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Lie Ju

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Published work

8 published item(s)

preprint2026arXiv

DermAgent: A Self-Reflective Agentic System for Dermatological Image Analysis with Multi-Tool Reasoning and Traceable Decision-Making

Dermatological diagnosis requires integrating fine-grained visual perception with expert clinical knowledge. Although Multimodal Large Language Models (MLLMs) facilitate interactive medical image analysis, their application in dermatology is hindered by insufficient domain-specific grounding and hallucinations. To address these issues, we propose DermAgent, a collaborative multi-tool agent that orchestrates seven specialized vision and language modules within a Plan-Execute-Reflect framework. DermAgent delivers stepwise, traceable diagnostic reasoning through three core components. First, it employs complementary visual perception tools for comprehensive morphological description, dermoscopic concept annotation, and disease diagnosis. Second, to overcome the lack of domain prior, a dual-modality retrieval module anchors every prediction in external evidence by cross-referencing 413,210 diagnosed image cases and 3,199 clinical guideline chunks. To further mitigate hallucinations, a deterministic critic module conducts strict post-hoc auditing via confidence, coverage, and conflict gates, automatically detecting inter-source disagreements to trigger targeted self-correction. Extensive experiments on five dermatology benchmarks demonstrate that DermAgent consistently outperforms state-of-the-art MLLMs and medical agent baselines across zero-shot fine-grained disease diagnosis, concept annotation, and clinical captioning tasks, exceeding GPT-4o by 17.6% in skin disease diagnostic accuracy and 3.15% in captioning ROUGE-L. Our code is available at https://github.com/YizeezLiu/DermAgent.

preprint2024arXiv

Prompt-driven Latent Domain Generalization for Medical Image Classification

Deep learning models for medical image analysis easily suffer from distribution shifts caused by dataset artifacts bias, camera variations, differences in the imaging station, etc., leading to unreliable diagnoses in real-world clinical settings. Domain generalization (DG) methods, which aim to train models on multiple domains to perform well on unseen domains, offer a promising direction to solve the problem. However, existing DG methods assume domain labels of each image are available and accurate, which is typically feasible for only a limited number of medical datasets. To address these challenges, we propose a novel DG framework for medical image classification without relying on domain labels, called Prompt-driven Latent Domain Generalization (PLDG). PLDG consists of unsupervised domain discovery and prompt learning. This framework first discovers pseudo domain labels by clustering the bias-associated style features, then leverages collaborative domain prompts to guide a Vision Transformer to learn knowledge from discovered diverse domains. To facilitate cross-domain knowledge learning between different prompts, we introduce a domain prompt generator that enables knowledge sharing between domain prompts and a shared prompt. A domain mixup strategy is additionally employed for more flexible decision margins and mitigates the risk of incorrect domain assignments. Extensive experiments on three medical image classification tasks and one debiasing task demonstrate that our method can achieve comparable or even superior performance than conventional DG algorithms without relying on domain labels. Our code will be publicly available upon the paper is accepted.

preprint2022arXiv

Medical Matting: A New Perspective on Medical Segmentation with Uncertainty

It is difficult to accurately label ambiguous and complex shaped targets manually by binary masks. The weakness of binary mask under-expression is highlighted in medical image segmentation, where blurring is prevalent. In the case of multiple annotations, reaching a consensus for clinicians by binary masks is more challenging. Moreover, these uncertain areas are related to the lesions' structure and may contain anatomical information beneficial to diagnosis. However, current studies on uncertainty mainly focus on the uncertainty in model training and data labels. None of them investigate the influence of the ambiguous nature of the lesion itself.Inspired by image matting, this paper introduces alpha matte as a soft mask to represent uncertain areas in medical scenes and accordingly puts forward a new uncertainty quantification method to fill the gap of uncertainty research for lesion structure. In this work, we introduce a new architecture to generate binary masks and alpha mattes in a multitasking framework, which outperforms all state-of-the-art matting algorithms compared. The proposed uncertainty map is able to highlight the ambiguous regions and a novel multitasking loss weighting strategy we presented can improve performance further and demonstrate their concrete benefits. To fully-evaluate the effectiveness of our proposed method, we first labelled three medical datasets with alpha matte to address the shortage of available matting datasets in medical scenes and prove the alpha matte to be a more efficient labeling method than a binary mask from both qualitative and quantitative aspects.

preprint2022arXiv

Skin Lesion Recognition with Class-Hierarchy Regularized Hyperbolic Embeddings

In practice, many medical datasets have an underlying taxonomy defined over the disease label space. However, existing classification algorithms for medical diagnoses often assume semantically independent labels. In this study, we aim to leverage class hierarchy with deep learning algorithms for more accurate and reliable skin lesion recognition. We propose a hyperbolic network to learn image embeddings and class prototypes jointly. The hyperbola provably provides a space for modeling hierarchical relations better than Euclidean geometry. Meanwhile, we restrict the distribution of hyperbolic prototypes with a distance matrix that is encoded from the class hierarchy. Accordingly, the learned prototypes preserve the semantic class relations in the embedding space and we can predict the label of an image by assigning its feature to the nearest hyperbolic class prototype. We use an in-house skin lesion dataset which consists of around 230k dermoscopic images on 65 skin diseases to verify our method. Extensive experiments provide evidence that our model can achieve higher accuracy with less severe classification errors than models without considering class relations.

