The Segmentation Anything Model (SAM) requires labor-intensive data labeling. We present Unsupervised SAM (UnSAM) for promptable and automatic whole-image segmentation that does not require human annotations.

Medical imaging tasks require an understanding of subtle and localized visual features due to the inherently detailed and area-specific nature of pathological patterns, which are crucial for clinical diagnosis. Although recent advances in medical vision-language pre-training (VLP) enable models to learn clinically relevant visual features by leveraging both medical images and their associated radiology reports, current medical VLP methods primarily focus on aligning images with entire reports. This focus hinders the learning of dense (pixel-level) visual features and is suboptimal for dense prediction tasks (e.g., medical image segmentation). To address this challenge, we propose a novel medical VLP framework, named G lobal to D ense level representation learning ( G2D), which aims to learn global and dense visual features simultaneously using only image-text pairs without extra annotations. In particular, G2D designs a Pseudo Segmentation ( PS) task, which enables the model to learn dense visual features during VLP . Notably, generating PS masks can be performed on the fly during VLP, which does not incur extra trainable parameters. With this simple yet effective idea, G2D achieves superior performance across 5 medical imaging tasks and 25 diseases. Particularly, in the segmentation task which requires dense visual features, G2D surpasses existing models even with just 1% of the training data for finetuning, compared to 100% used by other models.

Fibrotic Lung Disease (FLD) is a severe condition marked by lung stiffening and scarring, leading to respiratory decline. High-resolution computed tomography (HRCT) is critical for diagnosing and monitoring FLD; however, fibrosis appears as irregular, diffuse patterns with unclear boundaries, leading to high inter-observer variability and time-intensive manual annotation. To tackle this challenge, we propose DiffSeg, a novel weakly supervised semantic segmentation (WSSS) method that uses image-level annotations to generate pixel-level fibrosis segmentation, reducing the need for fine-grained manual labeling. Additionally, our DiffSeg incorporates a diffusion-based generative model to synthesize HRCT images with different levels of fibrosis from healthy slices, enabling the generation of the fibrosis-injected slices and their paired fibrosis location. Experiments indicate that our method significantly improves the accuracy of pseudo masks generated by existing WSSS methods, greatly reducing the complexity of manual labeling and enhancing the consistency of the generated masks.

Video Shadow Detection (VSD) aims to detect the shadow masks with frame sequence. Existing works suffer from inefficient temporal learning. Moreover, few works address the VSD problem by considering the characteristic (i.e., boundary) of shadow. Motivated by this, we propose a Timeline and Boundary Guided Diffusion (TBGDiff) network for VSD where we take account of the past-future temporal guidance and boundary information jointly. In detail, we design a Dual Scale Aggregation (DSA) module for better temporal understanding by rethinking the affinity of the long-term and short-term frames for the clipped video. Next, we introduce Shadow Boundary Aware Attention (SBAA) to utilize the edge contexts for capturing the characteristics of shadows. Moreover, we are the first to introduce the Diffusion model for VSD in which we explore a Space-Time Encoded Embedding (STEE) to inject the temporal guidance for Diffusion to conduct shadow detection. Benefiting from these designs, our model can not only capture the temporal information but also the shadow property. Extensive experiments show that the performance of our approach overtakes the state-of-the-art methods, verifying the effectiveness of our components. We release the codes, weights, and results at \url{https://github.com/haipengzhou856/TBGDiff}.

