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Dec 17

EchoPrime: A Multi-Video View-Informed Vision-Language Model for Comprehensive Echocardiography Interpretation

Echocardiography is the most widely used cardiac imaging modality, capturing ultrasound video data to assess cardiac structure and function. Artificial intelligence (AI) in echocardiography has the potential to streamline manual tasks and improve reproducibility and precision. However, most echocardiography AI models are single-view, single-task systems that do not synthesize complementary information from multiple views captured during a full exam, and thus lead to limited performance and scope of applications. To address this problem, we introduce EchoPrime, a multi-view, view-informed, video-based vision-language foundation model trained on over 12 million video-report pairs. EchoPrime uses contrastive learning to train a unified embedding model for all standard views in a comprehensive echocardiogram study with representation of both rare and common diseases and diagnoses. EchoPrime then utilizes view-classification and a view-informed anatomic attention model to weight video-specific interpretations that accurately maps the relationship between echocardiographic views and anatomical structures. With retrieval-augmented interpretation, EchoPrime integrates information from all echocardiogram videos in a comprehensive study and performs holistic comprehensive clinical echocardiography interpretation. In datasets from two independent healthcare systems, EchoPrime achieves state-of-the art performance on 23 diverse benchmarks of cardiac form and function, surpassing the performance of both task-specific approaches and prior foundation models. Following rigorous clinical evaluation, EchoPrime can assist physicians in the automated preliminary assessment of comprehensive echocardiography.

  • 8 authors
·
Oct 12, 2024 5

Multi-scale self-guided attention for medical image segmentation

Even though convolutional neural networks (CNNs) are driving progress in medical image segmentation, standard models still have some drawbacks. First, the use of multi-scale approaches, i.e., encoder-decoder architectures, leads to a redundant use of information, where similar low-level features are extracted multiple times at multiple scales. Second, long-range feature dependencies are not efficiently modeled, resulting in non-optimal discriminative feature representations associated with each semantic class. In this paper we attempt to overcome these limitations with the proposed architecture, by capturing richer contextual dependencies based on the use of guided self-attention mechanisms. This approach is able to integrate local features with their corresponding global dependencies, as well as highlight interdependent channel maps in an adaptive manner. Further, the additional loss between different modules guides the attention mechanisms to neglect irrelevant information and focus on more discriminant regions of the image by emphasizing relevant feature associations. We evaluate the proposed model in the context of semantic segmentation on three different datasets: abdominal organs, cardiovascular structures and brain tumors. A series of ablation experiments support the importance of these attention modules in the proposed architecture. In addition, compared to other state-of-the-art segmentation networks our model yields better segmentation performance, increasing the accuracy of the predictions while reducing the standard deviation. This demonstrates the efficiency of our approach to generate precise and reliable automatic segmentations of medical images. Our code is made publicly available at https://github.com/sinAshish/Multi-Scale-Attention

  • 2 authors
·
Jun 6, 2019

One Model to Rule them All: Towards Universal Segmentation for Medical Images with Text Prompts

In this study, we aim to build up a model that can Segment Anything in radiology scans, driven by medical terminologies as Text prompts, termed as SAT. Our main contributions are three folds: (i) for dataset construction, we construct the first multi-modal knowledge tree on human anatomy, including 6502 anatomical terminologies; Then, we build up the largest and most comprehensive segmentation dataset for training, by collecting over 22K 3D medical image scans from72 segmentation datasets, across 497 classes, with careful standardization on both image scans and label space; (ii) for architecture design, we propose to inject medical knowledge into a text encoder via contrastive learning, and then formulate a universal segmentation model, that can be prompted by feeding in medical terminologies in text form; (iii) As a result, we have trained SAT-Nano (110M parameters) and SAT-Pro (447M parameters), demonstrating superior or comparable performance to 72 specialist models, i.e., nnU-Nets, U-Mamba or SwinUNETR, trained on each dataset/subsets. We validate SAT as a foundational segmentation model, with better generalization on external (cross-center) datasets, and can be further improved on specific tasks after fine-tuning adaptation. Comparing with state-of-the-art interactive segmentation model MedSAM, SAT demonstrate superior performance, scalability and robustness. We further compare SAT with BiomedParse, and observe SAT is significantly superior in both internal and external evaluation. Through extensive ablation study, we validate the benefit of domain knowledge on universal segmentation, especially on tail categories. As a use case, we demonstrate that SAT can act as a powerful out-of-the-box agent for large language models, enabling visual grounding in versatile application scenarios. All the data, codes, and models in this work have been released.

  • 7 authors
·
Dec 28, 2023

Self-Supervised Anatomical Consistency Learning for Vision-Grounded Medical Report Generation

Vision-grounded medical report generation aims to produce clinically accurate descriptions of medical images, anchored in explicit visual evidence to improve interpretability and facilitate integration into clinical workflows. However, existing methods often rely on separately trained detection modules that require extensive expert annotations, introducing high labeling costs and limiting generalizability due to pathology distribution bias across datasets. To address these challenges, we propose Self-Supervised Anatomical Consistency Learning (SS-ACL) -- a novel and annotation-free framework that aligns generated reports with corresponding anatomical regions using simple textual prompts. SS-ACL constructs a hierarchical anatomical graph inspired by the invariant top-down inclusion structure of human anatomy, organizing entities by spatial location. It recursively reconstructs fine-grained anatomical regions to enforce intra-sample spatial alignment, inherently guiding attention maps toward visually relevant areas prompted by text. To further enhance inter-sample semantic alignment for abnormality recognition, SS-ACL introduces a region-level contrastive learning based on anatomical consistency. These aligned embeddings serve as priors for report generation, enabling attention maps to provide interpretable visual evidence. Extensive experiments demonstrate that SS-ACL, without relying on expert annotations, (i) generates accurate and visually grounded reports -- outperforming state-of-the-art methods by 10\% in lexical accuracy and 25\% in clinical efficacy, and (ii) achieves competitive performance on various downstream visual tasks, surpassing current leading visual foundation models by 8\% in zero-shot visual grounding.

