An increasing number of public datasets have shown a marked impact on automated organ segmentation and tumor detection. However, due to the small size and partially labeled problem of each dataset, as well as a limited investigation of diverse types of tumors, the resulting models are often limited to segmenting specific organs/tumors and ignore the semantics of anatomical structures, nor can they be extended to novel domains. To address these issues, we propose the CLIP-Driven Universal Model, which incorporates text embedding learned from Contrastive Language-Image Pre-training (CLIP) to segmentation models. This CLIP-based label encoding captures anatomical relationships, enabling the model to learn a structured feature embedding and segment 25 organs and 6 types of tumors. The proposed model is developed from an assembly of 14 datasets, using a total of 3,410 CT scans for training and then evaluated on 6,162 external CT scans from 3 additional datasets. We rank first on the Medical Segmentation Decathlon (MSD) public leaderboard and achieve state-of-the-art results on Beyond The Cranial Vault (BTCV). Additionally, the Universal Model is computationally more efficient (6x faster) compared with dataset-specific models, generalized better to CT scans from varying sites, and shows stronger transfer learning performance on novel tasks.

pdf/clip-driven-universal-model-for-organ-segmentation-and-tumor-yroalu0s.pdf

CLIP-Driven Universal Model for Organ Segmentation and Tumor Detection

The universal model emerges as a promising trend for medical image segmentation, paving up the way to build medical imaging large model (MILM). One popular strategy to build universal models is to encode each task as a one-hot vector and generate dynamic convolutional layers at the end of the decoder to extract the interested target. Although successful, it ignores the correlations among tasks and meanwhile is too late to make the model 'aware' of the ongoing task. To address both issues, we propose a prompt-driven Universal Segmentation model (UniSeg) for multi-task medical image segmentation using diverse modalities and domains. We first devise a learnable universal prompt to describe the correlations among all tasks and then convert this prompt and image features into a task-specific prompt, which is fed to the decoder as a part of its input. Thus, we make the model 'aware' of the ongoing task early and boost the task-specific training of the whole decoder. Our results indicate that the proposed UniSeg outperforms other universal models and single-task models on 11 upstream tasks. Moreover, UniSeg also beats other pre-trained models on two downstream datasets, providing the community with a high-quality pre-trained model for 3D medical image segmentation. Code and model are available at https://github.com/yeerwen/UniSeg.

pdf/uniseg-a-prompt-driven-universal-segmentation-model-as-well-rfe8dpbp.pdf

UniSeg: A Prompt-driven Universal Segmentation Model as well as A Strong Representation Learner

Objective and Impact Statement: Accurate organ segmentation is critical for many clinical applications at different clinical sites, which may have their specific application requirements that concern different organs. Introduction: However, learning high-quality, site-specific organ segmentation models is challenging as it often needs on-site curation of a large number of annotated images. Security concerns further complicate the matter. Methods: The paper aims to tackle these challenges via a two-phase aggregation-then-adaptation approach. The first phase of federated aggregation learns a single multi-organ segmentation model by leveraging the strength of 'bigger data', which are formed by (i) aggregating together datasets from multiple sites that with different organ labels to provide partial supervision, and (ii) conducting partially supervised learning without data breach. The second phase of site adaptation is to transfer the federated multi-organ segmentation model to site-specific organ segmentation models, one model per site, in order to further improve the performance of each site's organ segmentation task. Furthermore, improved marginal loss and exclusion loss functions are used to avoid 'knowledge conflict' problem in a partially supervision mechanism. Results and Conclusion: Extensive experiments on five organ segmentation datasets demonstrate the effectiveness of our multi-site approach, significantly outperforming the site-per-se learned models and achieving the performance comparable to the centrally learned models.

