new

Get trending papers in your email inbox!

Subscribe

Daily Papers

byAK and the research community

Dec 9

Reconstructing unseen modalities and pathology with an efficient Recurrent Inference Machine

Objective: To allow efficient learning using the Recurrent Inference Machine (RIM) for image reconstruction whereas not being strictly dependent on the training data distribution so that unseen modalities and pathologies are still accurately recovered. Methods: Theoretically, the RIM learns to solve the inverse problem of accelerated-MRI reconstruction whereas being robust to variable imaging conditions. The efficiency and generalization capabilities with different training datasets were studied, as well as recurrent network units with decreasing complexity: the Gated Recurrent Unit (GRU), the Minimal Gated Unit (MGU), and the Independently Recurrent Neural Network (IndRNN), to reduce inference times. Validation was performed against Compressed Sensing (CS) and further assessed based on data unseen during training. A pathology study was conducted by reconstructing simulated white matter lesions and prospectively undersampled data of a Multiple Sclerosis patient. Results: Training on a single modality of 3T T_1-weighted brain data appeared sufficient to also reconstruct 7T T_{2}^*-weighted brain and 3T T_2-weighted knee data. The IndRNN is an efficient recurrent unit, reducing inference time by 68\% compared to CS, whereas maintaining performance. The RIM was able to reconstruct lesions unseen during training more accurately than CS when trained on T_2-weighted knee data. Training on T_1-weighted brain data and on combined data slightly enhanced the signal compared to CS. Conclusion: The RIM is efficient when decreasing its complexity, which reduces the inference time, whereas still being able to reconstruct data and pathology that was unseen during training.

  • 7 authors
·
Dec 14, 2020

Assessment of Data Consistency through Cascades of Independently Recurrent Inference Machines for fast and robust accelerated MRI reconstruction

Machine Learning methods can learn how to reconstruct Magnetic Resonance Images and thereby accelerate acquisition, which is of paramount importance to the clinical workflow. Physics-informed networks incorporate the forward model of accelerated MRI reconstruction in the learning process. With increasing network complexity, robustness is not ensured when reconstructing data unseen during training. We aim to embed data consistency (DC) in deep networks while balancing the degree of network complexity. While doing so, we will assess whether either explicit or implicit enforcement of DC in varying network architectures is preferred to optimize performance. We propose a scheme called Cascades of Independently Recurrent Inference Machines (CIRIM) to assess DC through unrolled optimization. Herein we assess DC both implicitly by gradient descent and explicitly by a designed term. Extensive comparison of the CIRIM to CS as well as to other methods is performed: the E2EVN, CascadeNet, KIKINet, LPDNet, RIM, IRIM, and UNet. Models were trained and evaluated on T1-weighted and FLAIR contrast brain data, and T2-weighted knee data. Both 1D and 2D undersampling patterns were evaluated. Robustness was tested by reconstructing 7.5x prospectively undersampled 3D FLAIR MRI data of Multiple Sclerosis (MS) patients with white matter lesions. The CIRIM performed best when implicitly enforcing DC, while the E2EVN required an explicit DC formulation. In reconstructing MS patient data, prospectively acquired with a sampling pattern unseen during model training, the CIRIM maintained lesion contrast while efficiently denoising the images. The CIRIM showed highly promising generalization capabilities maintaining a very fair trade-off between reconstructed image quality and fast reconstruction times, which is crucial in the clinical workflow.

  • 5 authors
·
Nov 30, 2021

You Only Scan Once: Efficient Multi-dimension Sequential Modeling with LightNet

Linear attention mechanisms have gained prominence in causal language models due to their linear computational complexity and enhanced speed. However, the inherent decay mechanism in linear attention presents challenges when applied to multi-dimensional sequence modeling tasks, such as image processing and multi-modal learning. In these scenarios, the utilization of sequential scanning to establish a global receptive field necessitates multiple scans for multi-dimensional data, thereby leading to inefficiencies. This paper identifies the inefficiency caused by a multiplicative linear recurrence and proposes an efficient alternative additive linear recurrence to avoid the issue, as it can handle multi-dimensional data within a single scan. We further develop an efficient multi-dimensional sequential modeling framework called LightNet based on the new recurrence. Moreover, we present two new multi-dimensional linear relative positional encoding methods, MD-TPE and MD-LRPE to enhance the model's ability to discern positional information in multi-dimensional scenarios. Our empirical evaluations across various tasks, including image classification, image generation, bidirectional language modeling, and autoregressive language modeling, demonstrate the efficacy of LightNet, showcasing its potential as a versatile and efficient solution for multi-dimensional sequential modeling.

