Is attention all you need in medical image analysis? A review

Medical imaging is a key component in clinical diagnosis, treatment planning and clinical trial design, accounting for almost 90% of all healthcare data. CNNs achieved performance gains in medical image analysis (MIA) over the last years. CNNs can efficiently model local pixel interactions and be trained on small-scale MI data. The main disadvantage of typical CNN models is that they ignore global pixel relationships within images, which limits their generalisation ability to understand out-of-distribution data with different 'global' information. The recent progress of Artificial Intelligence gave rise to Transformers, which can learn global relationships from data. However, full Transformer models need to be trained on large-scale data and involve tremendous computational complexity. Attention and Transformer compartments (Transf/Attention) which can well maintain properties for modelling global relationships, have been proposed as lighter alternatives of full Transformers. Recently, there is an increasing trend to co-pollinate complementary local-global properties from CNN and Transf/Attention architectures, which led to a new era of hybrid models. The past years have witnessed substantial growth in hybrid CNN-Transf/Attention models across diverse MIA problems. In this systematic review, we survey existing hybrid CNN-Transf/Attention models, review and unravel key architectural designs, analyse breakthroughs, and evaluate current and future opportunities as well as challenges. We also introduced a comprehensive analysis framework on generalisation opportunities of scientific and clinical impact, based on which new data-driven domain generalisation and adaptation methods can be stimulated

Deep Learning in Cardiology

The medical field is creating large amount of data that physicians are unable to decipher and use efficiently. Moreover, rule-based expert systems are inefficient in solving complicated medical tasks or for creating insights using big data. Deep learning has emerged as a more accurate and effective technology in a wide range of medical problems such as diagnosis, prediction and intervention. Deep learning is a representation learning method that consists of layers that transform the data non-linearly, thus, revealing hierarchical relationships and structures. In this review we survey deep learning application papers that use structured data, signal and imaging modalities from cardiology. We discuss the advantages and limitations of applying deep learning in cardiology that also apply in medicine in general, while proposing certain directions as the most viable for clinical use.Comment: 27 pages, 2 figures, 10 table

Denoising method for dynamic contrast-enhanced CT perfusion studies using three-dimensional deep image prior as a simultaneous spatial and temporal regularizer

This study aimed to propose a denoising method for dynamic contrast-enhanced computed tomography (DCE-CT) perfusion studies using a three-dimensional deep image prior (DIP), and to investigate its usefulness in comparison with total variation (TV)-based methods with different regularization parameter (alpha) values through simulation studies. In the proposed DIP method, the DIP was incorporated into the constrained optimization problem for image denoising as a simultaneous spatial and temporal regularizer, which was solved using the alternating direction method of multipliers. In the simulation studies, DCE-CT images were generated using a digital brain phantom and their noise level was varied using the X-ray exposure noise model with different exposures (15, 30, 50, 75, and 100 mAs). Cerebral blood flow (CBF) images were generated from the original contrast enhancement (CE) images and those obtained by the DIP and TV methods using block-circulant singular value decomposition. The quality of the CE images was evaluated using the peak signal-to-noise ratio (PSNR) and structural similarity index (SSIM). To compare the CBF images obtained by the different methods and those generated from the ground truth images, linear regression analysis was performed. When using the DIP method, the PSNR and SSIM were not significantly dependent on the exposure, and the SSIM was the highest for all exposures. When using the TV methods, they were significantly dependent on the exposure and alpha values. The results of the linear regression analysis suggested that the linearity of the CBF images obtained by the DIP method was superior to those obtained from the original CE images and by the TV methods. Our preliminary results suggest that the DIP method is useful for denoising DCE-CT images at ultra-low to low exposures and for improving the accuracy of the CBF images generated from them

Noise2Contrast: Multi-Contrast Fusion Enables Self-Supervised Tomographic Image Denoising

Self-supervised image denoising techniques emerged as convenient methods that allow training denoising models without requiring ground-truth noise-free data. Existing methods usually optimize loss metrics that are calculated from multiple noisy realizations of similar images, e.g., from neighboring tomographic slices. However, those approaches fail to utilize the multiple contrasts that are routinely acquired in medical imaging modalities like MRI or dual-energy CT. In this work, we propose the new self-supervised training scheme Noise2Contrast that combines information from multiple measured image contrasts to train a denoising model. We stack denoising with domain-transfer operators to utilize the independent noise realizations of different image contrasts to derive a self-supervised loss. The trained denoising operator achieves convincing quantitative and qualitative results, outperforming state-of-the-art self-supervised methods by 4.7-11.0%/4.8-7.3% (PSNR/SSIM) on brain MRI data and by 43.6-50.5%/57.1-77.1% (PSNR/SSIM) on dual-energy CT X-ray microscopy data with respect to the noisy baseline. Our experiments on different real measured data sets indicate that Noise2Contrast training generalizes to other multi-contrast imaging modalities

On the Benefit of Dual-domain Denoising in a Self-supervised Low-dose CT Setting

Computed tomography (CT) is routinely used for three-dimensional non-invasive imaging. Numerous data-driven image denoising algorithms were proposed to restore image quality in low-dose acquisitions. However, considerably less research investigates methods already intervening in the raw detector data due to limited access to suitable projection data or correct reconstruction algorithms. In this work, we present an end-to-end trainable CT reconstruction pipeline that contains denoising operators in both the projection and the image domain and that are optimized simultaneously without requiring ground-truth high-dose CT data. Our experiments demonstrate that including an additional projection denoising operator improved the overall denoising performance by 82.4-94.1%/12.5-41.7% (PSNR/SSIM) on abdomen CT and 1.5-2.9%/0.4-0.5% (PSNR/SSIM) on XRM data relative to the low-dose baseline. We make our entire helical CT reconstruction framework publicly available that contains a raw projection rebinning step to render helical projection data suitable for differentiable fan-beam reconstruction operators and end-to-end learning.Comment: This work has been submitted to the IEEE for possible publication. Copyright may be transferred without notice, after which this version may no longer be accessibl

Physics-Informed Computer Vision: A Review and Perspectives

Incorporation of physical information in machine learning frameworks are opening and transforming many application domains. Here the learning process is augmented through the induction of fundamental knowledge and governing physical laws. In this work we explore their utility for computer vision tasks in interpreting and understanding visual data. We present a systematic literature review of formulation and approaches to computer vision tasks guided by physical laws. We begin by decomposing the popular computer vision pipeline into a taxonomy of stages and investigate approaches to incorporate governing physical equations in each stage. Existing approaches in each task are analyzed with regard to what governing physical processes are modeled, formulated and how they are incorporated, i.e. modify data (observation bias), modify networks (inductive bias), and modify losses (learning bias). The taxonomy offers a unified view of the application of the physics-informed capability, highlighting where physics-informed learning has been conducted and where the gaps and opportunities are. Finally, we highlight open problems and challenges to inform future research. While still in its early days, the study of physics-informed computer vision has the promise to develop better computer vision models that can improve physical plausibility, accuracy, data efficiency and generalization in increasingly realistic applications