  • 6 authors
·
Sep 30

MEDUSA: Multi-scale Encoder-Decoder Self-Attention Deep Neural Network Architecture for Medical Image Analysis

Medical image analysis continues to hold interesting challenges given the subtle characteristics of certain diseases and the significant overlap in appearance between diseases. In this work, we explore the concept of self-attention for tackling such subtleties in and between diseases. To this end, we introduce MEDUSA, a multi-scale encoder-decoder self-attention mechanism tailored for medical image analysis. While self-attention deep convolutional neural network architectures in existing literature center around the notion of multiple isolated lightweight attention mechanisms with limited individual capacities being incorporated at different points in the network architecture, MEDUSA takes a significant departure from this notion by possessing a single, unified self-attention mechanism with significantly higher capacity with multiple attention heads feeding into different scales in the network architecture. To the best of the authors' knowledge, this is the first "single body, multi-scale heads" realization of self-attention and enables explicit global context amongst selective attention at different levels of representational abstractions while still enabling differing local attention context at individual levels of abstractions. With MEDUSA, we obtain state-of-the-art performance on multiple challenging medical image analysis benchmarks including COVIDx, RSNA RICORD, and RSNA Pneumonia Challenge when compared to previous work. Our MEDUSA model is publicly available.

  • 7 authors
·
Oct 12, 2021

Anatomy-VLM: A Fine-grained Vision-Language Model for Medical Interpretation

Accurate disease interpretation from radiology remains challenging due to imaging heterogeneity. Achieving expert-level diagnostic decisions requires integration of subtle image features with clinical knowledge. Yet major vision-language models (VLMs) treat images as holistic entities and overlook fine-grained image details that are vital for disease diagnosis. Clinicians analyze images by utilizing their prior medical knowledge and identify anatomical structures as important region of interests (ROIs). Inspired from this human-centric workflow, we introduce Anatomy-VLM, a fine-grained, vision-language model that incorporates multi-scale information. First, we design a model encoder to localize key anatomical features from entire medical images. Second, these regions are enriched with structured knowledge for contextually-aware interpretation. Finally, the model encoder aligns multi-scale medical information to generate clinically-interpretable disease prediction. Anatomy-VLM achieves outstanding performance on both in- and out-of-distribution datasets. We also validate the performance of Anatomy-VLM on downstream image segmentation tasks, suggesting that its fine-grained alignment captures anatomical and pathology-related knowledge. Furthermore, the Anatomy-VLM's encoder facilitates zero-shot anatomy-wise interpretation, providing its strong expert-level clinical interpretation capabilities.

  • 4 authors
·
Nov 11

OAT: Object-Level Attention Transformer for Gaze Scanpath Prediction

Visual search is important in our daily life. The efficient allocation of visual attention is critical to effectively complete visual search tasks. Prior research has predominantly modelled the spatial allocation of visual attention in images at the pixel level, e.g. using a saliency map. However, emerging evidence shows that visual attention is guided by objects rather than pixel intensities. This paper introduces the Object-level Attention Transformer (OAT), which predicts human scanpaths as they search for a target object within a cluttered scene of distractors. OAT uses an encoder-decoder architecture. The encoder captures information about the position and appearance of the objects within an image and about the target. The decoder predicts the gaze scanpath as a sequence of object fixations, by integrating output features from both the encoder and decoder. We also propose a new positional encoding that better reflects spatial relationships between objects. We evaluated OAT on the Amazon book cover dataset and a new dataset for visual search that we collected. OAT's predicted gaze scanpaths align more closely with human gaze patterns, compared to predictions by algorithms based on spatial attention on both established metrics and a novel behavioural-based metric. Our results demonstrate the generalization ability of OAT, as it accurately predicts human scanpaths for unseen layouts and target objects.

  • 5 authors
·
Jul 18, 2024

A Textbook Remedy for Domain Shifts: Knowledge Priors for Medical Image Analysis

While deep networks have achieved broad success in analyzing natural images, when applied to medical scans, they often fail in unexcepted situations. We investigate this challenge and focus on model sensitivity to domain shifts, such as data sampled from different hospitals or data confounded by demographic variables such as sex, race, etc, in the context of chest X-rays and skin lesion images. A key finding we show empirically is that existing visual backbones lack an appropriate prior from the architecture for reliable generalization in these settings. Taking inspiration from medical training, we propose giving deep networks a prior grounded in explicit medical knowledge communicated in natural language. To this end, we introduce Knowledge-enhanced Bottlenecks (KnoBo), a class of concept bottleneck models that incorporates knowledge priors that constrain it to reason with clinically relevant factors found in medical textbooks or PubMed. KnoBo uses retrieval-augmented language models to design an appropriate concept space paired with an automatic training procedure for recognizing the concept. We evaluate different resources of knowledge and recognition architectures on a broad range of domain shifts across 20 datasets. In our comprehensive evaluation with two imaging modalities, KnoBo outperforms fine-tuned models on confounded datasets by 32.4% on average. Finally, evaluations reveal that PubMed is a promising resource for making medical models less sensitive to domain shift, outperforming other resources on both diversity of information and final prediction performance.