Multi-site Organ Segmentation with Federated Partial Supervision and Site Adaptation

Human readers or radiologists routinely perform full-body multi-organ multi-disease detection and diagnosis in clinical practice, while most medical AI systems are built to focus on single organs with a narrow list of a few diseases. This might severely limit AI's clinical adoption. A certain number of AI models need to be assembled non-trivially to match the diagnostic process of a human reading a CT scan. In this paper, we construct a Unified Tumor Transformer (UniT) model to detect (tumor existence and location) and diagnose (tumor characteristics) eight major cancer-prevalent organs in CT scans. UniT is a query-based Mask Transformer model with the output of multi-organ and multi-tumor semantic segmentation. We decouple the object queries into organ queries, detection queries and diagnosis queries, and further establish hierarchical relationships among the three groups. This clinically-inspired architecture effectively assists inter- and intra-organ representation learning of tumors and facilitates the resolution of these complex, anatomically related multi-organ cancer image reading tasks. UniT is trained end-to-end using a curated large-scale CT images of 10,042 patients including eight major types of cancers and occurring non-cancer tumors (all are pathology-confirmed with 3D tumor masks annotated by radiologists). On the test set of 631 patients, UniT has demonstrated strong performance under a set of clinically relevant evaluation metrics, substantially outperforming both multi-organ segmentation methods and an assembly of eight single-organ expert models in tumor detection, segmentation, and diagnosis. Such a unified multi-cancer image reading model (UniT) can significantly reduce the number of false positives produced by combined multi-system models. This moves one step closer towards a universal high-performance cancer screening tool. 

/pdf/towards-a-single-unified-model-for-effective-detection-8hrlf3mu.pdf

Towards a Single Unified Model for Effective Detection, Segmentation,
  and Diagnosis of Eight Major Cancers Using a Large Collection of CT Scans

—Automatic parsing of human anatomies at instance- level from 3D computed tomography (CT) scans is a pre-requisite step for many clinical applications. The presence of pathologies, broken structures or limited ﬁeld-of-view (FOV) all can make anatomy parsing algorithms vulnerable. In this work, we explore how to exploit and conduct the prosperous detection-then-segmentation paradigm in 3D medical data, and propose a steerable, robust, and efﬁcient computing framework for detection, identiﬁcation, and segmentation of anatomies in CT scans. Considering complicated shapes, sizes and orientations of anatomies, without lose of generality, we present the nine degrees- of-freedom (9-DoF) pose estimation solution in full 3D space using a novel single-stage, non-hierarchical forward representation. Our whole framework is executed in a steerable manner where any anatomy of interest can be directly retrieved to further boost the inference efﬁciency. We have validated the proposed method on three medical imaging parsing tasks of ribs, spine, and abdominal organs. For rib parsing, CT scans have been annotated at the rib instance-level for quantitative evaluation, similarly for spine vertebrae and abdominal organs. Extensive experiments on 9-DoF box detection and rib instance segmentation demonstrate the effectiveness of our framework (with the identiﬁcation rate of 97.0% and the segmentation Dice score of 90.9%) in high efﬁciency, compared favorably against several strong baselines (e.g., CenterNet, FCOS, and nnU-Net). For spine identiﬁcation and segmentation, our method achieves a new state-of-the-art result on the public CTSpine1K dataset. Last, we report highly competitive results in multi-organ segmentation at FLARE22 competition. Our annotations, code and models will be made publicly available at: Med-Query.

pdf/med-query-steerable-parsing-of-9-dof-medical-anatomies-with-1bvksupj.pdf

Med-Query: Steerable Parsing of 9-DoF Medical Anatomies with Query Embedding

In the paper, we present an approach for learning a single model that universally segments 33 anatomical structures, including vertebrae, pelvic bones, and abdominal organs. Our model building has to address the following challenges. Firstly, while it is ideal to learn such a model from a large-scale, fully-annotated dataset, it is practically hard to curate such a dataset. Thus, we resort to learn from a union of multiple datasets, with each dataset containing the images that are partially labeled. Secondly, along the line of partial labelling, we contribute an open-source, large-scale vertebra segmentation dataset for the benefit of spine analysis community, CTSpine1K, boasting over 1,000 3D volumes and over 11K annotated vertebrae. Thirdly, in a 3D medical image segmentation task, due to the limitation of GPU memory, we always train a model using cropped patches as inputs instead a whole 3D volume, which limits the amount of contextual information to be learned. To this, we propose a cross-patch transformer module to fuse more information in adjacent patches, which enlarges the aggregated receptive field for improved segmentation performance. This is especially important for segmenting, say, the elongated spine. Based on 7 partially labeled datasets that collectively contain about 2,800 3D volumes, we successfully learn such a universal model. Finally, we evaluate the universal model on multiple open-source datasets, proving that our model has a good generalization performance and can potentially serve as a solid foundation for downstream tasks.

Universal Segmentation of 33 Anatomies

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Universal Segmentation of 33 Anatomies