Pulmonary artery-vein segmentation is crucial for diagnosing pulmonary diseases and surgical planning, and is traditionally achieved by Computed Tomography Pulmonary Angiography (CTPA). However, concerns regarding adverse health effects from contrast agents used in CTPA have constrained its clinical utility. In contrast, identifying arteries and veins using non-contrast CT, a conventional and low-cost clinical examination routine, has long been considered impossible. Here we propose a High-abundant Pulmonary Artery-vein Segmentation (HiPaS) framework achieving accurate artery-vein segmentation on both non-contrast CT and CTPA across various spatial resolutions. HiPaS first performs spatial normalization on raw CT scans via a super-resolution module, and then iteratively achieves segmentation results at different branch levels by utilizing the low-level vessel segmentation as a prior for high-level vessel segmentation. We trained and validated HiPaS on our established multi-centric dataset comprising 1,073 CT volumes with meticulous manual annotation. Both quantitative experiments and clinical evaluation demonstrated the superior performance of HiPaS, achieving a dice score of 91.8% and a sensitivity of 98.0%. Further experiments demonstrated the non-inferiority of HiPaS segmentation on non-contrast CT compared to segmentation on CTPA. Employing HiPaS, we have conducted an anatomical study of pulmonary vasculature on 10,613 participants in China (five sites), discovering a new association between pulmonary vessel abundance and sex and age: vessel abundance is significantly higher in females than in males, and slightly decreases with age, under the controlling of lung volumes (p < 0.0001). HiPaS realizing accurate artery-vein segmentation delineates a promising avenue for clinical diagnosis and understanding pulmonary physiology in a non-invasive manner.
Revoking personal private data is one of the basic human rights, which has already been sheltered by several privacy-preserving laws in many countries. However, with the development of data science, machine learning and deep learning techniques, this right is usually neglected or violated as more and more patients' data are being collected and used for model training, especially in intelligent healthcare, thus making intelligent healthcare a sector where technology must meet the law, regulations, and privacy principles to ensure that the innovation is for the common good. In order to secure patients' right to be forgotten, we proposed a novel solution by using auditing to guide the forgetting process, where auditing means determining whether a dataset has been used to train the model and forgetting requires the information of a query dataset to be forgotten from the target model. We unified these two tasks by introducing a new approach called knowledge purification. To implement our solution, we developed AFS, a unified open-source software, which is able to evaluate and revoke patients' private data from pre-trained deep learning models. We demonstrated the generality of AFS by applying it to four tasks on different datasets with various data sizes and architectures of deep learning networks. The software is publicly available at \url{https://github.com/JoshuaChou2018/AFS}.
Heterogeneous data is endemic due to the use of diverse models and settings of devices by hospitals in the field of medical imaging. However, there are few open-source frameworks for federated heterogeneous medical image analysis with personalization and privacy protection simultaneously without the demand to modify the existing model structures or to share any private data. In this paper, we proposed PPPML-HMI, an open-source learning paradigm for personalized and privacy-preserving federated heterogeneous medical image analysis. To our best knowledge, personalization and privacy protection were achieved simultaneously for the first time under the federated scenario by integrating the PerFedAvg algorithm and designing our novel cyclic secure aggregation with the homomorphic encryption algorithm. To show the utility of PPPML-HMI, we applied it to a simulated classification task namely the classification of healthy people and patients from the RAD-ChestCT Dataset, and one real-world segmentation task namely the segmentation of lung infections from COVID-19 CT scans. For the real-world task, PPPML-HMI achieved $\sim$5\% higher Dice score on average compared to conventional FL under the heterogeneous scenario. Meanwhile, we applied the improved deep leakage from gradients to simulate adversarial attacks and showed the solid privacy-preserving capability of PPPML-HMI. By applying PPPML-HMI to both tasks with different neural networks, a varied number of users, and sample sizes, we further demonstrated the strong robustness of PPPML-HMI.