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J. Alison Noble

J. Alison Noble contributes to research discovery and scholarly infrastructure.

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Computer Vision eess.IV Machine Learning

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preprint2026arXiv

Segmentation, Detection and Explanation: A Unified Framework for CT Appearance Reasoning

Recent progress in deep learning has significantly advanced CT image analysis, particularly for segmentation tasks. However, these advances are largely confined to image-level pattern recognition, with most methods lacking explicit anatomical or contextual reasoning. Large vision-language models introduce linguistic context into image analysis, yet most approaches typically focus on a single task, which is insufficient for clinical workflow analysis that requires multiple fine-grained types of analysis, such as anatomy detection and segmentation. In this paper, we propose a unified autoregressive framework that integrates language-guided visual reasoning into CT interpretation. Our method introduces task-routing tokens that trigger detection and segmentation heads conditioned on the hidden states of a large vision-language model, enabling coherent generation of visual outputs (e.g., masks and bounding boxes) and textual reasonings. To progressively enhance localisation accuracy and semantic clarity, we further design a "closer-look" mechanism that allows the model to perform progressive coarse-to-fine visits to regions of interest under refined fields of view. To support model training and evaluation, we curated a new multimodal CT dataset containing pixel-wise masks, bounding boxes, spatial prompts, and structured descriptions for visual objects constructed through an AI-assisted annotation process with human verification. Experiments on public benchmarks demonstrate consistent improvements over the SoTA, achieving up to 1.0% Dice on BTCV and 1.7% Dice on MosMed+, while additionally providing appearance reasoning outputs. The code and dataset will be available.

preprint2025arXiv

Learning to learn skill assessment for fetal ultrasound scanning

Traditionally, ultrasound skill assessment has relied on expert supervision and feedback, a process known for its subjectivity and time-intensive nature. Previous works on quantitative and automated skill assessment have predominantly employed supervised learning methods, often limiting the analysis to predetermined or assumed factors considered influential in determining skill levels. In this work, we propose a novel bi-level optimisation framework that assesses fetal ultrasound skills by how well a task is performed on the acquired fetal ultrasound images, without using manually predefined skill ratings. The framework consists of a clinical task predictor and a skill predictor, which are optimised jointly by refining the two networks simultaneously. We validate the proposed method on real-world clinical ultrasound videos of scanning the fetal head. The results demonstrate the feasibility of predicting ultrasound skills by the proposed framework, which quantifies optimised task performance as a skill indicator.

preprint2022arXiv

Anatomy-Aware Contrastive Representation Learning for Fetal Ultrasound

Self-supervised contrastive representation learning offers the advantage of learning meaningful visual representations from unlabeled medical datasets for transfer learning. However, applying current contrastive learning approaches to medical data without considering its domain-specific anatomical characteristics may lead to visual representations that are inconsistent in appearance and semantics. In this paper, we propose to improve visual representations of medical images via anatomy-aware contrastive learning (AWCL), which incorporates anatomy information to augment the positive/negative pair sampling in a contrastive learning manner. The proposed approach is demonstrated for automated fetal ultrasound imaging tasks, enabling the positive pairs from the same or different ultrasound scans that are anatomically similar to be pulled together and thus improving the representation learning. We empirically investigate the effect of inclusion of anatomy information with coarse- and fine-grained granularity, for contrastive learning and find that learning with fine-grained anatomy information which preserves intra-class difference is more effective than its counterpart. We also analyze the impact of anatomy ratio on our AWCL framework and find that using more distinct but anatomically similar samples to compose positive pairs results in better quality representations. Experiments on a large-scale fetal ultrasound dataset demonstrate that our approach is effective for learning representations that transfer well to three clinical downstream tasks, and achieves superior performance compared to ImageNet supervised and the current state-of-the-art contrastive learning methods. In particular, AWCL outperforms ImageNet supervised method by 13.8% and state-of-the-art contrastive-based method by 7.1% on a cross-domain segmentation task.

preprint2022arXiv

Image quality assessment for machine learning tasks using meta-reinforcement learning

In this paper, we consider image quality assessment (IQA) as a measure of how images are amenable with respect to a given downstream task, or task amenability. When the task is performed using machine learning algorithms, such as a neural-network-based task predictor for image classification or segmentation, the performance of the task predictor provides an objective estimate of task amenability. In this work, we use an IQA controller to predict the task amenability which, itself being parameterised by neural networks, can be trained simultaneously with the task predictor. We further develop a meta-reinforcement learning framework to improve the adaptability for both IQA controllers and task predictors, such that they can be fine-tuned efficiently on new datasets or meta-tasks. We demonstrate the efficacy of the proposed task-specific, adaptable IQA approach, using two clinical applications for ultrasound-guided prostate intervention and pneumonia detection on X-ray images.

preprint2022arXiv

Multimodal-GuideNet: Gaze-Probe Bidirectional Guidance in Obstetric Ultrasound Scanning

Eye trackers can provide visual guidance to sonographers during ultrasound (US) scanning. Such guidance is potentially valuable for less experienced operators to improve their scanning skills on how to manipulate the probe to achieve the desired plane. In this paper, a multimodal guidance approach (Multimodal-GuideNet) is proposed to capture the stepwise dependency between a real-world US video signal, synchronized gaze, and probe motion within a unified framework. To understand the causal relationship between gaze movement and probe motion, our model exploits multitask learning to jointly learn two related tasks: predicting gaze movements and probe signals that an experienced sonographer would perform in routine obstetric scanning. The two tasks are associated by a modality-aware spatial graph to detect the co-occurrence among the multi-modality inputs and share useful cross-modal information. Instead of a deterministic scanning path, Multimodal-GuideNet allows for scanning diversity by estimating the probability distribution of real scans. Experiments performed with three typical obstetric scanning examinations show that the new approach outperforms single-task learning for both probe motion guidance and gaze movement prediction. Multimodal-GuideNet also provides a visual guidance signal with an error rate of less than 10 pixels for a 224x288 US image.

