Daily Papers

Africa faces significant challenges in healthcare delivery due to limited infrastructure and access to advanced medical technologies. This study explores the use of federated learning to overcome these barriers, focusing on perinatal health. We trained a fetal plane classifier using perinatal data from five African countries: Algeria, Ghana, Egypt, Malawi, and Uganda, along with data from Spanish hospitals. To incorporate the lack of computational resources in the analysis, we considered a heterogeneous set of devices, including a Raspberry Pi and several laptops, for model training. We demonstrate comparative performance between a centralized and a federated model, despite the compute limitations, and a significant improvement in model generalizability when compared to models trained only locally. These results show the potential for a future implementation at a large scale of a federated learning platform to bridge the accessibility gap and improve model generalizability with very little requirements.

Fetal ultrasound standard-plane classification underpins reliable prenatal biometry and anomaly screening, yet real-world deployment is limited by domain shift, image noise, and poor calibration of predicted probabilities. This paper presents a practical framework for uncertainty-calibrated explainable AI in fetal plane classification. We synthesize uncertainty estimation methods (Monte Carlo dropout, deep ensembles, evidential learning, and conformal prediction) with post-hoc and uncertainty-aware explanations (Grad-CAM variants, LIME-style local surrogates, and uncertainty-weighted multi-resolution activation maps), and we map these components to a clinician-facing workflow. Using FETAL_PLANES_DB as a reference benchmark, we define a reporting protocol that couples accuracy with calibration and selective prediction, including expected calibration error, Brier score, coverage-risk curves, and structured error analysis with explanations. We also discuss integration points for quality control and human-in-the-loop review, where uncertainty flags trigger re-acquisition or expert confirmation. The goal is a reproducible, clinically aligned blueprint for building fetal ultrasound classifiers whose confidence and explanations remain trustworthy under noisy acquisition conditions.

Ultrasound fetal imaging is beneficial to support prenatal development because it is affordable and non-intrusive. Nevertheless, fetal plane classification (FPC) remains challenging and time-consuming for obstetricians since it depends on nuanced clinical aspects, which increases the difficulty in identifying relevant features of the fetal anatomy. Thus, to assist with its accurate feature extraction, a lightweight artificial intelligence architecture leveraging convolutional neural networks and attention mechanisms is proposed to classify the largest benchmark ultrasound dataset. The approach fine-tunes from lightweight EfficientNet feature extraction backbones pre-trained on the ImageNet1k. to classify key fetal planes such as the brain, femur, thorax, cervix, and abdomen. Our methodology incorporates the attention mechanism to refine features and 3-layer perceptrons for classification, achieving superior performance with the highest Top-1 accuracy of 96.25%, Top-2 accuracy of 99.80% and F1-Score of 0.9576. Importantly, the model has 40x fewer trainable parameters than existing benchmark ensemble or transformer pipelines, facilitating easy deployment on edge devices to help clinical practitioners with real-time FPC. The findings are also interpreted using GradCAM to carry out clinical correlation to aid doctors with diagnostics and improve treatment plans for expectant mothers.

Ultrasound imaging is one of the most prominent technologies to evaluate the growth, progression, and overall health of a fetus during its gestation. However, the interpretation of the data obtained from such studies is best left to expert physicians and technicians who are trained and well-versed in analyzing such images. To improve the clinical workflow and potentially develop an at-home ultrasound-based fetal monitoring platform, we present a novel fetus phantom ultrasound dataset, FPUS23, which can be used to identify (1) the correct diagnostic planes for estimating fetal biometric values, (2) fetus orientation, (3) their anatomical features, and (4) bounding boxes of the fetus phantom anatomies at 23 weeks gestation. The entire dataset is composed of 15,728 images, which are used to train four different Deep Neural Network models, built upon a ResNet34 backbone, for detecting aforementioned fetus features and use-cases. We have also evaluated the models trained using our FPUS23 dataset, to show that the information learned by these models can be used to substantially increase the accuracy on real-world ultrasound fetus datasets. We make the FPUS23 dataset and the pre-trained models publicly accessible at https://github.com/bharathprabakaran/FPUS23, which will further facilitate future research on fetal ultrasound imaging and analysis.

Accurate fetal biometric measurements, such as abdominal circumference, play a vital role in prenatal care. However, obtaining high-quality ultrasound images for these measurements heavily depends on the expertise of sonographers, posing a significant challenge in low-income countries due to the scarcity of trained personnel. To address this issue, we leverage FetalCLIP, a vision-language model pretrained on a curated dataset of over 210,000 fetal ultrasound image-caption pairs, to perform automated fetal ultrasound image quality assessment (IQA) on blind-sweep ultrasound data. We introduce FetalCLIP_{CLS}, an IQA model adapted from FetalCLIP using Low-Rank Adaptation (LoRA), and evaluate it on the ACOUSLIC-AI dataset against six CNN and Transformer baselines. FetalCLIP_{CLS} achieves the highest F1 score of 0.757. Moreover, we show that an adapted segmentation model, when repurposed for classification, further improves performance, achieving an F1 score of 0.771. Our work demonstrates how parameter-efficient fine-tuning of fetal ultrasound foundation models can enable task-specific adaptations, advancing prenatal care in resource-limited settings. The experimental code is available at: https://github.com/donglihe-hub/FetalCLIP-IQA.

Foundation models are becoming increasingly effective in the medical domain, offering pre-trained models on large datasets that can be readily adapted for downstream tasks. Despite progress, fetal ultrasound images remain a challenging domain for foundation models due to their inherent complexity, often requiring substantial additional training and facing limitations due to the scarcity of paired multimodal data. To overcome these challenges, here we introduce FetalCLIP, a vision-language foundation model capable of generating universal representation of fetal ultrasound images. FetalCLIP was pre-trained using a multimodal learning approach on a diverse dataset of 210,035 fetal ultrasound images paired with text. This represents the largest paired dataset of its kind used for foundation model development to date. This unique training approach allows FetalCLIP to effectively learn the intricate anatomical features present in fetal ultrasound images, resulting in robust representations that can be used for a variety of downstream applications. In extensive benchmarking across a range of key fetal ultrasound applications, including classification, gestational age estimation, congenital heart defect (CHD) detection, and fetal structure segmentation, FetalCLIP outperformed all baselines while demonstrating remarkable generalizability and strong performance even with limited labeled data. We plan to release the FetalCLIP model publicly for the benefit of the broader scientific community.

Prenatal ultrasound imaging is the first-choice modality to assess fetal health. Medical image datasets for AI and ML methods must be diverse (i.e. diagnoses, diseases, pathologies, scanners, demographics, etc), however there are few public ultrasound fetal imaging datasets due to insufficient amounts of clinical data, patient privacy, rare occurrence of abnormalities in general practice, and limited experts for data collection and validation. To address such data scarcity, we proposed generative adversarial networks (GAN)-based models, diffusion-super-resolution-GAN and transformer-based-GAN, to synthesise images of fetal ultrasound brain planes from one public dataset. We reported that GAN-based methods can generate 256x256 pixel size of fetal ultrasound trans-cerebellum brain image plane with stable training losses, resulting in lower FID values for diffusion-super-resolution-GAN (average 7.04 and lower FID 5.09 at epoch 10) than the FID values of transformer-based-GAN (average 36.02 and lower 28.93 at epoch 60). The results of this work illustrate the potential of GAN-based methods to synthesise realistic high-resolution ultrasound images, leading to future work with other fetal brain planes, anatomies, devices and the need of a pool of experts to evaluate synthesised images. Code, data and other resources to reproduce this work are available at https://github.com/budai4medtech/midl2023.

Fetal ultrasound (US) is the primary imaging modality for prenatal screening, yet its interpretation relies heavily on the expertise of the clinician. Despite advances in deep learning and foundation models, existing automated tools for fetal US analysis struggle to balance task-specific accuracy with the whole-process versatility required to support end-to-end clinical workflows. To address these limitations, we propose FetalAgents, the first multi-agent system for comprehensive fetal US analysis. Through a lightweight, agentic coordination framework, FetalAgents dynamically orchestrates specialized vision experts to maximize performance across diagnosis, measurement, and segmentation. Furthermore, FetalAgents advances beyond static image analysis by supporting end-to-end video stream summarization, where keyframes are automatically identified across multiple anatomical planes, analyzed by coordinated experts, and synthesized with patient metadata into a structured clinical report. Extensive multi-center external evaluations across eight clinical tasks demonstrate that FetalAgents consistently delivers the most robust and accurate performance when compared against specialized models and multimodal large language models (MLLMs), ultimately providing an auditable, workflow-aligned solution for fetal ultrasound analysis and reporting.

Developing robust deep learning models for fetal ultrasound image analysis requires comprehensive, high-quality datasets to effectively learn informative data representations within the domain. However, the scarcity of labelled ultrasound images poses substantial challenges, especially in low-resource settings. To tackle this challenge, we leverage synthetic data to enhance the generalizability of deep learning models. This study proposes a diffusion-based method, Fetal Ultrasound LoRA (FU-LoRA), which involves fine-tuning latent diffusion models using the LoRA technique to generate synthetic fetal ultrasound images. These synthetic images are integrated into a hybrid dataset that combines real-world and synthetic images to improve the performance of zero-shot classifiers in low-resource settings. Our experimental results on fetal ultrasound images from African cohorts demonstrate that FU-LoRA outperforms the baseline method by a 13.73% increase in zero-shot classification accuracy. Furthermore, FU-LoRA achieves the highest accuracy of 82.40%, the highest F-score of 86.54%, and the highest AUC of 89.78%. It demonstrates that the FU-LoRA method is effective in the zero-shot classification of fetal ultrasound images in low-resource settings. Our code and data are publicly accessible on https://github.com/13204942/FU-LoRA.

Recent medical vision-language models have shown promise on tasks such as VQA, report generation, and anomaly detection. However, most are adapted to structured adult imaging and underperform in fetal ultrasound, which poses challenges of multi-view image reasoning, numerous diseases, and image diversity. To bridge this gap, we introduce FetalMind, a medical AI system tailored to fetal ultrasound for both report generation and diagnosis. Guided by clinical workflow, we propose Salient Epistemic Disentanglement (SED), which injects an expert-curated bipartite graph into the model to decouple view-disease associations and to steer preference selection along clinically faithful steps via reinforcement learning. This design mitigates variability across diseases and heterogeneity across views, reducing learning bottlenecks while aligning the model's inference with obstetric practice. To train FetalMind at scale, we curate FetalSigma-1M dataset, the first large-scale fetal ultrasound report corpus, comprising 20K reports from twelve medical centers, addressing the scarcity of domain data. Extensive experiments show that FetalMind outperforms open- and closed-source baselines across all gestational stages, achieving +14% average gains and +61.2% higher accuracy on critical conditions while remaining efficient, stable, and scalable. Project Page: https://hexiao0275.github.io/FetalMind.

A global shortage of trained sonographers limits prenatal ultrasound screening in low- and middle-income countries, where over half of pregnant women receive no skilled sonography. Current deep learning approaches address detection, segmentation, or classification in isolation, each demanding a separate model and expert-specified labels at inference. We present FADA, a unified vision-language model built on Qwen3.5-VL that performs clinical interpretation, classification, detection, and segmentation through a single interpretation-first pipeline without external labels. FADA distills knowledge from four domain-specific foundation models (FetalCLIP, UltraSAM, USF-MAE, UltraFedFM) via offline pre-computed feature caching. Selective distillation, which applies feature alignment only to annotation tasks while interpretation relies on standard fine-tuning, consistently outperforms full distillation across most evaluation axes. The recommended variant, FADA-SKD, achieves 0.8820 mean Dice for segmentation, 0.7671 mAP@0.50 for detection, and 100% structured interpretation compliance. Expert sonographer validation across 237 images confirms clinically acceptable outputs in both autonomous and human-in-the-loop modes, with 73.5% of interpretations scoring perfectly under clinician guidance. The system is trainable on a single consumer GPU and deployable without cloud connectivity. We validate edge deployment by running the compressed 0.8B model on a commodity smartphone (Qualcomm Snapdragon 7 Gen 1, 12 GB RAM) using llama.cpp with GGUF quantization, completing the full 5-phase pipeline in approximately 60 seconds entirely offline. This establishes a practical pathway for integrating AI-assisted fetal assessment with portable ultrasound devices, directly addressing diagnostic access gaps in resource-constrained settings. Code, models, and data are available at https://github.com/mahmoodphd/FADA.

Automated fetal head segmentation in ultrasound images is critical for accurate biometric measurements in prenatal care. While existing deep learning approaches have achieved a reasonable performance, they struggle with issues like low contrast, noise, and complex anatomical boundaries which are inherent to ultrasound imaging. This paper presents Attention-ResUNet. It is a novel architecture that synergistically combines residual learning with multi-scale attention mechanisms in order to achieve enhanced fetal head segmentation. Our approach integrates attention gates at four decoder levels to focus selectively on anatomically relevant regions while suppressing the background noise, and complemented by residual connections which facilitates gradient flow and feature reuse. Extensive evaluation on the HC18 Challenge dataset where n = 200 demonstrates that Attention ResUNet achieves a superior performance with a mean Dice score of 99.30 +/- 0.14% against similar architectures. It significantly outperforms five baseline architectures including ResUNet (99.26%), Attention U-Net (98.79%), Swin U-Net (98.60%), Standard U-Net (98.58%), and U-Net++ (97.46%). Through statistical analysis we confirm highly significant improvements (p < 0.001) with effect sizes that range from 0.230 to 13.159 (Cohen's d). Using Saliency map analysis, we reveal that our architecture produces highly concentrated, anatomically consistent activation patterns, which demonstrate an enhanced interpretability which is crucial for clinical deployment. The proposed method establishes a new state of the art performance for automated fetal head segmentation whilst maintaining computational efficiency with 14.7M parameters and a 45 GFLOPs inference cost. Code repository: https://github.com/Ammar-ss

Fetal ultrasound AI could transform prenatal care in low-resource settings, yet current foundation models exceed 300M visual parameters, precluding deployment on point-of-care devices. Standard knowledge distillation fails under such extreme capacity gaps (~26x), as compact students waste capacity mimicking architectural artifacts of oversized teachers. We introduce Selective Repulsive Knowledge Distillation, which decomposes contrastive KD into diagonal and off-diagonal components: matched pair alignment is preserved while the off-diagonal weight decays into negative values, repelling the student from the teacher's inter-class confusions and forcing discovery of architecturally native features. Our 11.4M parameter student surpasses the 304M-parameter FetalCLIP teacher on zero-shot HC18 biometry validity (88.6% vs. 83.5%) and brain sub-plane F1 (0.784 vs. 0.702), while running at 1.6 ms on iPhone 16 Pro, enabling real-time assistive AI on handheld ultrasound devices. Our code, models, and app are publicly available at https://github.com/numanai/MobileFetalCLIP.

