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Qi Dou

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Published work

35 published item(s)

preprint2026arXiv

Concepts from Representations: Post-hoc Concept Bottleneck Models via Sparse Decomposition of Visual Representations

Deep learning has achieved remarkable success in image recognition, yet their inherent opacity poses challenges for deployment in critical domains. Concept-based interpretations aim to address this by explaining model reasoning through human-understandable concepts. However, existing post-hoc methods and ante-hoc concept bottleneck models (CBMs), suffer from limitations such as unreliable concept relevance, non-visual or labor-intensive concept definitions, and model or data-agnostic assumptions. This paper introduces Post-hoc Concept Bottleneck Model via Representation Decomposition (PCBM-ReD), a novel pipeline that retrofits interpretability onto pretrained opaque models. PCBM-ReD automatically extracts visual concepts from a pre-trained encoder, employs multimodal large language models (MLLMs) to label and filter concepts based on visual identifiability and task relevance, and selects an independent subset via reconstruction-guided optimization. Leveraging CLIP's visual-text alignment, it decomposes image representations into linear combination of concept embeddings to fit into the CBMs abstraction. Extensive experiments across 11 image classification tasks show PCBM-ReD achieves state-of-the-art accuracy, narrows the performance gap with end-to-end models, and exhibits better interpretability.

preprint2026arXiv

From Articulated Kinematics to Routed Visual Control for Action-Conditioned Surgical Video Generation

Action-conditioned surgical video generation is a critical yet highly challenging problem for robotic surgery. The core difficulty is that low-dimensional control vectors must precisely govern complex image-space evolution. In this work, we propose a kinematic-to-visual lifting paradigm that converts articulated kinematics into a unified set of five image-aligned control modalities. Building on this representation, we introduce a hierarchically routed visual control framework that selectively activates the most relevant control modalities and motion scales. Instead of uniformly applying all control signals, our model performs hierarchical routing to dynamically allocate conditioning capacity. We further design kinematic-prior-guided routing loss functions to ensure physically meaningful, temporally stable, and efficient expert utilization. To improve efficiency, we propose a budgeted training and inference scheme that leverages routing-induced sparsity. By selectively discarding low-significance control pathways during training and execution, our approach enables adaptive computation that is complementary to standard distillation. We additionally construct a new benchmark with curated articulated annotations, obtained through human-in-the-loop semantic labeling and differentiable pose tracking, providing realistic supervision for action-conditioned surgical video generation. Extensive experiments demonstrate that our method consistently improves action faithfulness, visual fidelity, and cross-domain generalization over diverse baselines. Moreover, our efficient variant achieves substantial reductions in latency while maintaining strong control accuracy.

preprint2024arXiv

Foundation Model for Endoscopy Video Analysis via Large-scale Self-supervised Pre-train

Foundation models have exhibited remarkable success in various applications, such as disease diagnosis and text report generation. To date, a foundation model for endoscopic video analysis is still lacking. In this paper, we propose Endo-FM, a foundation model specifically developed using massive endoscopic video data. First, we build a video transformer, which captures both local and global long-range dependencies across spatial and temporal dimensions. Second, we pre-train our transformer model using global and local views via a self-supervised manner, aiming to make it robust to spatial-temporal variations and discriminative across different scenes. To develop the foundation model, we construct a large-scale endoscopy video dataset by combining 9 publicly available datasets and a privately collected dataset from Baoshan Branch of Renji Hospital in Shanghai, China. Our dataset overall consists of over 33K video clips with up to 5 million frames, encompassing various protocols, target organs, and disease types. Our pre-trained Endo-FM can be easily adopted for a given downstream task via fine-tuning by serving as the backbone. With experiments on 3 different types of downstream tasks, including classification, segmentation, and detection, our Endo-FM surpasses the current state-of-the-art (SOTA) self-supervised pre-training and adapter-based transfer learning methods by a significant margin, such as VCL (3.1% F1, 4.8% Dice, and 5.5% F1 for classification, segmentation, and detection) and ST-Adapter (5.9% F1, 9.6% Dice, and 9.9% F1 for classification, segmentation, and detection). Code, datasets, and models are released at https://github.com/med-air/Endo-FM.

preprint2023arXiv

Diffusion Model based Semi-supervised Learning on Brain Hemorrhage Images for Efficient Midline Shift Quantification

Brain midline shift (MLS) is one of the most critical factors to be considered for clinical diagnosis and treatment decision-making for intracranial hemorrhage. Existing computational methods on MLS quantification not only require intensive labeling in millimeter-level measurement but also suffer from poor performance due to their dependence on specific landmarks or simplified anatomical assumptions. In this paper, we propose a novel semi-supervised framework to accurately measure the scale of MLS from head CT scans. We formulate the MLS measurement task as a deformation estimation problem and solve it using a few MLS slices with sparse labels. Meanwhile, with the help of diffusion models, we are able to use a great number of unlabeled MLS data and 2793 non-MLS cases for representation learning and regularization. The extracted representation reflects how the image is different from a non-MLS image and regularization serves an important role in the sparse-to-dense refinement of the deformation field. Our experiment on a real clinical brain hemorrhage dataset has achieved state-of-the-art performance and can generate interpretable deformation fields.

preprint2022arXiv

3D Perception based Imitation Learning under Limited Demonstration for Laparoscope Control in Robotic Surgery