  • 8 authors
·
May 23, 2024

Landmark Attention: Random-Access Infinite Context Length for Transformers

While transformers have shown remarkable success in natural language processing, their attention mechanism's large memory requirements have limited their ability to handle longer contexts. Prior approaches, such as recurrent memory or retrieval-based augmentation, have either compromised the random-access flexibility of attention (i.e., the capability to select any token in the entire context) or relied on separate mechanisms for relevant context retrieval, which may not be compatible with the model's attention. In this paper, we present a novel approach that allows access to the complete context while retaining random-access flexibility, closely resembling running attention on the entire context. Our method uses a landmark token to represent each block of the input and trains the attention to use it for selecting relevant blocks, enabling retrieval of blocks directly through the attention mechanism instead of by relying on a separate mechanism. Our approach seamlessly integrates with specialized data structures and the system's memory hierarchy, enabling processing of arbitrarily long context lengths. We demonstrate that our method can obtain comparable performance with Transformer-XL while significantly reducing the number of retrieved tokens in each step. Finally, we show that fine-tuning LLaMA 7B with our method successfully extends its context length capacity up to 32k tokens, allowing for inference at the context lengths of GPT-4.

  • 2 authors
·
May 25, 2023 1

Efficient Content-Based Sparse Attention with Routing Transformers

Self-attention has recently been adopted for a wide range of sequence modeling problems. Despite its effectiveness, self-attention suffers from quadratic compute and memory requirements with respect to sequence length. Successful approaches to reduce this complexity focused on attending to local sliding windows or a small set of locations independent of content. Our work proposes to learn dynamic sparse attention patterns that avoid allocating computation and memory to attend to content unrelated to the query of interest. This work builds upon two lines of research: it combines the modeling flexibility of prior work on content-based sparse attention with the efficiency gains from approaches based on local, temporal sparse attention. Our model, the Routing Transformer, endows self-attention with a sparse routing module based on online k-means while reducing the overall complexity of attention to Oleft(n^{1.5}dright) from Oleft(n^2dright) for sequence length n and hidden dimension d. We show that our model outperforms comparable sparse attention models on language modeling on Wikitext-103 (15.8 vs 18.3 perplexity) as well as on image generation on ImageNet-64 (3.43 vs 3.44 bits/dim) while using fewer self-attention layers. Additionally, we set a new state-of-the-art on the newly released PG-19 data-set, obtaining a test perplexity of 33.2 with a 22 layer Routing Transformer model trained on sequences of length 8192.

  • 4 authors
·
Mar 12, 2020 1

Computation-Efficient Era: A Comprehensive Survey of State Space Models in Medical Image Analysis

Sequence modeling plays a vital role across various domains, with recurrent neural networks being historically the predominant method of performing these tasks. However, the emergence of transformers has altered this paradigm due to their superior performance. Built upon these advances, transformers have conjoined CNNs as two leading foundational models for learning visual representations. However, transformers are hindered by the O(N^2) complexity of their attention mechanisms, while CNNs lack global receptive fields and dynamic weight allocation. State Space Models (SSMs), specifically the \textbf{Mamba} model with selection mechanisms and hardware-aware architecture, have garnered immense interest lately in sequential modeling and visual representation learning, challenging the dominance of transformers by providing infinite context lengths and offering substantial efficiency maintaining linear complexity in the input sequence. Capitalizing on the advances in computer vision, medical imaging has heralded a new epoch with Mamba models. Intending to help researchers navigate the surge, this survey seeks to offer an encyclopedic review of Mamba models in medical imaging. Specifically, we start with a comprehensive theoretical review forming the basis of SSMs, including Mamba architecture and its alternatives for sequence modeling paradigms in this context. Next, we offer a structured classification of Mamba models in the medical field and introduce a diverse categorization scheme based on their application, imaging modalities, and targeted organs. Finally, we summarize key challenges, discuss different future research directions of the SSMs in the medical domain, and propose several directions to fulfill the demands of this field. In addition, we have compiled the studies discussed in this paper along with their open-source implementations on our GitHub repository.

  • 11 authors
·
Jun 5, 2024

Circuit Component Reuse Across Tasks in Transformer Language Models

Recent work in mechanistic interpretability has shown that behaviors in language models can be successfully reverse-engineered through circuit analysis. A common criticism, however, is that each circuit is task-specific, and thus such analysis cannot contribute to understanding the models at a higher level. In this work, we present evidence that insights (both low-level findings about specific heads and higher-level findings about general algorithms) can indeed generalize across tasks. Specifically, we study the circuit discovered in Wang et al. (2022) for the Indirect Object Identification (IOI) task and 1.) show that it reproduces on a larger GPT2 model, and 2.) that it is mostly reused to solve a seemingly different task: Colored Objects (Ippolito & Callison-Burch, 2023). We provide evidence that the process underlying both tasks is functionally very similar, and contains about a 78% overlap in in-circuit attention heads. We further present a proof-of-concept intervention experiment, in which we adjust four attention heads in middle layers in order to 'repair' the Colored Objects circuit and make it behave like the IOI circuit. In doing so, we boost accuracy from 49.6% to 93.7% on the Colored Objects task and explain most sources of error. The intervention affects downstream attention heads in specific ways predicted by their interactions in the IOI circuit, indicating that this subcircuit behavior is invariant to the different task inputs. Overall, our results provide evidence that it may yet be possible to explain large language models' behavior in terms of a relatively small number of interpretable task-general algorithmic building blocks and computational components.

  • 3 authors
·
Oct 12, 2023

Anatomical Foundation Models for Brain MRIs

Deep Learning (DL) in neuroimaging has become increasingly relevant for detecting neurological conditions and neurodegenerative disorders. One of the most predominant biomarkers in neuroimaging is represented by brain age, which has been shown to be a good indicator for different conditions, such as Alzheimer's Disease. Using brain age for weakly supervised pre-training of DL models in transfer learning settings has also recently shown promising results, especially when dealing with data scarcity of different conditions. On the other hand, anatomical information of brain MRIs (e.g. cortical thickness) can provide important information for learning good representations that can be transferred to many downstream tasks. In this work, we propose AnatCL, an anatomical foundation model for brain MRIs that i.) leverages anatomical information in a weakly contrastive learning approach, and ii.) achieves state-of-the-art performances across many different downstream tasks. To validate our approach we consider 12 different downstream tasks for the diagnosis of different conditions such as Alzheimer's Disease, autism spectrum disorder, and schizophrenia. Furthermore, we also target the prediction of 10 different clinical assessment scores using structural MRI data. Our findings show that incorporating anatomical information during pre-training leads to more robust and generalizable representations. Pre-trained models can be found at: https://github.com/EIDOSLAB/AnatCL.