The rapid advancement of Artificial Intelligence (AI) in healthcare presents a unique opportunity for advancements in obstetric care, particularly through the analysis of cardiotocography (CTG) for fetal monitoring. However, the effectiveness of such technologies depends upon the availability of large, high-quality datasets that are suitable for machine learning. This paper introduces the Oxford Maternity (OxMat) dataset, the world's largest curated dataset of CTGs, featuring raw time series CTG data and extensive clinical data for both mothers and babies, which is ideally placed for machine learning. The OxMat dataset addresses the critical gap in women's health data by providing over 177,211 unique CTG recordings from 51,036 pregnancies, carefully curated and reviewed since 1991. The dataset also comprises over 200 antepartum, intrapartum and postpartum clinical variables, ensuring near-complete data for crucial outcomes such as stillbirth and acidaemia. While this dataset also covers the intrapartum stage, around 94% of the constituent CTGS are antepartum. This allows for a unique focus on the underserved antepartum period, in which early detection of at-risk fetuses can significantly improve health outcomes. Our comprehensive review of existing datasets reveals the limitations of current datasets: primarily, their lack of sufficient volume, detailed clinical data and antepartum data. The OxMat dataset lays a foundation for future AI-driven prenatal care, offering a robust resource for developing and testing algorithms aimed at improving maternal and fetal health outcomes.

When developing deep neural networks for segmenting intraoperative ultrasound images, several practical issues are encountered frequently, such as the presence of ultrasound frames that do not contain regions of interest and the high variance in ground-truth labels. In this study, we evaluate the utility of a pre-screening classification network prior to the segmentation network. Experimental results demonstrate that such a classifier, minimising frame classification errors, was able to directly impact the number of false positive and false negative frames. Importantly, the segmentation accuracy on the classifier-selected frames, that would be segmented, remains comparable to or better than those from standalone segmentation networks. Interestingly, the efficacy of the pre-screening classifier was affected by the sampling methods for training labels from multiple observers, a seemingly independent problem. We show experimentally that a previously proposed approach, combining random sampling and consensus labels, may need to be adapted to perform well in our application. Furthermore, this work aims to share practical experience in developing a machine learning application that assists highly variable interventional imaging for prostate cancer patients, to present robust and reproducible open-source implementations, and to report a set of comprehensive results and analysis comparing these practical, yet important, options in a real-world clinical application.

Single-image piece-wise planar 3D reconstruction aims to simultaneously segment plane instances and recover 3D plane parameters from an image. Most recent approaches leverage convolutional neural networks (CNNs) and achieve promising results. However, these methods are limited to detecting a fixed number of planes with certain learned order. To tackle this problem, we propose a novel two-stage method based on associative embedding, inspired by its recent success in instance segmentation. In the first stage, we train a CNN to map each pixel to an embedding space where pixels from the same plane instance have similar embeddings. Then, the plane instances are obtained by grouping the embedding vectors in planar regions via an efficient mean shift clustering algorithm. In the second stage, we estimate the parameter for each plane instance by considering both pixel-level and instance-level consistencies. With the proposed method, we are able to detect an arbitrary number of planes. Extensive experiments on public datasets validate the effectiveness and efficiency of our method. Furthermore, our method runs at 30 fps at the testing time, thus could facilitate many real-time applications such as visual SLAM and human-robot interaction. Code is available at https://github.com/svip-lab/PlanarReconstruction.

We present E(3)-Pose, a novel fast pose estimation method that jointly and explicitly models rotation equivariance and object symmetry. Our work is motivated by the challenging problem of accounting for fetal head motion during a diagnostic MRI scan. We aim to enable automatic adaptive prescription of 2D diagnostic MRI slices with 6-DoF head pose estimation, supported by 3D MRI volumes rapidly acquired before each 2D slice. Existing methods struggle to generalize to clinical volumes, due to pose ambiguities induced by inherent anatomical symmetries, as well as low resolution, noise, and artifacts. In contrast, E(3)-Pose captures anatomical symmetries and rigid pose equivariance by construction, and yields robust estimates of the fetal head pose. Our experiments on publicly available and representative clinical fetal MRI datasets demonstrate the superior robustness and generalization of our method across domains. Crucially, E(3)-Pose achieves state-of-the-art accuracy on clinical MRI volumes, paving the way for clinical translation. Our implementation is available at github.com/ramyamut/E3-Pose.

An essential stage in computer aided diagnosis of chest X rays is automated lung segmentation. Due to rib cages and the unique modalities of each persons lungs, it is essential to construct an effective automated lung segmentation model. This paper presents a reliable model for the segmentation of lungs in chest radiographs. Our model overcomes the challenges by learning to ignore unimportant areas in the source Chest Radiograph and emphasize important features for lung segmentation. We evaluate our model on public datasets, Montgomery and Shenzhen. The proposed model has a DICE coefficient of 98.1 percent which demonstrates the reliability of our model.

Checklists are simple decision aids that are often used to promote safety and reliability in clinical applications. In this paper, we present a method to learn checklists for clinical decision support. We represent predictive checklists as discrete linear classifiers with binary features and unit weights. We then learn globally optimal predictive checklists from data by solving an integer programming problem. Our method allows users to customize checklists to obey complex constraints, including constraints to enforce group fairness and to binarize real-valued features at training time. In addition, it pairs models with an optimality gap that can inform model development and determine the feasibility of learning sufficiently accurate checklists on a given dataset. We pair our method with specialized techniques that speed up its ability to train a predictive checklist that performs well and has a small optimality gap. We benchmark the performance of our method on seven clinical classification problems, and demonstrate its practical benefits by training a short-form checklist for PTSD screening. Our results show that our method can fit simple predictive checklists that perform well and that can easily be customized to obey a rich class of custom constraints.

Computer vision techniques have advanced significantly in recent years, finding diverse and impactful applications within the medical field. In this paper, we introduce a new framework for the detection of Bethesda cells in Pap smear images, developed for Track B of the Riva Cytology Challenge held in association with the International Symposium on Biomedical Imaging (ISBI). This work focuses on enhancing computer vision models for cell detection, with performance evaluated using the mAP50-95 metric. We propose a solution based on an ensemble of YOLO and U-Net architectures, followed by a refinement stage utilizing overlap removal techniques and a binary classifier. Our framework achieved second place with a mAP50-95 score of 0.5909 in the competition. The implementation and source code are available at the following repository: github.com/martinamster/riva-trackb

The remarkable success of deep learning in recent years has prompted applications in medical image classification and diagnosis tasks. While classification models have demonstrated robustness in classifying simpler datasets like MNIST or natural images such as ImageNet, this resilience is not consistently observed in complex medical image datasets where data is more scarce and lacks diversity. Moreover, previous findings on natural image datasets have indicated a potential trade-off between data likelihood and classification accuracy. In this study, we explore the use of score-based generative models as classifiers for medical images, specifically mammographic images. Our findings suggest that our proposed generative classifier model not only achieves superior classification results on CBIS-DDSM, INbreast and Vin-Dr Mammo datasets, but also introduces a novel approach to image classification in a broader context. Our code is publicly available at https://github.com/sushmitasarker/sgc_for_medical_image_classification

3D plane reconstruction from a single image is a crucial yet challenging topic in 3D computer vision. Previous state-of-the-art (SOTA) methods have focused on training their system on a single dataset from either indoor or outdoor domain, limiting their generalizability across diverse testing data. In this work, we introduce a novel framework dubbed ZeroPlane, a Transformer-based model targeting zero-shot 3D plane detection and reconstruction from a single image, over diverse domains and environments. To enable data-driven models across multiple domains, we have curated a large-scale planar benchmark, comprising over 14 datasets and 560,000 high-resolution, dense planar annotations for diverse indoor and outdoor scenes. To address the challenge of achieving desirable planar geometry on multi-dataset training, we propose to disentangle the representation of plane normal and offset, and employ an exemplar-guided, classification-then-regression paradigm to learn plane and offset respectively. Additionally, we employ advanced backbones as image encoder, and present an effective pixel-geometry-enhanced plane embedding module to further facilitate planar reconstruction. Extensive experiments across multiple zero-shot evaluation datasets have demonstrated that our approach significantly outperforms previous methods on both reconstruction accuracy and generalizability, especially over in-the-wild data. Our code and data are available at: https://github.com/jcliu0428/ZeroPlane.

Organ segmentation is a fundamental task in medical imaging since it is useful for many clinical automation pipelines. However, some tasks do not require full segmentation. Instead, a classifier can identify the selected organ without segmenting the entire volume. In this study, we demonstrate a classifier based method to obtain organ labels in real time by using a large context size with a sparse data sampling strategy. Although our method operates as an independent classifier at query locations, it can generate full segmentations by querying grid locations at any resolution, offering faster performance than segmentation algorithms. We compared our method with existing segmentation techniques, demonstrating its superior runtime potential for practical applications in medical imaging.

Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting 35% of extremely low birth weight infants. Defined by oxygen dependence at 36 weeks postmenstrual age, it causes lifelong respiratory complications. However, preventive interventions carry severe risks, including neurodevelopmental impairment, ventilator-induced lung injury, and systemic complications. Therefore, early BPD prognosis and prediction of BPD outcome is crucial to avoid unnecessary toxicity in low risk infants. Admission radiographs of extremely preterm infants are routinely acquired within 24h of life and could serve as a non-invasive prognostic tool. In this work, we developed and investigated a deep learning approach using chest X-rays from 163 extremely low-birth-weight infants (leq32 weeks gestation, 401-999g) obtained within 24 hours of birth. We fine-tuned a ResNet-50 pretrained specifically on adult chest radiographs, employing progressive layer freezing with discriminative learning rates to prevent overfitting and evaluated a CutMix augmentation and linear probing. For moderate/severe BPD outcome prediction, our best performing model with progressive freezing, linear probing and CutMix achieved an AUROC of 0.78 pm 0.10, balanced accuracy of 0.69 pm 0.10, and an F1-score of 0.67 pm 0.11. In-domain pre-training significantly outperformed ImageNet initialization (p = 0.031) which confirms domain-specific pretraining to be important for BPD outcome prediction. Routine IRDS grades showed limited prognostic value (AUROC 0.57 pm 0.11), confirming the need of learned markers. Our approach demonstrates that domain-specific pretraining enables accurate BPD prediction from routine day-1 radiographs. Through progressive freezing and linear probing, the method remains computationally feasible for site-level implementation and future federated learning deployments.

Medical image data is less accessible than in other domains due to privacy and regulatory constraints. In addition, labeling requires costly, time-intensive manual image annotation by clinical experts. To overcome these challenges, synthetic medical data generation offers a promising solution. Generative AI (GenAI), employing generative deep learning models, has proven effective at producing realistic synthetic images. This study proposes a novel mask-guided GenAI approach using diffusion models to generate synthetic fetal head ultrasound images paired with segmentation masks. These synthetic pairs augment real datasets for supervised fine-tuning of the Segment Anything Model (SAM). Our results show that the synthetic data captures real image features effectively, and this approach reaches state-of-the-art fetal head segmentation, especially when trained with a limited number of real image-mask pairs. In particular, the segmentation reaches Dice Scores of 94.66\% and 94.38\% using a handful of ultrasound images from the Spanish and African cohorts, respectively. Our code, models, and data are available on GitHub.

We propose to investigate detecting and characterizing the 3D planar articulation of objects from ordinary videos. While seemingly easy for humans, this problem poses many challenges for computers. We propose to approach this problem by combining a top-down detection system that finds planes that can be articulated along with an optimization approach that solves for a 3D plane that can explain a sequence of observed articulations. We show that this system can be trained on a combination of videos and 3D scan datasets. When tested on a dataset of challenging Internet videos and the Charades dataset, our approach obtains strong performance. Project site: https://jasonqsy.github.io/Articulation3D

Placenta volume measurement from 3D ultrasound images is critical for predicting pregnancy outcomes, and manual annotation is the gold standard. However, such manual annotation is expensive and time-consuming. Automated segmentation algorithms can often successfully segment the placenta, but these methods may not consistently produce robust segmentations suitable for practical use. Recently, inspired by the Segment Anything Model (SAM), deep learning-based interactive segmentation models have been widely applied in the medical imaging domain. These models produce a segmentation from visual prompts provided to indicate the target region, which may offer a feasible solution for practical use. However, none of these models are specifically designed for interactively segmenting 3D ultrasound images, which remain challenging due to the inherent noise of this modality. In this paper, we evaluate publicly available state-of-the-art 3D interactive segmentation models in contrast to a human-in-the-loop approach for the placenta segmentation task. The Dice score, normalized surface Dice, averaged symmetric surface distance, and 95-percent Hausdorff distance are used as evaluation metrics. We consider a Dice score of 0.95 a successful segmentation. Our results indicate that the human-in-the-loop segmentation model reaches this standard. Moreover, we assess the efficiency of the human-in-the-loop model as a function of the amount of prompts. Our results demonstrate that the human-in-the-loop model is both effective and efficient for interactive placenta segmentation. The code is available at https://github.com/MedICL-VU/PRISM-placenta.

We introduce AirLetters, a new video dataset consisting of real-world videos of human-generated, articulated motions. Specifically, our dataset requires a vision model to predict letters that humans draw in the air. Unlike existing video datasets, accurate classification predictions for AirLetters rely critically on discerning motion patterns and on integrating long-range information in the video over time. An extensive evaluation of state-of-the-art image and video understanding models on AirLetters shows that these methods perform poorly and fall far behind a human baseline. Our work shows that, despite recent progress in end-to-end video understanding, accurate representations of complex articulated motions -- a task that is trivial for humans -- remains an open problem for end-to-end learning.

This paper introduces FGVC-Aircraft, a new dataset containing 10,000 images of aircraft spanning 100 aircraft models, organised in a three-level hierarchy. At the finer level, differences between models are often subtle but always visually measurable, making visual recognition challenging but possible. A benchmark is obtained by defining corresponding classification tasks and evaluation protocols, and baseline results are presented. The construction of this dataset was made possible by the work of aircraft enthusiasts, a strategy that can extend to the study of number of other object classes. Compared to the domains usually considered in fine-grained visual classification (FGVC), for example animals, aircraft are rigid and hence less deformable. They, however, present other interesting modes of variation, including purpose, size, designation, structure, historical style, and branding.

Motivated by the strong performance of CLIP-based models in natural image-text domains, recent efforts have adapted these architectures to medical tasks, particularly in radiology, where large paired datasets of images and reports, such as chest X-rays, are available. While these models have shown encouraging results in terms of accuracy and discriminative performance, their fairness and robustness in the different clinical tasks remain largely underexplored. In this study, we extensively evaluate six widely used CLIP-based models on chest X-ray classification using three publicly available datasets: MIMIC-CXR, NIH-CXR14, and NEATX. We assess the models fairness across six conditions and patient subgroups based on age, sex, and race. Additionally, we assess the robustness to shortcut learning by evaluating performance on pneumothorax cases with and without chest drains. Our results indicate performance gaps between patients of different ages, but more equitable results for the other attributes. Moreover, all models exhibit lower performance on images without chest drains, suggesting reliance on spurious correlations. We further complement the performance analysis with a study of the embeddings generated by the models. While the sensitive attributes could be classified from the embeddings, we do not see such patterns using PCA, showing the limitations of these visualisation techniques when assessing models. Our code is available at https://github.com/TheoSourget/clip_cxr_fairness

This paper presents an annotated dataset of brain MRI images designed to advance the field of brain symmetry study. Magnetic resonance imaging (MRI) has gained interest in analyzing brain symmetry in neonatal infants, and challenges remain due to the vast size differences between fetal and adult brains. Classification methods for brain structural MRI use scales and visual cues to assess hemisphere symmetry, which can help diagnose neonatal patients by comparing hemispheres and anatomical regions of interest in the brain. Using the Developing Human Connectome Project dataset, this work presents a dataset comprising cerebral images extracted as slices across selected portions of interest for clinical evaluation . All the extracted images are annotated with the brain's midline. All the extracted images are annotated with the brain's midline. From the assumption that a decrease in symmetry is directly related to possible clinical pathologies, the dataset can contribute to a more precise diagnosis because it can be used to train deep learning model application in neonatal cerebral MRI anomaly detection from postnatal infant scans thanks to computer vision. Such models learn to identify and classify anomalies by identifying potential asymmetrical patterns in medical MRI images. Furthermore, this dataset can contribute to the research and development of methods using the relative symmetry of the two brain hemispheres for crucial diagnosis and treatment planning.

