Jinhong Wang

Ordinal regression bridges regression and classification by assigning objects to ordered classes. While human experts rely on discriminative patch-level features for decisions, current approaches are limited by the availability of only image-level ordinal labels, overlooking fine-grained patch-level characteristics. In this paper, we propose a Dual-level Fuzzy Learning with Patch Guidance framework, named DFPG that learns precise feature-based grading boundaries from ambiguous ordinal labels, with patch-level supervision. Specifically, we propose patch-labeling and filtering strategies to enable the model to focus on patch-level features exclusively with only image-level ordinal labels available. We further design a dual-level fuzzy learning module, which leverages fuzzy logic to quantitatively capture and handle label ambiguity from both patch-wise and channel-wise perspectives. Extensive experiments on various image ordinal regression datasets demonstrate the superiority of our proposed method, further confirming its ability in distinguishing samples from difficult-to-classify categories. The code is available at https://github.com/ZJUMAI/DFPG-ord.

Ordinal regression refers to classifying object instances into ordinal categories. Ordinal regression is crucial for applications in various areas like facial age estimation, image aesthetics assessment, and even cancer staging, due to its capability to utilize ordered information effectively. More importantly, it also enhances model interpretation by considering category order, aiding the understanding of data trends and causal relationships. Despite significant recent progress, challenges remain, and further investigation of ordinal regression techniques and applications is essential to guide future research. In this survey, we present a comprehensive examination of advances and applications of ordinal regression. By introducing a systematic taxonomy, we meticulously classify the pertinent techniques and applications into three well-defined categories based on different strategies and objectives: Continuous Space Discretization, Distribution Ordering Learning, and Ambiguous Instance Delving. This categorization enables a structured exploration of diverse insights in ordinal regression problems, providing a framework for a more comprehensive understanding and evaluation of this field and its related applications. To our best knowledge, this is the first systematic survey of ordinal regression, which lays a foundation for future research in this fundamental and generic domain.

Automatic ophthalmic disease diagnosis on fundus images is important in clinical practice. However, due to complex fundus textures and limited annotated data, developing an effective automatic method for this problem is still challenging. In this paper, we present a self-supervised method via polar transformation based progressive contrastive learning, called PoCo, for ophthalmic disease diagnosis. Specifically, we novelly inject the polar transformation into contrastive learning to 1) promote contrastive learning pre-training to be faster and more stable and 2) naturally capture task-free and rotation-related textures, which provides insights into disease recognition on fundus images. Beneficially, simple normal translation-invariant convolution on transformed images can equivalently replace the complex rotation-invariant and sector convolution on raw images. After that, we develop a progressive contrastive learning method to efficiently utilize large unannotated images and a novel progressive hard negative sampling scheme to gradually reduce the negative sample number for efficient training and performance enhancement. Extensive experiments on three public ophthalmic disease datasets show that our PoCo achieves state-of-the-art performance with good generalization ability, validating that our method can reduce annotation efforts and provide reliable diagnosis. Codes are available at \url{https://github.com/wjh892521292/PoCo}.

As a common and critical medical image analysis task, deep learning based biomedical image segmentation is hindered by the dependence on costly fine-grained annotations. To alleviate this data dependence, in this paper, a novel approach, called Polygonal Approximation Learning (PAL), is proposed for convex object instance segmentation with only bounding-box supervision. The key idea behind PAL is that the detection model for convex objects already contains the necessary information for segmenting them since their convex hulls, which can be generated approximately by the intersection of bounding boxes, are equivalent to the masks representing the objects. To extract the essential information from the detection model, a repeated detection approach is employed on biomedical images where various rotation angles are applied and a dice loss with the projection of the rotated detection results is utilized as a supervised signal in training our segmentation model. In biomedical imaging tasks involving convex objects, such as nuclei instance segmentation, PAL outperforms the known models (e.g., BoxInst) that rely solely on box supervision. Furthermore, PAL achieves comparable performance with mask-supervised models including Mask R-CNN and Cascade Mask R-CNN. Interestingly, PAL also demonstrates remarkable performance on non-convex object instance segmentation tasks, for example, surgical instrument and organ instance segmentation. Our code is available at https://github.com/shenmishajing/PAL .

