Multimodal magnetic resonance imaging (MRI) is instrumental in differentiating liver lesions. The major challenge involves modeling reliable connections and simultaneously learning complementary information across various MRI sequences. While previous studies have primarily focused on multimodal integration in a pair-wise manner using few modalities, our research seeks to advance a more comprehensive understanding of interaction modeling by establishing complex high-order correlations among the diverse modalities in multimodal MRI. In this paper, we introduce a multimodal graph learning with multi-hypergraph reasoning network to capture the full spectrum of both pair-wise and group-wise relationships among different modalities. Specifically, a weight-shared encoder extracts features from regions of interest (ROI) images across all modalities. Subsequently, a collection of uniform hypergraphs are constructed with varying vertex configurations, allowing for the modeling of not only pair-wise correlations but also the high-order collaborations for relational reasoning. Following information propagation through the hypergraph message passing, adaptive intra-modality fusion module is proposed to effectively fuse feature representations from different hypergraphs of the same modality. Finally, all refined features are concatenated to prepare for the classification task. Our experimental evaluations, including focal liver lesions classification using the LLD-MMRI2023 dataset and early recurrence prediction of hepatocellular carcinoma using our internal datasets, demonstrate that our method significantly surpasses the performance of existing approaches, indicating the effectiveness of our model in handling both pair-wise and group-wise interactions across multiple modalities.

Large Vision Model (LVM) has recently demonstrated great potential for medical imaging tasks, potentially enabling image enhancement for sparse-view Cone-Beam Computed Tomography (CBCT), despite requiring a substantial amount of data for training. Meanwhile, Deep Image Prior (DIP) effectively guides an untrained neural network to generate high-quality CBCT images without any training data. However, the original DIP method relies on a well-defined forward model and a large-capacity backbone network, which is notoriously difficult to converge. In this paper, we propose a stable optimization method for the forward-model-free, LVM-based DIP model for sparse-view CBCT. Our approach consists of two main characteristics: (1) multi-scale perceptual loss (MSPL) which measures the similarity of perceptual features between the reference and output images at multiple resolutions without the need for any forward model, and (2) a reweighting mechanism that stabilizes the iteration trajectory of MSPL. One shot optimization is used to simultaneously and stably reweight MSPL and optimize LVM. We evaluate our approach on two publicly available datasets: SPARE and Walnut. The results show significant improvements in both image quality metrics and visualization that demonstrates reduced streak artifacts. The source code is available upon request.

Although contrast-enhanced computed tomography (CE-CT) images significantly improve the accuracy of diagnosing focal liver lesions (FLLs), the administration of contrast agents imposes a considerable physical burden on patients. The utilization of generative models to synthesize CE-CT images from non-contrasted CT images offers a promising solution. However, existing image synthesis models tend to overlook the importance of critical regions, inevitably reducing their effectiveness in downstream tasks. To overcome this challenge, we propose an innovative CE-CT image synthesis model called Segmentation Guided Crossing Dual Decoding Generative Adversarial Network (SGCDD-GAN). Specifically, the SGCDD-GAN involves a crossing dual decoding generator including an attention decoder and an improved transformation decoder. The attention decoder is designed to highlight some critical regions within the abdominal cavity, while the improved transformation decoder is responsible for synthesizing CE-CT images. These two decoders are interconnected using a crossing technique to enhance each other's capabilities. Furthermore, we employ a multi-task learning strategy to guide the generator to focus more on the lesion area. To evaluate the performance of proposed SGCDD-GAN, we test it on an in-house CE-CT dataset. In both CE-CT image synthesis tasks-namely, synthesizing ART images and synthesizing PV images-the proposed SGCDD-GAN demonstrates superior performance metrics across the entire image and liver region, including SSIM, PSNR, MSE, and PCC scores. Furthermore, CE-CT images synthetized from our SGCDD-GAN achieve remarkable accuracy rates of 82.68%, 94.11%, and 94.11% in a deep learning-based FLLs classification task, along with a pilot assessment conducted by two radiologists.

