Medical image segmentation is a critical component in clinical practice, facilitating accurate diagnosis, treatment planning, and disease monitoring. However, existing methods, often tailored to specific modalities or disease types, lack generalizability across the diverse spectrum of medical image segmentation tasks. Here we present MedSAM, a foundation model designed for bridging this gap by enabling universal medical image segmentation. The model is developed on a large-scale medical image dataset with 1,570,263 image-mask pairs, covering 10 imaging modalities and over 30 cancer types. We conduct a comprehensive evaluation on 86 internal validation tasks and 60 external validation tasks, demonstrating better accuracy and robustness than modality-wise specialist models. By delivering accurate and efficient segmentation across a wide spectrum of tasks, MedSAM holds significant potential to expedite the evolution of diagnostic tools and the personalization of treatment plans.

In this paper, we present a semi-supervised deep learning approach to accurately recover high-resolution (HR) CT images from low-resolution (LR) counterparts. Specifically, with the generative adversarial network (GAN) as the building block, we enforce the cycle-consistency in terms of the Wasserstein distance to establish a nonlinear end-to-end mapping from noisy LR input images to denoised and deblurred HR outputs. We also include the joint constraints in the loss function to facilitate structural preservation. In this process, we incorporate deep convolutional neural network (CNN), residual learning, and network in network techniques for feature extraction and restoration. In contrast to the current trend of increasing network depth and complexity to boost the imaging performance, we apply a parallel ${1}\times {1}$ CNN to compress the output of the hidden layer and optimize the number of layers and the number of filters for each convolutional layer. The quantitative and qualitative evaluative results demonstrate that our proposed model is accurate, efficient and robust for super-resolution (SR) image restoration from noisy LR input images. In particular, we validate our composite SR networks on three large-scale CT datasets, and obtain promising results as compared to the other state-of-the-art methods.

Automated segmentation in medical image analysis is a challenging task that requires a large amount of manually labeled data. However, most existing learning-based approaches usually suffer from limited manually annotated medical data, which poses a major practical problem for accurate and robust medical image segmentation. In addition, most existing semi-supervised approaches are usually not robust compared with the supervised counterparts, and also lack explicit modeling of geometric structure and semantic information, both of which limit the segmentation accuracy. In this work, we present SimCVD, a simple contrastive distillation framework that significantly advances state-of-the-art voxel-wise representation learning. We first describe an unsupervised training strategy, which takes two views of an input volume and predicts their signed distance maps of object boundaries in a contrastive objective, with only two independent dropout as mask. This simple approach works surprisingly well, performing on the same level as previous fully supervised methods with much less labeled data. We hypothesize that dropout can be viewed as a minimal form of data augmentation and makes the network robust to representation collapse. Then, we propose to perform structural distillation by distilling pair-wise similarities. We evaluate SimCVD on two popular datasets: the Left Atrial Segmentation Challenge (LA) and the NIH pancreas CT dataset. The results on the LA dataset demonstrate that, in two types of labeled ratios ( i.e. , 20% and 10%), SimCVD achieves an average Dice score of 90.85% and 89.03% respectively, a 0.91% and 2.22% improvement compared to previous best results. Our method can be trained in an end-to-end fashion, showing the promise of utilizing SimCVD as a general framework for downstream tasks, such as medical image synthesis, enhancement, and registration.

Computed tomography (CT) is a popular medical imaging modality and enjoys wide clinical applications. At the same time, the X-ray radiation dose associated with CT scannings raises a public concern due to its potential risks to the patients. Over the past years, major efforts have been dedicated to the development of low-dose CT (LDCT) methods. However, the radiation dose reduction compromises the signal-to-noise ratio, leading to strong noise and artifacts that down-grade the CT image quality. In this paper, we propose a novel 3-D noise reduction method, called structurally sensitive multi-scale generative adversarial net, to improve the LDCT image quality. Specifically, we incorporate 3-D volumetric information to improve the image quality. Also, different loss functions for training denoising models are investigated. Experiments show that the proposed method can effectively preserve the structural and textural information in reference to the normal-dose CT images and significantly suppress noise and artifacts. Qualitative visual assessments by three experienced radiologists demonstrate that the proposed method retrieves more information and outperforms competing methods.

Deep neural networks have been integrated into the whole clinical decision procedure which can improve the efficiency of diagnosis and alleviate the heavy workload of physicians. Since most neural networks are supervised, their performance heavily depends on the volume and quality of available labels. However, few such labels exist for rare diseases (e.g., new pandemics). Here we report a medical multimodal large language model (Med-MLLM) for radiograph representation learning, which can learn broad medical knowledge (e.g., image understanding, text semantics, and clinical phenotypes) from unlabelled data. As a result, when encountering a rare disease, our Med-MLLM can be rapidly deployed and easily adapted to them with limited labels. Furthermore, our model supports medical data across visual modality (e.g., chest X-ray and CT) and textual modality (e.g., medical report and free-text clinical note); therefore, it can be used for clinical tasks that involve both visual and textual data. We demonstrate the effectiveness of our Med-MLLM by showing how it would perform using the COVID-19 pandemic “in replay”. In the retrospective setting, we test the model on the early COVID-19 datasets; and in the prospective setting, we test the model on the new variant COVID-19-Omicron. The experiments are conducted on 1) three kinds of input data; 2) three kinds of downstream tasks, including disease reporting, diagnosis, and prognosis; 3) five COVID-19 datasets; and 4) three different languages, including English, Chinese, and Spanish. All experiments show that our model can make accurate and robust COVID-19 decision-support with little labelled data.