  • 4 authors
·
Aug 7, 2024

Does Circuit Analysis Interpretability Scale? Evidence from Multiple Choice Capabilities in Chinchilla

Circuit analysis is a promising technique for understanding the internal mechanisms of language models. However, existing analyses are done in small models far from the state of the art. To address this, we present a case study of circuit analysis in the 70B Chinchilla model, aiming to test the scalability of circuit analysis. In particular, we study multiple-choice question answering, and investigate Chinchilla's capability to identify the correct answer label given knowledge of the correct answer text. We find that the existing techniques of logit attribution, attention pattern visualization, and activation patching naturally scale to Chinchilla, allowing us to identify and categorize a small set of `output nodes' (attention heads and MLPs). We further study the `correct letter' category of attention heads aiming to understand the semantics of their features, with mixed results. For normal multiple-choice question answers, we significantly compress the query, key and value subspaces of the head without loss of performance when operating on the answer labels for multiple-choice questions, and we show that the query and key subspaces represent an `Nth item in an enumeration' feature to at least some extent. However, when we attempt to use this explanation to understand the heads' behaviour on a more general distribution including randomized answer labels, we find that it is only a partial explanation, suggesting there is more to learn about the operation of `correct letter' heads on multiple choice question answering.

  • 6 authors
·
Jul 18, 2023

Region Attention Transformer for Medical Image Restoration

Transformer-based methods have demonstrated impressive results in medical image restoration, attributed to the multi-head self-attention (MSA) mechanism in the spatial dimension. However, the majority of existing Transformers conduct attention within fixed and coarsely partitioned regions (e.g. the entire image or fixed patches), resulting in interference from irrelevant regions and fragmentation of continuous image content. To overcome these challenges, we introduce a novel Region Attention Transformer (RAT) that utilizes a region-based multi-head self-attention mechanism (R-MSA). The R-MSA dynamically partitions the input image into non-overlapping semantic regions using the robust Segment Anything Model (SAM) and then performs self-attention within these regions. This region partitioning is more flexible and interpretable, ensuring that only pixels from similar semantic regions complement each other, thereby eliminating interference from irrelevant regions. Moreover, we introduce a focal region loss to guide our model to adaptively focus on recovering high-difficulty regions. Extensive experiments demonstrate the effectiveness of RAT in various medical image restoration tasks, including PET image synthesis, CT image denoising, and pathological image super-resolution. Code is available at https://github.com/Yaziwel/Region-Attention-Transformer-for-Medical-Image-Restoration.git{https://github.com/RAT}.

  • 8 authors
·
Jul 12, 2024

Intensive Vision-guided Network for Radiology Report Generation

Automatic radiology report generation is booming due to its huge application potential for the healthcare industry. However, existing computer vision and natural language processing approaches to tackle this problem are limited in two aspects. First, when extracting image features, most of them neglect multi-view reasoning in vision and model single-view structure of medical images, such as space-view or channel-view. However, clinicians rely on multi-view imaging information for comprehensive judgment in daily clinical diagnosis. Second, when generating reports, they overlook context reasoning with multi-modal information and focus on pure textual optimization utilizing retrieval-based methods. We aim to address these two issues by proposing a model that better simulates clinicians' perspectives and generates more accurate reports. Given the above limitation in feature extraction, we propose a Globally-intensive Attention (GIA) module in the medical image encoder to simulate and integrate multi-view vision perception. GIA aims to learn three types of vision perception: depth view, space view, and pixel view. On the other hand, to address the above problem in report generation, we explore how to involve multi-modal signals to generate precisely matched reports, i.e., how to integrate previously predicted words with region-aware visual content in next word prediction. Specifically, we design a Visual Knowledge-guided Decoder (VKGD), which can adaptively consider how much the model needs to rely on visual information and previously predicted text to assist next word prediction. Hence, our final Intensive Vision-guided Network (IVGN) framework includes a GIA-guided Visual Encoder and the VKGD. Experiments on two commonly-used datasets IU X-Ray and MIMIC-CXR demonstrate the superior ability of our method compared with other state-of-the-art approaches.

  • 8 authors
·
Feb 6, 2024

Understanding Transformers through the Lens of Pavlovian Conditioning

Transformer architectures have revolutionized artificial intelligence (AI) through their attention mechanisms, yet the computational principles underlying their success remain opaque. We present a novel theoretical framework that reinterprets the core computation of attention as Pavlovian conditioning. Our model finds a direct mathematical analogue in linear attention, which simplifies the analysis of the underlying associative process. We demonstrate that attention's queries, keys, and values can be mapped to the three elements of classical conditioning: test stimuli that probe associations, conditional stimuli (CS) that serve as retrieval cues, and unconditional stimuli (US) that contain response information. Through this lens, we suggest that each attention operation constructs a transient associative memory via a Hebbian rule, where CS-US pairs form dynamic associations that test stimuli can later retrieve. Our framework yields several theoretical insights grounded in this linearized model: (1) a capacity theorem showing that attention heads can store O(d_k) associations before interference degrades retrieval; (2) an error propagation analysis revealing fundamental architectural trade-offs of balancing model depth, width, and head redundancy to maintain reliability; and (3) an understanding of how biologically plausible learning rules could enhance transformer architectures. By establishing this deep connection, we suggest that the success of modern AI may stem not from architectural novelty alone, but from implementing computational principles that biology optimized over millions of years of evolution.