  • 7 authors
·
May 31, 2024

DifIISR: A Diffusion Model with Gradient Guidance for Infrared Image Super-Resolution

Infrared imaging is essential for autonomous driving and robotic operations as a supportive modality due to its reliable performance in challenging environments. Despite its popularity, the limitations of infrared cameras, such as low spatial resolution and complex degradations, consistently challenge imaging quality and subsequent visual tasks. Hence, infrared image super-resolution (IISR) has been developed to address this challenge. While recent developments in diffusion models have greatly advanced this field, current methods to solve it either ignore the unique modal characteristics of infrared imaging or overlook the machine perception requirements. To bridge these gaps, we propose DifIISR, an infrared image super-resolution diffusion model optimized for visual quality and perceptual performance. Our approach achieves task-based guidance for diffusion by injecting gradients derived from visual and perceptual priors into the noise during the reverse process. Specifically, we introduce an infrared thermal spectrum distribution regulation to preserve visual fidelity, ensuring that the reconstructed infrared images closely align with high-resolution images by matching their frequency components. Subsequently, we incorporate various visual foundational models as the perceptual guidance for downstream visual tasks, infusing generalizable perceptual features beneficial for detection and segmentation. As a result, our approach gains superior visual results while attaining State-Of-The-Art downstream task performance. Code is available at https://github.com/zirui0625/DifIISR

  • 8 authors
·
Mar 3

ISLES'24: Final Infarct Prediction with Multimodal Imaging and Clinical Data. Where Do We Stand?

Accurate estimation of brain infarction (i.e., irreversibly damaged tissue) is critical for guiding treatment decisions in acute ischemic stroke. Reliable infarct prediction informs key clinical interventions, including the need for patient transfer to comprehensive stroke centers, the potential benefit of additional reperfusion attempts during mechanical thrombectomy, decisions regarding secondary neuroprotective treatments, and ultimately, prognosis of clinical outcomes. This work introduces the Ischemic Stroke Lesion Segmentation (ISLES) 2024 challenge, which focuses on the prediction of final infarct volumes from pre-interventional acute stroke imaging and clinical data. ISLES24 provides a comprehensive, multimodal setting where participants can leverage all clinically and practically available data, including full acute CT imaging, sub-acute follow-up MRI, and structured clinical information, across a train set of 150 cases. On the hidden test set of 98 cases, the top-performing model, a multimodal nnU-Net-based architecture, achieved a Dice score of 0.285 (+/- 0.213) and an absolute volume difference of 21.2 (+/- 37.2) mL, underlining the significant challenges posed by this task and the need for further advances in multimodal learning. This work makes two primary contributions: first, we establish a standardized, clinically realistic benchmark for post-treatment infarct prediction, enabling systematic evaluation of multimodal algorithmic strategies on a longitudinal stroke dataset; second, we analyze current methodological limitations and outline key research directions to guide the development of next-generation infarct prediction models.

  • 40 authors
·
Aug 20, 2024

ConSlide: Asynchronous Hierarchical Interaction Transformer with Breakup-Reorganize Rehearsal for Continual Whole Slide Image Analysis

Whole slide image (WSI) analysis has become increasingly important in the medical imaging community, enabling automated and objective diagnosis, prognosis, and therapeutic-response prediction. However, in clinical practice, the ever-evolving environment hamper the utility of WSI analysis models. In this paper, we propose the FIRST continual learning framework for WSI analysis, named ConSlide, to tackle the challenges of enormous image size, utilization of hierarchical structure, and catastrophic forgetting by progressive model updating on multiple sequential datasets. Our framework contains three key components. The Hierarchical Interaction Transformer (HIT) is proposed to model and utilize the hierarchical structural knowledge of WSI. The Breakup-Reorganize (BuRo) rehearsal method is developed for WSI data replay with efficient region storing buffer and WSI reorganizing operation. The asynchronous updating mechanism is devised to encourage the network to learn generic and specific knowledge respectively during the replay stage, based on a nested cross-scale similarity learning (CSSL) module. We evaluated the proposed ConSlide on four public WSI datasets from TCGA projects. It performs best over other state-of-the-art methods with a fair WSI-based continual learning setting and achieves a better trade-off of the overall performance and forgetting on previous task

  • 6 authors
·
Aug 25, 2023

Recurrent Variational Network: A Deep Learning Inverse Problem Solver applied to the task of Accelerated MRI Reconstruction

