Access to diverse, well-annotated medical images with interactive learning tools is fundamental for training practitioners in medicine and related fields to improve their diagnostic skills and understanding of anatomical structures. While medical atlases are valuable, they are often impractical due to their size and lack of interactivity, whereas online image search may provide mislabeled or incomplete material. To address this, we propose MIRAGE, a multimodal medical text and image retrieval and generation system that allows users to find and generate clinically relevant images from trustworthy sources by mapping both text and images to a shared latent space, enabling semantically meaningful queries. The system is based on a fine-tuned medical version of CLIP (MedICaT-ROCO), trained with the ROCO dataset, obtained from PubMed Central. MIRAGE allows users to give prompts to retrieve images, generate synthetic ones through a medical diffusion model (Prompt2MedImage) and receive enriched descriptions from a large language model (Dolly-v2-3b). It also supports a dual search option, enabling the visual comparison of different medical conditions. A key advantage of the system is that it
We present one of the very first extensive classifications of a large sample of molecular clouds based on their morphology. This is achieved using a recently published catalogue of 10663 clouds obtained from the first data release of the SEDIGISM survey. The clouds are classified into four different morphologies by visual inspection and using an automated algorithm -- J plots. The visual inspection also serves as a test for the J plots algorithm, as this is the first time it has been used on molecular gas. Generally, it has been found that the structure of molecular clouds is highly filamentary and our observations indeed verify that most of our molecular clouds are elongated structures. Based on our visual classification of the 10663 SEDIGISM clouds, 15% are ring-like, 57% are elongated, 15% are concentrated and 10% are clumpy clouds. The remaining clouds do not belong to any of these morphology classes and are termed unclassified. We compare the SEDIGISM molecular clouds with structures identified through other surveys, i.e. ATLASGAL elongated structures and the bubbles from Milky Way Project (MWP). We find that many of the ATLASGAL and MWP structures are velocity coherent. ATLAS
Vision-language foundation models (VLMs) have shown great potential in feature transfer and generalization across a wide spectrum of medical-related downstream tasks. However, fine-tuning these models is resource-intensive due to their large number of parameters. Prompt tuning has emerged as a viable solution to mitigate memory usage and reduce training time while maintaining competitive performance. Nevertheless, the challenge is that existing prompt tuning methods cannot precisely distinguish different kinds of medical concepts, which miss essentially specific disease-related features across various medical imaging modalities in medical image classification tasks. We find that Large Language Models (LLMs), trained on extensive text corpora, are particularly adept at providing this specialized medical knowledge. Motivated by this, we propose incorporating LLMs into the prompt tuning process. Specifically, we introduce the CILMP, Conditional Intervention of Large Language Models for Prompt Tuning, a method that bridges LLMs and VLMs to facilitate the transfer of medical knowledge into VLM prompts. CILMP extracts disease-specific representations from LLMs, intervenes within a low-ra
The Segment Anything Model (SAM) has recently gained popularity in the field of image segmentation due to its impressive capabilities in various segmentation tasks and its prompt-based interface. However, recent studies and individual experiments have shown that SAM underperforms in medical image segmentation, since the lack of the medical specific knowledge. This raises the question of how to enhance SAM's segmentation capability for medical images. In this paper, instead of fine-tuning the SAM model, we propose the Medical SAM Adapter (Med-SA), which incorporates domain-specific medical knowledge into the segmentation model using a light yet effective adaptation technique. In Med-SA, we propose Space-Depth Transpose (SD-Trans) to adapt 2D SAM to 3D medical images and Hyper-Prompting Adapter (HyP-Adpt) to achieve prompt-conditioned adaptation. We conduct comprehensive evaluation experiments on 17 medical image segmentation tasks across various image modalities. Med-SA outperforms several state-of-the-art (SOTA) medical image segmentation methods, while updating only 2\% of the parameters. Our code is released at https://github.com/KidsWithTokens/Medical-SAM-Adapter.