  • 1 authors
·
Aug 5

Retrieval Head Mechanistically Explains Long-Context Factuality

Despite the recent progress in long-context language models, it remains elusive how transformer-based models exhibit the capability to retrieve relevant information from arbitrary locations within the long context. This paper aims to address this question. Our systematic investigation across a wide spectrum of models reveals that a special type of attention heads are largely responsible for retrieving information, which we dub retrieval heads. We identify intriguing properties of retrieval heads:(1) universal: all the explored models with long-context capability have a set of retrieval heads; (2) sparse: only a small portion (less than 5\%) of the attention heads are retrieval. (3) intrinsic: retrieval heads already exist in models pretrained with short context. When extending the context length by continual pretraining, it is still the same set of heads that perform information retrieval. (4) dynamically activated: take Llama-2 7B for example, 12 retrieval heads always attend to the required information no matter how the context is changed. The rest of the retrieval heads are activated in different contexts. (5) causal: completely pruning retrieval heads leads to failure in retrieving relevant information and results in hallucination, while pruning random non-retrieval heads does not affect the model's retrieval ability. We further show that retrieval heads strongly influence chain-of-thought (CoT) reasoning, where the model needs to frequently refer back the question and previously-generated context. Conversely, tasks where the model directly generates the answer using its intrinsic knowledge are less impacted by masking out retrieval heads. These observations collectively explain which internal part of the model seeks information from the input tokens. We believe our insights will foster future research on reducing hallucination, improving reasoning, and compressing the KV cache.

  • 5 authors
·
Apr 23, 2024

Segment as You Wish -- Free-Form Language-Based Segmentation for Medical Images

Medical imaging is crucial for diagnosing a patient's health condition, and accurate segmentation of these images is essential for isolating regions of interest to ensure precise diagnosis and treatment planning. Existing methods primarily rely on bounding boxes or point-based prompts, while few have explored text-related prompts, despite clinicians often describing their observations and instructions in natural language. To address this gap, we first propose a RAG-based free-form text prompt generator, that leverages the domain corpus to generate diverse and realistic descriptions. Then, we introduce FLanS, a novel medical image segmentation model that handles various free-form text prompts, including professional anatomy-informed queries, anatomy-agnostic position-driven queries, and anatomy-agnostic size-driven queries. Additionally, our model also incorporates a symmetry-aware canonicalization module to ensure consistent, accurate segmentations across varying scan orientations and reduce confusion between the anatomical position of an organ and its appearance in the scan. FLanS is trained on a large-scale dataset of over 100k medical images from 7 public datasets. Comprehensive experiments demonstrate the model's superior language understanding and segmentation precision, along with a deep comprehension of the relationship between them, outperforming SOTA baselines on both in-domain and out-of-domain datasets.

  • 7 authors
·
Oct 2, 2024

Attention-based Dynamic Subspace Learners for Medical Image Analysis

Learning similarity is a key aspect in medical image analysis, particularly in recommendation systems or in uncovering the interpretation of anatomical data in images. Most existing methods learn such similarities in the embedding space over image sets using a single metric learner. Images, however, have a variety of object attributes such as color, shape, or artifacts. Encoding such attributes using a single metric learner is inadequate and may fail to generalize. Instead, multiple learners could focus on separate aspects of these attributes in subspaces of an overarching embedding. This, however, implies the number of learners to be found empirically for each new dataset. This work, Dynamic Subspace Learners, proposes to dynamically exploit multiple learners by removing the need of knowing apriori the number of learners and aggregating new subspace learners during training. Furthermore, the visual interpretability of such subspace learning is enforced by integrating an attention module into our method. This integrated attention mechanism provides a visual insight of discriminative image features that contribute to the clustering of image sets and a visual explanation of the embedding features. The benefits of our attention-based dynamic subspace learners are evaluated in the application of image clustering, image retrieval, and weakly supervised segmentation. Our method achieves competitive results with the performances of multiple learners baselines and significantly outperforms the classification network in terms of clustering and retrieval scores on three different public benchmark datasets. Moreover, our attention maps offer a proxy-labels, which improves the segmentation accuracy up to 15% in Dice scores when compared to state-of-the-art interpretation techniques.

  • 3 authors
·
Jun 17, 2022

Label Critic: Design Data Before Models

As medical datasets rapidly expand, creating detailed annotations of different body structures becomes increasingly expensive and time-consuming. We consider that requesting radiologists to create detailed annotations is unnecessarily burdensome and that pre-existing AI models can largely automate this process. Following the spirit don't use a sledgehammer on a nut, we find that, rather than creating annotations from scratch, radiologists only have to review and edit errors if the Best-AI Labels have mistakes. To obtain the Best-AI Labels among multiple AI Labels, we developed an automatic tool, called Label Critic, that can assess label quality through tireless pairwise comparisons. Extensive experiments demonstrate that, when incorporated with our developed Image-Prompt pairs, pre-existing Large Vision-Language Models (LVLM), trained on natural images and texts, achieve 96.5% accuracy when choosing the best label in a pair-wise comparison, without extra fine-tuning. By transforming the manual annotation task (30-60 min/scan) into an automatic comparison task (15 sec/scan), we effectively reduce the manual efforts required from radiologists by an order of magnitude. When the Best-AI Labels are sufficiently accurate (81% depending on body structures), they will be directly adopted as the gold-standard annotations for the dataset, with lower-quality AI Labels automatically discarded. Label Critic can also check the label quality of a single AI Label with 71.8% accuracy when no alternatives are available for comparison, prompting radiologists to review and edit if the estimated quality is low (19% depending on body structures).

