Medical Image Analysis (MedIA) has become indispensable in modern healthcare, enhancing clinical diagnostics and personalized treatment. Despite the remarkable advancements supported by deep learning (DL) technologies, their practical deployment faces challenges due to distribution shifts, where models trained on specific datasets underperform across others from varying hospitals, regions, or patient populations. To navigate this issue, researchers have been actively developing strategies to increase the adaptability and robustness of DL models, enabling their effective use in unfamiliar and diverse environments. This paper systematically reviews approaches that apply DL techniques to MedIA systems affected by distribution shifts. Unlike traditional categorizations based on technical specifications, our approach is grounded in the real-world operational constraints faced by healthcare institutions. Specifically, we categorize the existing body of work into Joint Training, Federated Learning, Fine-tuning, and Domain Generalization, with each method tailored to distinct scenarios caused by Data Accessibility, Privacy Concerns, and Collaborative Protocols. This perspective equips researchers with a nuanced understanding of how DL can be strategically deployed to address distribution shifts in MedIA, ensuring diverse and robust medical applications. By delving deeper into these topics, we highlight potential pathways for future research that not only address existing limitations but also push the boundaries of deployable MedIA technologies.

In the realm of automated robotic surgery and computer-assisted interventions, understanding robotic surgical activities stands paramount. Existing algorithms dedicated to surgical activity recognition predominantly cater to pre-defined closed-set paradigms, ignoring the challenges of real-world open-set scenarios. Such algorithms often falter in the presence of test samples originating from classes unseen during training phases. To tackle this problem, we introduce an innovative Open-Set Surgical Activity Recognition (OSSAR) framework. Our solution leverages the hyperspherical reciprocal point strategy to enhance the distinction between known and unknown classes in the feature space. Additionally, we address the issue of over-confidence in the closed set by refining model calibration, avoiding misclassification of unknown classes as known ones. To support our assertions, we establish an open-set surgical activity benchmark utilizing the public JIGSAWS dataset. Besides, we also collect a novel dataset on endoscopic submucosal dissection for surgical activity tasks. Extensive comparisons and ablation experiments on these datasets demonstrate the significant outperformance of our method over existing state-of-the-art approaches. Our proposed solution can effectively address the challenges of real-world surgical scenarios. Our code is publicly accessible at https://github.com/longbai1006/OSSAR.

Survival prediction based on whole slide images (WSIs) is a challenging task for patient-level multiple instance learning (MIL). Due to the vast amount of data for a patient (one or multiple gigapixels WSIs) and the irregularly shaped property of WSI, it is difficult to fully explore spatial, contextual, and hierarchical interaction in the patient-level bag. Many studies adopt random sampling pre-processing strategy and WSI-level aggregation models, which inevitably lose critical prognostic information in the patient-level bag. In this work, we propose a hierarchical vision Transformer framework named HVTSurv, which can encode the local-level relative spatial information, strengthen WSI-level context-aware communication, and establish patient-level hierarchical interaction. Firstly, we design a feature pre-processing strategy, including feature rearrangement and random window masking. Then, we devise three layers to progressively obtain patient-level representation, including a local-level interaction layer adopting Manhattan distance, a WSI-level interaction layer employing spatial shuffle, and a patient-level interaction layer using attention pooling. Moreover, the design of hierarchical network helps the model become more computationally efficient. Finally, we validate HVTSurv with 3,104 patients and 3,752 WSIs across 6 cancer types from The Cancer Genome Atlas (TCGA). The average C-Index is 2.50-11.30% higher than all the prior weakly supervised methods over 6 TCGA datasets. Ablation study and attention visualization further verify the superiority of the proposed HVTSurv. Implementation is available at: https://github.com/szc19990412/HVTSurv.

Precise thigh muscle volumes are crucial to monitor the motor functionality of patients with diseases that may result in various degrees of thigh muscle loss. T1-weighted MRI is the default surrogate to obtain thigh muscle masks due to its contrast between muscle and fat signals. Deep learning approaches have recently been widely used to obtain these masks through segmentation. However, due to the insufficient amount of precise annotations, thigh muscle masks generated by deep learning approaches tend to misclassify intra-muscular fat (IMF) as muscle impacting the analysis of muscle volumetrics. As IMF is infiltrated inside the muscle, human annotations require expertise and time. Thus, precise muscle masks where IMF is excluded are limited in practice. To alleviate this, we propose a few-shot segmentation framework to generate thigh muscle masks excluding IMF. In our framework, we design a novel pseudo-label correction and evaluation scheme, together with a new noise robust loss for exploiting high certainty areas. The proposed framework only takes $1\%$ of the fine-annotated training dataset, and achieves comparable performance with fully supervised methods according to the experimental results.

