Pancreatic cancer, characterized by its notable prevalence and mortality rates, demands accurate lesion delineation for effective diagnosis and therapeutic interventions. The generalizability of extant methods is frequently compromised due to the pronounced variability in imaging and the heterogeneous characteristics of pancreatic lesions, which may mimic normal tissues and exhibit significant inter-patient variability. Thus, we propose a generalization framework that synergizes pixel-level classification and regression tasks, to accurately delineate lesions and improve model stability. This framework not only seeks to align segmentation contours with actual lesions but also uses regression to elucidate spatial relationships between diseased and normal tissues, thereby improving tumor localization and morphological characterization. Enhanced by the reciprocal transformation of task outputs, our approach integrates additional regression supervision within the segmentation context, bolstering the model's generalization ability from a dual-task perspective. Besides, dual self-supervised learning in feature spaces and output spaces augments the model's representational capability and stability across different imaging views. Experiments on 594 samples composed of three datasets with significant imaging differences demonstrate that our generalized pancreas segmentation results comparable to mainstream in-domain validation performance (Dice: 84.07%). More importantly, it successfully improves the results of the highly challenging cross-lesion generalized pancreatic cancer segmentation task by 9.51%. Thus, our model constitutes a resilient and efficient foundational technological support for pancreatic disease management and wider medical applications. The codes will be released at https://github.com/SJTUBME-QianLab/Dual-Task-Seg.

Accurate pancreas segmentation is highly crucial for diagnosing and treating pancreatic diseases. Although CNN has demonstrated promising outcomes, the performance on unseen data can be significantly compromised by the wide appearance-style variations induced by different imaging factors. Thus, we propose a generalizable pancreas segmentation model based on a meta-learning strategy and latent-space feature flow generation method. Our approach enhances the generalizability by systematically reducing the interference from the cluttered background and appearance-style discrepancies through a coarse-to-fine workflow. Specifically, the integrity-preserving coarse segmentation module is designed to adaptively balance the pancreas coverage and segmentation accuracy with the meta-learning strategy for filtering out background clutter. It also enhances the generalization of the coarse model to reasonably-accurate ROIs thereby promoting the stability of fine segmentation. Subsequently, the appearance-style feature flow generation method is developed to generate a series of progressively-varying style-related intermediate representations between two latent spaces. This feature flow effectively models the distribution variations caused by appearance-style discrepancies, and thus enhances the adaptability of the fine model. Our method achieves superior performance on three pancreas datasets and outperforms state-of-the-art generalization methods. Besides, it can be easily integrated into other workflows, leading to a potential paradigm for enhancing generalization performance.

Recently, numerous pancreas segmentation methods have achieved promising performance on local single-source datasets. However, these methods don't adequately account for generalizability issues, and hence typically show limited performance and low stability on test data from other sources. Considering the limited availability of distinct data sources, we seek to improve the generalization performance of a pancreas segmentation model trained with a single-source dataset, i.e., the single-source generalization task. In particular, we propose a dual self-supervised learning model that incorporates both global and local anatomical contexts. Our model aims to fully exploit the anatomical features of the intra-pancreatic and extra-pancreatic regions, and hence enhance the characterization of the high-uncertainty regions for more robust generalization. Specifically, we first construct a global-feature contrastive self-supervised learning module that is guided by the pancreatic spatial structure. This module obtains complete and consistent pancreatic features through promoting intra-class cohesion, and also extracts more discriminative features for differentiating between pancreatic and non-pancreatic tissues through maximizing inter-class separation. It mitigates the influence of surrounding tissue on the segmentation outcomes in high-uncertainty regions. Subsequently, a local-image-restoration self-supervised learning module is introduced to further enhance the characterization of the high-uncertainty regions. In this module, informative anatomical contexts are actually learned to recover randomly-corrupted appearance patterns in those regions. The effectiveness of our method is demonstrated with state-of-the-art performance and comprehensive ablation analysis on three pancreas datasets (467 cases). The results demonstrate a great potential in providing a stable support for the diagnosis and treatment of pancreatic diseases.