  • 7 authors
·
Nov 4, 2024

Transformer brain encoders explain human high-level visual responses

A major goal of neuroscience is to understand brain computations during visual processing in naturalistic settings. A dominant approach is to use image-computable deep neural networks trained with different task objectives as a basis for linear encoding models. However, in addition to requiring tuning a large number of parameters, the linear encoding approach ignores the structure of the feature maps both in the brain and the models. Recently proposed alternatives have focused on decomposing the linear mapping to spatial and feature components but focus on finding static receptive fields for units that are applicable only in early visual areas. In this work, we employ the attention mechanism used in the transformer architecture to study how retinotopic visual features can be dynamically routed to category-selective areas in high-level visual processing. We show that this computational motif is significantly more powerful than alternative methods in predicting brain activity during natural scene viewing, across different feature basis models and modalities. We also show that this approach is inherently more interpretable, without the need to create importance maps, by interpreting the attention routing signal for different high-level categorical areas. Our approach proposes a mechanistic model of how visual information from retinotopic maps can be routed based on the relevance of the input content to different category-selective regions.

  • 3 authors
·
May 22

Representing Part-Whole Hierarchies in Foundation Models by Learning Localizability, Composability, and Decomposability from Anatomy via Self-Supervision

Humans effortlessly interpret images by parsing them into part-whole hierarchies; deep learning excels in learning multi-level feature spaces, but they often lack explicit coding of part-whole relations, a prominent property of medical imaging. To overcome this limitation, we introduce Adam-v2, a new self-supervised learning framework extending Adam [79] by explicitly incorporating part-whole hierarchies into its learning objectives through three key branches: (1) Localizability, acquiring discriminative representations to distinguish different anatomical patterns; (2) Composability, learning each anatomical structure in a parts-to-whole manner; and (3) Decomposability, comprehending each anatomical structure in a whole-to-parts manner. Experimental results across 10 tasks, compared to 11 baselines in zero-shot, few-shot transfer, and full fine-tuning settings, showcase Adam-v2's superior performance over large-scale medical models and existing SSL methods across diverse downstream tasks. The higher generality and robustness of Adam-v2's representations originate from its explicit construction of hierarchies for distinct anatomical structures from unlabeled medical images. Adam-v2 preserves a semantic balance of anatomical diversity and harmony in its embedding, yielding representations that are both generic and semantically meaningful, yet overlooked in existing SSL methods. All code and pretrained models are available at https://github.com/JLiangLab/Eden.

  • 3 authors
·
Apr 24, 2024

Temporal-spatial Correlation Attention Network for Clinical Data Analysis in Intensive Care Unit

In recent years, medical information technology has made it possible for electronic health record (EHR) to store fairly complete clinical data. This has brought health care into the era of "big data". However, medical data are often sparse and strongly correlated, which means that medical problems cannot be solved effectively. With the rapid development of deep learning in recent years, it has provided opportunities for the use of big data in healthcare. In this paper, we propose a temporal-saptial correlation attention network (TSCAN) to handle some clinical characteristic prediction problems, such as predicting death, predicting length of stay, detecting physiologic decline, and classifying phenotypes. Based on the design of the attention mechanism model, our approach can effectively remove irrelevant items in clinical data and irrelevant nodes in time according to different tasks, so as to obtain more accurate prediction results. Our method can also find key clinical indicators of important outcomes that can be used to improve treatment options. Our experiments use information from the Medical Information Mart for Intensive Care (MIMIC-IV) database, which is open to the public. Finally, we have achieved significant performance benefits of 2.0\% (metric) compared to other SOTA prediction methods. We achieved a staggering 90.7\% on mortality rate, 45.1\% on length of stay. The source code can be find: https://github.com/yuyuheintju/TSCAN.

  • 6 authors
·
Jun 2, 2023

TextBraTS: Text-Guided Volumetric Brain Tumor Segmentation with Innovative Dataset Development and Fusion Module Exploration

Deep learning has demonstrated remarkable success in medical image segmentation and computer-aided diagnosis. In particular, numerous advanced methods have achieved state-of-the-art performance in brain tumor segmentation from MRI scans. While recent studies in other medical imaging domains have revealed that integrating textual reports with visual data can enhance segmentation accuracy, the field of brain tumor analysis lacks a comprehensive dataset that combines radiological images with corresponding textual annotations. This limitation has hindered the exploration of multimodal approaches that leverage both imaging and textual data. To bridge this critical gap, we introduce the TextBraTS dataset, the first publicly available volume-level multimodal dataset that contains paired MRI volumes and rich textual annotations, derived from the widely adopted BraTS2020 benchmark. Building upon this novel dataset, we propose a novel baseline framework and sequential cross-attention method for text-guided volumetric medical image segmentation. Through extensive experiments with various text-image fusion strategies and templated text formulations, our approach demonstrates significant improvements in brain tumor segmentation accuracy, offering valuable insights into effective multimodal integration techniques. Our dataset, implementation code, and pre-trained models are publicly available at https://github.com/Jupitern52/TextBraTS.

  • 10 authors
·
Jun 20

Reconstructing the Mind's Eye: fMRI-to-Image with Contrastive Learning and Diffusion Priors

We present MindEye, a novel fMRI-to-image approach to retrieve and reconstruct viewed images from brain activity. Our model comprises two parallel submodules that are specialized for retrieval (using contrastive learning) and reconstruction (using a diffusion prior). MindEye can map fMRI brain activity to any high dimensional multimodal latent space, like CLIP image space, enabling image reconstruction using generative models that accept embeddings from this latent space. We comprehensively compare our approach with other existing methods, using both qualitative side-by-side comparisons and quantitative evaluations, and show that MindEye achieves state-of-the-art performance in both reconstruction and retrieval tasks. In particular, MindEye can retrieve the exact original image even among highly similar candidates indicating that its brain embeddings retain fine-grained image-specific information. This allows us to accurately retrieve images even from large-scale databases like LAION-5B. We demonstrate through ablations that MindEye's performance improvements over previous methods result from specialized submodules for retrieval and reconstruction, improved training techniques, and training models with orders of magnitude more parameters. Furthermore, we show that MindEye can better preserve low-level image features in the reconstructions by using img2img, with outputs from a separate autoencoder. All code is available on GitHub.

