A Survey on Deep Learning in Medical Image Registration: New Technologies, Uncertainty, Evaluation Metrics, and Beyond

Over the past decade, deep learning technologies have greatly advanced the field of medical image registration. The initial developments, such as ResNet-based and U-Net-based networks, laid the groundwork for deep learning-driven image registration. Subsequent progress has been made in various aspects of deep learning-based registration, including similarity measures, deformation regularizations, and uncertainty estimation. These advancements have not only enriched the field of deformable image registration but have also facilitated its application in a wide range of tasks, including atlas construction, multi-atlas segmentation, motion estimation, and 2D-3D registration. In this paper, we present a comprehensive overview of the most recent advancements in deep learning-based image registration. We begin with a concise introduction to the core concepts of deep learning-based image registration. Then, we delve into innovative network architectures, loss functions specific to registration, and methods for estimating registration uncertainty. Additionally, this paper explores appropriate evaluation metrics for assessing the performance of deep learning models in registration tasks. Finally, we highlight the practical applications of these novel techniques in medical imaging and discuss the future prospects of deep learning-based image registration

Neural Network Pruning for Real-time Polyp Segmentation

Computer-assisted treatment has emerged as a viable application of medical imaging, owing to the efficacy of deep learning models. Real-time inference speed remains a key requirement for such applications to help medical personnel. Even though there generally exists a trade-off between performance and model size, impressive efforts have been made to retain near-original performance by compromising model size. Neural network pruning has emerged as an exciting area that aims to eliminate redundant parameters to make the inference faster. In this study, we show an application of neural network pruning in polyp segmentation. We compute the importance score of convolutional filters and remove the filters having the least scores, which to some value of pruning does not degrade the performance. For computing the importance score, we use the Taylor First Order (TaylorFO) approximation of the change in network output for the removal of certain filters. Specifically, we employ a gradient-normalized backpropagation for the computation of the importance score. Through experiments in the polyp datasets, we validate that our approach can significantly reduce the parameter count and FLOPs retaining similar performance

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

AiAReSeg: Catheter Detection and Segmentation in Interventional Ultrasound using Transformers

To date, endovascular surgeries are performed using the golden standard of Fluoroscopy, which uses ionising radiation to visualise catheters and vasculature. Prolonged Fluoroscopic exposure is harmful for the patient and the clinician, and may lead to severe post-operative sequlae such as the development of cancer. Meanwhile, the use of interventional Ultrasound has gained popularity, due to its well-known benefits of small spatial footprint, fast data acquisition, and higher tissue contrast images. However, ultrasound images are hard to interpret, and it is difficult to localise vessels, catheters, and guidewires within them. This work proposes a solution using an adaptation of a state-of-the-art machine learning transformer architecture to detect and segment catheters in axial interventional Ultrasound image sequences. The network architecture was inspired by the Attention in Attention mechanism, temporal tracking networks, and introduced a novel 3D segmentation head that performs 3D deconvolution across time. In order to facilitate training of such deep learning networks, we introduce a new data synthesis pipeline that used physics-based catheter insertion simulations, along with a convolutional ray-casting ultrasound simulator to produce synthetic ultrasound images of endovascular interventions. The proposed method is validated on a hold-out validation dataset, thus demonstrated robustness to ultrasound noise and a wide range of scanning angles. It was also tested on data collected from silicon-based aorta phantoms, thus demonstrated its potential for translation from sim-to-real. This work represents a significant step towards safer and more efficient endovascular surgery using interventional ultrasound.Comment: This work has been submitted to the IEEE for possible publicatio

Multi-level feature fusion network combining attention mechanisms for polyp segmentation

Clinically, automated polyp segmentation techniques have the potential to significantly improve the efficiency and accuracy of medical diagnosis, thereby reducing the risk of colorectal cancer in patients. Unfortunately, existing methods suffer from two significant weaknesses that can impact the accuracy of segmentation. Firstly, features extracted by encoders are not adequately filtered and utilized. Secondly, semantic conflicts and information redundancy caused by feature fusion are not attended to. To overcome these limitations, we propose a novel approach for polyp segmentation, named MLFF-Net, which leverages multi-level feature fusion and attention mechanisms. Specifically, MLFF-Net comprises three modules: Multi-scale Attention Module (MAM), High-level Feature Enhancement Module (HFEM), and Global Attention Module (GAM). Among these, MAM is used to extract multi-scale information and polyp details from the shallow output of the encoder. In HFEM, the deep features of the encoders complement each other by aggregation. Meanwhile, the attention mechanism redistributes the weight of the aggregated features, weakening the conflicting redundant parts and highlighting the information useful to the task. GAM combines features from the encoder and decoder features, as well as computes global dependencies to prevent receptive field locality. Experimental results on five public datasets show that the proposed method not only can segment multiple types of polyps but also has advantages over current state-of-the-art methods in both accuracy and generalization ability

Dynamic Data Augmentation via MCTS for Prostate MRI Segmentation

Medical image data are often limited due to the expensive acquisition and annotation process. Hence, training a deep-learning model with only raw data can easily lead to overfitting. One solution to this problem is to augment the raw data with various transformations, improving the model's ability to generalize to new data. However, manually configuring a generic augmentation combination and parameters for different datasets is non-trivial due to inconsistent acquisition approaches and data distributions. Therefore, automatic data augmentation is proposed to learn favorable augmentation strategies for different datasets while incurring large GPU overhead. To this end, we present a novel method, called Dynamic Data Augmentation (DDAug), which is efficient and has negligible computation cost. Our DDAug develops a hierarchical tree structure to represent various augmentations and utilizes an efficient Monte-Carlo tree searching algorithm to update, prune, and sample the tree. As a result, the augmentation pipeline can be optimized for each dataset automatically. Experiments on multiple Prostate MRI datasets show that our method outperforms the current state-of-the-art data augmentation strategies

Detecting the Sensing Area of A Laparoscopic Probe in Minimally Invasive Cancer Surgery

In surgical oncology, it is challenging for surgeons to identify lymph nodes and completely resect cancer even with pre-operative imaging systems like PET and CT, because of the lack of reliable intraoperative visualization tools. Endoscopic radio-guided cancer detection and resection has recently been evaluated whereby a novel tethered laparoscopic gamma detector is used to localize a preoperatively injected radiotracer. This can both enhance the endoscopic imaging and complement preoperative nuclear imaging data. However, gamma activity visualization is challenging to present to the operator because the probe is non-imaging and it does not visibly indicate the activity origination on the tissue surface. Initial failed attempts used segmentation or geometric methods, but led to the discovery that it could be resolved by leveraging high-dimensional image features and probe position information. To demonstrate the effectiveness of this solution, we designed and implemented a simple regression network that successfully addressed the problem. To further validate the proposed solution, we acquired and publicly released two datasets captured using a custom-designed, portable stereo laparoscope system. Through intensive experimentation, we demonstrated that our method can successfully and effectively detect the sensing area, establishing a new performance benchmark. Code and data are available at https://github.com/br0202/Sensing_area_detection.gitComment: Accepted by MICCAI 202

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