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Cardiovascular disease (CVD) accounts for about half of non-communicable diseases. Vessel stenosis in the coronary artery is considered to be the major risk of CVD. Computed tomography angiography (CTA) is one of the widely used noninvasive imaging modalities in coronary artery diagnosis due to its superior image resolution. Clinically, segmentation of coronary arteries is essential for the diagnosis and quantification of coronary artery disease. Recently, a variety of works have been proposed to address this problem. However, on one hand, most works rely on in-house datasets, and only a few works published their datasets to the public which only contain tens of images. On the other hand, their source code have not been published, and most follow-up works have not made comparison with existing works, which makes it difficult to judge the effectiveness of the methods and hinders the further exploration of this challenging yet critical problem in the community. In this paper, we propose a large-scale dataset for coronary artery segmentation on CTA images. In addition, we have implemented a benchmark in which we have tried our best to implement several typical existing methods. Furthermore, we propose a strong baseline method which combines multi-scale patch fusion and two-stage processing to extract the details of vessels. Comprehensive experiments show that the proposed method achieves better performance than existing works on the proposed large-scale dataset. The benchmark and the dataset are published at https://github.com/XiaoweiXu/ImageCAS-A-Large-Scale-Dataset-and-Benchmark-for-Coronary-Artery-Segmentation-based-on-CT., Comment: 17 pages, 12 figures, 4 tables

Accurately segmenting temporal frames of cine magnetic resonance imaging (MRI) is a crucial step in various real-time MRI guided cardiac interventions. To achieve fast and accurate visual assistance, there are strict requirements on the maximum latency and minimum throughput of the segmentation framework. State-of-the-art neural networks on this task are mostly hand-crafted to satisfy these constraints while achieving high accuracy. On the other hand, while existing literature have demonstrated the power of neural architecture search (NAS) in automatically identifying the best neural architectures for various medical applications, they are mostly guided by accuracy, sometimes with computation complexity, and the importance of real-time constraints are overlooked. A major challenge is that such constraints are non-differentiable and are thus not compatible with the widely used differentiable NAS frameworks. In this paper, we present a strategy that directly handles real-time constraints in a differentiable NAS framework named RT-DNAS. Experiments on extended 2017 MICCAI ACDC dataset show that compared with state-of-the-art manually and automatically designed architectures, RT-DNAS is able to identify ones with better accuracy while satisfying the real-time constraints.

Many works have shown that deep learning-based medical image classification models can exhibit bias toward certain demographic attributes like race, gender, and age. Existing bias mitigation methods primarily focus on learning debiased models, which may not necessarily guarantee all sensitive information can be removed and usually comes with considerable accuracy degradation on both privileged and unprivileged groups. To tackle this issue, we propose a method, FairPrune, that achieves fairness by pruning. Conventionally, pruning is used to reduce the model size for efficient inference. However, we show that pruning can also be a powerful tool to achieve fairness. Our observation is that during pruning, each parameter in the model has different importance for different groups' accuracy. By pruning the parameters based on this importance difference, we can reduce the accuracy difference between the privileged group and the unprivileged group to improve fairness without a large accuracy drop. To this end, we use the second derivative of the parameters of a pre-trained model to quantify the importance of each parameter with respect to the model accuracy for each group. Experiments on two skin lesion diagnosis datasets over multiple sensitive attributes demonstrate that our method can greatly improve fairness while keeping the average accuracy of both groups as high as possible.

Medical images may contain various types of artifacts with different patterns and mixtures, which depend on many factors such as scan setting, machine condition, patients' characteristics, surrounding environment, etc. However, existing deep-learning-based artifact reduction methods are restricted by their training set with specific predetermined artifact types and patterns. As such, they have limited clinical adoption. In this paper, we introduce One-Shot medical image Artifact Reduction (OSAR), which exploits the power of deep learning but without using pre-trained general networks. Specifically, we train a light-weight image-specific artifact reduction network using data synthesized from the input image at test-time. Without requiring any prior large training data set, OSAR can work with almost any medical images that contain varying additive artifacts which are not in any existing data sets. In addition, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are used as vehicles and show that the proposed method can reduce artifacts better than state-of-the-art both qualitatively and quantitatively using shorter test time.