Automatic laparoscope motion control is fundamentally important for surgeons to efficiently perform operations. However, its traditional control methods based on tool tracking without considering information hidden in surgical scenes are not intelligent enough, while the latest supervised imitation learning (IL)-based methods require expensive sensor data and suffer from distribution mismatch issues caused by limited demonstrations. In this paper, we propose a novel Imitation Learning framework for Laparoscope Control (ILLC) with reinforcement learning (RL), which can efficiently learn the control policy from limited surgical video clips. Specially, we first extract surgical laparoscope trajectories from unlabeled videos as the demonstrations and reconstruct the corresponding surgical scenes. To fully learn from limited motion trajectory demonstrations, we propose Shape Preserving Trajectory Augmentation (SPTA) to augment these data, and build a simulation environment that supports parallel RGB-D rendering to reinforce the RL policy for interacting with the environment efficiently. With adversarial training for IL, we obtain the laparoscope control policy based on the generated rollouts and surgical demonstrations. Extensive experiments are conducted in unseen reconstructed surgical scenes, and our method outperforms the previous IL methods, which proves the feasibility of our unified learning-based framework for laparoscope control.

preprint2022arXiv

AutoLaparo: A New Dataset of Integrated Multi-tasks for Image-guided Surgical Automation in Laparoscopic Hysterectomy

Computer-assisted minimally invasive surgery has great potential in benefiting modern operating theatres. The video data streamed from the endoscope provides rich information to support context-awareness for next-generation intelligent surgical systems. To achieve accurate perception and automatic manipulation during the procedure, learning based technique is a promising way, which enables advanced image analysis and scene understanding in recent years. However, learning such models highly relies on large-scale, high-quality, and multi-task labelled data. This is currently a bottleneck for the topic, as available public dataset is still extremely limited in the field of CAI. In this paper, we present and release the first integrated dataset (named AutoLaparo) with multiple image-based perception tasks to facilitate learning-based automation in hysterectomy surgery. Our AutoLaparo dataset is developed based on full-length videos of entire hysterectomy procedures. Specifically, three different yet highly correlated tasks are formulated in the dataset, including surgical workflow recognition, laparoscope motion prediction, and instrument and key anatomy segmentation. In addition, we provide experimental results with state-of-the-art models as reference benchmarks for further model developments and evaluations on this dataset. The dataset is available at https://autolaparo.github.io.

preprint2022arXiv

DLTTA: Dynamic Learning Rate for Test-time Adaptation on Cross-domain Medical Images

Test-time adaptation (TTA) has increasingly been an important topic to efficiently tackle the cross-domain distribution shift at test time for medical images from different institutions. Previous TTA methods have a common limitation of using a fixed learning rate for all the test samples. Such a practice would be sub-optimal for TTA, because test data may arrive sequentially therefore the scale of distribution shift would change frequently. To address this problem, we propose a novel dynamic learning rate adjustment method for test-time adaptation, called DLTTA, which dynamically modulates the amount of weights update for each test image to account for the differences in their distribution shift. Specifically, our DLTTA is equipped with a memory bank based estimation scheme to effectively measure the discrepancy of a given test sample. Based on this estimated discrepancy, a dynamic learning rate adjustment strategy is then developed to achieve a suitable degree of adaptation for each test sample. The effectiveness and general applicability of our DLTTA is extensively demonstrated on three tasks including retinal optical coherence tomography (OCT) segmentation, histopathological image classification, and prostate 3D MRI segmentation. Our method achieves effective and fast test-time adaptation with consistent performance improvement over current state-of-the-art test-time adaptation methods. Code is available at: https://github.com/med-air/DLTTA.

preprint2022arXiv

Dynamic Bank Learning for Semi-supervised Federated Image Diagnosis with Class Imbalance

Despite recent progress on semi-supervised federated learning (FL) for medical image diagnosis, the problem of imbalanced class distributions among unlabeled clients is still unsolved for real-world use. In this paper, we study a practical yet challenging problem of class imbalanced semi-supervised FL (imFed-Semi), which allows all clients to have only unlabeled data while the server just has a small amount of labeled data. This imFed-Semi problem is addressed by a novel dynamic bank learning scheme, which improves client training by exploiting class proportion information. This scheme consists of two parts, i.e., the dynamic bank construction to distill various class proportions for each local client, and the sub-bank classification to impose the local model to learn different class proportions. We evaluate our approach on two public real-world medical datasets, including the intracranial hemorrhage diagnosis with 25,000 CT slices and skin lesion diagnosis with 10,015 dermoscopy images. The effectiveness of our method has been validated with significant performance improvements (7.61% and 4.69%) compared with the second-best on the accuracy, as well as comprehensive analytical studies. Code is available at https://github.com/med-air/imFedSemi.

preprint2022arXiv

Federated Learning from Only Unlabeled Data with Class-Conditional-Sharing Clients