In high dimension, low sample size (HDLSS) settings, classifiers based on Euclidean distances like the nearest neighbor classifier and the average distance classifier perform quite poorly if differences between locations of the underlying populations get masked by scale differences. To rectify this problem, several modifications of these classifiers have been proposed in the literature. However, existing methods are confined to location and scale differences only, and often fail to discriminate among populations differing outside of the first two moments. In this article, we propose some simple transformations of these classifiers resulting into improved performance even when the underlying populations have the same location and scale. We further propose a generalization of these classifiers based on the idea of grouping of variables. The high-dimensional behavior of the proposed classifiers is studied theoretically. Numerical experiments with a variety of simulated examples as well as an extensive analysis of real data sets exhibit advantages of the proposed methods.

Medical image classification requires not only high predictive performance but also interpretability to ensure clinical trust and adoption. Graph Neural Networks (GNNs) offer a powerful framework for modeling relational structures within datasets; however, standard GNNs often operate as black boxes, limiting transparency and usability, particularly in clinical settings. In this work, we present an interpretable graph-based learning framework named FireGNN that integrates trainable fuzzy rules into GNNs for medical image classification. These rules embed topological descriptors - node degree, clustering coefficient, and label agreement - using learnable thresholds and sharpness parameters to enable intrinsic symbolic reasoning. Additionally, we explore auxiliary self-supervised tasks (e.g., homophily prediction, similarity entropy) as a benchmark to evaluate the contribution of topological learning. Our fuzzy-rule-enhanced model achieves strong performance across five MedMNIST benchmarks and the synthetic dataset MorphoMNIST, while also generating interpretable rule-based explanations. To our knowledge, this is the first integration of trainable fuzzy rules within a GNN. Source Code: https://github.com/basiralab/FireGNN

Chromosome classification is critical for karyotyping in abnormality diagnosis. To expedite the diagnosis, we present a novel method named Varifocal-Net for simultaneous classification of chromosome's type and polarity using deep convolutional networks. The approach consists of one global-scale network (G-Net) and one local-scale network (L-Net). It follows three stages. The first stage is to learn both global and local features. We extract global features and detect finer local regions via the G-Net. By proposing a varifocal mechanism, we zoom into local parts and extract local features via the L-Net. Residual learning and multi-task learning strategies are utilized to promote high-level feature extraction. The detection of discriminative local parts is fulfilled by a localization subnet of the G-Net, whose training process involves both supervised and weakly-supervised learning. The second stage is to build two multi-layer perceptron classifiers that exploit features of both two scales to boost classification performance. The third stage is to introduce a dispatch strategy of assigning each chromosome to a type within each patient case, by utilizing the domain knowledge of karyotyping. Evaluation results from 1909 karyotyping cases showed that the proposed Varifocal-Net achieved the highest accuracy per patient case (%) 99.2 for both type and polarity tasks. It outperformed state-of-the-art methods, demonstrating the effectiveness of our varifocal mechanism, multi-scale feature ensemble, and dispatch strategy. The proposed method has been applied to assist practical karyotype diagnosis.

Recently, Computer-Aided Diagnosis (CAD) systems have emerged as indispensable tools in clinical diagnostic workflows, significantly alleviating the burden on radiologists. Nevertheless, despite their integration into clinical settings, CAD systems encounter limitations. Specifically, while CAD systems can achieve high performance in the detection of lung nodules, they face challenges in accurately predicting multiple cancer types. This limitation can be attributed to the scarcity of publicly available datasets annotated with expert-level cancer type information. This research aims to bridge this gap by providing publicly accessible datasets and reliable tools for medical diagnosis, facilitating a finer categorization of different types of lung diseases so as to offer precise treatment recommendations. To achieve this objective, we curated a diverse dataset of lung Computed Tomography (CT) images, comprising 330 annotated nodules (nodules are labeled as bounding boxes) from 95 distinct patients. The quality of the dataset was evaluated using a variety of classical classification and detection models, and these promising results demonstrate that the dataset has a feasible application and further facilitate intelligent auxiliary diagnosis.

To investigate whether the pleurae, airways and vessels surrounding a nodule on non-contrast computed tomography (CT) can discriminate benign and malignant pulmonary nodules. The LIDC-IDRI dataset, one of the largest publicly available CT database, was exploited for study. A total of 1556 nodules from 694 patients were involved in statistical analysis, where nodules with average scorings <3 and >3 were respectively denoted as benign and malignant. Besides, 339 nodules from 113 patients with diagnosis ground-truth were independently evaluated. Computer algorithms were developed to segment pulmonary structures and quantify the distances to pleural surface, airways and vessels, as well as the counting number and normalized volume of airways and vessels near a nodule. Odds ratio (OR) and Chi-square (\chi^2) testing were performed to demonstrate the correlation between features of surrounding structures and nodule malignancy. A non-parametric receiver operating characteristic (ROC) analysis was conducted in logistic regression to evaluate discrimination ability of each structure. For benign and malignant groups, the average distances from nodules to pleural surface, airways and vessels are respectively (6.56, 5.19), (37.08, 26.43) and (1.42, 1.07) mm. The correlation between nodules and the counting number of airways and vessels that contact or project towards nodules are respectively (OR=22.96, \chi^2=105.04) and (OR=7.06, \chi^2=290.11). The correlation between nodules and the volume of airways and vessels are (OR=9.19, \chi^2=159.02) and (OR=2.29, \chi^2=55.89). The areas-under-curves (AUCs) for pleurae, airways and vessels are respectively 0.5202, 0.6943 and 0.6529. Our results show that malignant nodules are often surrounded by more pulmonary structures compared with benign ones, suggesting that features of these structures could be viewed as lung cancer biomarkers.

Deep learning (DL) has proven highly effective for ultrasound-based computer-aided diagnosis (CAD) of breast cancers. In an automaticCAD system, lesion detection is critical for the following diagnosis. However, existing DL-based methods generally require voluminous manually-annotated region of interest (ROI) labels and class labels to train both the lesion detection and diagnosis models. In clinical practice, the ROI labels, i.e. ground truths, may not always be optimal for the classification task due to individual experience of sonologists, resulting in the issue of coarse annotation that limits the diagnosis performance of a CAD model. To address this issue, a novel Two-Stage Detection and Diagnosis Network (TSDDNet) is proposed based on weakly supervised learning to enhance diagnostic accuracy of the ultrasound-based CAD for breast cancers. In particular, all the ROI-level labels are considered as coarse labels in the first training stage, and then a candidate selection mechanism is designed to identify optimallesion areas for both the fully and partially annotated samples. It refines the current ROI-level labels in the fully annotated images and the detected ROIs in the partially annotated samples with a weakly supervised manner under the guidance of class labels. In the second training stage, a self-distillation strategy further is further proposed to integrate the detection network and classification network into a unified framework as the final CAD model for joint optimization, which then further improves the diagnosis performance. The proposed TSDDNet is evaluated on a B-mode ultrasound dataset, and the experimental results show that it achieves the best performance on both lesion detection and diagnosis tasks, suggesting promising application potential.

Placenta volume measured from 3D ultrasound (3DUS) images is an important tool for tracking the growth trajectory and is associated with pregnancy outcomes. Manual segmentation is the gold standard, but it is time-consuming and subjective. Although fully automated deep learning algorithms perform well, they do not always yield high-quality results for each case. Interactive segmentation models could address this issue. However, there is limited work on interactive segmentation models for the placenta. Despite their segmentation accuracy, these methods may not be feasible for clinical use as they require relatively large computational power which may be especially prohibitive in low-resource environments, or on mobile devices. In this paper, we propose a lightweight interactive segmentation model aiming for clinical use to interactively segment the placenta from 3DUS images in real-time. The proposed model adopts the segmentation from our fully automated model for initialization and is designed in a human-in-the-loop manner to achieve iterative improvements. The Dice score and normalized surface Dice are used as evaluation metrics. The results show that our model can achieve superior performance in segmentation compared to state-of-the-art models while using significantly fewer parameters. Additionally, the proposed model is much faster for inference and robust to poor initial masks. The code is available at https://github.com/MedICL-VU/PRISM-placenta.

Artificial intelligence (AI) that can effectively learn ultrasound representations by integrating multi-source data holds significant promise for advancing clinical care. However, the scarcity of large labeled datasets in real-world clinical environments and the limited generalizability of task-specific models have hindered the development of generalizable clinical AI models for ultrasound applications. In this study, we present EchoCare, a novel ultrasound foundation model for generalist clinical use, developed via self-supervised learning on our curated, publicly available, large-scale dataset EchoCareData. EchoCareData comprises 4.5 million ultrasound images, sourced from over 23 countries across 5 continents and acquired via a diverse range of distinct imaging devices, thus encompassing global cohorts that are multi-center, multi-device, and multi-ethnic. Unlike prior studies that adopt off-the-shelf vision foundation model architectures, we introduce a hierarchical classifier into EchoCare to enable joint learning of pixel-level and representation-level features, capturing both global anatomical contexts and local ultrasound characteristics. With minimal training, EchoCare outperforms state-of-the-art comparison models across 10 representative ultrasound benchmarks of varying diagnostic difficulties, spanning disease diagnosis, lesion segmentation, organ detection, landmark prediction, quantitative regression, imaging enhancement and report generation. The code and pretrained model are publicly released, rendering EchoCare accessible for fine-tuning and local adaptation, supporting extensibility to additional applications. EchoCare provides a fully open and generalizable foundation model to boost the development of AI technologies for diverse clinical ultrasound applications.

3D plane recovery from a single image can usually be divided into several subtasks of plane detection, segmentation, parameter estimation and possibly depth estimation. Previous works tend to solve this task by either extending the RCNN-based segmentation network or the dense pixel embedding-based clustering framework. However, none of them tried to integrate above related subtasks into a unified framework but treat them separately and sequentially, which we suspect is potentially a main source of performance limitation for existing approaches. Motivated by this finding and the success of query-based learning in enriching reasoning among semantic entities, in this paper, we propose PlaneRecTR, a Transformer-based architecture, which for the first time unifies all subtasks related to single-view plane recovery with a single compact model. Extensive quantitative and qualitative experiments demonstrate that our proposed unified learning achieves mutual benefits across subtasks, obtaining a new state-of-the-art performance on public ScanNet and NYUv2-Plane datasets. Codes are available at https://github.com/SJingjia/PlaneRecTR.

While machine learning shows promise for maternal health risk prediction, clinical adoption in resource-constrained settings faces a critical barrier: lack of explainability and trust. This study presents a hybrid explainable AI (XAI) framework combining ante-hoc fuzzy logic with post-hoc SHAP explanations, validated through systematic clinician feedback. We developed a fuzzy-XGBoost model on 1,014 maternal health records, achieving 88.67% accuracy (ROC-AUC: 0.9703). A validation study with 14 healthcare professionals in Bangladesh revealed strong preference for hybrid explanations (71.4% across three clinical cases) with 54.8% expressing trust for clinical use. SHAP analysis identified healthcare access as the primary predictor, with the engineered fuzzy risk score ranking third, validating clinical knowledge integration (r=0.298). Clinicians valued integrated clinical parameters but identified critical gaps: obstetric history, gestational age, and connectivity barriers. This work demonstrates that combining interpretable fuzzy rules with feature importance explanations enhances both utility and trust, providing practical insights for XAI deployment in maternal healthcare.

Purpose: Accurate segmentation of clinical target volumes (CTV) and organs-at-risk is crucial for optimizing gynecologic brachytherapy (GYN-BT) treatment planning. However, anatomical variability, low soft-tissue contrast in CT imaging, and limited annotated datasets pose significant challenges. This study presents GynBTNet, a novel multi-stage learning framework designed to enhance segmentation performance through self-supervised pretraining and hierarchical fine-tuning strategies. Methods: GynBTNet employs a three-stage training strategy: (1) self-supervised pretraining on large-scale CT datasets using sparse submanifold convolution to capture robust anatomical representations, (2) supervised fine-tuning on a comprehensive multi-organ segmentation dataset to refine feature extraction, and (3) task-specific fine-tuning on a dedicated GYN-BT dataset to optimize segmentation performance for clinical applications. The model was evaluated against state-of-the-art methods using the Dice Similarity Coefficient (DSC), 95th percentile Hausdorff Distance (HD95), and Average Surface Distance (ASD). Results: Our GynBTNet achieved superior segmentation performance, significantly outperforming nnU-Net and Swin-UNETR. Notably, it yielded a DSC of 0.837 +/- 0.068 for CTV, 0.940 +/- 0.052 for the bladder, 0.842 +/- 0.070 for the rectum, and 0.871 +/- 0.047 for the uterus, with reduced HD95 and ASD compared to baseline models. Self-supervised pretraining led to consistent performance improvements, particularly for structures with complex boundaries. However, segmentation of the sigmoid colon remained challenging, likely due to anatomical ambiguities and inter-patient variability. Statistical significance analysis confirmed that GynBTNet's improvements were significant compared to baseline models.

In this paper we introduce a novel family of attributed graphs for the purpose of shape discrimination. Our graphs typically arise from variations on the Mapper graph construction, which is an approximation of the Reeb graph for point cloud data. Our attributions enrich these constructions with (persistent) homology in ways that are provably stable, thereby recording extra topological information that is typically lost in these graph constructions. We provide experiments which illustrate the use of these invariants for shape representation and classification. In particular, we obtain competitive shape classification results when using our topologically attributed graphs as inputs to a simple graph neural network classifier.

Domain Adaptation (DA) is important for deep learning-based medical image segmentation models to deal with testing images from a new target domain. As the source-domain data are usually unavailable when a trained model is deployed at a new center, Source-Free Domain Adaptation (SFDA) is appealing for data and annotation-efficient adaptation to the target domain. However, existing SFDA methods have a limited performance due to lack of sufficient supervision with source-domain images unavailable and target-domain images unlabeled. We propose a novel Uncertainty-aware Pseudo Label guided (UPL) SFDA method for medical image segmentation. Specifically, we propose Target Domain Growing (TDG) to enhance the diversity of predictions in the target domain by duplicating the pre-trained model's prediction head multiple times with perturbations. The different predictions in these duplicated heads are used to obtain pseudo labels for unlabeled target-domain images and their uncertainty to identify reliable pseudo labels. We also propose a Twice Forward pass Supervision (TFS) strategy that uses reliable pseudo labels obtained in one forward pass to supervise predictions in the next forward pass. The adaptation is further regularized by a mean prediction-based entropy minimization term that encourages confident and consistent results in different prediction heads. UPL-SFDA was validated with a multi-site heart MRI segmentation dataset, a cross-modality fetal brain segmentation dataset, and a 3D fetal tissue segmentation dataset. It improved the average Dice by 5.54, 5.01 and 6.89 percentage points for the three tasks compared with the baseline, respectively, and outperformed several state-of-the-art SFDA methods.

