Developing a generalized segmentation model capable of simultaneously delineating multiple organs and diseases is highly desirable. Federated learning (FL) is a key technology enabling the collaborative development of a model without exchanging training data. However, the limited access to fully annotated training data poses a major challenge to training generalizable models. We propose "ConDistFL", a framework to solve this problem by combining FL with knowledge distillation. Local models can extract the knowledge of unlabeled organs and tumors from partially annotated data from the global model with an adequately designed conditional probability representation. We validate our framework on four distinct partially annotated abdominal CT datasets from the MSD and KiTS19 challenges. The experimental results show that the proposed framework significantly outperforms FedAvg and FedOpt baselines. Moreover, the performance on an external test dataset demonstrates superior generalizability compared to models trained on each dataset separately. Our ablation study suggests that ConDistFL can perform well without frequent aggregation, reducing the communication cost of FL. Our implementation will be available at https://github.com/NVIDIA/NVFlare/tree/dev/research/condist-fl.

We present a novel spectral machine learning (SML) method in screening for pancreatic mass using CT imaging. Our algorithm is trained with approximately 30,000 images from 250 patients (50 patients with normal pancreas and 200 patients with abnormal pancreas findings) based on public data sources. A test accuracy of 94.6 percents was achieved in the out-of-sample diagnosis classification based on a total of approximately 15,000 images from 113 patients, whereby 26 out of 32 patients with normal pancreas and all 81 patients with abnormal pancreas findings were correctly diagnosed. SML is able to automatically choose fundamental images (on average 5 or 9 images for each patient) in the diagnosis classification and achieve the above mentioned accuracy. The computational time is 75 seconds for diagnosing 113 patients in a laptop with standard CPU running environment. Factors that influenced high performance of a well-designed integration of spectral learning and machine learning included: 1) use of eigenvectors corresponding to several of the largest eigenvalues of sample covariance matrix (spike eigenvectors) to choose input attributes in classification training, taking into account only the fundamental information of the raw images with less noise; 2) removal of irrelevant pixels based on mean-level spectral test to lower the challenges of memory capacity and enhance computational efficiency while maintaining superior classification accuracy; 3) adoption of state-of-the-art machine learning classification, gradient boosting and random forest. Our methodology showcases practical utility and improved accuracy of image diagnosis in pancreatic mass screening in the era of AI.

Gliomas are the most common primary brain malignancies, with different degrees of aggressiveness, variable prognosis and various heterogeneous histologic sub-regions, i.e., peritumoral edematous/invaded tissue, necrotic core, active and non-enhancing core. This intrinsic heterogeneity is also portrayed in their radio-phenotype, as their sub-regions are depicted by varying intensity profiles disseminated across multi-parametric magnetic resonance imaging (mpMRI) scans, reflecting varying biological properties. Their heterogeneous shape, extent, and location are some of the factors that make these tumors difficult to resect, and in some cases inoperable. The amount of resected tumor is a factor also considered in longitudinal scans, when evaluating the apparent tumor for potential diagnosis of progression. Furthermore, there is mounting evidence that accurate segmentation of the various tumor sub-regions can offer the basis for quantitative image analysis towards prediction of patient overall survival. This study assesses the state-of-the-art machine learning (ML) methods used for brain tumor image analysis in mpMRI scans, during the last seven instances of the International Brain Tumor Segmentation (BraTS) challenge, i.e. 2012-2018. Specifically, we focus on i) evaluating segmentations of the various glioma sub-regions in pre-operative mpMRI scans, ii) assessing potential tumor progression by virtue of longitudinal growth of tumor sub-regions, beyond use of the RECIST criteria, and iii) predicting the overall survival from pre-operative mpMRI scans of patients that undergone gross total resection. Finally, we investigate the challenge of identifying the best ML algorithms for each of these tasks, considering that apart from being diverse on each instance of the challenge, the multi-institutional mpMRI BraTS dataset has also been a continuously evolving/growing dataset.