Supervised federated learning (FL) enables multiple clients to share the trained model without sharing their labeled data. However, potential clients might even be reluctant to label their own data, which could limit the applicability of FL in practice. In this paper, we show the possibility of unsupervised FL whose model is still a classifier for predicting class labels, if the class-prior probabilities are shifted while the class-conditional distributions are shared among the unlabeled data owned by the clients. We propose federation of unsupervised learning (FedUL), where the unlabeled data are transformed into surrogate labeled data for each of the clients, a modified model is trained by supervised FL, and the wanted model is recovered from the modified model. FedUL is a very general solution to unsupervised FL: it is compatible with many supervised FL methods, and the recovery of the wanted model can be theoretically guaranteed as if the data have been labeled. Experiments on benchmark and real-world datasets demonstrate the effectiveness of FedUL. Code is available at https://github.com/lunanbit/FedUL.

preprint2022arXiv

HarmoFL: Harmonizing Local and Global Drifts in Federated Learning on Heterogeneous Medical Images

Multiple medical institutions collaboratively training a model using federated learning (FL) has become a promising solution for maximizing the potential of data-driven models, yet the non-independent and identically distributed (non-iid) data in medical images is still an outstanding challenge in real-world practice. The feature heterogeneity caused by diverse scanners or protocols introduces a drift in the learning process, in both local (client) and global (server) optimizations, which harms the convergence as well as model performance. Many previous works have attempted to address the non-iid issue by tackling the drift locally or globally, but how to jointly solve the two essentially coupled drifts is still unclear. In this work, we concentrate on handling both local and global drifts and introduce a new harmonizing framework called HarmoFL. First, we propose to mitigate the local update drift by normalizing amplitudes of images transformed into the frequency domain to mimic a unified imaging setting, in order to generate a harmonized feature space across local clients. Second, based on harmonized features, we design a client weight perturbation guiding each local model to reach a flat optimum, where a neighborhood area of the local optimal solution has a uniformly low loss. Without any extra communication cost, the perturbation assists the global model to optimize towards a converged optimal solution by aggregating several local flat optima. We have theoretically analyzed the proposed method and empirically conducted extensive experiments on three medical image classification and segmentation tasks, showing that HarmoFL outperforms a set of recent state-of-the-art methods with promising convergence behavior. Code is available at https://github.com/med-air/HarmoFL.

preprint2022arXiv

Integrating Artificial Intelligence and Augmented Reality in Robotic Surgery: An Initial dVRK Study Using a Surgical Education Scenario

Robot-assisted surgery has become progressively more and more popular due to its clinical advantages. In the meanwhile, the artificial intelligence and augmented reality in robotic surgery are developing rapidly and receive lots of attention. However, current methods have not discussed the coherent integration of AI and AR in robotic surgery. In this paper, we develop a novel system by seamlessly merging artificial intelligence module and augmented reality visualization to automatically generate the surgical guidance for robotic surgery education. Specifically, we first leverage reinforcement leaning to learn from expert demonstration and then generate 3D guidance trajectory, providing prior context information of the surgical procedure. Along with other information such as text hint, the 3D trajectory is then overlaid in the stereo view of dVRK, where the user can perceive the 3D guidance and learn the procedure. The proposed system is evaluated through a preliminary experiment on surgical education task peg-transfer, which proves its feasibility and potential as the next generation of robot-assisted surgery education solution.

preprint2022arXiv

Neural Rendering for Stereo 3D Reconstruction of Deformable Tissues in Robotic Surgery

Reconstruction of the soft tissues in robotic surgery from endoscopic stereo videos is important for many applications such as intra-operative navigation and image-guided robotic surgery automation. Previous works on this task mainly rely on SLAM-based approaches, which struggle to handle complex surgical scenes. Inspired by recent progress in neural rendering, we present a novel framework for deformable tissue reconstruction from binocular captures in robotic surgery under the single-viewpoint setting. Our framework adopts dynamic neural radiance fields to represent deformable surgical scenes in MLPs and optimize shapes and deformations in a learning-based manner. In addition to non-rigid deformations, tool occlusion and poor 3D clues from a single viewpoint are also particular challenges in soft tissue reconstruction. To overcome these difficulties, we present a series of strategies of tool mask-guided ray casting, stereo depth-cueing ray marching and stereo depth-supervised optimization. With experiments on DaVinci robotic surgery videos, our method significantly outperforms the current state-of-the-art reconstruction method for handling various complex non-rigid deformations. To our best knowledge, this is the first work leveraging neural rendering for surgical scene 3D reconstruction with remarkable potential demonstrated. Code is available at: https://github.com/med-air/EndoNeRF.

preprint2022arXiv

Pseudo-label Guided Cross-video Pixel Contrast for Robotic Surgical Scene Segmentation with Limited Annotations

Surgical scene segmentation is fundamentally crucial for prompting cognitive assistance in robotic surgery. However, pixel-wise annotating surgical video in a frame-by-frame manner is expensive and time consuming. To greatly reduce the labeling burden, in this work, we study semi-supervised scene segmentation from robotic surgical video, which is practically essential yet rarely explored before. We consider a clinically suitable annotation situation under the equidistant sampling. We then propose PGV-CL, a novel pseudo-label guided cross-video contrast learning method to boost scene segmentation. It effectively leverages unlabeled data for a trusty and global model regularization that produces more discriminative feature representation. Concretely, for trusty representation learning, we propose to incorporate pseudo labels to instruct the pair selection, obtaining more reliable representation pairs for pixel contrast. Moreover, we expand the representation learning space from previous image-level to cross-video, which can capture the global semantics to benefit the learning process. We extensively evaluate our method on a public robotic surgery dataset EndoVis18 and a public cataract dataset CaDIS. Experimental results demonstrate the effectiveness of our method, consistently outperforming the state-of-the-art semi-supervised methods under different labeling ratios, and even surpassing fully supervised training on EndoVis18 with 10.1% labeling.

