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Yangming Ou

Publications and source records attributed to Yangming Ou.

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DAMamba-UNet3D: A Parameter-Efficient Mamba State Space U-Net with Dynamic Adaptive Scan for 3D Medical Image Segmentation

We propose parameter-efficient SSM-based U-Net architectures for 3D medical image segmentation. Convolutional U-Nets afford O(n) local mixing per layer but lack explicit global context; transformers provide global reasoning at O(n^2) cost in sequence length $n$. State-space models (SSMs), such as Mamba, offer $O(n)$ global propagation per block. Yet, existing medical SSM segmenters rely on fixed scan patterns and large parameter budgets. Dynamic Adaptive Scan (DAS), which learns data-dependent reordering before selective scan, has not been applied to medical imaging or extended to 3D volumes. We propose DAMamba-UNet3D, a hybrid encoder-decoder that integrates tri-plane 3D-DAS blocks at encoder stages E2-E4 while retaining convolutions elsewhere (~5.3M parameters). On BraTS 2020 five-fold cross-validation, DAMamba-UNet3D achieves mean Dice 0.815+/-0.013 (full-volume per-case evaluation) at ~13x lower parameter cost than SegMamba (0.824+\-0.014, ~70M). At comparable scale, DAMamba-L (~70M), a wide DAS-native variant with encoder-only DAMamba and a convolutional bottleneck, reaches 0.829+\-0.012, surpassing retrained SegMamba by 0.5pt. Component ablations show that encoder-only DAS placement is critical as bottleneck and decoder SSM blocks lower Dice. Together, the results suggest that learned tri-plane DAS in a hybrid U-Net is competitive with, and under our large-scale design may improve upon, SegMamba's fixed Tri-orientated Mamba (ToM) scanning on BraTS 2020. Code: https://github.com/marafathussain/DAMamba-UNet3D.

cs.CV

Data-driven registration and modeling of brain deformation for image-guided neurosurgery

Accurate compensation of brain deformation is critical for reliable image-guided neurosurgery. Surgical manipulation and tumor resection induce tissue motion, causing preoperative planning images to become misaligned with the intraoperative anatomy. In this review, we examine data-driven methods developed between 2020 and 2025 for brain deformation registration and modeling, with a particular focus on learning-based approaches. A comprehensive literature search was conducted in PubMed, IEEE Xplore, Scopus, and Web of Science using predefined inclusion and exclusion criteria for computational methods addressing brain deformation in neurosurgical imaging, resulting in 46 eligible studies. We provide a unified analysis of methodological strategies, including deep learning-based image registration, direct deformation field regression, synthesis-driven multimodal alignment, resection-aware architectures for handling missing correspondences, and hybrid models integrating biomechanical priors. We also examine dataset utilization, evaluation metrics, validation protocols, and the assessment of uncertainty and generalization across studies. While learning-based methods demonstrate promising accuracy and computational efficiency, current approaches remain limited by out-of-distribution robustness, standardized benchmarking, interpretability, and readiness for clinical deployment. Our review highlights these gaps and outlines future directions toward more robust, generalizable, and clinically translatable solutions for neurosurgical guidance. By organizing recent advances and critically assessing evaluation practices, this work provides a comprehensive reference for researchers and clinicians working on data-driven registration and modeling of brain deformation.

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Relation U-Net

Towards clinical interpretations, this paper presents a new ''output-with-confidence'' segmentation neural network with multiple input images and multiple output segmentation maps and their pairwise relations. A confidence score of the test image without ground-truth can be estimated from the difference among the estimated relation maps. We evaluate the method based on the widely used vanilla U-Net for segmentation and our new model is named Relation U-Net which can output segmentation maps of the input images as well as an estimated confidence score of the test image without ground-truth. Experimental results on four public datasets show that Relation U-Net can not only provide better accuracy than vanilla U-Net but also estimate a confidence score which is linearly correlated to the segmentation accuracy on test images.

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AGE2HIE: Transfer Learning from Brain Age to Predicting Neurocognitive Outcome for Infant Brain Injury

Hypoxic-Ischemic Encephalopathy (HIE) affects 1 to 5 out of every 1,000 newborns, with 30% to 50% of cases resulting in adverse neurocognitive outcomes. However, these outcomes can only be reliably assessed as early as age 2. Therefore, early and accurate prediction of HIE-related neurocognitive outcomes using deep learning models is critical for improving clinical decision-making, guiding treatment decisions and assessing novel therapies. However, a major challenge in developing deep learning models for this purpose is the scarcity of large, annotated HIE datasets. We have assembled the first and largest public dataset, however it contains only 156 cases with 2-year neurocognitive outcome labels. In contrast, we have collected 8,859 normal brain black Magnetic Resonance Imagings (MRIs) with 0-97 years of age that are available for brain age estimation using deep learning models. In this paper, we introduce AGE2HIE to transfer knowledge learned by deep learning models from healthy controls brain MRIs to a diseased cohort, from structural to diffusion MRIs, from regression of continuous age estimation to prediction of the binary neurocognitive outcomes, and from lifespan age (0-97 years) to infant (0-2 weeks). Compared to training from scratch, transfer learning from brain age estimation significantly improves not only the prediction accuracy (3% or 2% improvement in same or multi-site), but also the model generalization across different sites (5% improvement in cross-site validation).