Magnetic Resonance Imaging can produce detailed images of the anatomy and physiology of the human body that can assist doctors in diagnosing and treating pathologies such as tumours. However, MRI suffers from very long acquisition times that make it susceptible to patient motion artifacts and limit its potential to deliver dynamic treatments. Conventional approaches such as Parallel Imaging and Compressed Sensing allow for an increase in MRI acquisition speed by reconstructing MR images from sub-sampled MRI data acquired using multiple receiver coils. Recent advancements in Deep Learning combined with Parallel Imaging and Compressed Sensing techniques have the potential to produce high-fidelity reconstructions from highly accelerated MRI data. In this work we present a novel Deep Learning-based Inverse Problem solver applied to the task of Accelerated MRI Reconstruction, called the Recurrent Variational Network (RecurrentVarNet), by exploiting the properties of Convolutional Recurrent Neural Networks and unrolled algorithms for solving Inverse Problems. The RecurrentVarNet consists of multiple recurrent blocks, each responsible for one iteration of the unrolled variational optimization scheme for solving the inverse problem of multi-coil Accelerated MRI Reconstruction. Contrary to traditional approaches, the optimization steps are performed in the observation domain (k-space) instead of the image domain. Each block of the RecurrentVarNet refines the observed k-space and comprises a data consistency term and a recurrent unit which takes as input a learned hidden state and the prediction of the previous block. Our proposed method achieves new state of the art qualitative and quantitative reconstruction results on 5-fold and 10-fold accelerated data from a public multi-coil brain dataset, outperforming previous conventional and deep learning-based approaches.

  • 4 authors
·
Nov 18, 2021

What needs to go right for an induction head? A mechanistic study of in-context learning circuits and their formation

In-context learning is a powerful emergent ability in transformer models. Prior work in mechanistic interpretability has identified a circuit element that may be critical for in-context learning -- the induction head (IH), which performs a match-and-copy operation. During training of large transformers on natural language data, IHs emerge around the same time as a notable phase change in the loss. Despite the robust evidence for IHs and this interesting coincidence with the phase change, relatively little is known about the diversity and emergence dynamics of IHs. Why is there more than one IH, and how are they dependent on each other? Why do IHs appear all of a sudden, and what are the subcircuits that enable them to emerge? We answer these questions by studying IH emergence dynamics in a controlled setting by training on synthetic data. In doing so, we develop and share a novel optogenetics-inspired causal framework for modifying activations throughout training. Using this framework, we delineate the diverse and additive nature of IHs. By clamping subsets of activations throughout training, we then identify three underlying subcircuits that interact to drive IH formation, yielding the phase change. Furthermore, these subcircuits shed light on data-dependent properties of formation, such as phase change timing, already showing the promise of this more in-depth understanding of subcircuits that need to "go right" for an induction head.

  • 5 authors
·
Apr 10, 2024

A Review of Longitudinal Radiology Report Generation: Dataset Composition, Methods, and Performance Evaluation

Chest Xray imaging is a widely used diagnostic tool in modern medicine, and its high utilization creates substantial workloads for radiologists. To alleviate this burden, vision language models are increasingly applied to automate Chest Xray radiology report generation (CXRRRG), aiming for clinically accurate descriptions while reducing manual effort. Conventional approaches, however, typically rely on single images, failing to capture the longitudinal context necessary for producing clinically faithful comparison statements. Recently, growing attention has been directed toward incorporating longitudinal data into CXR RRG, enabling models to leverage historical studies in ways that mirror radiologists diagnostic workflows. Nevertheless, existing surveys primarily address single image CXRRRG and offer limited guidance for longitudinal settings, leaving researchers without a systematic framework for model design. To address this gap, this survey provides the first comprehensive review of longitudinal radiology report generation (LRRG). Specifically, we examine dataset construction strategies, report generation architectures alongside longitudinally tailored designs, and evaluation protocols encompassing both longitudinal specific measures and widely used benchmarks. We further summarize LRRG methods performance, alongside analyses of different ablation studies, which collectively highlight the critical role of longitudinal information and architectural design choices in improving model performance. Finally, we summarize five major limitations of current research and outline promising directions for future development, aiming to lay a foundation for advancing this emerging field.

  • 6 authors
·
Oct 14

Application of NotebookLM, a Large Language Model with Retrieval-Augmented Generation, for Lung Cancer Staging

Purpose: In radiology, large language models (LLMs), including ChatGPT, have recently gained attention, and their utility is being rapidly evaluated. However, concerns have emerged regarding their reliability in clinical applications due to limitations such as hallucinations and insufficient referencing. To address these issues, we focus on the latest technology, retrieval-augmented generation (RAG), which enables LLMs to reference reliable external knowledge (REK). Specifically, this study examines the utility and reliability of a recently released RAG-equipped LLM (RAG-LLM), NotebookLM, for staging lung cancer. Materials and methods: We summarized the current lung cancer staging guideline in Japan and provided this as REK to NotebookLM. We then tasked NotebookLM with staging 100 fictional lung cancer cases based on CT findings and evaluated its accuracy. For comparison, we performed the same task using a gold-standard LLM, GPT-4 Omni (GPT-4o), both with and without the REK. Results: NotebookLM achieved 86% diagnostic accuracy in the lung cancer staging experiment, outperforming GPT-4o, which recorded 39% accuracy with the REK and 25% without it. Moreover, NotebookLM demonstrated 95% accuracy in searching reference locations within the REK. Conclusion: NotebookLM successfully performed lung cancer staging by utilizing the REK, demonstrating superior performance compared to GPT-4o. Additionally, it provided highly accurate reference locations within the REK, allowing radiologists to efficiently evaluate the reliability of NotebookLM's responses and detect possible hallucinations. Overall, this study highlights the potential of NotebookLM, a RAG-LLM, in image diagnosis.