preprint2022arXiv

Unsupervised Domain Adaptive Fundus Image Segmentation with Category-level Regularization

Existing unsupervised domain adaptation methods based on adversarial learning have achieved good performance in several medical imaging tasks. However, these methods focus only on global distribution adaptation and ignore distribution constraints at the category level, which would lead to sub-optimal adaptation performance. This paper presents an unsupervised domain adaptation framework based on category-level regularization that regularizes the category distribution from three perspectives. Specifically, for inter-domain category regularization, an adaptive prototype alignment module is proposed to align feature prototypes of the same category in the source and target domains. In addition, for intra-domain category regularization, we tailored a regularization technique for the source and target domains, respectively. In the source domain, a prototype-guided discriminative loss is proposed to learn more discriminative feature representations by enforcing intra-class compactness and inter-class separability, and as a complement to traditional supervised loss. In the target domain, an augmented consistency category regularization loss is proposed to force the model to produce consistent predictions for augmented/unaugmented target images, which encourages semantically similar regions to be given the same label. Extensive experiments on two publicly fundus datasets show that the proposed approach significantly outperforms other state-of-the-art comparison algorithms.

preprint2021arXiv

Leveraging Regular Fundus Images for Training UWF Fundus Diagnosis Models via Adversarial Learning and Pseudo-Labeling

Recently, ultra-widefield (UWF) 200\degree~fundus imaging by Optos cameras has gradually been introduced because of its broader insights for detecting more information on the fundus than regular 30 degree - 60 degree fundus cameras. Compared with UWF fundus images, regular fundus images contain a large amount of high-quality and well-annotated data. Due to the domain gap, models trained by regular fundus images to recognize UWF fundus images perform poorly. Hence, given that annotating medical data is labor intensive and time consuming, in this paper, we explore how to leverage regular fundus images to improve the limited UWF fundus data and annotations for more efficient training. We propose the use of a modified cycle generative adversarial network (CycleGAN) model to bridge the gap between regular and UWF fundus and generate additional UWF fundus images for training. A consistency regularization term is proposed in the loss of the GAN to improve and regulate the quality of the generated data. Our method does not require that images from the two domains be paired or even that the semantic labels be the same, which provides great convenience for data collection. Furthermore, we show that our method is robust to noise and errors introduced by the generated unlabeled data with the pseudo-labeling technique. We evaluated the effectiveness of our methods on several common fundus diseases and tasks, such as diabetic retinopathy (DR) classification, lesion detection and tessellated fundus segmentation. The experimental results demonstrate that our proposed method simultaneously achieves superior generalizability of the learned representations and performance improvements in multiple tasks.

preprint2021arXiv

Synergic Adversarial Label Learning for Grading Retinal Diseases via Knowledge Distillation and Multi-task Learning

The need for comprehensive and automated screening methods for retinal image classification has long been recognized. Well-qualified doctors annotated images are very expensive and only a limited amount of data is available for various retinal diseases such as age-related macular degeneration (AMD) and diabetic retinopathy (DR). Some studies show that AMD and DR share some common features like hemorrhagic points and exudation but most classification algorithms only train those disease models independently. Inspired by knowledge distillation where additional monitoring signals from various sources is beneficial to train a robust model with much fewer data. We propose a method called synergic adversarial label learning (SALL) which leverages relevant retinal disease labels in both semantic and feature space as additional signals and train the model in a collaborative manner. Our experiments on DR and AMD fundus image classification task demonstrate that the proposed method can significantly improve the accuracy of the model for grading diseases. In addition, we conduct additional experiments to show the effectiveness of SALL from the aspects of reliability and interpretability in the context of medical imaging application.

preprint2020arXiv

Bridge the Domain Gap Between Ultra-wide-field and Traditional Fundus Images via Adversarial Domain Adaptation

For decades, advances in retinal imaging technology have enabled effective diagnosis and management of retinal disease using fundus cameras. Recently, ultra-wide-field (UWF) fundus imaging by Optos camera is gradually put into use because of its broader insights on fundus for some lesions that are not typically seen in traditional fundus images. Research on traditional fundus images is an active topic but studies on UWF fundus images are few. One of the most important reasons is that UWF fundus images are hard to obtain. In this paper, for the first time, we explore domain adaptation from the traditional fundus to UWF fundus images. We propose a flexible framework to bridge the domain gap between two domains and co-train a UWF fundus diagnosis model by pseudo-labelling and adversarial learning. We design a regularisation technique to regulate the domain adaptation. Also, we apply MixUp to overcome the over-fitting issue from incorrect generated pseudo-labels. Our experimental results on either single or both domains demonstrate that the proposed method can well adapt and transfer the knowledge from traditional fundus images to UWF fundus images and improve the performance of retinal disease recognition.