Automated prostate segmentation in MRI is highly demanded for computer-assisted diagnosis. Recently, a variety of deep learning methods have achieved remarkable progress in this task, usually relying on large amounts of training data. Due to the nature of scarcity for medical images, it is important to effectively aggregate data from multiple sites for robust model training, to alleviate the insufficiency of single-site samples. However, the prostate MRIs from different sites present heterogeneity due to the differences in scanners and imaging protocols, raising challenges for effective ways of aggregating multi-site data for network training. In this paper, we propose a novel multisite network (MS-Net) for improving prostate segmentation by learning robust representations, leveraging multiple sources of data. To compensate for the inter-site heterogeneity of different MRI datasets, we develop Domain-Specific Batch Normalization layers in the network backbone, enabling the network to estimate statistics and perform feature normalization for each site separately. Considering the difficulty of capturing the shared knowledge from multiple datasets, a novel learning paradigm, i.e., Multi-site-guided Knowledge Transfer, is proposed to enhance the kernels to extract more generic representations from multi-site data. Extensive experiments on three heterogeneous prostate MRI datasets demonstrate that our MS-Net improves the performance across all datasets consistently, and outperforms state-of-the-art methods for multi-site learning.

The pandemic of coronavirus disease 2019 (COVID-19) has lead to a global public health crisis spreading hundreds of countries. With the continuous growth of new infections, developing automated tools for COVID-19 identification with CT image is highly desired to assist the clinical diagnosis and reduce the tedious workload of image interpretation. To enlarge the datasets for developing machine learning methods, it is essentially helpful to aggregate the cases from different medical systems for learning robust and generalizable models. This paper proposes a novel joint learning framework to perform accurate COVID-19 identification by effectively learning with heterogeneous datasets with distribution discrepancy. We build a powerful backbone by redesigning the recently proposed COVID-Net in aspects of network architecture and learning strategy to improve the prediction accuracy and learning efficiency. On top of our improved backbone, we further explicitly tackle the cross-site domain shift by conducting separate feature normalization in latent space. Moreover, we propose to use a contrastive training objective to enhance the domain invariance of semantic embeddings for boosting the classification performance on each dataset. We develop and evaluate our method with two public large-scale COVID-19 diagnosis datasets made up of CT images. Extensive experiments show that our approach consistently improves the performanceson both datasets, outperforming the original COVID-Net trained on each dataset by 12.16% and 14.23% in AUC respectively, also exceeding existing state-of-the-art multi-site learning methods.

Training deep neural networks usually requires a large amount of labeled data to obtain good performance. However, in medical image analysis, obtaining high-quality labels for the data is laborious and expensive, as accurately annotating medical images demands expertise knowledge of the clinicians. In this paper, we present a novel relation-driven semi-supervised framework for medical image classification. It is a consistencybased method which exploits the unlabeled data by encouraging the prediction consistency of given input under perturbations, and leverages a self-ensembling model to produce high-quality consistency targets for the unlabeled data. Considering that human diagnosis often refers to previous analogous cases to make reliable decisions, we introduce a novel sample relation consistency (SRC) paradigm to effectively exploit unlabeled data by modeling the relationship information among different samples. Superior to existing consistency-based methods which simply enforce consistency of individual predictions, our framework explicitly enforces the consistency of semantic relation among different samples under perturbations, encouraging the model to explore extra semantic information from unlabeled data. We have conducted extensive experiments to evaluate our method on two public benchmark medical image classification datasets, i.e., skin lesion diagnosis with ISIC 2018 challenge and thorax disease classification with ChestX-ray14. Our method outperforms many state-of-the-art semi-supervised learning methods on both singlelabel and multi-label image classification scenarios.