High resolution (HR) 3D medical image segmentation is vital for an accurate diagnosis. However, in the field of medical imaging, it is still a challenging task to achieve a high segmentation performance with cost-effective and feasible computation resources. Previous methods commonly use patch-sampling to reduce the input size, but this inevitably harms the global context and decreases the model's performance. In recent years, a few patch-free strategies have been presented to deal with this issue, but either they have limited performance due to their over-simplified model structures or they follow a complicated training process. In this study, to effectively address these issues, we present Adaptive Decomposition (A-Decomp) and Shared Weight Volumetric Transformer Blocks (SW-VTB). A-Decomp can adaptively decompose features and reduce their spatial size, which greatly lowers GPU memory consumption. SW-VTB is able to capture long-range dependencies at a low cost with its lightweight design and cross-scale weight-sharing mechanism. Our proposed cross-scale weight-sharing approach enhances the network's ability to capture scale-invariant core semantic information in addition to reducing parameter numbers. By combining these two designs together, we present a novel patch-free segmentation framework named VolumeFormer. Experimental results on two datasets show that VolumeFormer outperforms existing patch-based and patch-free methods with a comparatively fast inference speed and relatively compact design.

Multi-modal tumor segmentation exploits complementary information from different modalities to help recognize tumor regions. Known multi-modal segmentation methods mainly have deficiencies in two aspects: First, the adopted multi-modal fusion strategies are built upon well-aligned input images, which are vulnerable to spatial misalignment between modalities (caused by respiratory motions, different scanning parameters, registration errors, etc). Second, the performance of known methods remains subject to the uncertainty of segmentation, which is particularly acute in tumor boundary regions. To tackle these issues, in this paper, we propose a novel multi-modal tumor segmentation method with deformable feature fusion and uncertain region refinement. Concretely, we introduce a deformable aggregation module, which integrates feature alignment and feature aggregation in an ensemble, to reduce inter-modality misalignment and make full use of cross-modal information. Moreover, we devise an uncertain region inpainting module to refine uncertain pixels using neighboring discriminative features. Experiments on two clinical multi-modal tumor datasets demonstrate that our method achieves promising tumor segmentation results and outperforms state-of-the-art methods.

Multimodal magnetic resonance imaging (MRI) provides complementary information about targets, and the segmentation of multimodal MRI is widely used as an essential preprocessing step for initial diagnosis, stage differentiation, and post-treatment efficacy evaluation in clinical situations. For the main modality or each of the modalities, it is important to enhance the visual information by modeling the connection and effectively fusing the features among them. However, the existing methods for multimodal segmentation have a drawback; they coincidentally drop information of individual modality during the fusion process. Recently, graph learning-based methods have been applied in segmentation, and these methods have achieved considerable improvements by modeling the relationships across feature regions and reasoning using global information. In this paper, we propose a graph learning-based approach to efficiently extract modality-specific features and establish regional correspondence effectively among all modalities. In detail, after projecting features into a graph domain and employing graph convolution to propagate information across all regions for learning global modality-specific features, we propose a mutual information-based graph co-attention module to learn the weight coefficients of one bipartite graph constructed by the fully connected graphs having different modalities in the graph domain and by selectively fusing the node features. Based on the deformation diagram between the spatial-graph space and our proposed graph co-attention module, we present a multimodal prior-guided segmentation framework, which uses two strategies for two clinical situations:Modality-Specific Learning StrategyandCo-Modality Learning Strategy. Besides, the improvedCo-Modality Learning Strategyis used with trainable weights in the multi-task loss for the optimization of the proposed framework. We validated our proposed modules and frameworks on two multimodal MRI datasets: our private liver lesion dataset and a public prostate zone dataset. Our experimental results on both datasets prove the superiority of our proposed approaches.

Organ segmentation is one of the most important step for various medical image analysis tasks. Recently, semi-supervised learning (SSL) has attracted much attentions by reducing labeling cost. However, most of the existing SSLs neglected the prior shape and position information specialized in the medical images, leading to unsatisfactory localization and non-smooth of objects. In this paper, we propose a novel atlas-based semi-supervised segmentation network with multi-task learning for medical organs, named MTL-ABS3Net, which incorporates the anatomical priors and makes full use of unlabeled data in a self-training and multi-task learning manner. The MTL-ABS3Net consists of two components: an Atlas-Based Semi-Supervised Segmentation Network (ABS3Net) and Reconstruction-Assisted Module (RAM). Specifically, the ABS3Net improves the existing SSLs by utilizing atlas prior, which generates credible pseudo labels in a self-training manner; while the RAM further assists the segmentation network by capturing the anatomical structures from the original images in a multi-task learning manner. Better reconstruction quality is achieved by using MS-SSIM loss function, which further improves the segmentation accuracy. Experimental results from the liver and spleen datasets demonstrated that the performance of our method was significantly improved compared to existing state-of-the-art methods.