Tissue-level semantic segmentation is a vital step in computational pathology. Fully-supervised models have already achieved outstanding performance with dense pixel-level annotations. However, drawing such labels on the giga-pixel whole slide images is extremely expensive and time-consuming. In this paper, we use only patch-level classification labels to achieve tissue semantic segmentation on histopathology images, finally reducing the annotation efforts. We proposed a two-step model including a classification and a segmentation phases. In the classification phase, we proposed a CAM-based model to generate pseudo masks by patch-level labels. In the segmentation phase, we achieved tissue semantic segmentation by our proposed Multi-Layer Pseudo-Supervision. Several technical novelties have been proposed to reduce the information gap between pixel-level and patch-level annotations. As a part of this paper, we introduced a new weakly-supervised semantic segmentation (WSSS) dataset for lung adenocarcinoma (LUAD-HistoSeg). We conducted several experiments to evaluate our proposed model on two datasets. Our proposed model outperforms two state-of-the-art WSSS approaches. Note that we can achieve comparable quantitative and qualitative results with the fully-supervised model, with only around a 2\% gap for MIoU and FwIoU. By comparing with manual labeling, our model can greatly save the annotation time from hours to minutes. The source code is available at: \url{https://github.com/ChuHan89/WSSS-Tissue}., Comment: 15 pages, 10 figures, journal

Automatic myocardial segmentation of contrast echocardiography has shown great potential in the quantification of myocardial perfusion parameters. Segmentation quality control is an important step to ensure the accuracy of segmentation results for quality research as well as its clinical application. Usually, the segmentation quality control happens after the data acquisition. At the data acquisition time, the operator could not know the quality of the segmentation results. On-the-fly segmentation quality control could help the operator to adjust the ultrasound probe or retake data if the quality is unsatisfied, which can greatly reduce the effort of time-consuming manual correction. However, it is infeasible to deploy state-of-the-art DNN-based models because the segmentation module and quality control module must fit in the limited hardware resource on the ultrasound machine while satisfying strict latency constraints. In this paper, we propose a hardware-aware neural architecture search framework for automatic myocardial segmentation and quality control of contrast echocardiography. We explicitly incorporate the hardware latency as a regularization term into the loss function during training. The proposed method searches the best neural network architecture for the segmentation module and quality prediction module with strict latency., Comment: 4 pages, DAC'21 invited paper

Type-B Aortic Dissection (TBAD) is one of the most serious cardiovascular events characterized by a growing yearly incidence,and the severity of disease prognosis. Currently, computed tomography angiography (CTA) has been widely adopted for the diagnosis and prognosis of TBAD. Accurate segmentation of true lumen (TL), false lumen (FL), and false lumen thrombus (FLT) in CTA are crucial for the precise quantification of anatomical features. However, existing works only focus on only TL and FL without considering FLT. In this paper, we propose ImageTBAD, the first 3D computed tomography angiography (CTA) image dataset of TBAD with annotation of TL, FL, and FLT. The proposed dataset contains 100 TBAD CTA images, which is of decent size compared with existing medical imaging datasets. As FLT can appear almost anywhere along the aorta with irregular shapes, segmentation of FLT presents a wide class of segmentation problems where targets exist in a variety of positions with irregular shapes. We further propose a baseline method for automatic segmentation of TBAD. Results show that the baseline method can achieve comparable results with existing works on aorta and TL segmentation. However, the segmentation accuracy of FLT is only 52%, which leaves large room for improvement and also shows the challenge of our dataset. To facilitate further research on this challenging problem, our dataset and codes are released to the public.