Neonatal death is still a concerning reality for underdeveloped and even some developed countries. Worldwide data indicate that 26.693 babies out of 1,000 births die, according to Macro Trades. To reduce this number, early prediction of endangered babies is crucial. Such prediction enables the opportunity to take ample care of the child and mother so that early child death can be avoided. In this context, machine learning was used to determine whether a newborn baby is at risk. To train the predictive model, historical data of 1.4 million newborns was used. Machine learning and deep learning techniques such as logical regression, K-nearest neighbor, random forest classifier, extreme gradient boosting (XGBoost), convolutional neural network, and long short-term memory (LSTM) were implemented using the dataset to identify the most accurate model for predicting neonatal mortality. Among the machine learning algorithms, XGBoost and random forest classifier achieved the best accuracy with 94%, while among the deep learning models, LSTM delivered the highest accuracy with 99%. Therefore, using LSTM appears to be the most suitable approach to predict whether precautionary measures for a child are necessary.

Cardiovascular diseases (CVDs) remain the leading cause of mortality globally, and echocardiography is critical for diagnosis of both common and congenital cardiac conditions. However, echocardiographic data for certain pathologies are scarce, hindering the development of robust automated diagnosis models. In this work, we propose Echo-Path, a novel generative framework to produce echocardiogram videos conditioned on specific cardiac pathologies. Echo-Path can synthesize realistic ultrasound video sequences that exhibit targeted abnormalities, focusing here on atrial septal defect (ASD) and pulmonary arterial hypertension (PAH). Our approach introduces a pathology-conditioning mechanism into a state-of-the-art echo video generator, allowing the model to learn and control disease-specific structural and motion patterns in the heart. Quantitative evaluation demonstrates that the synthetic videos achieve low distribution distances, indicating high visual fidelity. Clinically, the generated echoes exhibit plausible pathology markers. Furthermore, classifiers trained on our synthetic data generalize well to real data and, when used to augment real training sets, it improves downstream diagnosis of ASD and PAH by 7\% and 8\% respectively. Code, weights and dataset are available here https://github.com/Marshall-mk/EchoPathv1

Prototypical part network (ProtoPNet) methods have been designed to achieve interpretable classification by associating predictions with a set of training prototypes, which we refer to as trivial prototypes because they are trained to lie far from the classification boundary in the feature space. Note that it is possible to make an analogy between ProtoPNet and support vector machine (SVM) given that the classification from both methods relies on computing similarity with a set of training points (i.e., trivial prototypes in ProtoPNet, and support vectors in SVM). However, while trivial prototypes are located far from the classification boundary, support vectors are located close to this boundary, and we argue that this discrepancy with the well-established SVM theory can result in ProtoPNet models with inferior classification accuracy. In this paper, we aim to improve the classification of ProtoPNet with a new method to learn support prototypes that lie near the classification boundary in the feature space, as suggested by the SVM theory. In addition, we target the improvement of classification results with a new model, named ST-ProtoPNet, which exploits our support prototypes and the trivial prototypes to provide more effective classification. Experimental results on CUB-200-2011, Stanford Cars, and Stanford Dogs datasets demonstrate that ST-ProtoPNet achieves state-of-the-art classification accuracy and interpretability results. We also show that the proposed support prototypes tend to be better localised in the object of interest rather than in the background region.

One-class learning is the classic problem of fitting a model to data for which annotations are available only for a single class. In this paper, we propose a novel objective for one-class learning. Our key idea is to use a pair of orthonormal frames -- as subspaces -- to "sandwich" the labeled data via optimizing for two objectives jointly: i) minimize the distance between the origins of the two subspaces, and ii) to maximize the margin between the hyperplanes and the data, either subspace demanding the data to be in its positive and negative orthant respectively. Our proposed objective however leads to a non-convex optimization problem, to which we resort to Riemannian optimization schemes and derive an efficient conjugate gradient scheme on the Stiefel manifold. To study the effectiveness of our scheme, we propose a new dataset~Dash-Cam-Pose, consisting of clips with skeleton poses of humans seated in a car, the task being to classify the clips as normal or abnormal; the latter is when any human pose is out-of-position with regard to say an airbag deployment. Our experiments on the proposed Dash-Cam-Pose dataset, as well as several other standard anomaly/novelty detection benchmarks demonstrate the benefits of our scheme, achieving state-of-the-art one-class accuracy.

Foundation models (FMs) trained on electronic health records (EHRs) have shown strong performance on a range of clinical prediction tasks. However, adapting these models to local health systems remains challenging due to limited data availability and resource constraints. In this study, we investigated what these models learn and evaluated the transferability of an FM trained on MIMIC-IV to an institutional EHR dataset at the University of Chicago Medical Center. We assessed their ability to identify outlier patients and examined representation-space patient trajectories in relation to future clinical outcomes. We also evaluated the performance of supervised fine-tuned classifiers on both source and target datasets. Our findings offer insights into the adaptability of FMs across different healthcare systems, highlight considerations for their effective implementation, and provide an empirical analysis of the underlying factors that contribute to their predictive performance.

Extracting planes from a 3D scene is useful for downstream tasks in robotics and augmented reality. In this paper we tackle the problem of estimating the planar surfaces in a scene from posed images. Our first finding is that a surprisingly competitive baseline results from combining popular clustering algorithms with recent improvements in 3D geometry estimation. However, such purely geometric methods are understandably oblivious to plane semantics, which are crucial to discerning distinct planes. To overcome this limitation, we propose a method that predicts multi-view consistent plane embeddings that complement geometry when clustering points into planes. We show through extensive evaluation on the ScanNetV2 dataset that our new method outperforms existing approaches and our strong geometric baseline for the task of plane estimation.

Considering the increased workload in pathology laboratories today, automated tools such as artificial intelligence models can help pathologists with their tasks and ease the workload. In this paper, we are proposing a segmentation model (DRU-Net) that can provide a delineation of human non-small cell lung carcinomas and an augmentation method that can improve classification results. The proposed model is a fused combination of truncated pre-trained DenseNet201 and ResNet101V2 as a patch-wise classifier followed by a lightweight U-Net as a refinement model. We have used two datasets (Norwegian Lung Cancer Biobank and Haukeland University Hospital lung cancer cohort) to create our proposed model. The DRU-Net model achieves an average of 0.91 Dice similarity coefficient. The proposed spatial augmentation method (multi-lens distortion) improved the network performance by 3%. Our findings show that choosing image patches that specifically include regions of interest leads to better results for the patch-wise classifier compared to other sampling methods. The qualitative analysis showed that the DRU-Net model is generally successful in detecting the tumor. On the test set, some of the cases showed areas of false positive and false negative segmentation in the periphery, particularly in tumors with inflammatory and reactive changes.

With an estimated 160,000 deaths in 2018, lung cancer is the most common cause of cancer death in the United States. Lung cancer CT screening has been shown to reduce mortality by up to 40% and is now included in US screening guidelines. Reducing the high error rates in lung cancer screening is imperative because of the high clinical and financial costs caused by diagnosis mistakes. Despite the use of standards for radiological diagnosis, persistent inter-grader variability and incomplete characterization of comprehensive imaging findings remain as limitations of current methods. These limitations suggest opportunities for more sophisticated systems to improve performance and inter-reader consistency. In this report, we reproduce a state-of-the-art deep learning algorithm for lung cancer risk prediction. Our model predicts malignancy probability and risk bucket classification from lung CT studies. This allows for risk categorization of patients being screened and suggests the most appropriate surveillance and management. Combining our solution high accuracy, consistency and fully automated nature, our approach may enable highly efficient screening procedures and accelerate the adoption of lung cancer screening.

Foundation models (FMs), i.e., models trained on a vast amount of typically unlabeled data, have become popular and available recently for the domain of histopathology. The key idea is to extract semantically rich vectors from any input patch, allowing for the use of simple subsequent classification networks potentially reducing the required amounts of labeled data, and increasing domain robustness. In this work, we investigate to which degree this also holds for mitotic figure classification. Utilizing two popular public mitotic figure datasets, we compared linear probing of five publicly available FMs against models trained on ImageNet and a simple ResNet50 end-to-end-trained baseline. We found that the end-to-end-trained baseline outperformed all FM-based classifiers, regardless of the amount of data provided. Additionally, we did not observe the FM-based classifiers to be more robust against domain shifts, rendering both of the above assumptions incorrect.

Despite that deep learning has achieved state-of-the-art performance for medical image segmentation, its success relies on a large set of manually annotated images for training that are expensive to acquire. In this paper, we propose an annotation-efficient learning framework for segmentation tasks that avoids annotations of training images, where we use an improved Cycle-Consistent Generative Adversarial Network (GAN) to learn from a set of unpaired medical images and auxiliary masks obtained either from a shape model or public datasets. We first use the GAN to generate pseudo labels for our training images under the implicit high-level shape constraint represented by a Variational Auto-encoder (VAE)-based discriminator with the help of the auxiliary masks, and build a Discriminator-guided Generator Channel Calibration (DGCC) module which employs our discriminator's feedback to calibrate the generator for better pseudo labels. To learn from the pseudo labels that are noisy, we further introduce a noise-robust iterative learning method using noise-weighted Dice loss. We validated our framework with two situations: objects with a simple shape model like optic disc in fundus images and fetal head in ultrasound images, and complex structures like lung in X-Ray images and liver in CT images. Experimental results demonstrated that 1) Our VAE-based discriminator and DGCC module help to obtain high-quality pseudo labels. 2) Our proposed noise-robust learning method can effectively overcome the effect of noisy pseudo labels. 3) The segmentation performance of our method without using annotations of training images is close or even comparable to that of learning from human annotations.

Respiratory motion complicates accurate irradiation of thoraco-abdominal tumors during radiotherapy, as treatment-system latency entails target-location uncertainties. This work addresses frame forecasting in chest and liver cine MRI to compensate for such delays. We investigate RNNs trained with online learning algorithms, enabling adaptation to changing respiratory patterns via on-the-fly parameter updates, and transformers, increasingly common in time-series forecasting for their ability to capture long-term dependencies. Experiments used 12 sagittal thoracic and upper-abdominal cine-MRI sequences from ETH Zürich and OvGU; the OvGU data exhibited higher motion variability, noise, and lower contrast. PCA decomposes the Lucas-Kanade optical-flow field into static deformation modes and low-dimensional, time-dependent weights. We compare various methods for forecasting these weights: linear filters, population and sequence-specific transformer encoders, and RNNs trained with real-time recurrent learning (RTRL), unbiased online recurrent optimization, decoupled neural interfaces, and sparse one-step approximation (SnAp-1). Predicted displacements were used to warp the reference frame and generate future images. Prediction accuracy decreased with the horizon h. Linear regression performed best at short horizons (1.3mm geometrical error at h=0.32s, ETH Zürich dataset), while RTRL and SnAp-1 outperformed the other algorithms at medium-to-long horizons, with geometrical errors below 1.4mm and 2.8mm on the sequences from ETH Zürich and OvGU, respectively. The sequence-specific transformer was competitive for low-to-medium horizons, but transformers remained overall limited by data scarcity and domain shift between datasets. Predicted frames visually resembled the ground truth, with notable errors occurring near the diaphragm at end-inspiration and regions affected by out-of-plane motion.

In representation learning, uniformity refers to the uniform feature distribution in the latent space (i.e., unit hypersphere). Previous work has shown that improving uniformity contributes to the learning of under-represented classes. However, most of the previous work focused on classification; the representation space of imbalanced regression remains unexplored. Classification-based methods are not suitable for regression tasks because they cluster features into distinct groups without considering the continuous and ordered nature essential for regression. In a geometric aspect, we uniquely focus on ensuring uniformity in the latent space for imbalanced regression through two key losses: enveloping and homogeneity. The enveloping loss encourages the induced trace to uniformly occupy the surface of a hypersphere, while the homogeneity loss ensures smoothness, with representations evenly spaced at consistent intervals. Our method integrates these geometric principles into the data representations via a Surrogate-driven Representation Learning (SRL) framework. Experiments with real-world regression and operator learning tasks highlight the importance of uniformity in imbalanced regression and validate the efficacy of our geometry-based loss functions.

Monocular depth estimation aims to infer a dense depth map from a single image, which is a fundamental and prevalent task in computer vision. Many previous works have shown impressive depth estimation results through carefully designed network structures, but they usually ignore the planar information and therefore perform poorly in low-texture areas of indoor scenes. In this paper, we propose Plane2Depth, which adaptively utilizes plane information to improve depth prediction within a hierarchical framework. Specifically, in the proposed plane guided depth generator (PGDG), we design a set of plane queries as prototypes to softly model planes in the scene and predict per-pixel plane coefficients. Then the predicted plane coefficients can be converted into metric depth values with the pinhole camera model. In the proposed adaptive plane query aggregation (APGA) module, we introduce a novel feature interaction approach to improve the aggregation of multi-scale plane features in a top-down manner. Extensive experiments show that our method can achieve outstanding performance, especially in low-texture or repetitive areas. Furthermore, under the same backbone network, our method outperforms the state-of-the-art methods on the NYU-Depth-v2 dataset, achieves competitive results with state-of-the-art methods KITTI dataset and can be generalized to unseen scenes effectively.

The aerodynamic coefficients of aircrafts are significantly impacted by its geometry, especially when the angle of attack (AoA) is large. In the field of aerodynamics, traditional polynomial-based parameterization uses as few parameters as possible to describe the geometry of an airfoil. However, because the 3D geometry of a wing is more complicated than the 2D airfoil, polynomial-based parameterizations have difficulty in accurately representing the entire shape of a wing in 3D space. Existing deep learning-based methods can extract massive latent neural representations for the shape of 2D airfoils or 2D slices of wings. Recent studies highlight that directly taking geometric features as inputs to the neural networks can improve the accuracy of predicted aerodynamic coefficients. Motivated by geometry theory, we propose to incorporate Riemannian geometric features for learning Coefficient of Pressure (CP) distributions on wing surfaces. Our method calculates geometric features (Riemannian metric, connection, and curvature) and further inputs the geometric features, coordinates and flight conditions into a deep learning model to predict the CP distribution. Experimental results show that our method, compared to state-of-the-art Deep Attention Network (DAN), reduces the predicted mean square error (MSE) of CP by an average of 8.41% for the DLR-F11 aircraft test set.

Background: AI-based classification models are essential for improving lung cancer diagnosis. However, the relative performance of lesion-level versus chest-region models in internal and external datasets remains unclear. Purpose: This study evaluates the performance of lesion-level and chest-region models for lung cancer classification, comparing their effectiveness across internal Duke Lung Nodule Dataset 2024 (DLND24) and external (LUNA16, NLST) datasets, with a focus on subgroup analyses by demographics, histology, and imaging characteristics. Materials and Methods: Two AI models were trained: one using lesion-centric patches (64,64,64) and the other using chest-region patches (512,512,8). Internal validation was conducted on DLND24, while external validation utilized LUNA16 and NLST datasets. The models performances were assessed using AUC-ROC, with subgroup analyses for demographic, clinical, and imaging factors. Statistical comparisons were performed using DeLongs test. Gradient-based visualizations and probability distribution were further used for analysis. Results: The lesion-level model consistently outperformed the chest-region model across datasets. In internal validation, the lesion-level model achieved an AUC of 0.71(CI: 0.61-0.81), compared to 0.68(0.57-0.77) for the chest-region model. External validation showed similar trends, with AUCs of 0.90(0.87-0.92) and 0.81(0.79-0.82) on LUNA16 and NLST, respectively. Subgroup analyses revealed significant advantages for lesion-level models in certain histological subtypes (adenocarcinoma) and imaging conditions (CT manufacturers). Conclusion: Lesion-level models demonstrate superior classification performance, especially for external datasets and challenging subgroups, suggesting their clinical utility for precision lung cancer diagnostics.