  • 8 authors
·
Oct 8, 2024

iLRM: An Iterative Large 3D Reconstruction Model

Feed-forward 3D modeling has emerged as a promising approach for rapid and high-quality 3D reconstruction. In particular, directly generating explicit 3D representations, such as 3D Gaussian splatting, has attracted significant attention due to its fast and high-quality rendering, as well as numerous applications. However, many state-of-the-art methods, primarily based on transformer architectures, suffer from severe scalability issues because they rely on full attention across image tokens from multiple input views, resulting in prohibitive computational costs as the number of views or image resolution increases. Toward a scalable and efficient feed-forward 3D reconstruction, we introduce an iterative Large 3D Reconstruction Model (iLRM) that generates 3D Gaussian representations through an iterative refinement mechanism, guided by three core principles: (1) decoupling the scene representation from input-view images to enable compact 3D representations; (2) decomposing fully-attentional multi-view interactions into a two-stage attention scheme to reduce computational costs; and (3) injecting high-resolution information at every layer to achieve high-fidelity reconstruction. Experimental results on widely used datasets, such as RE10K and DL3DV, demonstrate that iLRM outperforms existing methods in both reconstruction quality and speed. Notably, iLRM exhibits superior scalability, delivering significantly higher reconstruction quality under comparable computational cost by efficiently leveraging a larger number of input views.

  • 6 authors
·
Jul 31 2

I-AI: A Controllable & Interpretable AI System for Decoding Radiologists' Intense Focus for Accurate CXR Diagnoses

In the field of chest X-ray (CXR) diagnosis, existing works often focus solely on determining where a radiologist looks, typically through tasks such as detection, segmentation, or classification. However, these approaches are often designed as black-box models, lacking interpretability. In this paper, we introduce Interpretable Artificial Intelligence (I-AI) a novel and unified controllable interpretable pipeline for decoding the intense focus of radiologists in CXR diagnosis. Our I-AI addresses three key questions: where a radiologist looks, how long they focus on specific areas, and what findings they diagnose. By capturing the intensity of the radiologist's gaze, we provide a unified solution that offers insights into the cognitive process underlying radiological interpretation. Unlike current methods that rely on black-box machine learning models, which can be prone to extracting erroneous information from the entire input image during the diagnosis process, we tackle this issue by effectively masking out irrelevant information. Our proposed I-AI leverages a vision-language model, allowing for precise control over the interpretation process while ensuring the exclusion of irrelevant features. To train our I-AI model, we utilize an eye gaze dataset to extract anatomical gaze information and generate ground truth heatmaps. Through extensive experimentation, we demonstrate the efficacy of our method. We showcase that the attention heatmaps, designed to mimic radiologists' focus, encode sufficient and relevant information, enabling accurate classification tasks using only a portion of CXR. The code, checkpoints, and data are at https://github.com/UARK-AICV/IAI

  • 5 authors
·
Sep 24, 2023

Individualizing Glioma Radiotherapy Planning by Optimization of Data and Physics-Informed Discrete Loss

Brain tumor growth is unique to each glioma patient and extends beyond what is visible in imaging scans, infiltrating surrounding brain tissue. Understanding these hidden patient-specific progressions is essential for effective therapies. Current treatment plans for brain tumors, such as radiotherapy, typically involve delineating a uniform margin around the visible tumor on pre-treatment scans to target this invisible tumor growth. This "one size fits all" approach is derived from population studies and often fails to account for the nuances of individual patient conditions. We present the GliODIL framework, which infers the full spatial distribution of tumor cell concentration from available multi-modal imaging, leveraging a Fisher-Kolmogorov type physics model to describe tumor growth. This is achieved through the newly introduced method of Optimizing the Discrete Loss (ODIL), where both data and physics-based constraints are softly assimilated into the solution. Our test dataset comprises 152 glioblastoma patients with pre-treatment imaging and post-treatment follow-ups for tumor recurrence monitoring. By blending data-driven techniques with physics-based constraints, GliODIL enhances recurrence prediction in radiotherapy planning, challenging traditional uniform margins and strict adherence to the Fisher-Kolmogorov partial differential equation (PDE) model, which is adapted for complex cases.