Patent foramen ovale (PFO) is a potential separation between the septum, primum and septum secundum located in the anterosuperior portion of the atrial septum. PFO is one of the main factors causing cryptogenic stroke which is the fifth leading cause of death in the United States. For PFO diagnosis, contrast transthoracic echocardiography (cTTE) is preferred as being a more robust method compared with others. However, the current PFO diagnosis through cTTE is extremely slow as it is proceeded manually by sonographers on echocardiography videos. Currently there is no publicly available dataset for this important topic in the community. In this paper, we present EchoCP, as the first echocardiography dataset in cTTE targeting PFO diagnosis. EchoCP consists of 30 patients with both rest and Valsalva maneuver videos which covers various PFO grades. We further establish an automated baseline method for PFO diagnosis based on the state-of-the-art cardiac chamber segmentation technique, which achieves 0.89 average mean Dice score, but only 0.60/0.67 mean accuracies for PFO diagnosis, leaving large room for improvement. We hope that the challenging EchoCP dataset can stimulate further research and lead to innovative and generic solutions that would have an impact in multiple domains. Our dataset is released., Comment: MICCAI2021

Retinal blood vessel can assist doctors in diagnosis of eye-related diseases such as diabetes and hypertension, and its segmentation is particularly important for automatic retinal image analysis. However, it is challenging to segment these vessels structures, especially the thin capillaries from the color retinal image due to low contrast and ambiguousness. In this paper, we propose pyramid U-Net for accurate retinal vessel segmentation. In pyramid U-Net, the proposed pyramid-scale aggregation blocks (PSABs) are employed in both the encoder and decoder to aggregate features at higher, current and lower levels. In this way, coarse-to-fine context information is shared and aggregated in each block thus to improve the location of capillaries. To further improve performance, two optimizations including pyramid inputs enhancement and deep pyramid supervision are applied to PSABs in the encoder and decoder, respectively. For PSABs in the encoder, scaled input images are added as extra inputs. While for PSABs in the decoder, scaled intermediate outputs are supervised by the scaled segmentation labels. Extensive evaluations show that our pyramid U-Net outperforms the current state-of-the-art methods on the public DRIVE and CHASE-DB1 datasets., Comment: 10 pages, 5 figures, Accepted by ICASSP2021

Congenital heart disease (CHD) is the most common type of birth defect, which occurs 1 in every 110 births in the United States. CHD usually comes with severe variations in heart structure and great artery connections that can be classified into many types. Thus highly specialized domain knowledge and the time-consuming human process is needed to analyze the associated medical images. On the other hand, due to the complexity of CHD and the lack of dataset, little has been explored on the automatic diagnosis (classification) of CHDs. In this paper, we present ImageCHD, the first medical image dataset for CHD classification. ImageCHD contains 110 3D Computed Tomography (CT) images covering most types of CHD, which is of decent size Classification of CHDs requires the identification of large structural changes without any local tissue changes, with limited data. It is an example of a larger class of problems that are quite difficult for current machine-learning-based vision methods to solve. To demonstrate this, we further present a baseline framework for the automatic classification of CHD, based on a state-of-the-art CHD segmentation method. Experimental results show that the baseline framework can only achieve a classification accuracy of 82.0\% under a selective prediction scheme with 88.4\% coverage, leaving big room for further improvement. We hope that ImageCHD can stimulate further research and lead to innovative and generic solutions that would have an impact in multiple domains. Our dataset is released to the public compared with existing medical imaging datasets., Comment: 11 pages, 6 figures, 2 tables, published at MICCAI 2020. The diagnosis info of the dataset is updated (thanks to the help of Kadirbarut from Bilgiuzayi)