Accurate detection of pulmonary nodules with high sensitivity and specificity is essential for automatic lung cancer diagnosis from CT scans. Although many deep learning-based algorithms make great progress for improving the accuracy of nodule detection, the high false positive rate is still a challenging problem which limited the automatic diagnosis in routine clinical practice. In this paper, we propose a novel pulmonary nodule detection framework based on a 3D Feature Pyramid Network (3DFPN) to improve the sensitivity of nodule detection by employing multi-scale features to increase the resolution of nodules, as well as a parallel top-down path to transit the high-level semantic features to complement low-level general features. Furthermore, a High Sensitivity and Specificity (HS^2) network is introduced to eliminate the falsely detected nodule candidates by tracking the appearance changes in continuous CT slices of each nodule candidate. The proposed framework is evaluated on the public Lung Nodule Analysis (LUNA16) challenge dataset. Our method is able to accurately detect lung nodules at high sensitivity and specificity and achieves 90.4% sensitivity with 1/8 false positive per scan which outperforms the state-of-the-art results 15.6%.

Generative models can produce impressively realistic images. This paper demonstrates that generated images have geometric features different from those of real images. We build a set of collections of generated images, prequalified to fool simple, signal-based classifiers into believing they are real. We then show that prequalified generated images can be identified reliably by classifiers that only look at geometric properties. We use three such classifiers. All three classifiers are denied access to image pixels, and look only at derived geometric features. The first classifier looks at the perspective field of the image, the second looks at lines detected in the image, and the third looks at relations between detected objects and shadows. Our procedure detects generated images more reliably than SOTA local signal based detectors, for images from a number of distinct generators. Saliency maps suggest that the classifiers can identify geometric problems reliably. We conclude that current generators cannot reliably reproduce geometric properties of real images.

This paper extends the classic theory of convex optimization to the minimization of functions that are equal to the negated logarithm of what we term as a sum-log-concave function, i.e., a sum of log-concave functions. In particular, we show that such functions are in general not convex but still satisfy generalized convexity inequalities. These inequalities unveil the key importance of a certain vector that we call the cross-gradient and that is, in general, distinct from the usual gradient. Thus, we propose the Cross Gradient Descent (XGD) algorithm moving in the opposite direction of the cross-gradient and derive a convergence analysis. As an application of our sum-log-concave framework, we introduce the so-called checkered regression method relying on a sum-log-concave function. This classifier extends (multiclass) logistic regression to non-linearly separable problems since it is capable of tessellating the feature space by using any given number of hyperplanes, creating a checkerboard-like pattern of decision regions.

Scoliosis, a prevalent condition characterized by abnormal spinal curvature leading to deformity, requires precise assessment methods for effective diagnosis and management. The Cobb angle is a widely used scoliosis quantification method that measures the degree of curvature between the tilted vertebrae. Yet, manual measuring of Cobb angles is time-consuming and labor-intensive, fraught with significant interobserver and intraobserver variability. To address these challenges and the lack of interpretability found in certain existing automated methods, we have created fully automated software that not only precisely measures the Cobb angle but also provides clear visualizations of these measurements. This software integrates deep neural network-based spine region detection and segmentation, spine centerline identification, pinpointing the most significantly tilted vertebrae, and direct visualization of Cobb angles on the original images. Upon comparison with the assessments of 7 expert readers, our algorithm exhibited a mean deviation in Cobb angle measurements of 4.17 degrees, notably surpassing the manual approach's average intra-reader discrepancy of 5.16 degrees. The algorithm also achieved intra-class correlation coefficients (ICC) exceeding 0.96 and Pearson correlation coefficients above 0.944, reflecting robust agreement with expert assessments and superior measurement reliability. Through the comprehensive reader study and statistical analysis, we believe this algorithm not only ensures a higher consensus with expert readers but also enhances interpretability and reproducibility during assessments. It holds significant promise for clinical application, potentially aiding physicians in more accurate scoliosis assessment and diagnosis, thereby improving patient care.

Recent AI-based scoliosis screening methods primarily rely on large-scale silhouette datasets, often neglecting clinically relevant postural asymmetries-key indicators in traditional screening. In contrast, pose data provide an intuitive skeletal representation, enhancing clinical interpretability across various medical applications. However, pose-based scoliosis screening remains underexplored due to two main challenges: (1) the scarcity of large-scale, annotated pose datasets; and (2) the discrete and noise-sensitive nature of raw pose coordinates, which hinders the modeling of subtle asymmetries. To address these limitations, we introduce Scoliosis1K-Pose, a 2D human pose annotation set that extends the original Scoliosis1K dataset, comprising 447,900 frames of 2D keypoints from 1,050 adolescents. Building on this dataset, we introduce the Dual Representation Framework (DRF), which integrates a continuous skeleton map to preserve spatial structure with a discrete Postural Asymmetry Vector (PAV) that encodes clinically relevant asymmetry descriptors. A novel PAV-Guided Attention (PGA) module further uses the PAV as clinical prior to direct feature extraction from the skeleton map, focusing on clinically meaningful asymmetries. Extensive experiments demonstrate that DRF achieves state-of-the-art performance. Visualizations further confirm that the model leverages clinical asymmetry cues to guide feature extraction and promote synergy between its dual representations. The dataset and code are publicly available at https://zhouzi180.github.io/Scoliosis1K/.

Regular screening and early discovery of uterine fibroid are crucial for preventing potential malignant transformations and ensuring timely, life-saving interventions. To this end, we collect and annotate the first ultrasound video dataset with 100 videos for uterine fibroid segmentation (UFUV). We also present Local-Global Reciprocal Network (LGRNet) to efficiently and effectively propagate the long-term temporal context which is crucial to help distinguish between uninformative noisy surrounding tissues and target lesion regions. Specifically, the Cyclic Neighborhood Propagation (CNP) is introduced to propagate the inter-frame local temporal context in a cyclic manner. Moreover, to aggregate global temporal context, we first condense each frame into a set of frame bottleneck queries and devise Hilbert Selective Scan (HilbertSS) to both efficiently path connect each frame and preserve the locality bias. A distribute layer is then utilized to disseminate back the global context for reciprocal refinement. Extensive experiments on UFUV and three public Video Polyp Segmentation (VPS) datasets demonstrate consistent improvements compared to state-of-the-art segmentation methods, indicating the effectiveness and versatility of LGRNet. Code, checkpoints, and dataset are available at https://github.com/bio-mlhui/LGRNet

Tabular biomedical data poses challenges in machine learning because it is often high-dimensional and typically low-sample-size (HDLSS). Previous research has attempted to address these challenges via local feature selection, but existing approaches often fail to achieve optimal performance due to their limitation in identifying globally important features and their susceptibility to the co-adaptation problem. In this paper, we propose ProtoGate, a prototype-based neural model for feature selection on HDLSS data. ProtoGate first selects instance-wise features via adaptively balancing global and local feature selection. Furthermore, ProtoGate employs a non-parametric prototype-based prediction mechanism to tackle the co-adaptation problem, ensuring the feature selection results and predictions are consistent with underlying data clusters. We conduct comprehensive experiments to evaluate the performance and interpretability of ProtoGate on synthetic and real-world datasets. The results show that ProtoGate generally outperforms state-of-the-art methods in prediction accuracy by a clear margin while providing high-fidelity feature selection and explainable predictions. Code is available at https://github.com/SilenceX12138/ProtoGate.

Chest X-rays (CXRs) are the most frequently performed imaging test in clinical practice. Recent advances in the development of vision-language foundation models (FMs) give rise to the possibility of performing automated CXR interpretation, which can assist physicians with clinical decision-making and improve patient outcomes. However, developing FMs that can accurately interpret CXRs is challenging due to the (1) limited availability of large-scale vision-language datasets in the medical image domain, (2) lack of vision and language encoders that can capture the complexities of medical data, and (3) absence of evaluation frameworks for benchmarking the abilities of FMs on CXR interpretation. In this work, we address these challenges by first introducing CheXinstruct - a large-scale instruction-tuning dataset curated from 28 publicly-available datasets. We then present CheXagent - an instruction-tuned FM capable of analyzing and summarizing CXRs. To build CheXagent, we design a clinical large language model (LLM) for parsing radiology reports, a vision encoder for representing CXR images, and a network to bridge the vision and language modalities. Finally, we introduce CheXbench - a novel benchmark designed to systematically evaluate FMs across 8 clinically-relevant CXR interpretation tasks. Extensive quantitative evaluations and qualitative reviews with five expert radiologists demonstrate that CheXagent outperforms previously-developed general- and medical-domain FMs on CheXbench tasks. Furthermore, in an effort to improve model transparency, we perform a fairness evaluation across factors of sex, race and age to highlight potential performance disparities. Our project is at https://stanford-aimi.github.io/chexagent.html.

To improve the prognosis of patients suffering from pulmonary diseases, such as lung cancer, early diagnosis and treatment are crucial. The analysis of CT images is invaluable for diagnosis, whereas high quality segmentation of the airway tree are required for intervention planning and live guidance during bronchoscopy. Recently, the Multi-domain Airway Tree Modeling (ATM'22) challenge released a large dataset, both enabling training of deep-learning based models and bringing substantial improvement of the state-of-the-art for the airway segmentation task. However, the ATM'22 dataset includes few patients with severe pathologies affecting the airway tree anatomy. In this study, we introduce a new public benchmark dataset (AeroPath), consisting of 27 CT images from patients with pathologies ranging from emphysema to large tumors, with corresponding trachea and bronchi annotations. Second, we present a multiscale fusion design for automatic airway segmentation. Models were trained on the ATM'22 dataset, tested on the AeroPath dataset, and further evaluated against competitive open-source methods. The same performance metrics as used in the ATM'22 challenge were used to benchmark the different considered approaches. Lastly, an open web application is developed, to easily test the proposed model on new data. The results demonstrated that our proposed architecture predicted topologically correct segmentations for all the patients included in the AeroPath dataset. The proposed method is robust and able to handle various anomalies, down to at least the fifth airway generation. In addition, the AeroPath dataset, featuring patients with challenging pathologies, will contribute to development of new state-of-the-art methods. The AeroPath dataset and the web application are made openly available.

We consider the hierarchical representation of documents as graphs and use geometric deep learning to classify them into different categories. While graph neural networks can efficiently handle the variable structure of hierarchical documents using the permutation invariant message passing operations, we show that we can gain extra performance improvements using our proposed selective graph pooling operation that arises from the fact that some parts of the hierarchy are invariable across different documents. We applied our model to classify clinical trial (CT) protocols into completed and terminated categories. We use bag-of-words based, as well as pre-trained transformer-based embeddings to featurize the graph nodes, achieving f1-scores around 0.85 on a publicly available large scale CT registry of around 360K protocols. We further demonstrate how the selective pooling can add insights into the CT termination status prediction. We make the source code and dataset splits accessible.

Chest X-ray (CXR) classification in clinical practice is often limited by imperfect supervision, arising from (i) extreme long-tailed multi-label disease distributions and (ii) missing annotations for rare or previously unseen findings. The CXR-LT 2026 challenge addresses these issues on a PadChest-based benchmark with a 36-class label space split into 30 in-distribution classes for training and 6 out-of-distribution (OOD) classes for zero-shot evaluation. We present task-specific solutions tailored to the distinct supervision regimes. For Task 1 (long-tailed multi-label classification), we adopt an imbalance-aware multi-label learning strategy to improve recognition of tail classes while maintaining stable performance on frequent findings. For Task 2 (zero-shot OOD recognition), we propose a prediction approach that produces scores for unseen disease categories without using any supervised labels or examples from the OOD classes during training. Evaluated with macro-averaged mean Average Precision (mAP), our method achieves strong performance on both tasks, ranking first on the public leaderboard of the development phase. Code and pre-trained models are available at https://github.com/hieuphamha19/CXR_LT.

Foundation models, often pre-trained with large-scale data, have achieved paramount success in jump-starting various vision and language applications. Recent advances further enable adapting foundation models in downstream tasks efficiently using only a few training samples, e.g., in-context learning. Yet, the application of such learning paradigms in medical image analysis remains scarce due to the shortage of publicly accessible data and benchmarks. In this paper, we aim at approaches adapting the foundation models for medical image classification and present a novel dataset and benchmark for the evaluation, i.e., examining the overall performance of accommodating the large-scale foundation models downstream on a set of diverse real-world clinical tasks. We collect five sets of medical imaging data from multiple institutes targeting a variety of real-world clinical tasks (22,349 images in total), i.e., thoracic diseases screening in X-rays, pathological lesion tissue screening, lesion detection in endoscopy images, neonatal jaundice evaluation, and diabetic retinopathy grading. Results of multiple baseline methods are demonstrated using the proposed dataset from both accuracy and cost-effective perspectives.

The Segment Anything Model (SAM) has set a new standard in interactive image segmentation, offering robust performance across various tasks. However, its significant computational requirements limit its deployment in real-time or resource-constrained environments. To address these challenges, we propose a novel knowledge distillation approach, KD SAM, which incorporates both encoder and decoder optimization through a combination of Mean Squared Error (MSE) and Perceptual Loss. This dual-loss framework captures structural and semantic features, enabling the student model to maintain high segmentation accuracy while reducing computational complexity. Based on the model evaluation on datasets, including Kvasir-SEG, ISIC 2017, Fetal Head Ultrasound, and Breast Ultrasound, we demonstrate that KD SAM achieves comparable or superior performance to the baseline models, with significantly fewer parameters. KD SAM effectively balances segmentation accuracy and computational efficiency, making it well-suited for real-time medical image segmentation applications in resource-constrained environments.

Artificial intelligence (AI) has significant potential in healthcare applications, but its training and deployment faces challenges due to healthcare's diverse data, complex tasks, and the need to preserve privacy. Foundation models that perform well on medical tasks and require less task-specific tuning data are critical to accelerate the development of healthcare AI applications. We introduce MedGemma, a collection of medical vision-language foundation models based on Gemma 3 4B and 27B. MedGemma demonstrates advanced medical understanding and reasoning on images and text, significantly exceeding the performance of similar-sized generative models and approaching the performance of task-specific models, while maintaining the general capabilities of the Gemma 3 base models. For out-of-distribution tasks, MedGemma achieves 2.6-10% improvement on medical multimodal question answering, 15.5-18.1% improvement on chest X-ray finding classification, and 10.8% improvement on agentic evaluations compared to the base models. Fine-tuning MedGemma further improves performance in subdomains, reducing errors in electronic health record information retrieval by 50% and reaching comparable performance to existing specialized state-of-the-art methods for pneumothorax classification and histopathology patch classification. We additionally introduce MedSigLIP, a medically-tuned vision encoder derived from SigLIP. MedSigLIP powers the visual understanding capabilities of MedGemma and as an encoder achieves comparable or better performance than specialized medical image encoders. Taken together, the MedGemma collection provides a strong foundation of medical image and text capabilities, with potential to significantly accelerate medical research and development of downstream applications. The MedGemma collection, including tutorials and model weights, can be found at https://goo.gle/medgemma.