Whole-slide images (WSI) in computational pathology have high resolution with gigapixel size, but are generally with sparse regions of interest, which leads to weak diagnostic relevance and data inefficiency for each area in the slide. Most of the existing methods rely on a multiple instance learning framework that requires densely sampling local patches at high magnification. The limitation is evident in the application stage as the heavy computation for extracting patch-level features is inevitable. In this paper, we develop RLogist, a benchmarking deep reinforcement learning (DRL) method for fast observation strategy on WSIs. Imitating the diagnostic logic of human pathologists, our RL agent learns how to find regions of observation value and obtain representative features across multiple resolution levels, without having to analyze each part of the WSI at the high magnification. We benchmark our method on two whole-slide level classification tasks, including detection of metastases in WSIs of lymph node sections, and subtyping of lung cancer. Experimental results demonstrate that RLogist achieves competitive classification performance compared to typical multiple instance learning algorithms, while having a significantly short observation path. In addition, the observation path given by RLogist provides good decision-making interpretability, and its ability of reading path navigation can potentially be used by pathologists for educational/assistive purposes. Our code is available at: \url{https://github.com/tencent-ailab/RLogist}.

Noninvasive medical neuroimaging has yielded many discoveries about the brain connectivity. Several substantial techniques mapping morphological, structural and functional brain connectivities were developed to create a comprehensive road map of neuronal activities in the human brain -namely brain graph. Relying on its non-Euclidean data type, graph neural network (GNN) provides a clever way of learning the deep graph structure and it is rapidly becoming the state-of-the-art leading to enhanced performance in various network neuroscience tasks. Here we review current GNN-based methods, highlighting the ways that they have been used in several applications related to brain graphs such as missing brain graph synthesis and disease classification. We conclude by charting a path toward a better application of GNN models in network neuroscience field for neurological disorder diagnosis and population graph integration. The list of papers cited in our work is available at https://github.com/basiralab/GNNs-in-Network-Neuroscience.

Deep learning based semi-supervised learning (SSL) methods have achieved strong performance in medical image segmentation, which can alleviate doctors' expensive annotation by utilizing a large amount of unlabeled data. Unlike most existing semi-supervised learning methods, adversarial training based methods distinguish samples from different sources by learning the data distribution of the segmentation map, leading the segmenter to generate more accurate predictions. We argue that the current performance restrictions for such approaches are the problems of feature extraction and learning preference. In this paper, we propose a new semi-supervised adversarial method called Patch Confidence Adversarial Training (PCA) for medical image segmentation. Rather than single scalar classification results or pixel-level confidence maps, our proposed discriminator creates patch confidence maps and classifies them at the scale of the patches. The prediction of unlabeled data learns the pixel structure and context information in each patch to get enough gradient feedback, which aids the discriminator in convergent to an optimal state and improves semi-supervised segmentation performance. Furthermore, at the discriminator's input, we supplement semantic information constraints on images, making it simpler for unlabeled data to fit the expected data distribution. Extensive experiments on the Automated Cardiac Diagnosis Challenge (ACDC) 2017 dataset and the Brain Tumor Segmentation (BraTS) 2019 challenge dataset show that our method outperforms the state-of-the-art semi-supervised methods, which demonstrates its effectiveness for medical image segmentation.

The scarcity of pixel-level annotation is a prevalent problem in medical image segmentation tasks. In this paper, we introduce a novel regularization strategy involving interpolation-based mixing for semi-supervised medical image segmentation. The proposed method is a new consistency regularization strategy that encourages segmentation of interpolation of two unlabelled data to be consistent with the interpolation of segmentation maps of those data. This method represents a specific type of data-adaptive regularization paradigm which aids to minimize the overfitting of labelled data under high confidence values. The proposed method is advantageous over adversarial and generative models as it requires no additional computation. Upon evaluation on two publicly available MRI datasets: ACDC and MMWHS, experimental results demonstrate the superiority of the proposed method in comparison to existing semi-supervised models. Code is available at: https://github.com/hritam-98/ICT-MedSeg

This work presents a single-step deep-learning framework for longitudinal image analysis, coined Segis-Net. To optimally exploit information available in longitudinal data, this method concurrently learns a multi-class segmentation and nonlinear registration. Segmentation and registration are modeled using a convolutional neural network and optimized simultaneously for their mutual benefit. An objective function that optimizes spatial correspondence for the segmented structures across time-points is proposed. We applied Segis-Net to the analysis of white matter tracts from N=8045 longitudinal brain MRI datasets of 3249 elderly individuals. Segis-Net approach showed a significant increase in registration accuracy, spatio-temporal segmentation consistency, and reproducibility comparing with two multistage pipelines. This also led to a significant reduction in the sample-size that would be required to achieve the same statistical power in analyzing tract-specific measures. Thus, we expect that Segis-Net can serve as a new reliable tool to support longitudinal imaging studies to investigate macro- and microstructural brain changes over time.

Uncertainty quantification (UQ) plays a pivotal role in reduction of uncertainties during both optimization and decision making processes. It can be applied to solve a variety of real-world applications in science and engineering. Bayesian approximation and ensemble learning techniques are two most widely-used UQ methods in the literature. In this regard, researchers have proposed different UQ methods and examined their performance in a variety of applications such as computer vision (e.g., self-driving cars and object detection), image processing (e.g., image restoration), medical image analysis (e.g., medical image classification and segmentation), natural language processing (e.g., text classification, social media texts and recidivism risk-scoring), bioinformatics, etc.This study reviews recent advances in UQ methods used in deep learning. Moreover, we also investigate the application of these methods in reinforcement learning (RL). Then, we outline a few important applications of UQ methods. Finally, we briefly highlight the fundamental research challenges faced by UQ methods and discuss the future research directions in this field.