preprint2022arXiv

Rapid model transfer for medical image segmentation via iterative human-in-the-loop update: from labelled public to unlabelled clinical datasets for multi-organ segmentation in CT

Despite the remarkable success on medical image analysis with deep learning, it is still under exploration regarding how to rapidly transfer AI models from one dataset to another for clinical applications. This paper presents a novel and generic human-in-the-loop scheme for efficiently transferring a segmentation model from a small-scale labelled dataset to a larger-scale unlabelled dataset for multi-organ segmentation in CT. To achieve this, we propose to use an igniter network which can learn from a small-scale labelled dataset and generate coarse annotations to start the process of human-machine interaction. Then, we use a sustainer network for our larger-scale dataset, and iteratively updated it on the new annotated data. Moreover, we propose a flexible labelling strategy for the annotator to reduce the initial annotation workload. The model performance and the time cost of annotation in each subject evaluated on our private dataset are reported and analysed. The results show that our scheme can not only improve the performance by 19.7% on Dice, but also expedite the cost time of manual labelling from 13.87 min to 1.51 min per CT volume during the model transfer, demonstrating the clinical usefulness with promising potentials.

preprint2022arXiv

Robust Medical Image Classification from Noisy Labeled Data with Global and Local Representation Guided Co-training

Deep neural networks have achieved remarkable success in a wide variety of natural image and medical image computing tasks. However, these achievements indispensably rely on accurately annotated training data. If encountering some noisy-labeled images, the network training procedure would suffer from difficulties, leading to a sub-optimal classifier. This problem is even more severe in the medical image analysis field, as the annotation quality of medical images heavily relies on the expertise and experience of annotators. In this paper, we propose a novel collaborative training paradigm with global and local representation learning for robust medical image classification from noisy-labeled data to combat the lack of high quality annotated medical data. Specifically, we employ the self-ensemble model with a noisy label filter to efficiently select the clean and noisy samples. Then, the clean samples are trained by a collaborative training strategy to eliminate the disturbance from imperfect labeled samples. Notably, we further design a novel global and local representation learning scheme to implicitly regularize the networks to utilize noisy samples in a self-supervised manner. We evaluated our proposed robust learning strategy on four public medical image classification datasets with three types of label noise,ie,random noise, computer-generated label noise, and inter-observer variability noise. Our method outperforms other learning from noisy label methods and we also conducted extensive experiments to analyze each component of our method.

preprint2022arXiv

Sim-to-Real 6D Object Pose Estimation via Iterative Self-training for Robotic Bin Picking

In this paper, we propose an iterative self-training framework for sim-to-real 6D object pose estimation to facilitate cost-effective robotic grasping. Given a bin-picking scenario, we establish a photo-realistic simulator to synthesize abundant virtual data, and use this to train an initial pose estimation network. This network then takes the role of a teacher model, which generates pose predictions for unlabeled real data. With these predictions, we further design a comprehensive adaptive selection scheme to distinguish reliable results, and leverage them as pseudo labels to update a student model for pose estimation on real data. To continuously improve the quality of pseudo labels, we iterate the above steps by taking the trained student model as a new teacher and re-label real data using the refined teacher model. We evaluate our method on a public benchmark and our newly-released dataset, achieving an ADD(-S) improvement of 11.49% and 22.62% respectively. Our method is also able to improve robotic bin-picking success by 19.54%, demonstrating the potential of iterative sim-to-real solutions for robotic applications.

preprint2022arXiv

Single-domain Generalization in Medical Image Segmentation via Test-time Adaptation from Shape Dictionary

Domain generalization typically requires data from multiple source domains for model learning. However, such strong assumption may not always hold in practice, especially in medical field where the data sharing is highly concerned and sometimes prohibitive due to privacy issue. This paper studies the important yet challenging single domain generalization problem, in which a model is learned under the worst-case scenario with only one source domain to directly generalize to different unseen target domains. We present a novel approach to address this problem in medical image segmentation, which extracts and integrates the semantic shape prior information of segmentation that are invariant across domains and can be well-captured even from single domain data to facilitate segmentation under distribution shifts. Besides, a test-time adaptation strategy with dual-consistency regularization is further devised to promote dynamic incorporation of these shape priors under each unseen domain to improve model generalizability. Extensive experiments on two medical image segmentation tasks demonstrate the consistent improvements of our method across various unseen domains, as well as its superiority over state-of-the-art approaches in addressing domain generalization under the worst-case scenario.

preprint2022arXiv

Tackling Long-Tailed Category Distribution Under Domain Shifts

Machine learning models fail to perform well on real-world applications when 1) the category distribution P(Y) of the training dataset suffers from long-tailed distribution and 2) the test data is drawn from different conditional distributions P(X|Y). Existing approaches cannot handle the scenario where both issues exist, which however is common for real-world applications. In this study, we took a step forward and looked into the problem of long-tailed classification under domain shifts. We designed three novel core functional blocks including Distribution Calibrated Classification Loss, Visual-Semantic Mapping and Semantic-Similarity Guided Augmentation. Furthermore, we adopted a meta-learning framework which integrates these three blocks to improve domain generalization on unseen target domains. Two new datasets were proposed for this problem, named AWA2-LTS and ImageNet-LTS. We evaluated our method on the two datasets and extensive experimental results demonstrate that our proposed method can achieve superior performance over state-of-the-art long-tailed/domain generalization approaches and the combinations. Source codes and datasets can be found at our project page https://xiaogu.site/LTDS.