Despite the progress in automatic detection of radiologic findings from chest X-ray (CXR) images in recent years, a quantitative evaluation of the explainability of these models is hampered by the lack of locally labeled datasets for different findings. With the exception of a few expert-labeled small-scale datasets for specific findings, such as pneumonia and pneumothorax, most of the CXR deep learning models to date are trained on global "weak" labels extracted from text reports, or trained via a joint image and unstructured text learning strategy. Inspired by the Visual Genome effort in the computer vision community, we constructed the first Chest ImaGenome dataset with a scene graph data structure to describe 242,072 images. Local annotations are automatically produced using a joint rule-based natural language processing (NLP) and atlas-based bounding box detection pipeline. Through a radiologist constructed CXR ontology, the annotations for each CXR are connected as an anatomy-centered scene graph, useful for image-level reasoning and multimodal fusion applications. Overall, we provide: i) 1,256 combinations of relation annotations between 29 CXR anatomical locations (objects with bounding box coordinates) and their attributes, structured as a scene graph per image, ii) over 670,000 localized comparison relations (for improved, worsened, or no change) between the anatomical locations across sequential exams, as well as ii) a manually annotated gold standard scene graph dataset from 500 unique patients.

The fine-grained localization of clinicians in the operating room (OR) is a key component to design the new generation of OR support systems. Computer vision models for person pixel-based segmentation and body-keypoints detection are needed to better understand the clinical activities and the spatial layout of the OR. This is challenging, not only because OR images are very different from traditional vision datasets, but also because data and annotations are hard to collect and generate in the OR due to privacy concerns. To address these concerns, we first study how joint person pose estimation and instance segmentation can be performed on low resolutions images with downsampling factors from 1x to 12x. Second, to address the domain shift and the lack of annotations, we propose a novel unsupervised domain adaptation method, called AdaptOR, to adapt a model from an in-the-wild labeled source domain to a statistically different unlabeled target domain. We propose to exploit explicit geometric constraints on the different augmentations of the unlabeled target domain image to generate accurate pseudo labels and use these pseudo labels to train the model on high- and low-resolution OR images in a self-training framework. Furthermore, we propose disentangled feature normalization to handle the statistically different source and target domain data. Extensive experimental results with detailed ablation studies on the two OR datasets MVOR+ and TUM-OR-test show the effectiveness of our approach against strongly constructed baselines, especially on the low-resolution privacy-preserving OR images. Finally, we show the generality of our method as a semi-supervised learning (SSL) method on the large-scale COCO dataset, where we achieve comparable results with as few as 1% of labeled supervision against a model trained with 100% labeled supervision.

Artificial intelligence is revealing what medicine never intended to encode. Deep vision models, trained on chest X-rays, can now detect not only disease but also invisible traces of social inequality. In this study, we show that state-of-the-art architectures (DenseNet121, SwinV2-B, MedMamba) can predict a patient's health insurance type, a strong proxy for socioeconomic status, from normal chest X-rays with significant accuracy (AUC around 0.70 on MIMIC-CXR-JPG, 0.68 on CheXpert). The signal was unlikely contributed by demographic features by our machine learning study combining age, race, and sex labels to predict health insurance types; it also remains detectable when the model is trained exclusively on a single racial group. Patch-based occlusion reveals that the signal is diffuse rather than localized, embedded in the upper and mid-thoracic regions. This suggests that deep networks may be internalizing subtle traces of clinical environments, equipment differences, or care pathways; learning socioeconomic segregation itself. These findings challenge the assumption that medical images are neutral biological data. By uncovering how models perceive and exploit these hidden social signatures, this work reframes fairness in medical AI: the goal is no longer only to balance datasets or adjust thresholds, but to interrogate and disentangle the social fingerprints embedded in clinical data itself.

Recently, intelligent analysis of lung nodules with the assistant of computer aided detection (CAD) techniques can improve the accuracy rate of lung cancer diagnosis. However, existing CAD systems and pulmonary datasets mainly focus on Computed Tomography (CT) images from one single period, while ignoring the cross spatio-temporal features associated with the progression of nodules contained in imaging data from various captured periods of lung cancer. If the evolution patterns of nodules across various periods in the patients' CT sequences can be explored, it will play a crucial role in guiding the precise screening identification of lung cancer. Therefore, a cross spatio-temporal lung nodule dataset with pathological information for nodule identification and diagnosis is constructed, which contains 328 CT sequences and 362 annotated nodules from 109 patients. This comprehensive database is intended to drive research in the field of CAD towards more practical and robust methods, and also contribute to the further exploration of precision medicine related field. To ensure patient confidentiality, we have removed sensitive information from the dataset.

Lung cancer remains the leading cause of cancer-related mortality worldwide, and early detection through low-dose computed tomography (LDCT) has shown significant promise in reducing death rates. With the growing integration of artificial intelligence (AI) into medical imaging, the development and evaluation of robust AI models require access to large, well-annotated datasets. In this study, we introduce the utility of Duke Lung Cancer Screening (DLCS) Dataset, the largest open-access LDCT dataset with over 2,000 scans and 3,000 expert-verified nodules. We benchmark deep learning models for both 3D nodule detection and lung cancer classification across internal and external datasets including LUNA16, LUNA25, and NLST-3D+. For detection, we develop two MONAI-based RetinaNet models (DLCSDmD and LUNA16-mD), evaluated using the Competition Performance Metric (CPM). For classification, we compare five models, including state-of-the-art pretrained models (Models Genesis, Med3D), a selfsupervised foundation model (FMCB), a randomly initialized ResNet50, and proposed a novel Strategic Warm-Start++ (SWS++) model. SWS++ uses curated candidate patches to pretrain a classification backbone within the same detection pipeline, enabling task-relevant feature learning. Our models demonstrated strong generalizability, with SWS++ achieving comparable or superior performance to existing foundational models across multiple datasets (AUC: 0.71 to 0.90). All code, models, and data are publicly released to promote reproducibility and collaboration. This work establishes a standardized benchmarking resource for lung cancer AI research, supporting future efforts in model development, validation, and clinical translation.

Increasingly advanced data augmentation techniques have greatly aided clinical medical research, increasing data diversity and improving model generalization capabilities. Although most current basic models exhibit strong generalization abilities, image quality varies due to differences in equipment and operators. To address these challenges, we present SegTTA, a framework that improves medical image segmentation without model retraining by combining four augmentations (Gamma correction, Contrast enhancement, Gaussian blur, Gaussian noise) with weighted voting across multiple MedSAM2 checkpoints. Experiments demonstrate consistent improvements across three diverse datasets: healthy uterus segmentation, uterine myoma detection, and multi class hepatic structure segmentation. Ablation studies reveal that large organs benefit from intensity augmentations while small lesions require noise augmentations. The voting threshold controls the coverage precision trade off, enabling task specific optimization for different clinical requirements. Ultimately, on a multiclass hepatic vessel dataset, compared to MedSAM2 baselines, our method achieves an increase of 1.6 in mIoU and 1.9 in aIoU, along with a reduction of approximately 2.0 in HD95. Code will be available at https://github.com/AIGeeksGroup/SegTTA.

Clinical machine learning research and AI driven clinical decision support models rely on clinically accurate labels. Manually extracting these labels with the help of clinical specialists is often time-consuming and expensive. This study tests the feasibility of automatic span- and document-level diagnosis extraction from unstructured Dutch echocardiogram reports. We included 115,692 unstructured echocardiogram reports from the UMCU a large university hospital in the Netherlands. A randomly selected subset was manually annotated for the occurrence and severity of eleven commonly described cardiac characteristics. We developed and tested several automatic labelling techniques at both span and document levels, using weighted and macro F1-score, precision, and recall for performance evaluation. We compared the performance of span labelling against document labelling methods, which included both direct document classifiers and indirect document classifiers that rely on span classification results. The SpanCategorizer and MedRoBERTa.nl models outperformed all other span and document classifiers, respectively. The weighted F1-score varied between characteristics, ranging from 0.60 to 0.93 in SpanCategorizer and 0.96 to 0.98 in MedRoBERTa.nl. Direct document classification was superior to indirect document classification using span classifiers. SetFit achieved competitive document classification performance using only 10\% of the training data. Utilizing a reduced label set yielded near-perfect document classification results. We recommend using our published SpanCategorizer and MedRoBERTa.nl models for span- and document-level diagnosis extraction from Dutch echocardiography reports. For settings with limited training data, SetFit may be a promising alternative for document classification.

Cardiac Magnetic Resonance (CMR) imaging serves as the gold-standard for evaluating cardiac morphology and function. Typically, a multi-view CMR stack, covering short-axis (SA) and 2/3/4-chamber long-axis (LA) views, is acquired for a thorough cardiac assessment. However, efficiently streamlining the complex, high-dimensional 3D+T CMR data and distilling compact, coherent representation remains a challenge. In this work, we introduce a whole-heart self-supervised learning framework that utilizes masked imaging modeling to automatically uncover the correlations between spatial and temporal patches throughout the cardiac stacks. This process facilitates the generation of meaningful and well-clustered heart representations without relying on the traditionally required, and often costly, labeled data. The learned heart representation can be directly used for various downstream tasks. Furthermore, our method demonstrates remarkable robustness, ensuring consistent representations even when certain CMR planes are missing/flawed. We train our model on 14,000 unlabeled CMR data from UK BioBank and evaluate it on 1,000 annotated data. The proposed method demonstrates superior performance to baselines in tasks that demand comprehensive 3D+T cardiac information, e.g. cardiac phenotype (ejection fraction and ventricle volume) prediction and multi-plane/multi-frame CMR segmentation, highlighting its effectiveness in extracting comprehensive cardiac features that are both anatomically and pathologically relevant.

Reading and interpreting chest X-ray images is one of the most radiologist's routines. However, it still can be challenging, even for the most experienced ones. Therefore, we proposed a multi-model deep learning-based automated chest X-ray report generator system designed to assist radiologists in their work. The basic idea of the proposed system is by utilizing multi binary-classification models for detecting multi abnormalities, with each model responsible for detecting one abnormality, in a single image. In this study, we limited the radiology abnormalities detection to only cardiomegaly, lung effusion, and consolidation. The system generates a radiology report by performing the following three steps: image pre-processing, utilizing deep learning models to detect abnormalities, and producing a report. The aim of the image pre-processing step is to standardize the input by scaling it to 128x128 pixels and slicing it into three segments, which covers the upper, lower, and middle parts of the lung. After pre-processing, each corresponding model classifies the image, resulting in a 0 (zero) for no abnormality detected and a 1 (one) for the presence of an abnormality. The prediction outputs of each model are then concatenated to form a 'result code'. The 'result code' is used to construct a report by selecting the appropriate pre-determined sentence for each detected abnormality in the report generation step. The proposed system is expected to reduce the workload of radiologists and increase the accuracy of chest X-ray diagnosis.

Deep learning based medical image classifiers have shown remarkable prowess in various application areas like ophthalmology, dermatology, pathology, and radiology. However, the acceptance of these Computer-Aided Diagnosis (CAD) systems in real clinical setups is severely limited primarily because their decision-making process remains largely obscure. This work aims at elucidating a deep learning based medical image classifier by verifying that the model learns and utilizes similar disease-related concepts as described and employed by dermatologists. We used a well-trained and high performing neural network developed by REasoning for COmplex Data (RECOD) Lab for classification of three skin tumours, i.e. Melanocytic Naevi, Melanoma and Seborrheic Keratosis and performed a detailed analysis on its latent space. Two well established and publicly available skin disease datasets, PH2 and derm7pt, are used for experimentation. Human understandable concepts are mapped to RECOD image classification model with the help of Concept Activation Vectors (CAVs), introducing a novel training and significance testing paradigm for CAVs. Our results on an independent evaluation set clearly shows that the classifier learns and encodes human understandable concepts in its latent representation. Additionally, TCAV scores (Testing with CAVs) suggest that the neural network indeed makes use of disease-related concepts in the correct way when making predictions. We anticipate that this work can not only increase confidence of medical practitioners on CAD but also serve as a stepping stone for further development of CAV-based neural network interpretation methods.

Prediction markets are used in real life to predict outcomes of interest such as presidential elections. This paper presents a mathematical theory of artificial prediction markets for supervised learning of conditional probability estimators. The artificial prediction market is a novel method for fusing the prediction information of features or trained classifiers, where the fusion result is the contract price on the possible outcomes. The market can be trained online by updating the participants' budgets using training examples. Inspired by the real prediction markets, the equations that govern the market are derived from simple and reasonable assumptions. Efficient numerical algorithms are presented for solving these equations. The obtained artificial prediction market is shown to be a maximum likelihood estimator. It generalizes linear aggregation, existent in boosting and random forest, as well as logistic regression and some kernel methods. Furthermore, the market mechanism allows the aggregation of specialized classifiers that participate only on specific instances. Experimental comparisons show that the artificial prediction markets often outperform random forest and implicit online learning on synthetic data and real UCI datasets. Moreover, an extensive evaluation for pelvic and abdominal lymph node detection in CT data shows that the prediction market improves adaboost's detection rate from 79.6% to 81.2% at 3 false positives/volume.

Thyroid nodule classification using ultrasound imaging is essential for early diagnosis and clinical decision-making; however, despite promising performance on in-distribution data, existing deep learning methods often exhibit limited robustness and generalisation when deployed across different ultrasound devices or clinical environments. This limitation is mainly attributed to the pronounced heterogeneity of thyroid ultrasound images, which can lead models to capture spurious correlations rather than reliable diagnostic cues. To address this challenge, we propose PEMV-thyroid, a Prototype-Enhanced Multi-View learning framework that accounts for data heterogeneity by learning complementary representations from multiple feature perspectives and refining decision boundaries through a prototype-based correction mechanism with mixed prototype information. By integrating multi-view representations with prototype-level guidance, the proposed approach enables more stable representation learning under heterogeneous imaging conditions. Extensive experiments on multiple thyroid ultrasound datasets demonstrate that PEMV-thyroid consistently outperforms state-of-the-art methods, particularly in cross-device and cross-domain evaluation scenarios, leading to improved diagnostic accuracy and generalisation performance in real-world clinical settings. The source code is available at https://github.com/chenyangmeii/Prototype-Enhanced-Multi-View-Learning.

Accurate classification of sleep stages from less obtrusive sensor measurements such as the electrocardiogram (ECG) or photoplethysmogram (PPG) could enable important applications in sleep medicine. Existing approaches to this problem have typically used deep learning models designed and trained to operate on one or more specific input signals. However, the datasets used to develop these models often do not contain the same sets of input signals. Some signals, particularly PPG, are much less prevalent than others, and this has previously been addressed with techniques such as transfer learning. Additionally, only training on one or more fixed modalities precludes cross-modal information transfer from other sources, which has proved valuable in other problem domains. To address this, we introduce wav2sleep, a unified model designed to operate on variable sets of input signals during training and inference. After jointly training on over 10,000 overnight recordings from six publicly available polysomnography datasets, including SHHS and MESA, wav2sleep outperforms existing sleep stage classification models across test-time input combinations including ECG, PPG, and respiratory signals.