  • 10 authors
·
Dec 8, 2023

One Timestep is All You Need: Training Spiking Neural Networks with Ultra Low Latency

Spiking Neural Networks (SNNs) are energy efficient alternatives to commonly used deep neural networks (DNNs). Through event-driven information processing, SNNs can reduce the expensive compute requirements of DNNs considerably, while achieving comparable performance. However, high inference latency is a significant hindrance to the edge deployment of deep SNNs. Computation over multiple timesteps not only increases latency as well as overall energy budget due to higher number of operations, but also incurs memory access overhead of fetching membrane potentials, both of which lessen the energy benefits of SNNs. To overcome this bottleneck and leverage the full potential of SNNs, we propose an Iterative Initialization and Retraining method for SNNs (IIR-SNN) to perform single shot inference in the temporal axis. The method starts with an SNN trained with T timesteps (T>1). Then at each stage of latency reduction, the network trained at previous stage with higher timestep is utilized as initialization for subsequent training with lower timestep. This acts as a compression method, as the network is gradually shrunk in the temporal domain. In this paper, we use direct input encoding and choose T=5, since as per literature, it is the minimum required latency to achieve satisfactory performance on ImageNet. The proposed scheme allows us to obtain SNNs with up to unit latency, requiring a single forward pass during inference. We achieve top-1 accuracy of 93.05%, 70.15% and 67.71% on CIFAR-10, CIFAR-100 and ImageNet, respectively using VGG16, with just 1 timestep. In addition, IIR-SNNs perform inference with 5-2500X reduced latency compared to other state-of-the-art SNNs, maintaining comparable or even better accuracy. Furthermore, in comparison with standard DNNs, the proposed IIR-SNNs provide25-33X higher energy efficiency, while being comparable to them in classification performance.

  • 3 authors
·
Oct 1, 2021

Feature Re-Embedding: Towards Foundation Model-Level Performance in Computational Pathology

Multiple instance learning (MIL) is the most widely used framework in computational pathology, encompassing sub-typing, diagnosis, prognosis, and more. However, the existing MIL paradigm typically requires an offline instance feature extractor, such as a pre-trained ResNet or a foundation model. This approach lacks the capability for feature fine-tuning within the specific downstream tasks, limiting its adaptability and performance. To address this issue, we propose a Re-embedded Regional Transformer (R^2T) for re-embedding the instance features online, which captures fine-grained local features and establishes connections across different regions. Unlike existing works that focus on pre-training powerful feature extractor or designing sophisticated instance aggregator, R^2T is tailored to re-embed instance features online. It serves as a portable module that can seamlessly integrate into mainstream MIL models. Extensive experimental results on common computational pathology tasks validate that: 1) feature re-embedding improves the performance of MIL models based on ResNet-50 features to the level of foundation model features, and further enhances the performance of foundation model features; 2) the R^2T can introduce more significant performance improvements to various MIL models; 3) R^2T-MIL, as an R^2T-enhanced AB-MIL, outperforms other latest methods by a large margin.The code is available at: https://github.com/DearCaat/RRT-MIL.

  • 6 authors
·
Feb 27, 2024

SuPRA: Surgical Phase Recognition and Anticipation for Intra-Operative Planning

Intra-operative recognition of surgical phases holds significant potential for enhancing real-time contextual awareness in the operating room. However, we argue that online recognition, while beneficial, primarily lends itself to post-operative video analysis due to its limited direct impact on the actual surgical decisions and actions during ongoing procedures. In contrast, we contend that the prediction and anticipation of surgical phases are inherently more valuable for intra-operative assistance, as they can meaningfully influence a surgeon's immediate and long-term planning by providing foresight into future steps. To address this gap, we propose a dual approach that simultaneously recognises the current surgical phase and predicts upcoming ones, thus offering comprehensive intra-operative assistance and guidance on the expected remaining workflow. Our novel method, Surgical Phase Recognition and Anticipation (SuPRA), leverages past and current information for accurate intra-operative phase recognition while using future segments for phase prediction. This unified approach challenges conventional frameworks that treat these objectives separately. We have validated SuPRA on two reputed datasets, Cholec80 and AutoLaparo21, where it demonstrated state-of-the-art performance with recognition accuracies of 91.8% and 79.3%, respectively. Additionally, we introduce and evaluate our model using new segment-level evaluation metrics, namely Edit and F1 Overlap scores, for a more temporal assessment of segment classification. In conclusion, SuPRA presents a new multi-task approach that paves the way for improved intra-operative assistance through surgical phase recognition and prediction of future events.

