Data efficient deep learning for medical image analysis: A survey

The rapid evolution of deep learning has significantly advanced the field of medical image analysis. However, despite these achievements, the further enhancement of deep learning models for medical image analysis faces a significant challenge due to the scarcity of large, well-annotated datasets. To address this issue, recent years have witnessed a growing emphasis on the development of data-efficient deep learning methods. This paper conducts a thorough review of data-efficient deep learning methods for medical image analysis. To this end, we categorize these methods based on the level of supervision they rely on, encompassing categories such as no supervision, inexact supervision, incomplete supervision, inaccurate supervision, and only limited supervision. We further divide these categories into finer subcategories. For example, we categorize inexact supervision into multiple instance learning and learning with weak annotations. Similarly, we categorize incomplete supervision into semi-supervised learning, active learning, and domain-adaptive learning and so on. Furthermore, we systematically summarize commonly used datasets for data efficient deep learning in medical image analysis and investigate future research directions to conclude this survey.Comment: Under Revie

Probabilistic 3D surface reconstruction from sparse MRI information

Surface reconstruction from magnetic resonance (MR) imaging data is indispensable in medical image analysis and clinical research. A reliable and effective reconstruction tool should: be fast in prediction of accurate well localised and high resolution models, evaluate prediction uncertainty, work with as little input data as possible. Current deep learning state of the art (SOTA) 3D reconstruction methods, however, often only produce shapes of limited variability positioned in a canonical position or lack uncertainty evaluation. In this paper, we present a novel probabilistic deep learning approach for concurrent 3D surface reconstruction from sparse 2D MR image data and aleatoric uncertainty prediction. Our method is capable of reconstructing large surface meshes from three quasi-orthogonal MR imaging slices from limited training sets whilst modelling the location of each mesh vertex through a Gaussian distribution. Prior shape information is encoded using a built-in linear principal component analysis (PCA) model. Extensive experiments on cardiac MR data show that our probabilistic approach successfully assesses prediction uncertainty while at the same time qualitatively and quantitatively outperforms SOTA methods in shape prediction. Compared to SOTA, we are capable of properly localising and orientating the prediction via the use of a spatially aware neural network.Comment: MICCAI 202

Deep learning for unsupervised domain adaptation in medical imaging: Recent advancements and future perspectives

Deep learning has demonstrated remarkable performance across various tasks in medical imaging. However, these approaches primarily focus on supervised learning, assuming that the training and testing data are drawn from the same distribution. Unfortunately, this assumption may not always hold true in practice. To address these issues, unsupervised domain adaptation (UDA) techniques have been developed to transfer knowledge from a labeled domain to a related but unlabeled domain. In recent years, significant advancements have been made in UDA, resulting in a wide range of methodologies, including feature alignment, image translation, self-supervision, and disentangled representation methods, among others. In this paper, we provide a comprehensive literature review of recent deep UDA approaches in medical imaging from a technical perspective. Specifically, we categorize current UDA research in medical imaging into six groups and further divide them into finer subcategories based on the different tasks they perform. We also discuss the respective datasets used in the studies to assess the divergence between the different domains. Finally, we discuss emerging areas and provide insights and discussions on future research directions to conclude this survey.Comment: Under Revie

Comparing Adversarial and Supervised Learning for Organs at Risk Segmentation in CT images

Organ at Risk (OAR) segmentation from CT scans is a key component of the radiotherapy treatment workflow. In recent years, deep learning techniques have shown remarkable potential in automating this process. In this paper, we investigate the performance of Generative Adversarial Networks (GANs) compared to supervised learning approaches for segmenting OARs from CT images. We propose three GAN-based models with identical generator architectures but different discriminator networks. These models are compared with well-established CNN models, such as SE-ResUnet and DeepLabV3, using the StructSeg dataset, which consists of 50 annotated CT scans containing contours of six OARs. Our work aims to provide insight into the advantages and disadvantages of adversarial training in the context of OAR segmentation. The results are very promising and show that the proposed GAN-based approaches are similar or superior to their CNN-based counterparts, particularly when segmenting more challenging target organs

SA2-Net: Scale-aware Attention Network for Microscopic Image Segmentation

Microscopic image segmentation is a challenging task, wherein the objective is to assign semantic labels to each pixel in a given microscopic image. While convolutional neural networks (CNNs) form the foundation of many existing frameworks, they often struggle to explicitly capture long-range dependencies. Although transformers were initially devised to address this issue using self-attention, it has been proven that both local and global features are crucial for addressing diverse challenges in microscopic images, including variations in shape, size, appearance, and target region density. In this paper, we introduce SA2-Net, an attention-guided method that leverages multi-scale feature learning to effectively handle diverse structures within microscopic images. Specifically, we propose scale-aware attention (SA2) module designed to capture inherent variations in scales and shapes of microscopic regions, such as cells, for accurate segmentation. This module incorporates local attention at each level of multi-stage features, as well as global attention across multiple resolutions. Furthermore, we address the issue of blurred region boundaries (e.g., cell boundaries) by introducing a novel upsampling strategy called the Adaptive Up-Attention (AuA) module. This module enhances the discriminative ability for improved localization of microscopic regions using an explicit attention mechanism. Extensive experiments on five challenging datasets demonstrate the benefits of our SA2-Net model. Our source code is publicly available at \url{https://github.com/mustansarfiaz/SA2-Net}.Comment: BMVC 2023 accepted as ora