preprint2022arXiv

Test-time Adaptation with Calibration of Medical Image Classification Nets for Label Distribution Shift

Class distribution plays an important role in learning deep classifiers. When the proportion of each class in the test set differs from the training set, the performance of classification nets usually degrades. Such a label distribution shift problem is common in medical diagnosis since the prevalence of disease vary over location and time. In this paper, we propose the first method to tackle label shift for medical image classification, which effectively adapt the model learned from a single training label distribution to arbitrary unknown test label distribution. Our approach innovates distribution calibration to learn multiple representative classifiers, which are capable of handling different one-dominating-class distributions. When given a test image, the diverse classifiers are dynamically aggregated via the consistency-driven test-time adaptation, to deal with the unknown test label distribution. We validate our method on two important medical image classification tasks including liver fibrosis staging and COVID-19 severity prediction. Our experiments clearly show the decreased model performance under label shift. With our method, model performance significantly improves on all the test datasets with different label shifts for both medical image diagnosis tasks.

preprint2022arXiv

Towards Robust Part-aware Instance Segmentation for Industrial Bin Picking

Industrial bin picking is a challenging task that requires accurate and robust segmentation of individual object instances. Particularly, industrial objects can have irregular shapes, that is, thin and concave, whereas in bin-picking scenarios, objects are often closely packed with strong occlusion. To address these challenges, we formulate a novel part-aware instance segmentation pipeline. The key idea is to decompose industrial objects into correlated approximate convex parts and enhance the object-level segmentation with part-level segmentation. We design a part-aware network to predict part masks and part-to-part offsets, followed by a part aggregation module to assemble the recognized parts into instances. To guide the network learning, we also propose an automatic label decoupling scheme to generate ground-truth part-level labels from instance-level labels. Finally, we contribute the first instance segmentation dataset, which contains a variety of industrial objects that are thin and have non-trivial shapes. Extensive experimental results on various industrial objects demonstrate that our method can achieve the best segmentation results compared with the state-of-the-art approaches.

preprint2022arXiv

Transformer-empowered Multi-scale Contextual Matching and Aggregation for Multi-contrast MRI Super-resolution

Magnetic resonance imaging (MRI) can present multi-contrast images of the same anatomical structures, enabling multi-contrast super-resolution (SR) techniques. Compared with SR reconstruction using a single-contrast, multi-contrast SR reconstruction is promising to yield SR images with higher quality by leveraging diverse yet complementary information embedded in different imaging modalities. However, existing methods still have two shortcomings: (1) they neglect that the multi-contrast features at different scales contain different anatomical details and hence lack effective mechanisms to match and fuse these features for better reconstruction; and (2) they are still deficient in capturing long-range dependencies, which are essential for the regions with complicated anatomical structures. We propose a novel network to comprehensively address these problems by developing a set of innovative Transformer-empowered multi-scale contextual matching and aggregation techniques; we call it McMRSR. Firstly, we tame transformers to model long-range dependencies in both reference and target images. Then, a new multi-scale contextual matching method is proposed to capture corresponding contexts from reference features at different scales. Furthermore, we introduce a multi-scale aggregation mechanism to gradually and interactively aggregate multi-scale matched features for reconstructing the target SR MR image. Extensive experiments demonstrate that our network outperforms state-of-the-art approaches and has great potential to be applied in clinical practice. Codes are available at https://github.com/XAIMI-Lab/McMRSR.

preprint2022arXiv

Where is VALDO? VAscular Lesions Detection and segmentatiOn challenge at MICCAI 2021

Imaging markers of cerebral small vessel disease provide valuable information on brain health, but their manual assessment is time-consuming and hampered by substantial intra- and interrater variability. Automated rating may benefit biomedical research, as well as clinical assessment, but diagnostic reliability of existing algorithms is unknown. Here, we present the results of the \textit{VAscular Lesions DetectiOn and Segmentation} (\textit{Where is VALDO?}) challenge that was run as a satellite event at the international conference on Medical Image Computing and Computer Aided Intervention (MICCAI) 2021. This challenge aimed to promote the development of methods for automated detection and segmentation of small and sparse imaging markers of cerebral small vessel disease, namely enlarged perivascular spaces (EPVS) (Task 1), cerebral microbleeds (Task 2) and lacunes of presumed vascular origin (Task 3) while leveraging weak and noisy labels. Overall, 12 teams participated in the challenge proposing solutions for one or more tasks (4 for Task 1 - EPVS, 9 for Task 2 - Microbleeds and 6 for Task 3 - Lacunes). Multi-cohort data was used in both training and evaluation. Results showed a large variability in performance both across teams and across tasks, with promising results notably for Task 1 - EPVS and Task 2 - Microbleeds and not practically useful results yet for Task 3 - Lacunes. It also highlighted the performance inconsistency across cases that may deter use at an individual level, while still proving useful at a population level.