COVID-19 pneumonia is a disease that causes an existential health crisis in many people by directly affecting and damaging lung cells. The segmentation of infected areas from computed tomography (CT) images can be used to assist and provide useful information for COVID-19 diagnosis. Although several deep learning-based segmentation methods have been proposed for COVID-19 segmentation and have achieved state-of-the-art results, the segmentation accuracy is still not high enough (approximately 85%) due to the variations of COVID-19 infected areas (such as shape and size variations) and the similarities between COVID-19 and non-COVID-infected areas. To improve the segmentation accuracy of COVID-19 infected areas, we propose an interactive attention refinement network (Attention RefNet). The interactive attention refinement network can be connected with any segmentation network and trained with the segmentation network in an end-to-end fashion. We propose a skip connection attention module to improve the important features in both segmentation and refinement networks and a seed point module to enhance the important seeds (positions) for interactive refinement. The effectiveness of the proposed method was demonstrated on public datasets (COVID-19CTSeg and MICCAI) and our private multicenter dataset. The segmentation accuracy was improved to more than 90%. We also confirmed the generalizability of the proposed network on our multicenter dataset. The proposed method can still achieve high segmentation accuracy.

Organ segmentation from medical images is one of the most important pre-processing steps in computer-aided diagnosis, but it is a challenging task because of limited annotated data, low-contrast and non-homogenous textures. Compared with natural images, organs in the medical images have obvious anatomical prior knowledge (e.g., organ shape and position), which can be used to improve the segmentation accuracy. In this paper, we propose a novel segmentation framework which integrates the medical image anatomical prior through loss into the deep learning models. The proposed prior loss function is based on probabilistic atlas, which is called as deep atlas prior (DAP). It includes prior location and shape information of organs, which are important prior information for accurate organ segmentation. Further, we combine the proposed deep atlas prior loss with the conventional likelihood losses such as Dice loss and focal loss into an adaptive Bayesian loss in a Bayesian framework, which consists of a prior and a likelihood. The adaptive Bayesian loss dynamically adjusts the ratio of the DAP loss and the likelihood loss in the training epoch for better learning. The proposed loss function is universal and can be combined with a wide variety of existing deep segmentation models to further enhance their performance. We verify the significance of our proposed framework with some state-of-the-art models, including fully-supervised and semi-supervised segmentation models on a public dataset (ISBI LiTS 2017 Challenge) for liver segmentation and a private dataset for spleen segmentation.

Convolutional neural networks (CNNs) have achieved great success in numerous challenging vision tasks, and have great potential for object detection in natural images. Compared with the natural images, medical images exhibit some unique characteristics. Therefore, substantial challenges still remain in this field. The first challenge is to develop a method for effectively distilling enhancement patterns from the dynamic CT images. Moreover, since tumor sizes vary greatly and small lesions are important for early liver tumor detection, lesion detection with a widely variable scale is another challenge. In this paper, we propose a multi-stream scale-insensitive convolutional and recurrent neural network (MSCR) for liver tumor detection. Specifically, we propose the use of grouped convolutional long short-term memory (GCLSTM) to extract enhancement patterns, which is developed as a plug-and-play module. Experiments show that the MSCR framework exhibits superior performance over state-of-the-art approaches, achieving an average precision of 77.06% for detection of focal liver lesions. We have released the code of MSCR in1.

Automated tissue classification is an essential step for quantitative analysis and treatment of emphysema. Although many studies have been conducted in this area, there still remain two major challenges. First, different emphysematous tissue appears in different scales, which we call "inter-class variations." Second, the intensities of CT images acquired from different patients, scanners or scanning protocols may vary, which we call "intra-class variations". In this paper, we present a novel multi-scale residual network with two channels of raw CT image and its differential excitation component. We incorporate multi-scale information into our networks to address the challenge of inter-class variations. In addition to the conventional raw CT image, we use its differential excitation component as a pair of inputs to handle intra-class variations. Experimental results show that our approach has superior performance over the state-of-the- art methods, achieving a classification accuracy of 93.74% on our original emphysema database. Based on the classification results, we also perform the quantitative analysis of emphysema in 50 subjects by correlating the quantitative results (the area percentage of each class) with pulmonary functions. We show that centrilobular emphysema (CLE) and panlobular emphysema (PLE) have strong correlation with the pulmonary functions and the sum of CLE and PLE can be used as a new and accurate measure of emphysema severity instead of the conventional measure (sum of all subtypes of emphysema). The correlations between the new measure and various pulmonary functions are up to |r| = 0.922 (r is correlation coefficient).