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Foundation AI Model for Medical Image Segmentation

Foundation models refer to artificial intelligence (AI) models that are trained on massive amounts of data and demonstrate broad generalizability across various tasks with high accuracy. These models offer versatile, one-for-many or one-for-all solutions, eliminating the need for developing task-specific AI models. Examples of such foundation models include the Chat Generative Pre-trained Transformer (ChatGPT) and the Segment Anything Model (SAM). These models have been trained on millions to billions of samples and have shown wide-ranging and accurate applications in numerous tasks such as text processing (using ChatGPT) and natural image segmentation (using SAM). In medical image segmentation - finding target regions in medical images - there is a growing need for these one-for-many or one-for-all foundation models. Such models could obviate the need to develop thousands of task-specific AI models, which is currently standard practice in the field. They can also be adapted to tasks with datasets too small for effective training. We discuss two paths to achieve foundation models for medical image segmentation and comment on progress, challenges, and opportunities. One path is to adapt or fine-tune existing models, originally developed for natural images, for use with medical images. The second path entails building models from scratch, exclusively training on medical images.

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BOston Neonatal Brain Injury Data for Hypoxic Ischemic Encephalopathy (BONBID-HIE): II. 2-year Neurocognitive Outcome and NICU Outcome

Hypoxic Ischemic Encephalopathy (HIE) affects approximately 1-5/1000 newborns globally and leads to adverse neurocognitive outcomes in 30% to 50% of cases by two years of age. Despite therapeutic advances with Therapeutic Hypothermia (TH), prognosis remains challenging, highlighting the need for improved biomarkers. This paper introduces the second release of the Boston Neonatal Brain Injury Dataset for Hypoxic-Ischemic Encephalopathy (BONBID-HIE), an open-source, comprehensive MRI and clinical dataset featuring 237 patients, including NICU outcomes and 2-year neurocognitive outcomes from Massachusetts General Hospital and Boston Children's Hospital.

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A Self-Supervised Image Registration Approach for Measuring Local Response Patterns in Metastatic Ovarian Cancer

High-grade serous ovarian carcinoma (HGSOC) is characterised by significant spatial and temporal heterogeneity, typically manifesting at an advanced metastatic stage. A major challenge in treating advanced HGSOC is effectively monitoring localised change in tumour burden across multiple sites during neoadjuvant chemotherapy (NACT) and predicting long-term pathological response and overall patient survival. In this work, we propose a self-supervised deformable image registration algorithm that utilises a general-purpose image encoder for image feature extraction to co-register contrast-enhanced computerised tomography scan images acquired before and after neoadjuvant chemotherapy. This approach addresses challenges posed by highly complex tumour deformations and longitudinal lesion matching during treatment. Localised tumour changes are calculated using the Jacobian determinant maps of the registration deformation at multiple disease sites and their macroscopic areas, including hypo-dense (i.e., cystic/necrotic), hyper-dense (i.e., calcified), and intermediate density (i.e., soft tissue) portions. A series of experiments is conducted to understand the role of a general-purpose image encoder and its application in quantifying change in tumour burden during neoadjuvant chemotherapy in HGSOC. This work is the first to demonstrate the feasibility of a self-supervised image registration approach in quantifying NACT-induced localised tumour changes across the whole disease burden of patients with complex multi-site HGSOC, which could be used as a potential marker for ovarian cancer patient's long-term pathological response and survival.

cs.CV

Tackling Heterogeneity in Medical Federated learning via Vision Transformers

Optimization-based regularization methods have been effective in addressing the challenges posed by data heterogeneity in medical federated learning, particularly in improving the performance of underrepresented clients. However, these methods often lead to lower overall model accuracy and slower convergence rates. In this paper, we demonstrate that using Vision Transformers can substantially improve the performance of underrepresented clients without a significant trade-off in overall accuracy. This improvement is attributed to the Vision transformer's ability to capture long-range dependencies within the input data.

cs.CV

Computer-Vision Benchmark Segment-Anything Model (SAM) in Medical Images: Accuracy in 12 Datasets