preprint2020arXiv

A Learning-Driven Framework with Spatial Optimization For Surgical Suture Thread Reconstruction and Autonomous Grasping Under Multiple Topologies and Environmental Noises

Surgical knot tying is one of the most fundamental and important procedures in surgery, and a high-quality knot can significantly benefit the postoperative recovery of the patient. However, a longtime operation may easily cause fatigue to surgeons, especially during the tedious wound closure task. In this paper, we present a vision-based method to automate the suture thread grasping, which is a sub-task in surgical knot tying and an intermediate step between the stitching and looping manipulations. To achieve this goal, the acquisition of a suture's three-dimensional (3D) information is critical. Towards this objective, we adopt a transfer-learning strategy first to fine-tune a pre-trained model by learning the information from large legacy surgical data and images obtained by the on-site equipment. Thus, a robust suture segmentation can be achieved regardless of inherent environment noises. We further leverage a searching strategy with termination policies for a suture's sequence inference based on the analysis of multiple topologies. Exact results of the pixel-level sequence along a suture can be obtained, and they can be further applied for a 3D shape reconstruction using our optimized shortest path approach. The grasping point considering the suturing criterion can be ultimately acquired. Experiments regarding the suture 2D segmentation and ordering sequence inference under environmental noises were extensively evaluated. Results related to the automated grasping operation were demonstrated by simulations in V-REP and by robot experiments using Universal Robot (UR) together with the da Vinci Research Kit (dVRK) adopting our learning-driven framework.

preprint2020arXiv

Automatic Gesture Recognition in Robot-assisted Surgery with Reinforcement Learning and Tree Search

Automatic surgical gesture recognition is fundamental for improving intelligence in robot-assisted surgery, such as conducting complicated tasks of surgery surveillance and skill evaluation. However, current methods treat each frame individually and produce the outcomes without effective consideration on future information. In this paper, we propose a framework based on reinforcement learning and tree search for joint surgical gesture segmentation and classification. An agent is trained to segment and classify the surgical video in a human-like manner whose direct decisions are re-considered by tree search appropriately. Our proposed tree search algorithm unites the outputs from two designed neural networks, i.e., policy and value network. With the integration of complementary information from distinct models, our framework is able to achieve the better performance than baseline methods using either of the neural networks. For an overall evaluation, our developed approach consistently outperforms the existing methods on the suturing task of JIGSAWS dataset in terms of accuracy, edit score and F1 score. Our study highlights the utilization of tree search to refine actions in reinforcement learning framework for surgical robotic applications.

preprint2020arXiv

Constrained Multi-shape Evolution for Overlapping Cytoplasm Segmentation

Segmenting overlapping cytoplasm of cells in cervical smear images is a clinically essential task, for quantitatively measuring cell-level features in order to diagnose cervical cancer. This task, however, remains rather challenging, mainly due to the deficiency of intensity (or color) information in the overlapping region. Although shape prior-based models that compensate intensity deficiency by introducing prior shape information (shape priors) about cytoplasm are firmly established, they often yield visually implausible results, mainly because they model shape priors only by limited shape hypotheses about cytoplasm, exploit cytoplasm-level shape priors alone, and impose no shape constraint on the resulting shape of the cytoplasm. In this paper, we present a novel and effective shape prior-based approach, called constrained multi-shape evolution, that segments all overlapping cytoplasms in the clump simultaneously by jointly evolving each cytoplasm's shape guided by the modeled shape priors. We model local shape priors (cytoplasm--level) by an infinitely large shape hypothesis set which contains all possible shapes of the cytoplasm. In the shape evolution, we compensate intensity deficiency for the segmentation by introducing not only the modeled local shape priors but also global shape priors (clump--level) modeled by considering mutual shape constraints of cytoplasms in the clump. We also constrain the resulting shape in each evolution to be in the built shape hypothesis set, for further reducing implausible segmentation results. We evaluated the proposed method in two typical cervical smear datasets, and the extensive experimental results show that the proposed method is effective to segment overlapping cytoplasm, consistently outperforming the state-of-the-art methods.

preprint2020arXiv

Contrastive Cross-site Learning with Redesigned Net for COVID-19 CT Classification

The pandemic of coronavirus disease 2019 (COVID-19) has lead to a global public health crisis spreading hundreds of countries. With the continuous growth of new infections, developing automated tools for COVID-19 identification with CT image is highly desired to assist the clinical diagnosis and reduce the tedious workload of image interpretation. To enlarge the datasets for developing machine learning methods, it is essentially helpful to aggregate the cases from different medical systems for learning robust and generalizable models. This paper proposes a novel joint learning framework to perform accurate COVID-19 identification by effectively learning with heterogeneous datasets with distribution discrepancy. We build a powerful backbone by redesigning the recently proposed COVID-Net in aspects of network architecture and learning strategy to improve the prediction accuracy and learning efficiency. On top of our improved backbone, we further explicitly tackle the cross-site domain shift by conducting separate feature normalization in latent space. Moreover, we propose to use a contrastive training objective to enhance the domain invariance of semantic embeddings for boosting the classification performance on each dataset. We develop and evaluate our method with two public large-scale COVID-19 diagnosis datasets made up of CT images. Extensive experiments show that our approach consistently improves the performances on both datasets, outperforming the original COVID-Net trained on each dataset by 12.16% and 14.23% in AUC respectively, also exceeding existing state-of-the-art multi-site learning methods.