Coronary artery disease (CAD) is the most common cause of death globally, and its diagnosis is usually based on manual myocardial segmentation of Magnetic Resonance Imaging (MRI) sequences. As the manual segmentation is tedious, time-consuming and with low applicability, automatic myocardial segmentation using machine learning techniques has been widely explored recently. However, almost all the existing methods treat the input MRI sequences independently, which fails to capture the temporal information between sequences, e.g., the shape and location information of the myocardium in sequences along time. In this paper, we propose a myocardial segmentation framework for sequence of cardiac MRI (CMR) scanning images of left ventricular cavity, right ventricular cavity, and myocardium. Specifically, we propose to combine conventional networks and recurrent networks to incorporate temporal information between sequences to ensure temporal consistent. We evaluated our framework on the Automated Cardiac Diagnosis Challenge (ACDC) dataset. Experiment results demonstrate that our framework can improve the segmentation accuracy by up to 2% in Dice coefficient., Comment: 9 pages, 9 figures

Deep learning had already demonstrated its power in medical images, including denoising, classification, segmentation, etc. All these applications are proposed to automatically analyze medical images beforehand, which brings more information to radiologists during clinical assessment for accuracy improvement. Recently, many medical denoising methods had shown their significant artifact reduction result and noise removal both quantitatively and qualitatively. However, those existing methods are developed around human-vision, i.e., they are designed to minimize the noise effect that can be perceived by human eyes. In this paper, we introduce an application-guided denoising framework, which focuses on denoising for the following neural networks. In our experiments, we apply the proposed framework to different datasets, models, and use cases. Experimental results show that our proposed framework can achieve a better result than human-vision denoising network.

Real-time cardiac magnetic resonance imaging (MRI) plays an increasingly important role in guiding various cardiac interventions. In order to provide better visual assistance, the cine MRI frames need to be segmented on-the-fly to avoid noticeable visual lag. In addition, considering reliability and patient data privacy, the computation is preferably done on local hardware. State-of-the-art MRI segmentation methods mostly focus on accuracy only, and can hardly be adopted for real-time application or on local hardware. In this work, we present the first hardware-aware multi-scale neural architecture search (NAS) framework for real-time 3D cardiac cine MRI segmentation. The proposed framework incorporates a latency regularization term into the loss function to handle real-time constraints, with the consideration of underlying hardware. In addition, the formulation is fully differentiable with respect to the architecture parameters, so that stochastic gradient descent (SGD) can be used for optimization to reduce the computation cost while maintaining optimization quality. Experimental results on ACDC MICCAI 2017 dataset demonstrate that our hardware-aware multi-scale NAS framework can reduce the latency by up to 3.5 times and satisfy the real-time constraints, while still achieving competitive segmentation accuracy, compared with the state-of-the-art NAS segmentation framework., Comment: 8 pages, conference

Real-time cine magnetic resonance imaging (MRI) plays an increasingly important role in various cardiac interventions. In order to enable fast and accurate visual assistance, the temporal frames need to be segmented on-the-fly. However, state-of-the-art MRI segmentation methods are used either offline because of their high computation complexity, or in real-time but with significant accuracy loss and latency increase (causing visually noticeable lag). As such, they can hardly be adopted to assist visual guidance. In this work, inspired by a new interpretation of Independent Component Analysis (ICA) for learning, we propose a novel ICA-UNet for real-time 3D cardiac cine MRI segmentation. Experiments using the MICCAI ACDC 2017 dataset show that, compared with the state-of-the-arts, ICA-UNet not only achieves higher Dice scores, but also meets the real-time requirements for both throughput and latency (up to 12.6X reduction), enabling real-time guidance for cardiac interventions without visual lag., Comment: MICCAI2020, 12 pages, 3 figures

