Federated learning is an emerging technology that enables the decentralised training of machine learning-based methods for medical image analysis across multiple sites while ensuring privacy. This review paper thoroughly examines federated learning research applied to medical image analysis, outlining technical contributions. We followed the guidelines of Okali and Schabram, a review methodology, to produce a comprehensive summary and discussion of the literature in information systems. Searches were conducted at leading indexing platforms: PubMed, IEEE Xplore, Scopus, ACM, and Web of Science. We found a total of 433 papers and selected 118 of them for further examination. The findings highlighted research on applying federated learning to neural network methods in cardiology, dermatology, gastroenterology, neurology, oncology, respiratory medicine, and urology. The main challenges reported were the ability of machine learning models to adapt effectively to real-world datasets and privacy preservation. We outlined two strategies to address these challenges: non-independent and identically distributed data and privacy-enhancing methods. This review paper offers a reference overview for those already working in the field and an introduction to those new to the topic.

Large Vision-Language Models (VLMs), possessing millions or billions of parameters, typically require large text and image datasets for effective fine-tuning. However, collecting data from various sites, especially in healthcare, is challenging due to strict privacy regulations. An alternative is to fine-tune these foundation models on end-user devices, such as in medical clinics and hospitals, without sending data to a server. These local clients typically have limited computing power and small datasets, which are not enough for fully fine-tuning large VLMs on their own. A naive solution to these scenarios is to leverage parameter-efficient fine-tuning (PEFT) strategies such as adapters and apply federated learning (FL) algorithms to combine the learned adapter weights, thereby respecting the resource limitations and data privacy of the clients. However, this approach does not fully leverage the knowledge from multiple adapters trained on diverse data distributions and for diverse tasks. The adapters are adversely impacted by data heterogeneity and task heterogeneity across clients resulting in sub-optimal convergence. To this end, we propose a novel framework called FedPIA that improves upon the naive combinations of FL and PEFT by introducing Permutation and Integration of the local Adapters in the server and global Adapters in the clients exploiting Wasserstein barycenters for improved blending of client-specific and client-agnostic knowledge. This layerwise permutation helps to bridge the gap in the parameter space of local and global adapters before integration. We conduct over 2000 client-level experiments utilizing 48 medical image datasets across five different medical vision-language FL task settings encompassing visual question answering as well as image and report-based multi-label disease detection. Our experiments involving diverse client settings, ten different modalities, and two VLM backbones demonstrate that FedPIA consistently outperforms the state-of-the-art PEFT-FL baselines.

The utilization of deep learning-based object detection is an effective approach to assist visually impaired individuals in avoiding obstacles. In this paper, we implemented seven different YOLO object detection models viz., YOLO-NAS (small, medium, large), YOLOv8, YOLOv7, YOLOv6, and YOLOv5 and performed comprehensive evaluation with carefully tuned hyperparameters, to analyze how these models performed on images containing common daily-life objects presented on roads and sidewalks. After a systematic investigation, YOLOv8 was found to be the best model, which reached a precision of 80% and a recall of 68.2% on a well-known Obstacle Dataset which includes images from VOC dataset, COCO dataset, and TT100K dataset along with images collected by the researchers in the field. Despite being the latest model and demonstrating better performance in many other applications, YOLO-NAS was found to be suboptimal for the obstacle detection task.

Federated Learning (FL) in healthcare ensures patient privacy by allowing hospitals to collaboratively train machine learning models while keeping sensitive medical data secure and localized. Most existing research in FL has concentrated on unimodal scenarios, where all healthcare institutes share the same type of data. However, in real-world healthcare situations, some clients may have access to multiple types of data pertaining to the same disease. Multimodal Federated Learning (MMFL) utilizes multiple modalities to build a more powerful FL model than its unimodal counterpart. However, the impact of missing modality in different clients, called modality incongruity, has been greatly overlooked. This paper, for the first time, analyses the impact of modality incongruity and reveals its connection with data heterogeneity across participating clients. We particularly inspect whether incongruent MMFL with unimodal and multimodal clients is more beneficial than unimodal FL. Furthermore, we examine three potential routes of addressing this issue. Firstly, we study the effectiveness of various self-attention mechanisms towards incongruity-agnostic information fusion in MMFL. Secondly, we introduce a modality imputation network (MIN) pre-trained in a multimodal client for modality translation in unimodal clients and investigate its potential towards mitigating the missing modality problem. Thirdly, we introduce several client-level and server-level regularization techniques including Modality-aware knowledge Distillation (MAD) and Leave-one-out teacher (LOOT) towards mitigating modality incongruity effects. Experiments are conducted with Chest X-Ray and radiology reports under several MMFL settings on two publicly available real-world datasets, MIMIC-CXR and Open-I.