preprint2020arXiv

Harmonizing Transferability and Discriminability for Adapting Object Detectors

Recent advances in adaptive object detection have achieved compelling results in virtue of adversarial feature adaptation to mitigate the distributional shifts along the detection pipeline. Whilst adversarial adaptation significantly enhances the transferability of feature representations, the feature discriminability of object detectors remains less investigated. Moreover, transferability and discriminability may come at a contradiction in adversarial adaptation given the complex combinations of objects and the differentiated scene layouts between domains. In this paper, we propose a Hierarchical Transferability Calibration Network (HTCN) that hierarchically (local-region/image/instance) calibrates the transferability of feature representations for harmonizing transferability and discriminability. The proposed model consists of three components: (1) Importance Weighted Adversarial Training with input Interpolation (IWAT-I), which strengthens the global discriminability by re-weighting the interpolated image-level features; (2) Context-aware Instance-Level Alignment (CILA) module, which enhances the local discriminability by capturing the underlying complementary effect between the instance-level feature and the global context information for the instance-level feature alignment; (3) local feature masks that calibrate the local transferability to provide semantic guidance for the following discriminative pattern alignment. Experimental results show that HTCN significantly outperforms the state-of-the-art methods on benchmark datasets.

preprint2020arXiv

Learning Motion Flows for Semi-supervised Instrument Segmentation from Robotic Surgical Video

Performing low hertz labeling for surgical videos at intervals can greatly releases the burden of surgeons. In this paper, we study the semi-supervised instrument segmentation from robotic surgical videos with sparse annotations. Unlike most previous methods using unlabeled frames individually, we propose a dual motion based method to wisely learn motion flows for segmentation enhancement by leveraging temporal dynamics. We firstly design a flow predictor to derive the motion for jointly propagating the frame-label pairs given the current labeled frame. Considering the fast instrument motion, we further introduce a flow compensator to estimate intermediate motion within continuous frames, with a novel cycle learning strategy. By exploiting generated data pairs, our framework can recover and even enhance temporal consistency of training sequences to benefit segmentation. We validate our framework with binary, part, and type tasks on 2017 MICCAI EndoVis Robotic Instrument Segmentation Challenge dataset. Results show that our method outperforms the state-of-the-art semi-supervised methods by a large margin, and even exceeds fully supervised training on two tasks.

preprint2020arXiv

LRTD: Long-Range Temporal Dependency based Active Learning for Surgical Workflow Recognition

Automatic surgical workflow recognition in video is an essentially fundamental yet challenging problem for developing computer-assisted and robotic-assisted surgery. Existing approaches with deep learning have achieved remarkable performance on analysis of surgical videos, however, heavily relying on large-scale labelled datasets. Unfortunately, the annotation is not often available in abundance, because it requires the domain knowledge of surgeons. In this paper, we propose a novel active learning method for cost-effective surgical video analysis. Specifically, we propose a non-local recurrent convolutional network (NL-RCNet), which introduces non-local block to capture the long-range temporal dependency (LRTD) among continuous frames. We then formulate an intra-clip dependency score to represent the overall dependency within this clip. By ranking scores among clips in unlabelled data pool, we select the clips with weak dependencies to annotate, which indicates the most informative ones to better benefit network training. We validate our approach on a large surgical video dataset (Cholec80) by performing surgical workflow recognition task. By using our LRTD based selection strategy, we can outperform other state-of-the-art active learning methods. Using only up to 50% of samples, our approach can exceed the performance of full-data training.

preprint2020arXiv

MS-Net: Multi-Site Network for Improving Prostate Segmentation with Heterogeneous MRI Data

Automated prostate segmentation in MRI is highly demanded for computer-assisted diagnosis. Recently, a variety of deep learning methods have achieved remarkable progress in this task, usually relying on large amounts of training data. Due to the nature of scarcity for medical images, it is important to effectively aggregate data from multiple sites for robust model training, to alleviate the insufficiency of single-site samples. However, the prostate MRIs from different sites present heterogeneity due to the differences in scanners and imaging protocols, raising challenges for effective ways of aggregating multi-site data for network training. In this paper, we propose a novel multi-site network (MS-Net) for improving prostate segmentation by learning robust representations, leveraging multiple sources of data. To compensate for the inter-site heterogeneity of different MRI datasets, we develop Domain-Specific Batch Normalization layers in the network backbone, enabling the network to estimate statistics and perform feature normalization for each site separately. Considering the difficulty of capturing the shared knowledge from multiple datasets, a novel learning paradigm, i.e., Multi-site-guided Knowledge Transfer, is proposed to enhance the kernels to extract more generic representations from multi-site data. Extensive experiments on three heterogeneous prostate MRI datasets demonstrate that our MS-Net improves the performance across all datasets consistently, and outperforms state-of-the-art methods for multi-site learning.

preprint2020arXiv

Robust Multimodal Brain Tumor Segmentation via Feature Disentanglement and Gated Fusion