Background: The segment-anything model (SAM), introduced in April 2023, shows promise as a benchmark model and a universal solution to segment various natural images. It comes without previously-required re-training or fine-tuning specific to each new dataset. Purpose: To test SAM's accuracy in various medical image segmentation tasks and investigate potential factors that may affect its accuracy in medical images. Methods: SAM was tested on 12 public medical image segmentation datasets involving 7,451 subjects. The accuracy was measured by the Dice overlap between the algorithm-segmented and ground-truth masks. SAM was compared with five state-of-the-art algorithms specifically designed for medical image segmentation tasks. Associations of SAM's accuracy with six factors were computed, independently and jointly, including segmentation difficulties as measured by segmentation ability score and by Dice overlap in U-Net, image dimension, size of the target region, image modality, and contrast. Results: The Dice overlaps from SAM were significantly lower than the five medical-image-based algorithms in all 12 medical image segmentation datasets, by a margin of 0.1-0.5 and even 0.6-0.7 Dice. SAM-Semantic was significantly associated with medical image segmentation difficulty and the image modality, and SAM-Point and SAM-Box were significantly associated with image segmentation difficulty, image dimension, target region size, and target-vs-background contrast. All these 3 variations of SAM were more accurate in 2D medical images, larger target region sizes, easier cases with a higher Segmentation Ability score and higher U-Net Dice, and higher foreground-background contrast.

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U-Netmer: U-Net meets Transformer for medical image segmentation

The combination of the U-Net based deep learning models and Transformer is a new trend for medical image segmentation. U-Net can extract the detailed local semantic and texture information and Transformer can learn the long-rang dependencies among pixels in the input image. However, directly adapting the Transformer for segmentation has ``token-flatten" problem (flattens the local patches into 1D tokens which losses the interaction among pixels within local patches) and ``scale-sensitivity" problem (uses a fixed scale to split the input image into local patches). Compared to directly combining U-Net and Transformer, we propose a new global-local fashion combination of U-Net and Transformer, named U-Netmer, to solve the two problems. The proposed U-Netmer splits an input image into local patches. The global-context information among local patches is learnt by the self-attention mechanism in Transformer and U-Net segments each local patch instead of flattening into tokens to solve the `token-flatten" problem. The U-Netmer can segment the input image with different patch sizes with the identical structure and the same parameter. Thus, the U-Netmer can be trained with different patch sizes to solve the ``scale-sensitivity" problem. We conduct extensive experiments in 7 public datasets on 7 organs (brain, heart, breast, lung, polyp, pancreas and prostate) and 4 imaging modalities (MRI, CT, ultrasound, and endoscopy) to show that the proposed U-Netmer can be generally applied to improve accuracy of medical image segmentation. These experimental results show that U-Netmer provides state-of-the-art performance compared to baselines and other models. In addition, the discrepancy among the outputs of U-Netmer with different scales is linearly correlated to the segmentation accuracy which can be considered as a confidence score to rank test images by difficulty without ground-truth.

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Segmentation Ability Map: Interpret deep features for medical image segmentation

Deep convolutional neural networks (CNNs) have been widely used for medical image segmentation. In most studies, only the output layer is exploited to compute the final segmentation results and the hidden representations of the deep learned features have not been well understood. In this paper, we propose a prototype segmentation (ProtoSeg) method to compute a binary segmentation map based on deep features. We measure the segmentation abilities of the features by computing the Dice between the feature segmentation map and ground-truth, named as the segmentation ability score (SA score for short). The corresponding SA score can quantify the segmentation abilities of deep features in different layers and units to understand the deep neural networks for segmentation. In addition, our method can provide a mean SA score which can give a performance estimation of the output on the test images without ground-truth. Finally, we use the proposed ProtoSeg method to compute the segmentation map directly on input images to further understand the segmentation ability of each input image. Results are presented on segmenting tumors in brain MRI, lesions in skin images, COVID-related abnormality in CT images, prostate segmentation in abdominal MRI, and pancreatic mass segmentation in CT images. Our method can provide new insights for interpreting and explainable AI systems for medical image segmentation. Our code is available on: \url{https://github.com/shengfly/ProtoSeg}.