The Segmentation Anything Model (SAM) requires labor-intensive data labeling. We present Unsupervised SAM (UnSAM) for promptable and automatic whole-image segmentation that does not require human annotations. UnSAM utilizes a divide-and-conquer strategy to "discover" the hierarchical structure of visual scenes. We first leverage top-down clustering methods to partition an unlabeled image into instance/semantic level segments. For all pixels within a segment, a bottom-up clustering method is employed to iteratively merge them into larger groups, thereby forming a hierarchical structure. These unsupervised multi-granular masks are then utilized to supervise model training. Evaluated across seven popular datasets, UnSAM achieves competitive results with the supervised counterpart SAM, and surpasses the previous state-of-the-art in unsupervised segmentation by 11% in terms of AR. Moreover, we show that supervised SAM can also benefit from our self-supervised labels. By integrating our unsupervised pseudo masks into SA-1B's ground-truth masks and training UnSAM with only 1% of SA-1B, a lightly semi-supervised UnSAM can often segment entities overlooked by supervised SAM, exceeding SAM's AR by over 6.7% and AP by 3.9% on SA-1B.

Interpretability is crucial for machine learning algorithms in high-stakes medical applications. However, high-performing neural networks typically cannot explain their predictions. Post-hoc explanation methods provide a way to understand neural networks but have been shown to suffer from conceptual problems. Moreover, current research largely focuses on providing local explanations for individual samples rather than global explanations for the model itself. In this paper, we propose Attri-Net, an inherently interpretable model for multi-label classification that provides local and global explanations. Attri-Net first counterfactually generates class-specific attribution maps to highlight the disease evidence, then performs classification with logistic regression classifiers based solely on the attribution maps. Local explanations for each prediction can be obtained by interpreting the attribution maps weighted by the classifiers' weights. Global explanation of whole model can be obtained by jointly considering learned average representations of the attribution maps for each class (called the class centers) and the weights of the linear classifiers. To ensure the model is ``right for the right reason", we further introduce a mechanism to guide the model's explanations to align with human knowledge. Our comprehensive evaluations show that Attri-Net can generate high-quality explanations consistent with clinical knowledge while not sacrificing classification performance.

Although weakly supervised semantic segmentation using only image-level labels (WSSS-IL) is potentially useful, its low performance and implementation complexity still limit its application. The main causes are (a) non-detection and (b) false-detection phenomena: (a) The class activation maps refined from existing WSSS-IL methods still only represent partial regions for large-scale objects, and (b) for small-scale objects, over-activation causes them to deviate from the object edges. We propose RecurSeed, which alternately reduces non- and false detections through recursive iterations, thereby implicitly finding an optimal junction that minimizes both errors. We also propose a novel data augmentation (DA) approach called EdgePredictMix, which further expresses an object's edge by utilizing the probability difference information between adjacent pixels in combining the segmentation results, thereby compensating for the shortcomings when applying the existing DA methods to WSSS. We achieved new state-of-the-art performances on both the PASCAL VOC 2012 and MS COCO 2014 benchmarks (VOC val: 74.4%, COCO val: 46.4%). The code is available at https://github.com/shjo-april/RecurSeed_and_EdgePredictMix.

Recently, medical vision-language pre-training (VLP) has reached substantial progress to learn global visual representation from medical images and their paired radiology reports. However, medical imaging tasks in real world usually require finer granularity in visual features. These tasks include visual localization tasks (e.g., semantic segmentation, object detection) and visual grounding task. Yet, current medical VLP methods face challenges in learning these fine-grained features, as they primarily focus on brute-force alignment between image patches and individual text tokens for local visual feature learning, which is suboptimal for downstream dense prediction tasks. In this work, we propose a new VLP framework, named \textbf{G}lobal to \textbf{D}ense level representation learning (G2D) that achieves significantly improved granularity and more accurate grounding for the learned features, compared to existing medical VLP approaches. In particular, G2D learns dense and semantically-grounded image representations via a pseudo segmentation task parallel with the global vision-language alignment. Notably, generating pseudo segmentation targets does not incur extra trainable parameters: they are obtained on the fly during VLP with a parameter-free processor. G2D achieves superior performance across 6 medical imaging tasks and 25 diseases, particularly in semantic segmentation, which necessitates fine-grained, semantically-grounded image features. In this task, G2D surpasses peer models even when fine-tuned with just 1\% of the training data, compared to the 100\% used by these models. The code will be released upon acceptance.