Large volumes of medical data remain underutilized because centralizing distributed data is often infeasible due to strict privacy regulations and institutional constraints. In addition, models trained in centralized settings frequently fail to generalize across clinical sites because of heterogeneity in imaging protocols and continuously evolving data distributions arising from differences in scanners, acquisition parameters, and patient populations. Federated learning offers a promising solution by enabling collaborative model training without sharing raw data. However, incorporating differential privacy into federated learning, while essential for privacy guarantees, often leads to degraded accuracy, unstable convergence, and reduced generalization. In this work, we propose an adaptive differentially private federated learning (ADP-FL) framework for medical image segmentation that dynamically adjusts privacy mechanisms to better balance the privacy-utility trade-off. The proposed approach stabilizes training, significantly improves Dice scores and segmentation boundary quality, and maintains rigorous privacy guarantees. We evaluated ADP-FL across diverse imaging modalities and s
Medical imaging is an essential tool for diagnosing and treating diseases. However, lacking medical images can lead to inaccurate diagnoses and ineffective treatments. Generative models offer a promising solution for addressing medical image shortage problems due to their ability to generate new data from existing datasets and detect anomalies in this data. Data augmentation with position augmentation methods like scaling, cropping, flipping, padding, rotation, and translation could lead to more overfitting in domains with little data, such as medical image data. This paper proposes the GAN-GA, a generative model optimized by embedding a genetic algorithm. The proposed model enhances image fidelity and diversity while preserving distinctive features. The proposed medical image synthesis approach improves the quality and fidelity of medical images, an essential aspect of image interpretation. To evaluate synthesized images: Frechet Inception Distance (FID) is used. The proposed GAN-GA model is tested by generating Acute lymphoblastic leukemia (ALL) medical images, an image dataset, and is the first time to be used in generative models. Our results were compared to those of InfoGAN a
Mathematical morphology provides a nonlinear framework for image and spatial data processing and analysis. Although there have been many successful applications of mathematical morphology to vector-valued images, such as color and hyperspectral images, there is still no consensus on the most suitable vector ordering for constructing morphological operators. This paper addresses this issue by examining a reduced ordering approximating the Condorcet ranking derived from a set of vector orderings. Inspired by voting problems, the Condorcet ordering ranks elements from most to least voted, with voters representing different orderings. In this paper, we develop a machine learning approach that learns a reduced ordering that approximates the Condorcet ordering. Preliminary computational experiments confirm the effectiveness of learning the reduced mapping to define vector-valued morphological operators for color images.
Deep learning has achieved widespread success in medical image analysis, leading to an increasing demand for large-scale expert-annotated medical image datasets. Yet, the high cost of annotating medical images severely hampers the development of deep learning in this field. To reduce annotation costs, active learning aims to select the most informative samples for annotation and train high-performance models with as few labeled samples as possible. In this survey, we review the core methods of active learning, including the evaluation of informativeness and sampling strategy. For the first time, we provide a detailed summary of the integration of active learning with other label-efficient techniques, such as semi-supervised, self-supervised learning, and so on. We also summarize active learning works that are specifically tailored to medical image analysis. Additionally, we conduct a thorough comparative analysis of the performance of different AL methods in medical image analysis with experiments. In the end, we offer our perspectives on the future trends and challenges of active learning and its applications in medical image analysis.
Medical image segmentation is critical for clinical diagnosis, treatment planning, and monitoring, yet segmentation models often struggle with uncertainties stemming from occlusions, ambiguous boundaries, and variations in imaging devices. Traditional test-time augmentation (TTA) techniques typically rely on predefined geometric and photometric transformations, limiting their adaptability and effectiveness in complex medical scenarios. In this study, we introduced Test-Time Generative Augmentation (TTGA), a novel augmentation strategy specifically tailored for medical image segmentation at inference time. Different from conventional augmentation strategies that suffer from excessive randomness or limited flexibility, TTGA leverages a domain-fine-tuned generative model to produce contextually relevant and diverse augmentations tailored to the characteristics of each test image. Built upon diffusion model inversion, a masked null-text inversion method is proposed to enable region-specific augmentations during sampling. Furthermore, a dual denoising pathway is designed to balance precise identity preservation with controlled variability. We demonstrate the efficacy of our TTGA through
