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

CoTr: Efficiently Bridging CNN and Transformer for 3D Medical Image Segmentation

Clusters of viral pneumonia occurrences over a short period may be a harbinger of an outbreak or pandemic. Rapid and accurate detection of viral pneumonia using chest X-rays can be of significant value for large-scale screening and epidemic prevention, particularly when other more sophisticated imaging modalities are not readily accessible. However, the emergence of novel mutated viruses causes a substantial dataset shift, which can greatly limit the performance of classification-based approaches. In this paper, we formulate the task of differentiating viral pneumonia from non-viral pneumonia and healthy controls into a one-class classification-based anomaly detection problem. We therefore propose the confidence-aware anomaly detection (CAAD) model, which consists of a shared feature extractor, an anomaly detection module, and a confidence prediction module. If the anomaly score produced by the anomaly detection module is large enough, or the confidence score estimated by the confidence prediction module is small enough, the input will be accepted as an anomaly case ( i.e. , viral pneumonia). The major advantage of our approach over binary classification is that we avoid modeling individual viral pneumonia classes explicitly and treat all known viral pneumonia cases as anomalies to improve the one-class model. The proposed model outperforms binary classification models on the clinical X-VIRAL dataset that contains 5,977 viral pneumonia (no COVID-19) cases, 37,393 non-viral pneumonia or healthy cases. Moreover, when directly testing on the X-COVID dataset that contains 106 COVID-19 cases and 107 normal controls without any fine-tuning, our model achieves an AUC of 83.61% and sensitivity of 71.70%, which is comparable to the performance of radiologists reported in the literature.

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Viral Pneumonia Screening on Chest X-Rays Using Confidence-Aware Anomaly Detection

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 . 

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

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

Viral Pneumonia Screening on Chest X-ray Images Using Confidence-Aware Anomaly Detection

Deep learning has become the mainstream technology in computer vision, and it has received extensive research interest in developing new medical image processing algorithms to support disease detection and diagnosis. As compared to conventional machine learning technologies, the major advantage of deep learning is that models can automatically identify and recognize representative features through the hierarchal model architecture, while avoiding the laborious development of hand-crafted features. In this paper, we reviewed and summarized more than 200 recently published papers to provide a comprehensive overview of applying deep learning methods in various medical image analysis tasks. Especially, we emphasize the latest progress and contributions of state-of-the-art unsupervised and semi-supervised deep learning in medical images, which are summarized based on different application scenarios, including lesion classification, segmentation, detection, and image registration. Additionally, we also discussed the major technical challenges and suggested the possible solutions in future research efforts.

Recent advances and clinical applications of deep learning in medical image analysis.

Medical image segmentation is an essential task in computer-aided diagnosis. Despite their prevalence and success, deep convolutional neural networks (DCNNs) still need to be improved to produce accurate and robust enough segmentation results for clinical use. In this paper, we propose a novel and generic framework called Segmentation-Emendation-reSegmentation-Verification (SESV) to improve the accuracy of existing DCNNs in medical image segmentation, instead of designing a more accurate segmentation model. Our idea is to predict the segmentation errors produced by an existing model and then correct them. Since predicting segmentation errors is challenging, we design two ways to tolerate the mistakes in the error prediction. First, rather than using a predicted segmentation error map to correct the segmentation mask directly, we only treat the error map as the prior that indicates the locations where segmentation errors are prone to occur, and then concatenate the error map with the image and segmentation mask as the input of a re-segmentation network. Second, we introduce a verification network to determine whether to accept or reject the refined mask produced by the re-segmentation network on a region-by-region basis. The experimental results on the CRAG, ISIC, and IDRiD datasets suggest that using our SESV framework can improve the accuracy of DeepLabv3+ substantially and achieve advanced performance in the segmentation of gland cells, skin lesions, and retinal microaneurysms. Consistent conclusions can also be drawn when using PSPNet, U-Net, and FPN as the segmentation network, respectively. Therefore, our SESV framework is capable of improving the accuracy of different DCNNs on different medical image segmentation tasks.

SESV: Accurate Medical Image Segmentation by Predicting and Correcting Errors

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

DoDNet: Learning to segment multi-organ and tumors from multiple partially labeled datasets

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

Inter-Slice Context Residual Learning for 3D Medical Image Segmentation

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

Jianpeng Zhang

Papers

CoTr: Efficiently Bridging CNN and Transformer for 3D Medical Image Segmentation

SESV: Accurate Medical Image Segmentation by Predicting and Correcting Errors

DoDNet: Learning to segment multi-organ and tumors from multiple partially labeled datasets

Inter-Slice Context Residual Learning for 3D Medical Image Segmentation

Inter-slice Context Residual Learning for 3D Medical Image Segmentation.