Automated diagnosis prediction from medical images is a valuable resource to support clinical decision-making. However, such systems usually need to be trained on large amounts of annotated data, which often is scarce in the medical domain. Zero-shot methods address this challenge by allowing a flexible adaption to new settings with different clinical findings without relying on labeled data. Further, to integrate automated diagnosis in the clinical workflow, methods should be transparent and explainable, increasing medical professionals' trust and facilitating correctness verification. In this work, we introduce Xplainer, a novel framework for explainable zero-shot diagnosis in the clinical setting. Xplainer adapts the classification-by-description approach of contrastive vision-language models to the multi-label medical diagnosis task. Specifically, instead of directly predicting a diagnosis, we prompt the model to classify the existence of descriptive observations, which a radiologist would look for on an X-Ray scan, and use the descriptor probabilities to estimate the likelihood of a diagnosis. Our model is explainable by design, as the final diagnosis prediction is directly based on the prediction of the underlying descriptors. We evaluate Xplainer on two chest X-ray datasets, CheXpert and ChestX-ray14, and demonstrate its effectiveness in improving the performance and explainability of zero-shot diagnosis. Our results suggest that Xplainer provides a more detailed understanding of the decision-making process and can be a valuable tool for clinical diagnosis.

Online surgical phase recognition (SPR) underpins context-aware operating-room systems and requires committing to a prediction at every frame from past context alone. Surgical video poses three demands that natural-video recognizers do not jointly address: procedures span tens of thousands of frames, time flows non-uniformly as long routine stretches are punctuated by brief phase-defining transitions, and the visual domain is narrow so backbone features are strongly correlated across channels. Existing recognizers either let per-frame cost grow with elapsed length, or hold cost bounded but advance state at a uniform rate with channel-independent dynamics, leaving the latter two demands unaddressed. We present SurgicalMamba, a causal SPR model built on Mamba2's structured state-space duality (SSD) that holds per-frame cost at O(d). It introduces three SSD-compatible components, each targeting one demand: a dual-path SSD block that separates long- and short-term regimes at the level of recurrent state; intensity-modulated stepping, a continuous-time time-warp that adapts the slow path's effective rate to phase-relevant information; and state regramming, a per-chunk Cayley rotation that opens cross-channel mixing in the otherwise axis-aligned SSM recurrence. The learned rotation planes inherit a phase-aligned structure without any direct supervision, offering an interpretable internal signature of surgical workflow. Across seven public SPR benchmarks, SurgicalMamba reaches state-of-the-art accuracy and phase-level Jaccard under strict online evaluation: 94.6%/82.7% on Cholec80 (+0.7 pp/+2.2 pp over the strongest prior) and 89.5%/68.9% on AutoLaparo (+1.7 pp/+2.0 pp), at 119 fps on a single GPU. Ablations isolate the contribution of each component. The code is publicly available at https://github.com/sukjuoh/Surgical-Mamba.

This paper addresses complex challenges in histopathological image analysis through three key contributions. Firstly, it introduces a fast patch selection method, FPS, for whole-slide image (WSI) analysis, significantly reducing computational cost while maintaining accuracy. Secondly, it presents PathDino, a lightweight histopathology feature extractor with a minimal configuration of five Transformer blocks and only 9 million parameters, markedly fewer than alternatives. Thirdly, it introduces a rotation-agnostic representation learning paradigm using self-supervised learning, effectively mitigating overfitting. We also show that our compact model outperforms existing state-of-the-art histopathology-specific vision transformers on 12 diverse datasets, including both internal datasets spanning four sites (breast, liver, skin, and colorectal) and seven public datasets (PANDA, CAMELYON16, BRACS, DigestPath, Kather, PanNuke, and WSSS4LUAD). Notably, even with a training dataset of 6 million histopathology patches from The Cancer Genome Atlas (TCGA), our approach demonstrates an average 8.5% improvement in patch-level majority vote performance. These contributions provide a robust framework for enhancing image analysis in digital pathology, rigorously validated through extensive evaluation. Project Page: https://rhazeslab.github.io/PathDino-Page/

Various screening and diagnostic methods have led to a large reduction of cervical cancer death rates in developed countries. However, cervical cancer is the leading cause of cancer related deaths in women in India and other low and middle income countries (LMICs) especially among the urban poor and slum dwellers. Several sophisticated techniques such as cytology tests, HPV tests etc. have been widely used for screening of cervical cancer. These tests are inherently time consuming. In this paper, we propose a convolutional autoencoder based framework, having an architecture similar to SegNet which is trained in an adversarial fashion for classifying images of the cervix acquired using a colposcope. We validate performance on the Intel-Mobile ODT cervical image classification dataset. The proposed method outperforms the standard technique of fine-tuning convolutional neural networks pre-trained on ImageNet database with an average accuracy of 73.75%.

A large-scale deep model pre-trained on massive labeled or unlabeled data transfers well to downstream tasks. Linear evaluation freezes parameters in the pre-trained model and trains a linear classifier separately, which is efficient and attractive for transfer. However, little work has investigated the classifier in linear evaluation except for the default logistic regression. Inspired by the statistical efficiency of naive Bayes, the paper revisits the classical topic on discriminative vs. generative classifiers. Theoretically, the paper considers the surrogate loss instead of the zero-one loss in analyses and generalizes the classical results from binary cases to multiclass ones. We show that, under mild assumptions, multiclass naive Bayes requires O(log n) samples to approach its asymptotic error while the corresponding multiclass logistic regression requires O(n) samples, where n is the feature dimension. To establish it, we present a multiclass H-consistency bound framework and an explicit bound for logistic loss, which are of independent interests. Simulation results on a mixture of Gaussian validate our theoretical findings. Experiments on various pre-trained deep vision models show that naive Bayes consistently converges faster as the number of data increases. Besides, naive Bayes shows promise in few-shot cases and we observe the "two regimes" phenomenon in pre-trained supervised models. Our code is available at https://github.com/ML-GSAI/Revisiting-Dis-vs-Gen-Classifiers.

This paper presents a comparison of six machine learning (ML) algorithms: GRU-SVM (Agarap, 2017), Linear Regression, Multilayer Perceptron (MLP), Nearest Neighbor (NN) search, Softmax Regression, and Support Vector Machine (SVM) on the Wisconsin Diagnostic Breast Cancer (WDBC) dataset (Wolberg, Street, & Mangasarian, 1992) by measuring their classification test accuracy and their sensitivity and specificity values. The said dataset consists of features which were computed from digitized images of FNA tests on a breast mass (Wolberg, Street, & Mangasarian, 1992). For the implementation of the ML algorithms, the dataset was partitioned in the following fashion: 70% for training phase, and 30% for the testing phase. The hyper-parameters used for all the classifiers were manually assigned. Results show that all the presented ML algorithms performed well (all exceeded 90% test accuracy) on the classification task. The MLP algorithm stands out among the implemented algorithms with a test accuracy of ~99.04%.

Objective: To transform heterogeneous clinical data from electronic health records into clinically meaningful constructed features using data driven method that rely, in part, on temporal relations among data. Materials and Methods: The clinically meaningful representations of medical concepts and patients are the key for health analytic applications. Most of existing approaches directly construct features mapped to raw data (e.g., ICD or CPT codes), or utilize some ontology mapping such as SNOMED codes. However, none of the existing approaches leverage EHR data directly for learning such concept representation. We propose a new way to represent heterogeneous medical concepts (e.g., diagnoses, medications and procedures) based on co-occurrence patterns in longitudinal electronic health records. The intuition behind the method is to map medical concepts that are co-occuring closely in time to similar concept vectors so that their distance will be small. We also derive a simple method to construct patient vectors from the related medical concept vectors. Results: For qualitative evaluation, we study similar medical concepts across diagnosis, medication and procedure. In quantitative evaluation, our proposed representation significantly improves the predictive modeling performance for onset of heart failure (HF), where classification methods (e.g. logistic regression, neural network, support vector machine and K-nearest neighbors) achieve up to 23% improvement in area under the ROC curve (AUC) using this proposed representation. Conclusion: We proposed an effective method for patient and medical concept representation learning. The resulting representation can map relevant concepts together and also improves predictive modeling performance.

Purpose: Recent advancements in large language models (LLMs) have expanded their capabilities in a multimodal fashion, potentially replicating the image interpretation of human radiologists. This study aimed to develop open-source multimodal large language model for interpreting chest X-ray images (CXR-LLaVA). We also examined the effect of prompt engineering and model parameters such as temperature and nucleus sampling. Materials and Methods: For training, we collected 659,287 publicly available CXRs: 417,336 CXRs had labels for certain radiographic abnormalities (dataset 1); 241,951 CXRs provided free-text radiology reports (dataset 2). After pre-training the Resnet50 as an image encoder, the contrastive language-image pre-training was used to align CXRs and corresponding radiographic abnormalities. Then, the Large Language Model Meta AI-2 was fine-tuned using dataset 2, which were refined using GPT-4, with generating various question answering scenarios. The code can be found at https://github.com/ECOFRI/CXR_LLaVA. Results: In the test set, we observed that the model's performance fluctuated based on its parameters. On average, it achieved F1 score of 0.34 for five pathologic findings (atelectasis, cardiomegaly, consolidation, edema, and pleural effusion), which was improved to 0.46 through prompt engineering. In the independent set, the model achieved an average F1 score of 0.30 for the same pathologic findings. Notably, for the pediatric chest radiograph dataset, which was unseen during training, the model differentiated abnormal radiographs with an F1 score ranging from 0.84 to 0.85. Conclusion: CXR-LLaVA demonstrates promising potential in CXR interpretation. Both prompt engineering and model parameter adjustments can play pivotal roles in interpreting CXRs.

We present a new challenging dataset, CPPE - 5 (Medical Personal Protective Equipment), with the goal to allow the study of subordinate categorization of medical personal protective equipments, which is not possible with other popular data sets that focus on broad-level categories (such as PASCAL VOC, ImageNet, Microsoft COCO, OpenImages, etc). To make it easy for models trained on this dataset to be used in practical scenarios in complex scenes, our dataset mainly contains images that show complex scenes with several objects in each scene in their natural context. The image collection for this dataset focuses on: obtaining as many non-iconic images as possible and making sure all the images are real-life images, unlike other existing datasets in this area. Our dataset includes 5 object categories (coveralls, face shields, gloves, masks, and goggles), and each image is annotated with a set of bounding boxes and positive labels. We present a detailed analysis of the dataset in comparison to other popular broad category datasets as well as datasets focusing on personal protective equipments, we also find that at present there exist no such publicly available datasets. Finally, we also analyze performance and compare model complexities on baseline and state-of-the-art models for bounding box results. Our code, data, and trained models are available at https://git.io/cppe5-dataset.

Fully automatic cardiac segmentation can be a fast and reproducible method to extract clinical measurements from an echocardiography examination. The U-Net architecture is the current state-of-the-art deep learning architecture for medical segmentation and can segment cardiac structures in real-time with average errors comparable to inter-observer variability. However, this architecture still generates large outliers that are often anatomically incorrect. This work uses the concept of graph convolutional neural networks that predict the contour points of the structures of interest instead of labeling each pixel. We propose a graph architecture that uses two convolutional rings based on cardiac anatomy and show that this eliminates anatomical incorrect multi-structure segmentations on the publicly available CAMUS dataset. Additionally, this work contributes with an ablation study on the graph convolutional architecture and an evaluation of clinical measurements on the clinical HUNT4 dataset. Finally, we propose to use the inter-model agreement of the U-Net and the graph network as a predictor of both the input and segmentation quality. We show this predictor can detect out-of-distribution and unsuitable input images in real-time. Source code is available online: https://github.com/gillesvntnu/GCN_multistructure

We introduce methods for obtaining pretrained Geometric Neural Operators (GNPs) that can serve as basal foundation models for use in obtaining geometric features. These can be used within data processing pipelines for machine learning tasks and numerical methods. We show how our GNPs can be trained to learn robust latent representations for the differential geometry of point-clouds to provide estimates of metric, curvature, and other shape-related features. We demonstrate how our pre-trained GNPs can be used (i) to estimate the geometric properties of surfaces of arbitrary shape and topologies with robustness in the presence of noise, (ii) to approximate solutions of geometric partial differential equations (PDEs) on manifolds, and (iii) to solve equations for shape deformations such as curvature driven flows. We release codes and weights for using GNPs in the package geo_neural_op. This allows for incorporating our pre-trained GNPs as components for reuse within existing and new data processing pipelines. The GNPs also can be used as part of numerical solvers involving geometry or as part of methods for performing inference and other geometric tasks.

We introduce a new type of foundational model for parsing human anatomy in medical images that works for different modalities. It supports supervised or unsupervised training and can perform matching, registration, classification, or segmentation with or without user interaction. We achieve this by training a neural network estimator that maps query locations to atlas coordinates via regression. Efficiency is improved by sparsely sampling the input, enabling response times of less than 1 ms without additional accelerator hardware. We demonstrate the utility of the algorithm in both CT and MRI modalities.

3D medical image classification is essential for modern clinical workflows. Medical foundation models (FMs) have emerged as a promising approach for scaling to new tasks, yet current research suffers from three critical pitfalls: data-regime bias, suboptimal adaptation, and insufficient task coverage. In this paper, we address these pitfalls and introduce AnyMC3D, a scalable 3D classifier adapted from 2D FMs. Our method scales efficiently to new tasks by adding only lightweight plugins (about 1M parameters per task) on top of a single frozen backbone. This versatile framework also supports multi-view inputs, auxiliary pixel-level supervision, and interpretable heatmap generation. We establish a comprehensive benchmark of 12 tasks covering diverse pathologies, anatomies, and modalities, and systematically analyze state-of-the-art 3D classification techniques. Our analysis reveals key insights: (1) effective adaptation is essential to unlock FM potential, (2) general-purpose FMs can match medical-specific FMs if properly adapted, and (3) 2D-based methods surpass 3D architectures for 3D classification. For the first time, we demonstrate the feasibility of achieving state-of-the-art performance across diverse applications using a single scalable framework (including 1st place in the VLM3D challenge), eliminating the need for separate task-specific models.

Training convolutional neural networks (CNNs) for segmentation of pulmonary airway, artery, and vein is challenging due to sparse supervisory signals caused by the severe class imbalance between tubular targets and background. We present a CNNs-based method for accurate airway and artery-vein segmentation in non-contrast computed tomography. It enjoys superior sensitivity to tenuous peripheral bronchioles, arterioles, and venules. The method first uses a feature recalibration module to make the best use of features learned from the neural networks. Spatial information of features is properly integrated to retain relative priority of activated regions, which benefits the subsequent channel-wise recalibration. Then, attention distillation module is introduced to reinforce representation learning of tubular objects. Fine-grained details in high-resolution attention maps are passing down from one layer to its previous layer recursively to enrich context. Anatomy prior of lung context map and distance transform map is designed and incorporated for better artery-vein differentiation capacity. Extensive experiments demonstrated considerable performance gains brought by these components. Compared with state-of-the-art methods, our method extracted much more branches while maintaining competitive overall segmentation performance. Codes and models are available at http://www.pami.sjtu.edu.cn/News/56

The electrocardiogram (ECG) is a dependable instrument for assessing the function of the cardiovascular system. There has recently been much emphasis on precisely classifying ECGs. While ECG situations have numerous similarities, little attention has been paid to categorizing ECGs using graph neural networks. In this study, we offer three distinct techniques for classifying heartbeats using deep graph neural networks to classify the ECG signals accurately. We suggest using different methods to extract topological features from the ECG signal and then using a branch of the graph neural network named graph isomorphism network for classifying the ECGs. On the PTB Diagnostics data set, we tested the three proposed techniques. According to the findings, the three proposed techniques are capable of making arrhythmia classification predictions with the accuracy of 99.38, 98.76, and 91.93 percent, respectively.