  • 5 authors
·
Mar 10, 2024

Attention in Large Language Models Yields Efficient Zero-Shot Re-Rankers

Information retrieval (IR) systems have played a vital role in modern digital life and have cemented their continued usefulness in this new era of generative AI via retrieval-augmented generation. With strong language processing capabilities and remarkable versatility, large language models (LLMs) have become popular choices for zero-shot re-ranking in IR systems. So far, LLM-based re-ranking methods rely on strong generative capabilities, which restricts their use to either specialized or powerful proprietary models. Given these restrictions, we ask: is autoregressive generation necessary and optimal for LLMs to perform re-ranking? We hypothesize that there are abundant signals relevant to re-ranking within LLMs that might not be used to their full potential via generation. To more directly leverage such signals, we propose in-context re-ranking (ICR), a novel method that leverages the change in attention pattern caused by the search query for accurate and efficient re-ranking. To mitigate the intrinsic biases in LLMs, we propose a calibration method using a content-free query. Due to the absence of generation, ICR only requires two (O(1)) forward passes to re-rank N documents, making it substantially more efficient than generative re-ranking methods that require at least O(N) forward passes. Our novel design also enables ICR to be applied to any LLM without specialized training while guaranteeing a well-formed ranking. Extensive experiments with two popular open-weight LLMs on standard single-hop and multi-hop information retrieval benchmarks show that ICR outperforms RankGPT while cutting the latency by more than 60% in practice. Through detailed analyses, we show that ICR's performance is specially strong on tasks that require more complex re-ranking signals. Our findings call for further exploration on novel ways of utilizing open-weight LLMs beyond text generation.

  • 3 authors
·
Oct 3, 2024

Sequential Diagnosis with Language Models

Artificial intelligence holds great promise for expanding access to expert medical knowledge and reasoning. However, most evaluations of language models rely on static vignettes and multiple-choice questions that fail to reflect the complexity and nuance of evidence-based medicine in real-world settings. In clinical practice, physicians iteratively formulate and revise diagnostic hypotheses, adapting each subsequent question and test to what they've just learned, and weigh the evolving evidence before committing to a final diagnosis. To emulate this iterative process, we introduce the Sequential Diagnosis Benchmark, which transforms 304 diagnostically challenging New England Journal of Medicine clinicopathological conference (NEJM-CPC) cases into stepwise diagnostic encounters. A physician or AI begins with a short case abstract and must iteratively request additional details from a gatekeeper model that reveals findings only when explicitly queried. Performance is assessed not just by diagnostic accuracy but also by the cost of physician visits and tests performed. We also present the MAI Diagnostic Orchestrator (MAI-DxO), a model-agnostic orchestrator that simulates a panel of physicians, proposes likely differential diagnoses and strategically selects high-value, cost-effective tests. When paired with OpenAI's o3 model, MAI-DxO achieves 80% diagnostic accuracy--four times higher than the 20% average of generalist physicians. MAI-DxO also reduces diagnostic costs by 20% compared to physicians, and 70% compared to off-the-shelf o3. When configured for maximum accuracy, MAI-DxO achieves 85.5% accuracy. These performance gains with MAI-DxO generalize across models from the OpenAI, Gemini, Claude, Grok, DeepSeek, and Llama families. We highlight how AI systems, when guided to think iteratively and act judiciously, can advance diagnostic precision and cost-effectiveness in clinical care.

  • 15 authors
·
Jun 27

Segmentation variability and radiomics stability for predicting Triple-Negative Breast Cancer subtype using Magnetic Resonance Imaging

Most papers caution against using predictive models for disease stratification based on unselected radiomic features, as these features are affected by contouring variability. Instead, they advocate for the use of the Intraclass Correlation Coefficient (ICC) as a measure of stability for feature selection. However, the direct effect of segmentation variability on the predictive models is rarely studied. This study investigates the impact of segmentation variability on feature stability and predictive performance in radiomics-based prediction of Triple-Negative Breast Cancer (TNBC) subtype using Magnetic Resonance Imaging. A total of 244 images from the Duke dataset were used, with segmentation variability introduced through modifications of manual segmentations. For each mask, explainable radiomic features were selected using the Shapley Additive exPlanations method and used to train logistic regression models. Feature stability across segmentations was assessed via ICC, Pearson's correlation, and reliability scores quantifying the relationship between feature stability and segmentation variability. Results indicate that segmentation accuracy does not significantly impact predictive performance. While incorporating peritumoral information may reduce feature reproducibility, it does not diminish feature predictive capability. Moreover, feature selection in predictive models is not inherently tied to feature stability with respect to segmentation, suggesting that an overreliance on ICC or reliability scores for feature selection might exclude valuable predictive features.

  • 7 authors
·
Apr 2

ISLES 2022: A multi-center magnetic resonance imaging stroke lesion segmentation dataset

Magnetic resonance imaging (MRI) is a central modality for stroke imaging. It is used upon patient admission to make treatment decisions such as selecting patients for intravenous thrombolysis or endovascular therapy. MRI is later used in the duration of hospital stay to predict outcome by visualizing infarct core size and location. Furthermore, it may be used to characterize stroke etiology, e.g. differentiation between (cardio)-embolic and non-embolic stroke. Computer based automated medical image processing is increasingly finding its way into clinical routine. Previous iterations of the Ischemic Stroke Lesion Segmentation (ISLES) challenge have aided in the generation of identifying benchmark methods for acute and sub-acute ischemic stroke lesion segmentation. Here we introduce an expert-annotated, multicenter MRI dataset for segmentation of acute to subacute stroke lesions. This dataset comprises 400 multi-vendor MRI cases with high variability in stroke lesion size, quantity and location. It is split into a training dataset of n=250 and a test dataset of n=150. All training data will be made publicly available. The test dataset will be used for model validation only and will not be released to the public. This dataset serves as the foundation of the ISLES 2022 challenge with the goal of finding algorithmic methods to enable the development and benchmarking of robust and accurate segmentation algorithms for ischemic stroke.