Improving the domain generalization and robustness of neural networks for medical imaging

Deep neural networks are powerful tools to process medical images, with great potential to accelerate clinical workflows and facilitate large-scale studies. However, in order to achieve satisfactory performance at deployment, these networks generally require massive labeled data collected from various domains (e.g., hospitals, scanners), which is rarely available in practice. The main goal of this work is to improve the domain generalization and robustness of neural networks for medical imaging when labeled data is limited. First, we develop multi-task learning methods to exploit auxiliary data to enhance networks. We first present a multi-task U-net that performs image classification and MR atrial segmentation simultaneously. We then present a shape-aware multi-view autoencoder together with a multi-view U-net, which enables extracting useful shape priors from complementary long-axis views and short-axis views in order to assist the left ventricular myocardium segmentation task on the short-axis MR images. Experimental results show that the proposed networks successfully leverage complementary information from auxiliary tasks to improve model generalization on the main segmentation task. Second, we consider utilizing unlabeled data. We first present an adversarial data augmentation method with bias fields to improve semi-supervised learning for general medical image segmentation tasks. We further explore a more challenging setting where the source and the target images are from different data distributions. We demonstrate that an unsupervised image style transfer method can bridge the domain gap, successfully transferring the knowledge learned from labeled balanced Steady-State Free Precession (bSSFP) images to unlabeled Late Gadolinium Enhancement (LGE) images, achieving state-of-the-art performance on a public multi-sequence cardiac MR segmentation challenge. For scenarios with limited training data from a single domain, we first propose a general training and testing pipeline to improve cardiac image segmentation across various unseen domains. We then present a latent space data augmentation method with a cooperative training framework to further enhance model robustness against unseen domains and imaging artifacts.Open Acces

EdgeAL: An Edge Estimation Based Active Learning Approach for OCT Segmentation

Active learning algorithms have become increasingly popular for training models with limited data. However, selecting data for annotation remains a challenging problem due to the limited information available on unseen data. To address this issue, we propose EdgeAL, which utilizes the edge information of unseen images as {\it a priori} information for measuring uncertainty. The uncertainty is quantified by analyzing the divergence and entropy in model predictions across edges. This measure is then used to select superpixels for annotation. We demonstrate the effectiveness of EdgeAL on multi-class Optical Coherence Tomography (OCT) segmentation tasks, where we achieved a 99% dice score while reducing the annotation label cost to 12%, 2.3%, and 3%, respectively, on three publicly available datasets (Duke, AROI, and UMN). The source code is available at \url{https://github.com/Mak-Ta-Reque/EdgeAL}Comment: This version of the contribution has been submitted in miccai202

Self-training with dual uncertainty for semi-supervised medical image segmentation

In the field of semi-supervised medical image segmentation, the shortage of labeled data is the fundamental problem. How to effectively learn image features from unlabeled images to improve segmentation accuracy is the main research direction in this field. Traditional self-training methods can partially solve the problem of insufficient labeled data by generating pseudo labels for iterative training. However, noise generated due to the model's uncertainty during training directly affects the segmentation results. Therefore, we added sample-level and pixel-level uncertainty to stabilize the training process based on the self-training framework. Specifically, we saved several moments of the model during pre-training, and used the difference between their predictions on unlabeled samples as the sample-level uncertainty estimate for that sample. Then, we gradually add unlabeled samples from easy to hard during training. At the same time, we added a decoder with different upsampling methods to the segmentation network and used the difference between the outputs of the two decoders as pixel-level uncertainty. In short, we selectively retrained unlabeled samples and assigned pixel-level uncertainty to pseudo labels to optimize the self-training process. We compared the segmentation results of our model with five semi-supervised approaches on the public 2017 ACDC dataset and 2018 Prostate dataset. Our proposed method achieves better segmentation performance on both datasets under the same settings, demonstrating its effectiveness, robustness, and potential transferability to other medical image segmentation tasks. Keywords: Medical image segmentation, semi-supervised learning, self-training, uncertainty estimatio

Distribution Aligned Diffusion and Prototype-guided network for Unsupervised Domain Adaptive Segmentation

The Diffusion Probabilistic Model (DPM) has emerged as a highly effective generative model in the field of computer vision. Its intermediate latent vectors offer rich semantic information, making it an attractive option for various downstream tasks such as segmentation and detection. In order to explore its potential further, we have taken a step forward and considered a more complex scenario in the medical image domain, specifically, under an unsupervised adaptation condition. To this end, we propose a Diffusion-based and Prototype-guided network (DP-Net) for unsupervised domain adaptive segmentation. Concretely, our DP-Net consists of two stages: 1) Distribution Aligned Diffusion (DADiff), which involves training a domain discriminator to minimize the difference between the intermediate features generated by the DPM, thereby aligning the inter-domain distribution; and 2) Prototype-guided Consistency Learning (PCL), which utilizes feature centroids as prototypes and applies a prototype-guided loss to ensure that the segmentor learns consistent content from both source and target domains. Our approach is evaluated on fundus datasets through a series of experiments, which demonstrate that the performance of the proposed method is reliable and outperforms state-of-the-art methods. Our work presents a promising direction for using DPM in complex medical image scenarios, opening up new possibilities for further research in medical imaging