Lumbar disc degeneration, a progressive structural wear and tear of lumbar intervertebral disc, is regarded as an essential role on low back pain, a significant global health concern. Automated lumbar spine geometry reconstruction from MR images will enable fast measurement of medical parameters to evaluate the lumbar status, in order to determine a suitable treatment. Existing image segmentation-based techniques often generate erroneous segments or unstructured point clouds, unsuitable for medical parameter measurement. In this work, we present $\textit{UNet-DeformSA}$ and $\textit{TransDeformer}$: novel attention-based deep neural networks that reconstruct the geometry of the lumbar spine with high spatial accuracy and mesh correspondence across patients, and we also present a variant of $\textit{TransDeformer}$ for error estimation. Specially, we devise new attention modules with a new attention formula, which integrate image features and tokenized contour features to predict the displacements of the points on a shape template without the need for image segmentation. The deformed template reveals the lumbar spine geometry in an image. Experiment results show that our networks generate artifact-free geometry outputs, and the variant of $\textit{TransDeformer}$ can predict the errors of a reconstructed geometry. Our code is available at https://github.com/linchenq/TransDeformer-Mesh.

Intervertebral disc disease, a prevalent ailment, frequently leads to intermittent or persistent low back pain, and diagnosing and assessing of this disease rely on accurate measurement of vertebral bone and intervertebral disc geometries from lumbar MR images. Deep neural network (DNN) models may assist clinicians with more efficient image segmentation of individual instances (disks and vertebrae) of the lumbar spine in an automated way, which is termed as instance image segmentation. In this work, we proposed SymTC, an innovative lumbar spine MR image segmentation model that combines the strengths of Transformer and Convolutional Neural Network (CNN). Specifically, we designed a parallel dual-path architecture to merge CNN layers and Transformer layers, and we integrated a novel position embedding into the self-attention module of Transformer, enhancing the utilization of positional information for more accurate segmentation. To further improves model performance, we introduced a new data augmentation technique to create synthetic yet realistic MR image dataset, named SSMSpine, which is made publicly available. We evaluated our SymTC and the other 15 existing image segmentation models on our private in-house dataset and the public SSMSpine dataset, using two metrics, Dice Similarity Coefficient and 95% Hausdorff Distance. The results show that our SymTC has the best performance for segmenting vertebral bones and intervertebral discs in lumbar spine MR images. The SymTC code and SSMSpine dataset are available at https://github.com/jiasongchen/SymTC.

Deep neural networks (DNNs) are vulnerable to adversarial noises. Adversarial training is a general and effective strategy to improve DNN robustness (i.e., accuracy on noisy data) against adversarial noises. However, DNN models trained by the current existing adversarial training methods may have much lower standard accuracy (i.e., accuracy on clean data), compared to the same models trained by the standard method on clean data, and this phenomenon is known as the trade-off between accuracy and robustness and is considered unavoidable. This issue prevents adversarial training from being used in many application domains, such as medical image analysis, as practitioners do not want to sacrifice standard accuracy too much in exchange for adversarial robustness. Our objective is to lift (i.e., alleviate or even avoid) this trade-off between standard accuracy and adversarial robustness for medical image classification and segmentation. We propose a novel adversarial training method, named Increasing-Margin Adversarial (IMA) Training, which is supported by an equilibrium state analysis about the optimality of adversarial training samples. Our method aims to preserve accuracy while improving robustness by generating optimal adversarial training samples. We evaluate our method and the other eight representative methods on six publicly available image datasets corrupted by noises generated by AutoAttack and white-noise attack. Our method achieves the highest adversarial robustness for image classification and segmentation with the smallest reduction in accuracy on clean data. For one of the applications, our method improves both accuracy and robustness. Our study has demonstrated that our method can lift the trade-off between standard accuracy and adversarial robustness for the image classification and segmentation applications.

Electrocardiogram (ECG) is the most widely used diagnostic tool to monitor the condition of the human heart. By using deep neural networks (DNNs), interpretation of ECG signals can be fully automated for the identification of potential abnormalities in a patient's heart in a fraction of a second. Studies have shown that given a sufficiently large amount of training data, DNN accuracy for ECG classification could reach human-expert cardiologist level. However, despite of the excellent performance in classification accuracy, DNNs are highly vulnerable to adversarial noises that are subtle changes in the input of a DNN and may lead to a wrong class-label prediction. It is challenging and essential to improve robustness of DNNs against adversarial noises, which are a threat to life-critical applications. In this work, we proposed a regularization method to improve DNN robustness from the perspective of noise-to-signal ratio (NSR) for the application of ECG signal classification. We evaluated our method on PhysioNet MIT-BIH dataset and CPSC2018 ECG dataset, and the results show that our method can substantially enhance DNN robustness against adversarial noises generated from adversarial attacks, with a minimal change in accuracy on clean data.