  • 25 authors
·
Jun 14, 2022

Learn or Recall? Revisiting Incremental Learning with Pre-trained Language Models

Incremental Learning (IL) has been a long-standing problem in both vision and Natural Language Processing (NLP) communities. In recent years, as Pre-trained Language Models (PLMs) have achieved remarkable progress in various NLP downstream tasks, utilizing PLMs as backbones has become a common practice in recent research of IL in NLP. Most assume that catastrophic forgetting is the biggest obstacle to achieving superior IL performance and propose various techniques to overcome this issue. However, we find that this assumption is problematic. Specifically, we revisit more than 20 methods on four classification tasks (Text Classification, Intent Classification, Relation Extraction, and Named Entity Recognition) under the two most popular IL settings (Class-Incremental and Task-Incremental) and reveal that most of them severely underestimate the inherent anti-forgetting ability of PLMs. Based on the observation, we propose a frustratingly easy method called SEQ* for IL with PLMs. The results show that SEQ* has competitive or superior performance compared to state-of-the-art (SOTA) IL methods and requires considerably less trainable parameters and training time. These findings urge us to revisit the IL with PLMs and encourage future studies to have a fundamental understanding of the catastrophic forgetting in PLMs. The data, code and scripts are publicly available at https://github.com/zzz47zzz/codebase-for-incremental-learning-with-llm.

  • 3 authors
·
Dec 12, 2023

A Robust Ensemble Algorithm for Ischemic Stroke Lesion Segmentation: Generalizability and Clinical Utility Beyond the ISLES Challenge

Diffusion-weighted MRI (DWI) is essential for stroke diagnosis, treatment decisions, and prognosis. However, image and disease variability hinder the development of generalizable AI algorithms with clinical value. We address this gap by presenting a novel ensemble algorithm derived from the 2022 Ischemic Stroke Lesion Segmentation (ISLES) challenge. ISLES'22 provided 400 patient scans with ischemic stroke from various medical centers, facilitating the development of a wide range of cutting-edge segmentation algorithms by the research community. Through collaboration with leading teams, we combined top-performing algorithms into an ensemble model that overcomes the limitations of individual solutions. Our ensemble model achieved superior ischemic lesion detection and segmentation accuracy on our internal test set compared to individual algorithms. This accuracy generalized well across diverse image and disease variables. Furthermore, the model excelled in extracting clinical biomarkers. Notably, in a Turing-like test, neuroradiologists consistently preferred the algorithm's segmentations over manual expert efforts, highlighting increased comprehensiveness and precision. Validation using a real-world external dataset (N=1686) confirmed the model's generalizability. The algorithm's outputs also demonstrated strong correlations with clinical scores (admission NIHSS and 90-day mRS) on par with or exceeding expert-derived results, underlining its clinical relevance. This study offers two key findings. First, we present an ensemble algorithm (https://github.com/Tabrisrei/ISLES22_Ensemble) that detects and segments ischemic stroke lesions on DWI across diverse scenarios on par with expert (neuro)radiologists. Second, we show the potential for biomedical challenge outputs to extend beyond the challenge's initial objectives, demonstrating their real-world clinical applicability.

  • 58 authors
·
Mar 28, 2024

Recurrent Residual Convolutional Neural Network based on U-Net (R2U-Net) for Medical Image Segmentation

Deep learning (DL) based semantic segmentation methods have been providing state-of-the-art performance in the last few years. More specifically, these techniques have been successfully applied to medical image classification, segmentation, and detection tasks. One deep learning technique, U-Net, has become one of the most popular for these applications. In this paper, we propose a Recurrent Convolutional Neural Network (RCNN) based on U-Net as well as a Recurrent Residual Convolutional Neural Network (RRCNN) based on U-Net models, which are named RU-Net and R2U-Net respectively. The proposed models utilize the power of U-Net, Residual Network, as well as RCNN. There are several advantages of these proposed architectures for segmentation tasks. First, a residual unit helps when training deep architecture. Second, feature accumulation with recurrent residual convolutional layers ensures better feature representation for segmentation tasks. Third, it allows us to design better U-Net architecture with same number of network parameters with better performance for medical image segmentation. The proposed models are tested on three benchmark datasets such as blood vessel segmentation in retina images, skin cancer segmentation, and lung lesion segmentation. The experimental results show superior performance on segmentation tasks compared to equivalent models including U-Net and residual U-Net (ResU-Net).