The diagnosis and treatment of various diseases had been expedited with the help of medical imaging. Different medical imaging modalities, including X-ray, Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Nuclear Imaging, Ultrasound, Electrical Impedance Tomography (EIT), and Emerging Technologies for in vivo imaging modalities is presented in this chapter, in addition to these modalities, some advanced techniques such as contrast-enhanced MRI, MR approaches for osteoarthritis, Cardiovascular Imaging, and Medical Imaging data mining and search. Despite its important role and potential effectiveness as a diagnostic tool, reading and interpreting medical images by radiologists is often tedious and difficult due to the large heterogeneity of diseases and the limitation of image quality or resolution. Besides the introduction and discussion of the basic principles, typical clinical applications, advantages, and limitations of each modality used in current clinical practice, this chapter also highlights the importance of emerging technologies in medical imaging and the role of data mining and search aiming to support translational clinical research, improve patient care, and
Autonomous morphology, such as inflection class systems and paradigmatic distribution patterns, is widespread and diachronically resilient in natural language. Why this should be so has remained unclear given that autonomous morphology imposes learning costs, offers no clear benefit relative to its absence and could easily be removed by the analogical forces which are constantly reshaping it. Here we propose an explanation for the resilience of autonomous morphology, in terms of a diachronic dynamic of attraction and repulsion between morphomic categories, which emerges spontaneously from a simple paradigm cell filling process. Employing computational evolutionary models, our key innovation is to bring to light the role of `dissociative evidence', i.e., evidence for inflectional distinctiveness which a rational reasoner will have access to during analogical inference. Dissociative evidence creates a repulsion dynamic which prevents morphomic classes from collapsing together entirely, i.e., undergoing complete levelling. As we probe alternative models, we reveal the limits of conditional entropy as a measure for predictability in systems that are undergoing change. Finally, we demon
Determining whether two sets of images belong to the same or different distributions or domains is a crucial task in modern medical image analysis and deep learning; for example, to evaluate the output quality of image generative models. Currently, metrics used for this task either rely on the (potentially biased) choice of some downstream task, such as segmentation, or adopt task-independent perceptual metrics (e.g., Fréchet Inception Distance/FID) from natural imaging, which we show insufficiently capture anatomical features. To this end, we introduce a new perceptual metric tailored for medical images, FRD (Fréchet Radiomic Distance), which utilizes standardized, clinically meaningful, and interpretable image features. We show that FRD is superior to other image distribution metrics for a range of medical imaging applications, including out-of-domain (OOD) detection, the evaluation of image-to-image translation (by correlating more with downstream task performance as well as anatomical consistency and realism), and the evaluation of unconditional image generation. Moreover, FRD offers additional benefits such as stability and computational efficiency at low sample sizes, sensiti
Over the years, the Invariant Scattering Transform (IST) technique has become popular for medical image analysis, including using wavelet transform computation using Convolutional Neural Networks (CNN) to capture patterns' scale and orientation in the input signal. IST aims to be invariant to transformations that are common in medical images, such as translation, rotation, scaling, and deformation, used to improve the performance in medical imaging applications such as segmentation, classification, and registration, which can be integrated into machine learning algorithms for disease detection, diagnosis, and treatment planning. Additionally, combining IST with deep learning approaches has the potential to leverage their strengths and enhance medical image analysis outcomes. This study provides an overview of IST in medical imaging by considering the types of IST, their application, limitations, and potential scopes for future researchers and practitioners.
Medical image segmentation has been significantly advanced with the rapid development of deep learning (DL) techniques. Existing DL-based segmentation models are typically discriminative; i.e., they aim to learn a mapping from the input image to segmentation masks. However, these discriminative methods neglect the underlying data distribution and intrinsic class characteristics, suffering from unstable feature space. In this work, we propose to complement discriminative segmentation methods with the knowledge of underlying data distribution from generative models. To that end, we propose a novel hybrid diffusion framework for medical image segmentation, termed HiDiff, which can synergize the strengths of existing discriminative segmentation models and new generative diffusion models. HiDiff comprises two key components: discriminative segmentor and diffusion refiner. First, we utilize any conventional trained segmentation models as discriminative segmentor, which can provide a segmentation mask prior for diffusion refiner. Second, we propose a novel binary Bernoulli diffusion model (BBDM) as the diffusion refiner, which can effectively, efficiently, and interactively refine the seg
Artificial intelligence (AI) models trained using medical images for clinical tasks often exhibit bias in the form of disparities in performance between subgroups. Since not all sources of biases in real-world medical imaging data are easily identifiable, it is challenging to comprehensively assess how those biases are encoded in models, and how capable bias mitigation methods are at ameliorating performance disparities. In this article, we introduce a novel analysis framework for systematically and objectively investigating the impact of biases in medical images on AI models. We developed and tested this framework for conducting controlled in silico trials to assess bias in medical imaging AI using a tool for generating synthetic magnetic resonance images with known disease effects and sources of bias. The feasibility is showcased by using three counterfactual bias scenarios to measure the impact of simulated bias effects on a convolutional neural network (CNN) classifier and the efficacy of three bias mitigation strategies. The analysis revealed that the simulated biases resulted in expected subgroup performance disparities when the CNN was trained on the synthetic datasets. More
