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

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

GLSFormer: Gated - Long, Short Sequence Transformer for Step Recognition in Surgical Videos

Automated surgical step recognition is an important task that can significantly improve patient safety and decision-making during surgeries. Existing state-of-the-art methods for surgical step recognition either rely on separate, multi-stage modeling of spatial and temporal information or operate on short-range temporal resolution when learned jointly. However, the benefits of joint modeling of spatio-temporal features and long-range information are not taken in account. In this paper, we propose a vision transformer-based approach to jointly learn spatio-temporal features directly from sequence of frame-level patches. Our method incorporates a gated-temporal attention mechanism that intelligently combines short-term and long-term spatio-temporal feature representations. We extensively evaluate our approach on two cataract surgery video datasets, namely Cataract-101 and D99, and demonstrate superior performance compared to various state-of-the-art methods. These results validate the suitability of our proposed approach for automated surgical step recognition. Our code is released at: https://github.com/nisargshah1999/GLSFormerComment: Accepted to MICCAI 2023 (Early Accept

A Chebyshev Confidence Guided Source-Free Domain Adaptation Framework for Medical Image Segmentation

Source-free domain adaptation (SFDA) aims to adapt models trained on a labeled source domain to an unlabeled target domain without the access to source data. In medical imaging scenarios, the practical significance of SFDA methods has been emphasized due to privacy concerns. Recent State-of-the-art SFDA methods primarily rely on self-training based on pseudo-labels (PLs). Unfortunately, PLs suffer from accuracy deterioration caused by domain shift, and thus limit the effectiveness of the adaptation process. To address this issue, we propose a Chebyshev confidence guided SFDA framework to accurately assess the reliability of PLs and generate self-improving PLs for self-training. The Chebyshev confidence is estimated by calculating probability lower bound of the PL confidence, given the prediction and the corresponding uncertainty. Leveraging the Chebyshev confidence, we introduce two confidence-guided denoising methods: direct denoising and prototypical denoising. Additionally, we propose a novel teacher-student joint training scheme (TJTS) that incorporates a confidence weighting module to improve PLs iteratively. The TJTS, in collaboration with the denoising methods, effectively prevents the propagation of noise and enhances the accuracy of PLs. Extensive experiments in diverse domain scenarios validate the effectiveness of our proposed framework and establish its superiority over state-of-the-art SFDA methods. Our paper contributes to the field of SFDA by providing a novel approach for precisely estimating the reliability of pseudo-labels and a framework for obtaining high-quality PLs, resulting in improved adaptation performance

Dual-Decoder Consistency via Pseudo-Labels Guided Data Augmentation for Semi-Supervised Medical Image Segmentation

Medical image segmentation methods often rely on fully supervised approaches to achieve excellent performance, which is contingent upon having an extensive set of labeled images for training. However, annotating medical images is both expensive and time-consuming. Semi-supervised learning offers a solution by leveraging numerous unlabeled images alongside a limited set of annotated ones. In this paper, we introduce a semi-supervised medical image segmentation method based on the mean-teacher model, referred to as Dual-Decoder Consistency via Pseudo-Labels Guided Data Augmentation (DCPA). This method combines consistency regularization, pseudo-labels, and data augmentation to enhance the efficacy of semi-supervised segmentation. Firstly, the proposed model comprises both student and teacher models with a shared encoder and two distinct decoders employing different up-sampling strategies. Minimizing the output discrepancy between decoders enforces the generation of consistent representations, serving as regularization during student model training. Secondly, we introduce mixup operations to blend unlabeled data with labeled data, creating mixed data and thereby achieving data augmentation. Lastly, pseudo-labels are generated by the teacher model and utilized as labels for mixed data to compute unsupervised loss. We compare the segmentation results of the DCPA model with six state-of-the-art semi-supervised methods on three publicly available medical datasets. Beyond classical 10\% and 20\% semi-supervised settings, we investigate performance with less supervision (5\% labeled data). Experimental outcomes demonstrate that our approach consistently outperforms existing semi-supervised medical image segmentation methods across the three semi-supervised settings

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

Treatment-aware Diffusion Probabilistic Model for Longitudinal MRI Generation and Diffuse Glioma Growth Prediction

Diffuse gliomas are malignant brain tumors that grow widespread through the brain. The complex interactions between neoplastic cells and normal tissue, as well as the treatment-induced changes often encountered, make glioma tumor growth modeling challenging. In this paper, we present a novel end-to-end network capable of generating future tumor masks and realistic MRIs of how the tumor will look at any future time points for different treatment plans. Our approach is based on cutting-edge diffusion probabilistic models and deep-segmentation neural networks. We included sequential multi-parametric magnetic resonance images (MRI) and treatment information as conditioning inputs to guide the generative diffusion process. This allows for tumor growth estimates at any given time point. We trained the model using real-world postoperative longitudinal MRI data with glioma tumor growth trajectories represented as tumor segmentation maps over time. The model has demonstrated promising performance across a range of tasks, including the generation of high-quality synthetic MRIs with tumor masks, time-series tumor segmentations, and uncertainty estimates. Combined with the treatment-aware generated MRIs, the tumor growth predictions with uncertainty estimates can provide useful information for clinical decision-making.Comment: 13 pages, 10 figures, 2 tables, 2 agls, preprints in the IEEE trans. format for submission to IEEE-TM

Test-time augmentation-based active learning and self-training for label-efficient segmentation

Deep learning techniques depend on large datasets whose annotation is time-consuming. To reduce annotation burden, the self-training (ST) and active-learning (AL) methods have been developed as well as methods that combine them in an iterative fashion. However, it remains unclear when each method is the most useful, and when it is advantageous to combine them. In this paper, we propose a new method that combines ST with AL using Test-Time Augmentations (TTA). First, TTA is performed on an initial teacher network. Then, cases for annotation are selected based on the lowest estimated Dice score. Cases with high estimated scores are used as soft pseudo-labels for ST. The selected annotated cases are trained with existing annotated cases and ST cases with border slices annotations. We demonstrate the method on MRI fetal body and placenta segmentation tasks with different data variability characteristics. Our results indicate that ST is highly effective for both tasks, boosting performance for in-distribution (ID) and out-of-distribution (OOD) data. However, while self-training improved the performance of single-sequence fetal body segmentation when combined with AL, it slightly deteriorated performance of multi-sequence placenta segmentation on ID data. AL was helpful for the high variability placenta data, but did not improve upon random selection for the single-sequence body data. For fetal body segmentation sequence transfer, combining AL with ST following ST iteration yielded a Dice of 0.961 with only 6 original scans and 2 new sequence scans. Results using only 15 high-variability placenta cases were similar to those using 50 cases. Code is available at: https://github.com/Bella31/TTA-quality-estimation-ST-ALComment: Accepted to MICCAI MILLanD workshop 202