Multi-modal learning is typically performed with network architectures containing modality-specific layers and shared layers, utilizing co-registered images of different modalities. We propose a novel learning scheme for unpaired crossmodality image segmentation, with a highly compact architecture achieving superior segmentation accuracy. In our method, we heavily reuse network parameters, by sharing all convolutional kernels across CT and MRI, and only employ modality-specific internal normalization layers which compute respective statistics.To effectively train such a highly compact model, we introduce a novel loss term inspired by knowledge distillation, by explicitly constraining the KL-divergence of our derived prediction distributions between modalities. We have extensively validated our approach on two multi-class segmentation problems: i) cardiac structure segmentation, and ii) abdominal organ segmentation. Different network settings, i.e., 2D dilated network and 3D Unet, are utilized to investigate our method's general efficacy. Experimental results on both tasks demonstrate that our novel multi-modal learning scheme consistently outperforms singlemodal training and previous multi-modal approaches.

Data privacy mechanisms are essential for rapidly scaling medical training databases to capture the heterogeneity of patient data distributions toward robust and generalizable machine learning systems. In the current COVID-19 pandemic, a major focus of artificial intelligence (AI) is interpreting chest CT, which can be readily used in the assessment and management of the disease. This paper demonstrates the feasibility of a federated learning method for detecting COVID-19 related CT abnormalities with external validation on patients from a multinational study. We recruited 132 patients from seven multinational different centers, with three internal hospitals from Hong Kong for training and testing, and four external, independent datasets from Mainland China and Germany, for validating model generalizability. We also conducted case studies on longitudinal scans for automated estimation of lesion burden for hospitalized COVID-19 patients. We explore the federated learning algorithms to develop a privacy-preserving AI model for COVID-19 medical image diagnosis with good generalization capability on unseen multinational datasets. Federated learning could provide an effective mechanism during pandemics to rapidly develop clinically useful AI across institutions and countries overcoming the burden of central aggregation of large amounts of sensitive data.

Model generalization capacity at domain shift (e.g., various imaging protocols and scanners) is crucial for deep learning methods in real-world clinical deployment. This paper tackles the challenging problem of domain generalization, i.e., learning a model from multi-domain source data such that it can directly generalize to an unseen target domain. We present a novel shape-aware meta-learning scheme to improve the model generalization in prostate MRI segmentation. Our learning scheme roots in the gradient-based meta-learning, by explicitly simulating domain shift with virtual meta-train and meta-test during training. Importantly, considering the deficiencies encountered when applying a segmentation model to unseen domains (i.e., incomplete shape and ambiguous boundary of the prediction masks), we further introduce two complementary loss objectives to enhance the meta-optimization, by particularly encouraging the shape compactness and shape smoothness of the segmentations under simulated domain shift. We evaluate our method on prostate MRI data from six different institutions with distribution shifts acquired from public datasets. Experimental results show that our approach outperforms many state-of-the-art generalization methods consistently across all six settings of unseen domains 4 .

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Deep learning approaches have demonstrated remarkable progress in automatic Chest X-ray analysis. The datadriven feature of deep models requires training data to cover a large distribution. Therefore, it is substantial to integrate knowledge from multiple datasets, especially for medical images. However, learning a disease classification model with extra Chest X-ray (CXR) data is yet challenging. Recent researches have demonstrated that performance bottleneck exists in joint training on different CXR datasets, and few made efforts to address the obstacle. In this paper, we argue that incorporating an external CXR dataset leads to imperfect training data, which raises the challenges. Specifically, the imperfect data is in two folds: domain discrepancy, as the image appearances vary across datasets; and label discrepancy, as different datasets are partially labeled. To this end, we formulate the multi-label thoracic disease classification problem as weighted independent binary tasks according to the categories. For common categories shared across domains, we adopt task-specific adversarial training to alleviate the feature differences. For categories existing in a single dataset, we present uncertainty-aware temporal ensembling of model predictions to mine the information from the missing labels further. In this way, our framework simultaneously models and tackles the domain and label discrepancies, enabling superior knowledge mining ability. We conduct extensive experiments on three datasets with more than 360,000 Chest X-ray images. Our method outperforms other competing models and sets state-ofthe-art performance on the official NIH test set with 0.8349 AUC, demonstrating its effectiveness of utilizing the external dataset to improve the internal classification.