Over the last decade, convolutional neural networks have emerged and advanced the state-of-the-art in various image analysis and computer vision applications. The performance of 2D image classification networks is constantly improving and being trained on databases made of millions of natural images. However, progress in medical image analysis has been hindered by limited annotated data and acquisition constraints. These limitations are even more pronounced given the volumetry of medical imaging data. In this paper, we introduce an efficient way to transfer the efficiency of a 2D classification network trained on natural images to 2D, 3D uni- and multi-modal medical image segmentation applications. In this direction, we designed novel architectures based on two key principles: weight transfer by embedding a 2D pre-trained encoder into a higher dimensional U-Net, and dimensional transfer by expanding a 2D segmentation network into a higher dimension one. The proposed networks were tested on benchmarks comprising different modalities: MR, CT, and ultrasound images. Our 2D network ranked first on the CAMUS challenge dedicated to echo-cardiographic data segmentation and surpassed the s
Training segmentation models for medical images continues to be challenging due to the limited availability of data annotations. Segment Anything Model (SAM) is a foundation model that is intended to segment user-defined objects of interest in an interactive manner. While the performance on natural images is impressive, medical image domains pose their own set of challenges. Here, we perform an extensive evaluation of SAM's ability to segment medical images on a collection of 19 medical imaging datasets from various modalities and anatomies. We report the following findings: (1) SAM's performance based on single prompts highly varies depending on the dataset and the task, from IoU=0.1135 for spine MRI to IoU=0.8650 for hip X-ray. (2) Segmentation performance appears to be better for well-circumscribed objects with prompts with less ambiguity and poorer in various other scenarios such as the segmentation of brain tumors. (3) SAM performs notably better with box prompts than with point prompts. (4) SAM outperforms similar methods RITM, SimpleClick, and FocalClick in almost all single-point prompt settings. (5) When multiple-point prompts are provided iteratively, SAM's performance ge
Recently, the state space model Mamba has demonstrated efficient long-sequence modeling capabilities, particularly for addressing long-sequence visual tasks in 3D medical imaging. However, existing generative self-supervised learning methods have not yet fully unleashed Mamba's potential for handling long-range dependencies because they overlook the inherent causal properties of state space sequences in masked modeling. To address this challenge, we propose a general-purpose pre-training framework called MambaMIM, a masked image modeling method based on a novel TOKen-Interpolation strategy (TOKI) for the selective structure state space sequence, which learns causal relationships of state space within the masked sequence. Further, MambaMIM introduces a bottom-up 3D hybrid masking strategy to maintain a masking consistency across different architectures and can be used on any single or hybrid Mamba architecture to enhance its multi-scale and long-range representation capability. We pre-train MambaMIM on a large-scale dataset of 6.8K CT scans and evaluate its performance across eight public medical segmentation benchmarks. Extensive downstream experiments reveal the feasibility and ad
Modern generative models, such as generative adversarial networks (GANs), hold tremendous promise for several areas of medical imaging, such as unconditional medical image synthesis, image restoration, reconstruction and translation, and optimization of imaging systems. However, procedures for establishing stochastic image models (SIMs) using GANs remain generic and do not address specific issues relevant to medical imaging. In this work, canonical SIMs that simulate realistic vessels in angiography images are employed to evaluate procedures for establishing SIMs using GANs. The GAN-based SIM is compared to the canonical SIM based on its ability to reproduce those statistics that are meaningful to the particular medically realistic SIM considered. It is shown that evaluating GANs using classical metrics and medically relevant metrics may lead to different conclusions about the fidelity of the trained GANs. This work highlights the need for the development of objective metrics for evaluating GANs.
Federated learning (FL) enables multiple client medical institutes collaboratively train a deep learning (DL) model with privacy protection. However, the performance of FL can be constrained by the limited availability of labeled data in small institutes and the heterogeneous (i.e., non-i.i.d.) data distribution across institutes. Though data augmentation has been a proven technique to boost the generalization capabilities of conventional centralized DL as a "free lunch", its application in FL is largely underexplored. Notably, constrained by costly labeling, 3D medical segmentation generally relies on data augmentation. In this work, we aim to develop a vicinal feature-level data augmentation (VFDA) scheme to efficiently alleviate the local feature shift and facilitate collaborative training for privacy-aware FL segmentation. We take both the inner- and inter-institute divergence into consideration, without the need for cross-institute transfer of raw data or their mixup. Specifically, we exploit the batch-wise feature statistics (e.g., mean and standard deviation) in each institute to abstractly represent the discrepancy of data, and model each feature statistic probabilistically