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Besides per-pixel accuracy, topological correctness is also crucial for the segmentation of images with fine-scale structures, e.g., satellite images and biomedical images. In this paper, by leveraging the theory of digital topology, we identify pixels in an image that are critical for topology. By focusing on these critical pixels, we propose a new homotopy warping loss to train deep image segmentation networks for better topological accuracy. To efficiently identify these topologically critical pixels, we propose a new algorithm exploiting the distance transform. The proposed algorithm, as well as the loss function, naturally generalize to different topological structures in both 2D and 3D settings. The proposed loss function helps deep nets achieve better performance in terms of topology-aware metrics, outperforming state-of-the-art structure/topology-aware segmentation methods. 

Deep-learning-based clinical decision support using structured electronic health records (EHR) has been an active research area for predicting risks of mortality and diseases. Meanwhile, large amounts of narrative clinical notes provide complementary information, but are often not integrated into predictive models. In this paper, we provide a novel multimodal transformer to fuse clinical notes and structured EHR data for better prediction of in-hospital mortality. To improve interpretability, we propose an integrated gradients (IG) method to select important words in clinical notes and discover the critical structured EHR features with Shapley values. These important words and clinical features are visualized to assist with interpretation of the prediction outcomes. We also investigate the significance of domain adaptive pretraining and task adaptive fine-tuning on the Clinical BERT, which is used to learn the representations of clinical notes. Experiments demonstrated that our model outperforms other methods (AUCPR: 0.538, AUCROC: 0.877, F1:0.490). 

Deep learning methods have achieved impressive performance for multi-class medical image segmentation. However, they are limited in their ability to encode topological interactions among different classes (e.g., containment and exclusion). These constraints naturally arise in biomedical images and can be crucial in improving segmentation quality. In this paper, we introduce a novel topological interaction module to encode the topological interactions into a deep neural network. The implementation is completely convolution-based and thus can be very efficient. This empowers us to incorporate the constraints into end-to-end training and enrich the feature representation of neural networks. The efficacy of the proposed method is validated on different types of interactions. We also demonstrate the generalizability of the method on both proprietary and public challenge datasets, in both 2D and 3D settings, as well as across different modalities such as CT and Ultrasound. Code is available at: https://github.com/TopoXLab/TopoInteraction. 

Clinical outcome or severity prediction from medical images has largely focused on learning representations from single-timepoint or snapshot scans. It has been shown that disease progression can be better characterized by temporal imaging. We therefore hypothesized that outcome predictions can be improved by utilizing the disease progression information from sequential images. We present a deep learning approach that leverages temporal progression information to improve clinical outcome predictions from single-timepoint images. In our method, a self-attention based Temporal Convolutional Network (TCN) is used to learn a representation that is most reflective of the disease trajectory. Meanwhile, a Vision Transformer is pretrained in a self-supervised fashion to extract features from single-timepoint images. The key contribution is to design a recalibration module that employs maximum mean discrepancy loss (MMD) to align distributions of the above two contextual representations. We train our system to predict clinical outcomes and severity grades from single-timepoint images. Experiments on chest and osteoarthritis radiography datasets demonstrate that our approach outperforms other state-of-the-art techniques. 

The adversarial risk of a machine learning model has been widely studied. Most previous works assume that the data lies in the whole ambient space. We propose to take a new angle and take the manifold assumption into consideration. Assuming data lies in a manifold, we investigate two new types of adversarial risk, the normal adversarial risk due to perturbation along normal direction, and the in-manifold adversarial risk due to perturbation within the manifold. We prove that the classic adversarial risk can be bounded from both sides using the normal and in-manifold adversarial risks. We also show with a surprisingly pessimistic case that the standard adversarial risk can be nonzero even when both normal and in-manifold risks are zero. We finalize the paper with empirical studies supporting our theoretical results. Our results suggest the possibility of improving the robustness of a classifier by only focusing on the normal adversarial risk. 

Structural accuracy of segmentation is important for fine-scale structures in biomedical images. We propose a novel Topological-Attention ConvLSTM Network (TACLNet) for 3D anisotropic image segmentation with high structural accuracy. We adopt ConvLSTM to leverage contextual information from adjacent slices while achieving high efficiency. We propose a Spatial Topological-Attention (STA) module to effectively transfer topologically critical information across slices. Furthermore, we propose an Iterative Topological-Attention (ITA) module that provides a more stable topologically critical map for segmentation. Quantitative and qualitative results show that our proposed method outperforms various baselines in terms of topology-aware evaluation metrics.