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Deep Relation Learning for Regression and Its Application to Brain Age Estimation

Most deep learning models for temporal regression directly output the estimation based on single input images, ignoring the relationships between different images. In this paper, we propose deep relation learning for regression, aiming to learn different relations between a pair of input images. Four non-linear relations are considered: "cumulative relation", "relative relation", "maximal relation" and "minimal relation". These four relations are learned simultaneously from one deep neural network which has two parts: feature extraction and relation regression. We use an efficient convolutional neural network to extract deep features from the pair of input images and apply a Transformer for relation learning. The proposed method is evaluated on a merged dataset with 6,049 subjects with ages of 0-97 years using 5-fold cross-validation for the task of brain age estimation. The experimental results have shown that the proposed method achieved a mean absolute error (MAE) of 2.38 years, which is lower than the MAEs of 8 other state-of-the-art algorithms with statistical significance (p$<$0.05) in paired T-test (two-side).

cs.CV

Global-Local Transformer for Brain Age Estimation

Deep learning can provide rapid brain age estimation based on brain magnetic resonance imaging (MRI). However, most studies use one neural network to extract the global information from the whole input image, ignoring the local fine-grained details. In this paper, we propose a global-local transformer, which consists of a global-pathway to extract the global-context information from the whole input image and a local-pathway to extract the local fine-grained details from local patches. The fine-grained information from the local patches are fused with the global-context information by the attention mechanism, inspired by the transformer, to estimate the brain age. We evaluate the proposed method on 8 public datasets with 8,379 healthy brain MRIs with the age range of 0-97 years. 6 datasets are used for cross-validation and 2 datasets are used for evaluating the generality. Comparing with other state-of-the-art methods, the proposed global-local transformer reduces the mean absolute error of the estimated ages to 2.70 years and increases the correlation coefficient of the estimated age and the chronological age to 0.9853. In addition, our proposed method provides regional information of which local patches are most informative for brain age estimation. Our source code is available on: \url{https://github.com/shengfly/global-local-transformer}.

cs.CV

Brain Age Estimation Using LSTM on Children's Brain MRI

Brain age prediction based on children's brain MRI is an important biomarker for brain health and brain development analysis. In this paper, we consider the 3D brain MRI volume as a sequence of 2D images and propose a new framework using the recurrent neural network for brain age estimation. The proposed method is named as 2D-ResNet18+Long short-term memory (LSTM), which consists of four parts: 2D ResNet18 for feature extraction on 2D images, a pooling layer for feature reduction over the sequences, an LSTM layer, and a final regression layer. We apply the proposed method on a public multisite NIH-PD dataset and evaluate generalization on a second multisite dataset, which shows that the proposed 2D-ResNet18+LSTM method provides better results than traditional 3D based neural network for brain age estimation.

cs.CV

Infant FreeSurfer: An automated segmentation and surface extraction pipeline for T1-weighted neuroimaging data of infants 0-2 years

The development of automated tools for brain morphometric analysis in infants has lagged significantly behind analogous tools for adults. This gap reflects the greater challenges in this domain due to: 1) a smaller-scaled region of interest, 2) increased motion corruption, 3) regional changes in geometry due to heterochronous growth, and 4) regional variations in contrast properties corresponding to ongoing myelination and other maturation processes. Nevertheless, there is a great need for automated image-processing tools to quantify differences between infant groups and other individuals, because aberrant cortical morphologic measurements (including volume, thickness, surface area, and curvature) have been associated with neuropsychiatric, neurologic, and developmental disorders in children. In this paper we present an automated segmentation and surface extraction pipeline designed to accommodate clinical MRI studies of infant brains in a population 0-2 year-olds. The algorithm relies on a single channel of T1-weighted MR images to achieve automated segmentation of cortical and subcortical brain areas, producing volumes of subcortical structures and surface models of the cerebral cortex. We evaluated the algorithm both qualitatively and quantitatively using manually labeled datasets, relevant comparator software solutions cited in the literature, and expert evaluations. The computational tools and atlases described in this paper will be distributed to the research community as part of the FreeSurfer image analysis package.

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Evaluation of MRI to ultrasound registration methods for brain shift correction: The CuRIOUS2018 Challenge

In brain tumor surgery, the quality and safety of the procedure can be impacted by intra-operative tissue deformation, called brain shift. Brain shift can move the surgical targets and other vital structures such as blood vessels, thus invalidating the pre-surgical plan. Intra-operative ultrasound (iUS) is a convenient and cost-effective imaging tool to track brain shift and tumor resection. Accurate image registration techniques that update pre-surgical MRI based on iUS are crucial but challenging. The MICCAI Challenge 2018 for Correction of Brain shift with Intra-Operative UltraSound (CuRIOUS2018) provided a public platform to benchmark MRI-iUS registration algorithms on newly released clinical datasets. In this work, we present the data, setup, evaluation, and results of CuRIOUS 2018, which received 6 fully automated algorithms from leading academic and industrial research groups. All algorithms were first trained with the public RESECT database, and then ranked based on test dataset of 10 additional cases with identical data curation and annotation protocols as the RESECT database. The article compares the results of all participating teams and discusses the insights gained from the challenge, as well as future work.

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