Unsupervised domain adaptation has attracted growing research attention on semantic segmentation. However, 1) most existing models cannot be directly applied into lesions transfer of medical images, due to the diverse appearances of same lesion among different datasets; 2) equal attention has been paid into all semantic representations instead of neglecting irrelevant knowledge, which leads to negative transfer of untransferable knowledge. To address these challenges, we develop a new unsupervised semantic transfer model including two complementary modules (i.e., T_D and T_F ) for endoscopic lesions segmentation, which can alternatively determine where and how to explore transferable domain-invariant knowledge between labeled source lesions dataset (e.g., gastroscope) and unlabeled target diseases dataset (e.g., enteroscopy). Specifically, T_D focuses on where to translate transferable visual information of medical lesions via residual transferability-aware bottleneck, while neglecting untransferable visual characterizations. Furthermore, T_F highlights how to augment transferable semantic features of various lesions and automatically ignore untransferable representations, which explores domain-invariant knowledge and in return improves the performance of T_D. To the end, theoretical analysis and extensive experiments on medical endoscopic dataset and several non-medical public datasets well demonstrate the superiority of our proposed model., Comment: This paper is accepted by IEEE Conference on Computer Vision and Pattern Recognition 2020 (CVPR 2020)

We found that the real time reverse transcription-polymerase chain reaction (RT-PCR) detection of viral RNA from sputum or nasopharyngeal swab has a relatively low positive rate in the early stage to determine COVID-19 (named by the World Health Organization). The manifestations of computed tomography (CT) imaging of COVID-19 had their own characteristics, which are different from other types of viral pneumonia, such as Influenza-A viral pneumonia. Therefore, clinical doctors call for another early diagnostic criteria for this new type of pneumonia as soon as possible.This study aimed to establish an early screening model to distinguish COVID-19 pneumonia from Influenza-A viral pneumonia and healthy cases with pulmonary CT images using deep learning techniques. The candidate infection regions were first segmented out using a 3-dimensional deep learning model from pulmonary CT image set. These separated images were then categorized into COVID-19, Influenza-A viral pneumonia and irrelevant to infection groups, together with the corresponding confidence scores using a location-attention classification model. Finally the infection type and total confidence score of this CT case were calculated with Noisy-or Bayesian function.The experiments result of benchmark dataset showed that the overall accuracy was 86.7 % from the perspective of CT cases as a whole.The deep learning models established in this study were effective for the early screening of COVID-19 patients and demonstrated to be a promising supplementary diagnostic method for frontline clinical doctors.

Cardiac magnetic resonance imaging (MRI) is an essential tool for MRI-guided surgery and real-time intervention. The MRI videos are expected to be segmented on-the-fly in real practice. However, existing segmentation methods would suffer from drastic accuracy loss when modified for speedup. In this work, we propose Multiscale Statistical U-Net (MSU-Net) for real-time 3D MRI video segmentation in cardiac surgical guidance. Our idea is to model the input samples as multiscale canonical form distributions for speedup, while the spatio-temporal correlation is still fully utilized. A parallel statistical U-Net is then designed to efficiently process these distributions. The fast data sampling and efficient parallel structure of MSU-Net endorse the fast and accurate inference. Compared with vanilla U-Net and a modified state-of-the-art method GridNet, our method achieves up to 268% and 237% speedup with 1.6% and 3.6% increased Dice scores., Comment: MICCAI19

3D printing has been widely adopted for clinical decision making and interventional planning of Congenital heart disease (CHD), while whole heart and great vessel segmentation is the most significant but time-consuming step in the model generation for 3D printing. While various automatic whole heart and great vessel segmentation frameworks have been developed in the literature, they are ineffective when applied to medical images in CHD, which have significant variations in heart structure and great vessel connections. To address the challenge, we leverage the power of deep learning in processing regular structures and that of graph algorithms in dealing with large variations and propose a framework that combines both for whole heart and great vessel segmentation in CHD. Particularly, we first use deep learning to segment the four chambers and myocardium followed by the blood pool, where variations are usually small. We then extract the connection information and apply graph matching to determine the categories of all the vessels. Experimental results using 683D CT images covering 14 types of CHD show that our method can increase Dice score by 11.9% on average compared with the state-of-the-art whole heart and great vessel segmentation method in normal anatomy. The segmentation results are also printed out using 3D printers for validation., Comment: 6 figures, 2 tables, accepted by the IEEE International Workshop on Signal Processing Systems