and varies per spatial location. These properties lead to inefficient memory accesses of inputs with existing hardware. In this work, we first investigate the overhead of the deformable convolution on embedded FPGA SoCs, and then show the accuracy-latency tradeoffs for a set of algorithm modifications including full versus depthwise, fixed-shape, and limited-range. These modifications benefit the energy efficiency for embedded devices in general as they reduce the compute complexity. We then build an efficient object detection network with modified deformable convolutions and quantize the network using state-of-the-art quantization methods. We implement a unified hardware engine on FPGA to support all the operations in the network. Preliminary experiments show that little accuracy is compromised and speedup can be achieved with our co-design optimization for the deformable convolution.