Accurate medical image segmentation commonly requires effective learning of the complementary information from multimodal data. However, in clinical practice, we often encounter the problem of missing imaging modalities. We tackle this challenge and propose a novel multimodal segmentation framework which is robust to the absence of imaging modalities. Our network uses feature disentanglement to decompose the input modalities into the modality-specific appearance code, which uniquely sticks to each modality, and the modality-invariant content code, which absorbs multimodal information for the segmentation task. With enhanced modality-invariance, the disentangled content code from each modality is fused into a shared representation which gains robustness to missing data. The fusion is achieved via a learning-based strategy to gate the contribution of different modalities at different locations. We validate our method on the important yet challenging multimodal brain tumor segmentation task with the BRATS challenge dataset. With competitive performance to the state-of-the-art approaches for full modality, our method achieves outstanding robustness under various missing modality(ies) situations, significantly exceeding the state-of-the-art method by over 16% in average for Dice on whole tumor segmentation.

preprint2020arXiv

Semi-supervised Medical Image Classification with Relation-driven Self-ensembling Model

Training deep neural networks usually requires a large amount of labeled data to obtain good performance. However, in medical image analysis, obtaining high-quality labels for the data is laborious and expensive, as accurately annotating medical images demands expertise knowledge of the clinicians. In this paper, we present a novel relation-driven semi-supervised framework for medical image classification. It is a consistency-based method which exploits the unlabeled data by encouraging the prediction consistency of given input under perturbations, and leverages a self-ensembling model to produce high-quality consistency targets for the unlabeled data. Considering that human diagnosis often refers to previous analogous cases to make reliable decisions, we introduce a novel sample relation consistency (SRC) paradigm to effectively exploit unlabeled data by modeling the relationship information among different samples. Superior to existing consistency-based methods which simply enforce consistency of individual predictions, our framework explicitly enforces the consistency of semantic relation among different samples under perturbations, encouraging the model to explore extra semantic information from unlabeled data. We have conducted extensive experiments to evaluate our method on two public benchmark medical image classification datasets, i.e.,skin lesion diagnosis with ISIC 2018 challenge and thorax disease classification with ChestX-ray14. Our method outperforms many state-of-the-art semi-supervised learning methods on both single-label and multi-label image classification scenarios.

preprint2020arXiv

Shape-aware Meta-learning for Generalizing Prostate MRI Segmentation to Unseen Domains

Model generalization capacity at domain shift (e.g., various imaging protocols and scanners) is crucial for deep learning methods in real-world clinical deployment. This paper tackles the challenging problem of domain generalization, i.e., learning a model from multi-domain source data such that it can directly generalize to an unseen target domain. We present a novel shape-aware meta-learning scheme to improve the model generalization in prostate MRI segmentation. Our learning scheme roots in the gradient-based meta-learning, by explicitly simulating domain shift with virtual meta-train and meta-test during training. Importantly, considering the deficiencies encountered when applying a segmentation model to unseen domains (i.e., incomplete shape and ambiguous boundary of the prediction masks), we further introduce two complementary loss objectives to enhance the meta-optimization, by particularly encouraging the shape compactness and shape smoothness of the segmentations under simulated domain shift. We evaluate our method on prostate MRI data from six different institutions with distribution shifts acquired from public datasets. Experimental results show that our approach outperforms many state-of-the-art generalization methods consistently across all six settings of unseen domains.

preprint2020arXiv

Unpaired Multi-modal Segmentation via Knowledge Distillation

Multi-modal learning is typically performed with network architectures containing modality-specific layers and shared layers, utilizing co-registered images of different modalities. We propose a novel learning scheme for unpaired cross-modality image segmentation, with a highly compact architecture achieving superior segmentation accuracy. In our method, we heavily reuse network parameters, by sharing all convolutional kernels across CT and MRI, and only employ modality-specific internal normalization layers which compute respective statistics. To effectively train such a highly compact model, we introduce a novel loss term inspired by knowledge distillation, by explicitly constraining the KL-divergence of our derived prediction distributions between modalities. We have extensively validated our approach on two multi-class segmentation problems: i) cardiac structure segmentation, and ii) abdominal organ segmentation. Different network settings, i.e., 2D dilated network and 3D U-net, are utilized to investigate our method's general efficacy. Experimental results on both tasks demonstrate that our novel multi-modal learning scheme consistently outperforms single-modal training and previous multi-modal approaches.

preprint2020arXiv

Unsupervised Bidirectional Cross-Modality Adaptation via Deeply Synergistic Image and Feature Alignment for Medical Image Segmentation

Unsupervised domain adaptation has increasingly gained interest in medical image computing, aiming to tackle the performance degradation of deep neural networks when being deployed to unseen data with heterogeneous characteristics. In this work, we present a novel unsupervised domain adaptation framework, named as Synergistic Image and Feature Alignment (SIFA), to effectively adapt a segmentation network to an unlabeled target domain. Our proposed SIFA conducts synergistic alignment of domains from both image and feature perspectives. In particular, we simultaneously transform the appearance of images across domains and enhance domain-invariance of the extracted features by leveraging adversarial learning in multiple aspects and with a deeply supervised mechanism. The feature encoder is shared between both adaptive perspectives to leverage their mutual benefits via end-to-end learning. We have extensively evaluated our method with cardiac substructure segmentation and abdominal multi-organ segmentation for bidirectional cross-modality adaptation between MRI and CT images. Experimental results on two different tasks demonstrate that our SIFA method is effective in improving segmentation performance on unlabeled target images, and outperforms the state-of-the-art domain adaptation approaches by a large margin.