  • 12 authors
·
May 29, 2023 1

Attention Meets Perturbations: Robust and Interpretable Attention with Adversarial Training

Although attention mechanisms have been applied to a variety of deep learning models and have been shown to improve the prediction performance, it has been reported to be vulnerable to perturbations to the mechanism. To overcome the vulnerability to perturbations in the mechanism, we are inspired by adversarial training (AT), which is a powerful regularization technique for enhancing the robustness of the models. In this paper, we propose a general training technique for natural language processing tasks, including AT for attention (Attention AT) and more interpretable AT for attention (Attention iAT). The proposed techniques improved the prediction performance and the model interpretability by exploiting the mechanisms with AT. In particular, Attention iAT boosts those advantages by introducing adversarial perturbation, which enhances the difference in the attention of the sentences. Evaluation experiments with ten open datasets revealed that AT for attention mechanisms, especially Attention iAT, demonstrated (1) the best performance in nine out of ten tasks and (2) more interpretable attention (i.e., the resulting attention correlated more strongly with gradient-based word importance) for all tasks. Additionally, the proposed techniques are (3) much less dependent on perturbation size in AT. Our code is available at https://github.com/shunk031/attention-meets-perturbation

  • 2 authors
·
Sep 25, 2020

BiFormer: Vision Transformer with Bi-Level Routing Attention

As the core building block of vision transformers, attention is a powerful tool to capture long-range dependency. However, such power comes at a cost: it incurs a huge computation burden and heavy memory footprint as pairwise token interaction across all spatial locations is computed. A series of works attempt to alleviate this problem by introducing handcrafted and content-agnostic sparsity into attention, such as restricting the attention operation to be inside local windows, axial stripes, or dilated windows. In contrast to these approaches, we propose a novel dynamic sparse attention via bi-level routing to enable a more flexible allocation of computations with content awareness. Specifically, for a query, irrelevant key-value pairs are first filtered out at a coarse region level, and then fine-grained token-to-token attention is applied in the union of remaining candidate regions (\ie, routed regions). We provide a simple yet effective implementation of the proposed bi-level routing attention, which utilizes the sparsity to save both computation and memory while involving only GPU-friendly dense matrix multiplications. Built with the proposed bi-level routing attention, a new general vision transformer, named BiFormer, is then presented. As BiFormer attends to a small subset of relevant tokens in a query adaptive manner without distraction from other irrelevant ones, it enjoys both good performance and high computational efficiency, especially in dense prediction tasks. Empirical results across several computer vision tasks such as image classification, object detection, and semantic segmentation verify the effectiveness of our design. Code is available at https://github.com/rayleizhu/BiFormer.

  • 5 authors
·
Mar 15, 2023

How Does Attention Work in Vision Transformers? A Visual Analytics Attempt

Vision transformer (ViT) expands the success of transformer models from sequential data to images. The model decomposes an image into many smaller patches and arranges them into a sequence. Multi-head self-attentions are then applied to the sequence to learn the attention between patches. Despite many successful interpretations of transformers on sequential data, little effort has been devoted to the interpretation of ViTs, and many questions remain unanswered. For example, among the numerous attention heads, which one is more important? How strong are individual patches attending to their spatial neighbors in different heads? What attention patterns have individual heads learned? In this work, we answer these questions through a visual analytics approach. Specifically, we first identify what heads are more important in ViTs by introducing multiple pruning-based metrics. Then, we profile the spatial distribution of attention strengths between patches inside individual heads, as well as the trend of attention strengths across attention layers. Third, using an autoencoder-based learning solution, we summarize all possible attention patterns that individual heads could learn. Examining the attention strengths and patterns of the important heads, we answer why they are important. Through concrete case studies with experienced deep learning experts on multiple ViTs, we validate the effectiveness of our solution that deepens the understanding of ViTs from head importance, head attention strength, and head attention pattern.

  • 8 authors
·
Mar 23, 2023

MedBookVQA: A Systematic and Comprehensive Medical Benchmark Derived from Open-Access Book

The accelerating development of general medical artificial intelligence (GMAI), powered by multimodal large language models (MLLMs), offers transformative potential for addressing persistent healthcare challenges, including workforce deficits and escalating costs. The parallel development of systematic evaluation benchmarks emerges as a critical imperative to enable performance assessment and provide technological guidance. Meanwhile, as an invaluable knowledge source, the potential of medical textbooks for benchmark development remains underexploited. Here, we present MedBookVQA, a systematic and comprehensive multimodal benchmark derived from open-access medical textbooks. To curate this benchmark, we propose a standardized pipeline for automated extraction of medical figures while contextually aligning them with corresponding medical narratives. Based on this curated data, we generate 5,000 clinically relevant questions spanning modality recognition, disease classification, anatomical identification, symptom diagnosis, and surgical procedures. A multi-tier annotation system categorizes queries through hierarchical taxonomies encompassing medical imaging modalities (42 categories), body anatomies (125 structures), and clinical specialties (31 departments), enabling nuanced analysis across medical subdomains. We evaluate a wide array of MLLMs, including proprietary, open-sourced, medical, and reasoning models, revealing significant performance disparities across task types and model categories. Our findings highlight critical capability gaps in current GMAI systems while establishing textbook-derived multimodal benchmarks as essential evaluation tools. MedBookVQA establishes textbook-derived benchmarking as a critical paradigm for advancing clinical AI, exposing limitations in GMAI systems while providing anatomically structured performance metrics across specialties.