  • 5 authors
·
Feb 19, 2018

Improved Robustness for Deep Learning-based Segmentation of Multi-Center Myocardial Perfusion MRI Datasets Using Data Adaptive Uncertainty-guided Space-time Analysis

Background. Fully automatic analysis of myocardial perfusion MRI datasets enables rapid and objective reporting of stress/rest studies in patients with suspected ischemic heart disease. Developing deep learning techniques that can analyze multi-center datasets despite limited training data and variations in software and hardware is an ongoing challenge. Methods. Datasets from 3 medical centers acquired at 3T (n = 150 subjects) were included: an internal dataset (inD; n = 95) and two external datasets (exDs; n = 55) used for evaluating the robustness of the trained deep neural network (DNN) models against differences in pulse sequence (exD-1) and scanner vendor (exD-2). A subset of inD (n = 85) was used for training/validation of a pool of DNNs for segmentation, all using the same spatiotemporal U-Net architecture and hyperparameters but with different parameter initializations. We employed a space-time sliding-patch analysis approach that automatically yields a pixel-wise "uncertainty map" as a byproduct of the segmentation process. In our approach, a given test case is segmented by all members of the DNN pool and the resulting uncertainty maps are leveraged to automatically select the "best" one among the pool of solutions. Results. The proposed DAUGS analysis approach performed similarly to the established approach on the internal dataset (p = n.s.) whereas it significantly outperformed on the external datasets (p < 0.005 for exD-1 and exD-2). Moreover, the number of image series with "failed" segmentation was significantly lower for the proposed vs. the established approach (4.3% vs. 17.1%, p < 0.0005). Conclusions. The proposed DAUGS analysis approach has the potential to improve the robustness of deep learning methods for segmentation of multi-center stress perfusion datasets with variations in the choice of pulse sequence, site location or scanner vendor.

  • 11 authors
·
Aug 8, 2024

Catastrophic Interference is Mitigated in Naturalistic Power-Law Learning Environments

Neural networks often suffer from catastrophic interference (CI): performance on previously learned tasks drops off significantly when learning a new task. This contrasts strongly with humans, who can sequentially learn new tasks without appreciably forgetting previous tasks. Prior work has explored various techniques for mitigating CI such as regularization, rehearsal, generative replay, and distillation methods. The current work takes a different approach, one guided by cognitive science research showing that in naturalistic environments, the probability of encountering a task decreases as a power-law of the time since it was last performed. We argue that a realistic evaluation of techniques for the mitigation of CI should be performed in simulated naturalistic learning environments. Thus, we evaluate the extent of mitigation of CI when training simple rehearsal-based methods in power-law environments similar to the ones humans face. Our work explores this novel rehearsal-based approach for a domain-incremental task: learning permutations in the MNIST task. We compare our rehearsal environment with other baselines to show its efficacy in promoting continual learning. Additionally, we investigate whether this environment shows forward facilitation, i.e., faster learning of later tasks. Next, we explore the robustness of our learning environment to the number of tasks, model size, and amount of data rehearsed after each task. Notably, our results show that the performance is comparable or superior to that of models trained using popular regularization methods and also to rehearsals in non-power-law environments. The benefits of this training paradigm include simplicity and the lack of a need for extra neural circuitry. In addition, because our method is orthogonal to other methods, future research can combine training in power-law environments with other continual learning mechanisms.

  • 4 authors
·
Jan 18, 2024

IRepair: An Intent-Aware Approach to Repair Data-Driven Errors in Large Language Models

Not a day goes by without hearing about the impressive feats of large language models (LLMs), and equally, not a day passes without hearing about their challenges. LLMs are notoriously vulnerable to biases in their dataset, leading to issues such as toxicity. While domain-adaptive training has been employed to mitigate these issues, these techniques often address all model parameters indiscriminately during the repair process, resulting in poor repair quality and reduced model versatility. In this paper, we introduce a novel dynamic slicing-based intent-aware LLM repair strategy, IRepair. This approach selectively targets the most error-prone sections of the model for repair. Specifically, we propose dynamically slicing the model's most sensitive layers that require immediate attention, concentrating repair efforts on those areas. This method enables more effective repairs with potentially less impact on the model's overall performance by altering a smaller portion of the model. We evaluated our technique on three models from the GPT2 and GPT-Neo families, with parameters ranging from 800M to 1.6B, in a toxicity mitigation setup. Our results show that IRepair repairs errors 43.6% more effectively while causing 46% less disruption to general performance compared to the closest baseline, direct preference optimization. Our empirical analysis also reveals that errors are more concentrated in a smaller section of the model, with the top 20% of layers exhibiting 773% more error density than the remaining 80\%. This highlights the need for selective repair. Additionally, we demonstrate that a dynamic selection approach is essential for addressing errors dispersed throughout the model, ensuring a robust and efficient repair.

  • 4 authors
·
Feb 10