preprint2020arXiv

Automatic Probe Movement Guidance for Freehand Obstetric Ultrasound

We present the first system that provides real-time probe movement guidance for acquiring standard planes in routine freehand obstetric ultrasound scanning. Such a system can contribute to the worldwide deployment of obstetric ultrasound scanning by lowering the required level of operator expertise. The system employs an artificial neural network that receives the ultrasound video signal and the motion signal of an inertial measurement unit (IMU) that is attached to the probe, and predicts a guidance signal. The network termed US-GuideNet predicts either the movement towards the standard plane position (goal prediction), or the next movement that an expert sonographer would perform (action prediction). While existing models for other ultrasound applications are trained with simulations or phantoms, we train our model with real-world ultrasound video and probe motion data from 464 routine clinical scans by 17 accredited sonographers. Evaluations for 3 standard plane types show that the model provides a useful guidance signal with an accuracy of 88.8% for goal prediction and 90.9% for action prediction.

preprint2020arXiv

Discovering Salient Anatomical Landmarks by Predicting Human Gaze

Anatomical landmarks are a crucial prerequisite for many medical imaging tasks. Usually, the set of landmarks for a given task is predefined by experts. The landmark locations for a given image are then annotated manually or via machine learning methods trained on manual annotations. In this paper, in contrast, we present a method to automatically discover and localize anatomical landmarks in medical images. Specifically, we consider landmarks that attract the visual attention of humans, which we term visually salient landmarks. We illustrate the method for fetal neurosonographic images. First, full-length clinical fetal ultrasound scans are recorded with live sonographer gaze-tracking. Next, a convolutional neural network (CNN) is trained to predict the gaze point distribution (saliency map) of the sonographers on scan video frames. The CNN is then used to predict saliency maps of unseen fetal neurosonographic images, and the landmarks are extracted as the local maxima of these saliency maps. Finally, the landmarks are matched across images by clustering the landmark CNN features. We show that the discovered landmarks can be used within affine image registration, with average landmark alignment errors between 4.1% and 10.9% of the fetal head long axis length.

preprint2020arXiv

Self-supervised Contrastive Video-Speech Representation Learning for Ultrasound

In medical imaging, manual annotations can be expensive to acquire and sometimes infeasible to access, making conventional deep learning-based models difficult to scale. As a result, it would be beneficial if useful representations could be derived from raw data without the need for manual annotations. In this paper, we propose to address the problem of self-supervised representation learning with multi-modal ultrasound video-speech raw data. For this case, we assume that there is a high correlation between the ultrasound video and the corresponding narrative speech audio of the sonographer. In order to learn meaningful representations, the model needs to identify such correlation and at the same time understand the underlying anatomical features. We designed a framework to model the correspondence between video and audio without any kind of human annotations. Within this framework, we introduce cross-modal contrastive learning and an affinity-aware self-paced learning scheme to enhance correlation modelling. Experimental evaluations on multi-modal fetal ultrasound video and audio show that the proposed approach is able to learn strong representations and transfers well to downstream tasks of standard plane detection and eye-gaze prediction.

preprint2020arXiv

Self-supervised Representation Learning for Ultrasound Video

Recent advances in deep learning have achieved promising performance for medical image analysis, while in most cases ground-truth annotations from human experts are necessary to train the deep model. In practice, such annotations are expensive to collect and can be scarce for medical imaging applications. Therefore, there is significant interest in learning representations from unlabelled raw data. In this paper, we propose a self-supervised learning approach to learn meaningful and transferable representations from medical imaging video without any type of human annotation. We assume that in order to learn such a representation, the model should identify anatomical structures from the unlabelled data. Therefore we force the model to address anatomy-aware tasks with free supervision from the data itself. Specifically, the model is designed to correct the order of a reshuffled video clip and at the same time predict the geometric transformation applied to the video clip. Experiments on fetal ultrasound video show that the proposed approach can effectively learn meaningful and strong representations, which transfer well to downstream tasks like standard plane detection and saliency prediction.

preprint2020arXiv

Self-Supervised Ultrasound to MRI Fetal Brain Image Synthesis

Fetal brain magnetic resonance imaging (MRI) offers exquisite images of the developing brain but is not suitable for second-trimester anomaly screening, for which ultrasound (US) is employed. Although expert sonographers are adept at reading US images, MR images which closely resemble anatomical images are much easier for non-experts to interpret. Thus in this paper we propose to generate MR-like images directly from clinical US images. In medical image analysis such a capability is potentially useful as well, for instance for automatic US-MRI registration and fusion. The proposed model is end-to-end trainable and self-supervised without any external annotations. Specifically, based on an assumption that the US and MRI data share a similar anatomical latent space, we first utilise a network to extract the shared latent features, which are then used for MRI synthesis. Since paired data is unavailable for our study (and rare in practice), pixel-level constraints are infeasible to apply. We instead propose to enforce the distributions to be statistically indistinguishable, by adversarial learning in both the image domain and feature space. To regularise the anatomical structures between US and MRI during synthesis, we further propose an adversarial structural constraint. A new cross-modal attention technique is proposed to utilise non-local spatial information, by encouraging multi-modal knowledge fusion and propagation. We extend the approach to consider the case where 3D auxiliary information (e.g., 3D neighbours and a 3D location index) from volumetric data is also available, and show that this improves image synthesis. The proposed approach is evaluated quantitatively and qualitatively with comparison to real fetal MR images and other approaches to synthesis, demonstrating its feasibility of synthesising realistic MR images.

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