  • 7 authors
·
Jun 1

Unveiling and Harnessing Hidden Attention Sinks: Enhancing Large Language Models without Training through Attention Calibration

Attention is a fundamental component behind the remarkable achievements of large language models (LLMs). However, our current understanding of the attention mechanism, especially regarding how attention distributions are established, remains limited. Inspired by recent studies that explore the presence of attention sink in the initial token, which receives disproportionately large attention scores despite their lack of semantic importance, this work delves deeper into this phenomenon. We aim to provide a more profound understanding of the existence of attention sinks within LLMs and to uncover ways to enhance the achievable accuracy of LLMs by directly optimizing the attention distributions, without the need for weight finetuning. Specifically, this work begins with comprehensive visualizations of the attention distributions in LLMs during inference across various inputs and tasks. Based on these visualizations, to the best of our knowledge, we are the first to discover that (1) attention sinks occur not only at the start of sequences but also within later tokens of the input, and (2) not all attention sinks have a positive impact on the achievable accuracy of LLMs. Building upon our findings, we propose a training-free Attention Calibration Technique (ACT) that automatically optimizes the attention distributions on the fly during inference in an input-adaptive manner. Extensive experiments validate that ACT consistently enhances the accuracy of various LLMs across different applications. Specifically, ACT achieves an average improvement of up to 7.30% in accuracy across different datasets when applied to Llama-30B. Our code is available at https://github.com/GATECH-EIC/ACT.

  • 6 authors
·
Jun 22, 2024

CRISP-SAM2: SAM2 with Cross-Modal Interaction and Semantic Prompting for Multi-Organ Segmentation

Multi-organ medical segmentation is a crucial component of medical image processing, essential for doctors to make accurate diagnoses and develop effective treatment plans. Despite significant progress in this field, current multi-organ segmentation models often suffer from inaccurate details, dependence on geometric prompts and loss of spatial information. Addressing these challenges, we introduce a novel model named CRISP-SAM2 with CRoss-modal Interaction and Semantic Prompting based on SAM2. This model represents a promising approach to multi-organ medical segmentation guided by textual descriptions of organs. Our method begins by converting visual and textual inputs into cross-modal contextualized semantics using a progressive cross-attention interaction mechanism. These semantics are then injected into the image encoder to enhance the detailed understanding of visual information. To eliminate reliance on geometric prompts, we use a semantic prompting strategy, replacing the original prompt encoder to sharpen the perception of challenging targets. In addition, a similarity-sorting self-updating strategy for memory and a mask-refining process is applied to further adapt to medical imaging and enhance localized details. Comparative experiments conducted on seven public datasets indicate that CRISP-SAM2 outperforms existing models. Extensive analysis also demonstrates the effectiveness of our method, thereby confirming its superior performance, especially in addressing the limitations mentioned earlier. Our code is available at: https://github.com/YU-deep/CRISP\_SAM2.git.

  • 8 authors
·
Jun 29 1

CAB: Comprehensive Attention Benchmarking on Long Sequence Modeling

Transformer has achieved remarkable success in language, image, and speech processing. Recently, various efficient attention architectures have been proposed to improve transformer's efficiency while largely preserving its efficacy, especially in modeling long sequences. A widely-used benchmark to test these efficient methods' capability on long-range modeling is Long Range Arena (LRA). However, LRA only focuses on the standard bidirectional (or noncausal) self attention, and completely ignores cross attentions and unidirectional (or causal) attentions, which are equally important to downstream applications. Although designing cross and causal variants of an attention method is straightforward for vanilla attention, it is often challenging for efficient attentions with subquadratic time and memory complexity. In this paper, we propose Comprehensive Attention Benchmark (CAB) under a fine-grained attention taxonomy with four distinguishable attention patterns, namely, noncausal self, causal self, noncausal cross, and causal cross attentions. CAB collects seven real-world tasks from different research areas to evaluate efficient attentions under the four attention patterns. Among these tasks, CAB validates efficient attentions in eight backbone networks to show their generalization across neural architectures. We conduct exhaustive experiments to benchmark the performances of nine widely-used efficient attention architectures designed with different philosophies on CAB. Extensive experimental results also shed light on the fundamental problems of efficient attentions, such as efficiency length against vanilla attention, performance consistency across attention patterns, the benefit of attention mechanisms, and interpolation/extrapolation on long-context language modeling.

  • 5 authors
·
Oct 14, 2022

See What You Are Told: Visual Attention Sink in Large Multimodal Models

Large multimodal models (LMMs) "see" images by leveraging the attention mechanism between text and visual tokens in the transformer decoder. Ideally, these models should focus on key visual information relevant to the text token. However, recent findings indicate that LMMs have an extraordinary tendency to consistently allocate high attention weights to specific visual tokens, even when these tokens are irrelevant to the corresponding text. In this study, we investigate the property behind the appearance of these irrelevant visual tokens and examine their characteristics. Our findings show that this behavior arises due to the massive activation of certain hidden state dimensions, which resembles the attention sink found in language models. Hence, we refer to this phenomenon as the visual attention sink. In particular, our analysis reveals that removing the irrelevant visual sink tokens does not impact model performance, despite receiving high attention weights. Consequently, we recycle the attention to these tokens as surplus resources, redistributing the attention budget to enhance focus on the image. To achieve this, we introduce Visual Attention Redistribution (VAR), a method that redistributes attention in image-centric heads, which we identify as innately focusing on visual information. VAR can be seamlessly applied across different LMMs to improve performance on a wide range of tasks, including general vision-language tasks, visual hallucination tasks, and vision-centric tasks, all without the need for additional training, models, or inference steps. Experimental results demonstrate that VAR enables LMMs to process visual information more effectively by adjusting their internal attention mechanisms, offering a new direction to enhancing the multimodal capabilities of LMMs.

  • 4 authors
·
Mar 5