Glioblastoma multiforme (GBM) is the most common type of brain tumors with high recurrence and mortality rates. After chemotherapy treatment, GBM patients still show a high rate of differentiating pseudoprogression (PsP), which is often confused as true tumor progression (TTP) due to high phenotypical similarities. Thus, it is crucial to construct an automated diagnosis model for differentiating between these two types of glioma progression. However, attaining this goal is impeded by the limited data availability and the high demand for interpretability in clinical settings. In this work, we propose an interpretable structure-constrained graph neural network (ISGNN) with enhanced features to automatically discriminate between PsP and TTP. This network employs a metric-based meta-learning strategy to aggregate class-specific graph nodes, focus on meta-tasks associated with various small graphs, thus improving the classification performance on small-scale datasets. Specifically, a node feature enhancement module is proposed to account for the relative importance of node features and enhance their distinguishability through inductive learning. A graph generation constraint module enables learning reasonable graph structures to improve the efficiency of information diffusion while avoiding propagation errors. Furthermore, model interpretability can be naturally enhanced based on the learned node features and graph structures that are closely related to the classification results. Comprehensive experimental evaluation of our method demonstrated excellent interpretable results in the diagnosis of glioma progression. In general, our work provides a novel systematic GNN approach for dealing with data scarcity and enhancing decision interpretability. Our source codes will be released at https://github.com/SJTUBME-QianLab/GBM-GNN.

Automated pancreatic cancer segmentation is highly crucial for computer-assisted diagnosis. The general practice is to label images from selected modalities since it is expensive to label all modalities. This practice brought about a significant interest in learning the knowledge transfer from the labeled modalities to unlabeled ones. However, the imaging parameter inconsistency between modalities leads to a domain shift, limiting the transfer learning performance. Therefore, we propose an unsupervised domain adaptation segmentation framework for pancreatic cancer based on GCN and meta-learning strategy. Our model first transforms the source image into a target-like visual appearance through the synergistic collaboration between image and feature adaptation. Specifically, we employ encoders incorporating adversarial learning to separate domain-invariant features from domain-specific ones to achieve visual appearance translation. Then, the meta-learning strategy with good generalization capabilities is exploited to strike a reasonable balance in the training of the source and transformed images. Thus, the model acquires more correlated features and improve the adaptability to the target images. Moreover, a GCN is introduced to supervise the high-dimensional abstract features directly related to the segmentation outcomes, and hence ensure the integrity of key structural features. Extensive experiments on four multi-parameter pancreatic-cancer magnetic resonance imaging datasets demonstrate improved performance in all adaptation directions, confirming our model's effectiveness for unlabeled pancreatic cancer images. The results are promising for reducing the burden of annotation and improving the performance of computer-aided diagnosis of pancreatic cancer. Our source codes will be released at https://github.com/SJTUBME-QianLab/UDAseg, once this manuscript is accepted for publication.

Pancreatic cancer is a lethal malignant tumor with one of the worst prognoses. Accurate segmentation of pancreatic cancer is vital in clinical diagnosis and treatment. Due to the unclear boundary and small size of cancers, it is challenging to both manually annotate and automatically segment cancers. Considering 3D information utilization and small sample sizes, we propose a model-driven deep learning method for pancreatic cancer segmentation based on spiral transformation. Specifically, a spiral-transformation algorithm with uniform sampling was developed to map 3D images onto 2D planes while preserving the spatial relationship between textures, thus addressing the challenge in effectively applying 3D contextual information in a 2D model. This study is the first to introduce spiral transformation in a segmentation task to provide effective data augmentation, alleviating the issue of small sample size. Moreover, a transformation-weight-corrected module was embedded into the deep learning model to unify the entire framework. It can achieve 2D segmentation and corresponding 3D rebuilding constraint to overcome non-unique 3D rebuilding results due to the uniform and dense sampling. A smooth regularization based on rebuilding prior knowledge was also designed to optimize segmentation results. The extensive experiments showed that the proposed method achieved a promising segmentation performance on multi-parametric MRIs, where T2, T1, ADC, DWI images obtained the DSC of 65.6%, 64.0%, 64.5%, 65.3%, respectively. This method can provide a novel paradigm to efficiently apply 3D information and augment sample sizes in the development of artificial intelligence for cancer segmentation. Our source codes will be released at https://github.com/SJTUBME-QianLab/ Spiral-Segmentation.