Domains shift originated from differences in devices or patients in the medical field, poses a significant challenge when applying pre-trained models to clinical applications. To tackle this challenge, domain adaptation methods have been explored. However, most existing methods are designed for a single target domain adaptation or require sharing all target domain data for adaptation, which is infeasible in the medical field due to privacy issues. In this paper, we propose a novel unsupervised multi-target domain adaptation method without requiring data sharing. To this end, we introduce an additional signal, termed Adaptogen-Perturbation (AP) optimized to bridge the gap between the source and target domains. The optimized AP is injected into the latent feature and facilitates the adaptation of the pre-trained model to the target domain. Moreover, we propose a Spectral/Geometric Consistency learning framework to optimize the AP in an unsupervised manner. This promotes consistent predictions across two types of transformations: geometric and frequency-space spectral transformations, enhancing robustness to both variations. Extensive experiments with multiple medical segmentation datasets demonstrate the effectiveness of APs.

Anomaly detection in medical imaging plays a crucial role in identifying pathological regions across various imaging modalities, such as brain MRI, liver CT, and carotid ultrasound (US). However, training fully supervised segmentation models is often hindered by the scarcity of expert annotations and the complexity of diverse anatomical structures. To address these issues, we propose a novel unsupervised anomaly detection framework based on a diffusion model that incorporates a synthetic anomaly (Synomaly) noise function and a multi-stage diffusion process. Synomaly noise introduces synthetic anomalies into healthy images during training, allowing the model to effectively learn anomaly removal. The multi-stage diffusion process is introduced to progressively denoise images, preserving fine details while improving the quality of anomaly-free reconstructions. The generated high-fidelity counterfactual healthy images can further enhance the interpretability of the segmentation models, as well as provide a reliable baseline for evaluating the extent of anomalies and supporting clinical decision-making. Notably, the unsupervised anomaly detection model is trained purely on healthy images, eliminating the need for anomalous training samples and pixel-level annotations. We validate the proposed approach on brain MRI, liver CT datasets, and carotid US. The experimental results demonstrate that the proposed framework outperforms existing state-of-the-art unsupervised anomaly detection methods, achieving performance comparable to fully supervised segmentation models in the US dataset. Ablation studies further highlight the contributions of Synomaly noise and the multi-stage diffusion process in improving anomaly segmentation. These findings underscore the potential of our approach as a robust and annotation-efficient alternative for medical anomaly detection. Code:https://github.com/yuan-12138/Synomaly.

Ultrasound imaging has been widely used in clinical examinations owing to the advantages of being portable, real-time, and radiation-free. Considering the potential of extensive deployment of autonomous examination systems in hospitals, robotic US imaging has attracted increased attention. However, due to the inter-patient variations, it is still challenging to have an optimal path for each patient, particularly for thoracic applications with limited acoustic windows, e.g., intercostal liver imaging. To address this problem, a class-aware cartilage bone segmentation network with geometry-constraint post-processing is presented to capture patient-specific rib skeletons. Then, a dense skeleton graph-based non-rigid registration is presented to map the intercostal scanning path from a generic template to individual patients. By explicitly considering the high-acoustic impedance bone structures, the transferred scanning path can be precisely located in the intercostal space, enhancing the visibility of internal organs by reducing the acoustic shadow. To evaluate the proposed approach, the final path mapping performance is validated on five distinct CTs and two volunteer US data, resulting in ten pairs of CT-US combinations. Results demonstrate that the proposed graph-based registration method can robustly and precisely map the path from CT template to individual patients (Euclidean error:$2.21\pm 1.11~mm$). Note to Practitioners—The precise mapping of trajectories has been a bottleneck in developing autonomous intercostal intervention within limited acoustic space. Existing methods, based on external features such as the skin surface or passive markers, fail to capture the acoustic properties of local tissues, leading to significant shadowing when ribs are involved. The proposed method begins by utilizing distinctive anatomical features to extract cartilage bones and stiff ribs through a class-aware segmentation network. To ensure the segmentation accuracy of the shape of the anatomy of interest, a VAE-based boundary-constraint post-processing in manifold space is developed. Subsequently, a dense skeleton graph-based registration is developed to explicitly consider the subcutaneous bone structure, allowing for the precise mapping of intercostal paths from generic templates to individual patients. Results from ten randomly paired CT and US datasets show that the proposed method accurately maps the intercostal path from the template to individual patients, significantly improving accuracy and robustness over previous methods. We believe that the proposed method can further pave the way for autonomous robotic US imaging.

Ultrasound (US) imaging is widely used for diagnosing and monitoring arterial diseases, mainly due to the advantages of being non-invasive, radiation-free, and real-time. In order to provide additional information to assist clinicians in diagnosis, the tubular structures are often segmented from US images. To improve the artery segmentation accuracy and stability during scans, this work presents a novel pulsation-assisted segmentation neural network (PAS-NN) by explicitly taking advantage of the cardiac-induced motions. Motion magnification techniques are employed to amplify the subtle motion within the frequency band of interest to extract the pulsation signals from sequential US images. The extracted real-time pulsation information can help to locate the arteries on cross-section US images; therefore, we explicitly integrated the pulsation into the proposed PAS-NN as attention guidance. Notably, a robotic arm is necessary to provide stable movement during US imaging since magnifying the target motions from the US images captured along a scan path is not manually feasible due to the hand tremor. To validate the proposed robotic US system for imaging arteries, experiments are carried out on volunteers' carotid and radial arteries. The results demonstrated that the PAS-NN could achieve comparable results as state-of-the-art on carotid and can effectively improve the segmentation performance for small vessels (radial artery). The code11Code: https://qithub.com/dianveHuanq/RobPMEPASNN and demonstration video22Video: https://youtu.belc9AM042_lUQ can be publicly accessed.