Cortical cataract, a common type of cataract, is particularly difficult to be diagnosed automatically due to the complex features of the lesions. Recently, many methods based on edge detection or deep learning were proposed for automatic cataract grading. However, these methods suffer a large performance drop in cortical cataract grading due to the more complex cortical opacities and uncertain data. In this paper, we propose a novel Transformer-based Knowledge Distillation Network, called TKD-Net, for cortical cataract grading. To tackle the complex opacity problem, we first devise a zone decomposition strategy to extract more refined features and introduce special sub-scores to consider critical factors of clinical cortical opacity assessment (location, area, density) for comprehensive quantification. Next, we develop a multi-modal mix-attention Transformer to efficiently fuse sub-scores and image modality for complex feature learning. However, obtaining the sub-score modality is a challenge in the clinic, which could cause the modality missing problem instead. To simultaneously alleviate the issues of modality missing and uncertain data, we further design a Transformer-based knowledge distillation method, which uses a teacher model with perfect data to guide a student model with modality-missing and uncertain data. We conduct extensive experiments on a dataset of commonly-used slit-lamp images annotated by the LOCS III grading system to demonstrate that our TKD-Net outperforms state-of-the-art methods, as well as the effectiveness of its key components. Codes are available at https://github.com/wjh892521292/Cataract_TKD-Net.

Ordinal regression refers to classifying object instances into ordinal categories. It has been widely studied in many scenarios, such as medical disease grading, movie rating, etc. Known methods focused only on learning inter-class ordinal relationships, but still incur limitations in distinguishing adjacent categories thus far. In this paper, we propose a simple sequence prediction framework for ordinal regression called Ord2Seq, which, for the first time, transforms each ordinal category label into a special label sequence and thus regards an ordinal regression task as a sequence prediction process. In this way, we decompose an ordinal regression task into a series of recursive binary classification steps, so as to subtly distinguish adjacent categories. Comprehensive experiments show the effectiveness of distinguishing adjacent categories for performance improvement and our new approach exceeds state-of-the-art performances in four different scenarios. Codes are available at https://github.com/wjh892521292/Ord2Seq.

Surgery is the only viable treatment for cataract patients with visual acuity (VA) impairment. Clinically, to assess the necessity of cataract surgery, accurately predicting postoperative VA before surgery by analyzing multi-view optical coherence tomography (OCT) images is crucially needed. Unfortunately, due to complicated fundus conditions, determining postoperative VA remains difficult for medical experts. Deep learning methods for this problem were developed in recent years. Although effective, these methods still face several issues, such as not efficiently exploring potential relations between multi-view OCT images, neglecting the key role of clinical prior knowledge (e.g., preoperative VA value), and using only regression-based metrics which are lacking reference. In this paper, we propose a novel Cross-token Transformer Network (CTT-Net) for postoperative VA prediction by analyzing both the multi-view OCT images and preoperative VA. To effectively fuse multi-view features of OCT images, we develop cross-token attention that could restrict redundant/unnecessary attention flow. Further, we utilize the preoperative VA value to provide more information for postoperative VA prediction and facilitate fusion between views. Moreover, we design an auxiliary classification loss to improve model performance and assess VA recovery more sufficiently, avoiding the limitation by only using the regression metrics. To evaluate CTT-Net, we build a multi-view OCT image dataset collected from our collaborative hospital. A set of extensive experiments validate the effectiveness of our model compared to existing methods in various metrics. Code is available at: https://github.com/wjh892521292/Cataract OCT.

Computer-aided medical image segmentation has been applied widely in diagnosis and treatment to obtain clinically useful information of shapes and volumes of target organs and tissues. In the past several years, convolutional neural network (CNN) based methods (e.g., U-Net) have dominated this area, but still suffered from inadequate long-range information capturing. Hence, recent work presented computer vision Transformer variants for medical image segmentation tasks and obtained promising performances. Such Transformers model long-range dependency by computing pair-wise patch relations. However, they incur prohibitive computational costs, especially on 3D medical images (e.g., CT and MRI). In this paper, we propose a new method called Dilated Transformer, which conducts self-attention for pair-wise patch relations captured alternately in local and global scopes. Inspired by dilated convolution kernels, we conduct the global self-attention in a dilated manner, enlarging receptive fields without increasing the patches involved and thus reducing computational costs. Based on this design of Dilated Transformer, we construct a U-shaped encoder-decoder hierarchical architecture called D-Former for 3D medical image segmentation. Experiments on the Synapse and ACDC datasets show that our D-Former model, trained from scratch, outperforms various competitive CNN-based or Transformer-based segmentation models at a low computational cost without time-consuming per-training process.