Vision-language pre-training, i.e., aligning images with paired text, is a powerful paradigm to create encoders that can be directly used for tasks such as classification and retrieval, and for downstream tasks such as segmentation and report generation. In the 3D medical image domain, these capabilities allow vision-language encoders (VLEs) to support radiologists by retrieving patients with similar abnormalities or predicting likelihoods of abnormality. While the methodology holds promise, data availability limits the capabilities of current 3D VLEs. In this paper, we alleviate the lack of data by injecting additional inductive biases: introducing a report generation objective and pairing vision-language pre-training with vision-only pre-training. This allows us to leverage both image-only and paired image-text 3D datasets, increasing the total amount of data to which our model is exposed. Through these additional inductive biases, paired with best practices of the 3D medical imaging domain, we develop the Comprehensive Language-image Pre-training (COLIPRI) encoder family. Our COLIPRI encoders achieve state-of-the-art performance in report generation, classification probing, and zero-shot classification, and remain competitive for semantic segmentation.

Feature attribution methods identify which features of an input most influence a model's output. Most widely-used feature attribution methods (such as SHAP, LIME, and Grad-CAM) are "class-dependent" methods in that they generate a feature attribution vector as a function of class. In this work, we demonstrate that class-dependent methods can "leak" information about the selected class, making that class appear more likely than it is. Thus, an end user runs the risk of drawing false conclusions when interpreting an explanation generated by a class-dependent method. In contrast, we introduce "distribution-aware" methods, which favor explanations that keep the label's distribution close to its distribution given all features of the input. We introduce SHAP-KL and FastSHAP-KL, two baseline distribution-aware methods that compute Shapley values. Finally, we perform a comprehensive evaluation of seven class-dependent and three distribution-aware methods on three clinical datasets of different high-dimensional data types: images, biosignals, and text.

Vision-Language Models (VLMs) have demonstrated impressive performance on zero-shot classification, i.e. classification when provided merely with a list of class names. In this paper, we tackle the case of zero-shot classification in the presence of unlabeled data. We leverage the graph structure of the unlabeled data and introduce ZLaP, a method based on label propagation (LP) that utilizes geodesic distances for classification. We tailor LP to graphs containing both text and image features and further propose an efficient method for performing inductive inference based on a dual solution and a sparsification step. We perform extensive experiments to evaluate the effectiveness of our method on 14 common datasets and show that ZLaP outperforms the latest related works. Code: https://github.com/vladan-stojnic/ZLaP

Accurate delineation of pathological lungs from computed tomography (CT) images remains mostly unsolved because available methods fail to provide a reliable generic solution due to high variability of abnormality appearance. Local descriptor-based classification methods have shown to work well in annotating pathologies; however, these methods are usually computationally intensive which restricts their widespread use in real-time or near-real-time clinical applications. In this paper, we present a novel approach for fast, accurate, reliable segmentation of pathological lungs from CT scans by combining region-based segmentation method with local descriptor classification that is performed on an optimized sampling grid. Our method works in two stages; during stage one, we adapted the fuzzy connectedness (FC) image segmentation algorithm to perform initial lung parenchyma extraction. In the second stage, texture-based local descriptors are utilized to segment abnormal imaging patterns using a near optimal keypoint analysis by employing centroid of supervoxel as grid points. The quantitative results show that our pathological lung segmentation method is fast, robust, and improves on current standards and has potential to enhance the performance of routine clinical tasks.

The in-vivo identification of the kidney stone types during an ureteroscopy would be a major medical advance in urology, as it could reduce the time of the tedious renal calculi extraction process, while diminishing infection risks. Furthermore, such an automated procedure would make possible to prescribe anti-recurrence treatments immediately. Nowadays, only few experienced urologists are able to recognize the kidney stone types in the images of the videos displayed on a screen during the endoscopy. Thus, several deep learning (DL) models have recently been proposed to automatically recognize the kidney stone types using ureteroscopic images. However, these DL models are of black box nature whicl limits their applicability in clinical settings. This contribution proposes a case-based reasoning DL model which uses prototypical parts (PPs) and generates local and global descriptors. The PPs encode for each class (i.e., kidney stone type) visual feature information (hue, saturation, intensity and textures) similar to that used by biologists. The PPs are optimally generated due a new loss function used during the model training. Moreover, the local and global descriptors of PPs allow to explain the decisions ("what" information, "where in the images") in an understandable way for biologists and urologists. The proposed DL model has been tested on a database including images of the six most widespread kidney stone types. The overall average classification accuracy was 90.37. When comparing this results with that of the eight other DL models of the kidney stone state-of-the-art, it can be seen that the valuable gain in explanability was not reached at the expense of accuracy which was even slightly increased with respect to that (88.2) of the best method of the literature. These promising and interpretable results also encourage urologists to put their trust in AI-based solutions.

Tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis, primarily affecting the lungs. Early detection is crucial for improving treatment effectiveness and reducing transmission risk. Artificial intelligence (AI), particularly through image classification of chest X-rays, can assist in TB detection. However, class imbalance in TB chest X-ray datasets presents a challenge for accurate classification. In this paper, we propose a few-shot learning (FSL) approach using the Prototypical Network algorithm to address this issue. We compare the performance of ResNet-18, ResNet-50, and VGG16 in feature extraction from the TBX11K Chest X-ray dataset. Experimental results demonstrate classification accuracies of 98.93% for ResNet-18, 98.60% for ResNet-50, and 33.33% for VGG16. These findings indicate that the proposed method outperforms others in mitigating data imbalance, which is particularly beneficial for disease classification applications.

In this paper, we propose HiPoNet, an end-to-end differentiable neural network for regression, classification, and representation learning on high-dimensional point clouds. Our work is motivated by single-cell data which can have very high-dimensionality --exceeding the capabilities of existing methods for point clouds which are mostly tailored for 3D data. Moreover, modern single-cell and spatial experiments now yield entire cohorts of datasets (i.e., one data set for every patient), necessitating models that can process large, high-dimensional point-clouds at scale. Most current approaches build a single nearest-neighbor graph, discarding important geometric and topological information. In contrast, HiPoNet models the point-cloud as a set of higher-order simplicial complexes, with each particular complex being created using a reweighting of features. This method thus generates multiple constructs corresponding to different views of high-dimensional data, which in biology offers the possibility of disentangling distinct cellular processes. It then employs simplicial wavelet transforms to extract multiscale features, capturing both local and global topology from each view. We show that geometric and topological information is preserved in this framework both theoretically and empirically. We showcase the utility of HiPoNet on point-cloud level tasks, involving classification and regression of entire point-clouds in data cohorts. Experimentally, we find that HiPoNet outperforms other point-cloud and graph-based models on single-cell data. We also apply HiPoNet to spatial transcriptomics datasets using spatial coordinates as one of the views. Overall, HiPoNet offers a robust and scalable solution for high-dimensional data analysis.

Respiratory sound classification is hindered by the limited size, high noise levels, and severe class imbalance of benchmark datasets like ICBHI 2017. While Transformer-based models offer powerful feature extraction capabilities, they are prone to overfitting and often converge to sharp minima in the loss landscape when trained on such constrained medical data. To address this, we introduce a framework that enhances the Audio Spectrogram Transformer (AST) using Sharpness-Aware Minimization (SAM). Instead of merely minimizing the training loss, our approach optimizes the geometry of the loss surface, guiding the model toward flatter minima that generalize better to unseen patients. We also implement a weighted sampling strategy to handle class imbalance effectively. Our method achieves a state-of-the-art score of 68.10% on the ICBHI 2017 dataset, outperforming existing CNN and hybrid baselines. More importantly, it reaches a sensitivity of 68.31%, a crucial improvement for reliable clinical screening. Further analysis using t-SNE and attention maps confirms that the model learns robust, discriminative features rather than memorizing background noise.

The complexity and variability inherent in high-resolution pathological images present significant challenges in computational pathology. While pathology foundation models leveraging AI have catalyzed transformative advancements, their development demands large-scale datasets, considerable storage capacity, and substantial computational resources. Furthermore, ensuring their clinical applicability and generalizability requires rigorous validation across a broad spectrum of clinical tasks. Here, we present PathOrchestra, a versatile pathology foundation model trained via self-supervised learning on a dataset comprising 300K pathological slides from 20 tissue and organ types across multiple centers. The model was rigorously evaluated on 112 clinical tasks using a combination of 61 private and 51 public datasets. These tasks encompass digital slide preprocessing, pan-cancer classification, lesion identification, multi-cancer subtype classification, biomarker assessment, gene expression prediction, and the generation of structured reports. PathOrchestra demonstrated exceptional performance across 27,755 WSIs and 9,415,729 ROIs, achieving over 0.950 accuracy in 47 tasks, including pan-cancer classification across various organs, lymphoma subtype diagnosis, and bladder cancer screening. Notably, it is the first model to generate structured reports for high-incidence colorectal cancer and diagnostically complex lymphoma-areas that are infrequently addressed by foundational models but hold immense clinical potential. Overall, PathOrchestra exemplifies the feasibility and efficacy of a large-scale, self-supervised pathology foundation model, validated across a broad range of clinical-grade tasks. Its high accuracy and reduced reliance on extensive data annotation underline its potential for clinical integration, offering a pathway toward more efficient and high-quality medical services.

Modern medicine generates vast multimodal data across siloed systems, yet no existing model integrates the full breadth and temporal depth of the clinical record into a unified patient representation. We introduce Apollo, a multimodal temporal foundation model trained and evaluated on over three decades of longitudinal hospital records from a major US hospital system, composed of 25 billion records from 7.2 million patients, representing 28 distinct medical modalities and 12 major medical specialties. Apollo learns a unified representation space integrating over 100 thousand unique medical events in our clinical vocabulary as well as images and clinical text. This "atlas of medical concepts" forms a computational substrate for modeling entire patient care journeys comprised of sequences of structured and unstructured events, which are compressed by Apollo into virtual patient representations. To assess the potential of these whole-patient representations, we created 322 prognosis and retrieval tasks from a held-out test set of 1.4 million patients. We demonstrate the generalized clinical forecasting potential of Apollo embeddings, including predicting new disease onset risk up to five years in advance (95 tasks), disease progression (78 tasks), treatment response (59 tasks), risk of treatment-related adverse events (17 tasks), and hospital operations endpoints (12 tasks). Using feature attribution techniques, we show that model predictions align with clinically-interpretable multimodal biomarkers. We evaluate semantic similarity search on 61 retrieval tasks, and moreover demonstrate the potential of Apollo as a multimodal medical search engine using text and image queries. Together, these modeling capabilities establish the foundation for computable medicine, where the full context of patient care becomes accessible to computational reasoning.

This work introduces a new framework, ProtoSAM, for one-shot medical image segmentation. It combines the use of prototypical networks, known for few-shot segmentation, with SAM - a natural image foundation model. The method proposed creates an initial coarse segmentation mask using the ALPnet prototypical network, augmented with a DINOv2 encoder. Following the extraction of an initial mask, prompts are extracted, such as points and bounding boxes, which are then input into the Segment Anything Model (SAM). State-of-the-art results are shown on several medical image datasets and demonstrate automated segmentation capabilities using a single image example (one shot) with no need for fine-tuning of the foundation model. Our code is available at: https://github.com/levayz/ProtoSAM

We propose ImGeoNet, a multi-view image-based 3D object detection framework that models a 3D space by an image-induced geometry-aware voxel representation. Unlike previous methods which aggregate 2D features into 3D voxels without considering geometry, ImGeoNet learns to induce geometry from multi-view images to alleviate the confusion arising from voxels of free space, and during the inference phase, only images from multiple views are required. Besides, a powerful pre-trained 2D feature extractor can be leveraged by our representation, leading to a more robust performance. To evaluate the effectiveness of ImGeoNet, we conduct quantitative and qualitative experiments on three indoor datasets, namely ARKitScenes, ScanNetV2, and ScanNet200. The results demonstrate that ImGeoNet outperforms the current state-of-the-art multi-view image-based method, ImVoxelNet, on all three datasets in terms of detection accuracy. In addition, ImGeoNet shows great data efficiency by achieving results comparable to ImVoxelNet with 100 views while utilizing only 40 views. Furthermore, our studies indicate that our proposed image-induced geometry-aware representation can enable image-based methods to attain superior detection accuracy than the seminal point cloud-based method, VoteNet, in two practical scenarios: (1) scenarios where point clouds are sparse and noisy, such as in ARKitScenes, and (2) scenarios involve diverse object classes, particularly classes of small objects, as in the case in ScanNet200.

For many segmentation tasks, especially for the biomedical image, the topological prior is vital information which is useful to exploit. The containment/nesting is a typical inter-class geometric relationship. In the MICCAI Brain tumor segmentation challenge, with its three hierarchically nested classes 'whole tumor', 'tumor core', 'active tumor', the nested classes relationship is introduced into the 3D-residual-Unet architecture. The network comprises a context aggregation pathway and a localization pathway, which encodes increasingly abstract representation of the input as going deeper into the network, and then recombines these representations with shallower features to precisely localize the interest domain via a localization path. The nested-class-prior is combined by proposing the multi-class activation function and its corresponding loss function. The model is trained on the training dataset of Brats2018, and 20% of the dataset is regarded as the validation dataset to determine parameters. When the parameters are fixed, we retrain the model on the whole training dataset. The performance achieved on the validation leaderboard is 86%, 77% and 72% Dice scores for the whole tumor, enhancing tumor and tumor core classes without relying on ensembles or complicated post-processing steps. Based on the same start-of-the-art network architecture, the accuracy of nested-class (enhancing tumor) is reasonably improved from 69% to 72% compared with the traditional Softmax-based method which blind to topological prior.

Diabetic foot ulcers are a common manifestation of lesions on the diabetic foot, a syndrome acquired as a long-term complication of diabetes mellitus. Accompanying neuropathy and vascular damage promote acquisition of pressure injuries and tissue death due to ischaemia. Affected areas are prone to infections, hindering the healing progress. The research at hand investigates an approach on classification of infection and ischaemia, conducted as part of the Diabetic Foot Ulcer Challenge (DFUC) 2021. Different models of the EfficientNet family are utilized in ensembles. An extension strategy for the training data is applied, involving pseudo-labeling for unlabeled images, and extensive generation of synthetic images via pix2pixHD to cope with severe class imbalances. The resulting extended training dataset features 8.68 times the size of the baseline and shows a real to synthetic image ratio of 1:3. Performances of models and ensembles trained on the baseline and extended training dataset are compared. Synthetic images featured a broad qualitative variety. Results show that models trained on the extended training dataset as well as their ensemble benefit from the large extension. F1-Scores for rare classes receive outstanding boosts, while those for common classes are either not harmed or boosted moderately. A critical discussion concretizes benefits and identifies limitations, suggesting improvements. The work concludes that classification performance of individual models as well as that of ensembles can be boosted utilizing synthetic images. Especially performance for rare classes benefits notably.

Some recent studies have described deep convolutional neural networks to diagnose breast cancer in mammograms with similar or even superior performance to that of human experts. One of the best techniques does two transfer learnings: the first uses a model trained on natural images to create a "patch classifier" that categorizes small subimages; the second uses the patch classifier to scan the whole mammogram and create the "single-view whole-image classifier". We propose to make a third transfer learning to obtain a "two-view classifier" to use the two mammographic views: bilateral craniocaudal and mediolateral oblique. We use EfficientNet as the basis of our model. We "end-to-end" train the entire system using CBIS-DDSM dataset. To ensure statistical robustness, we test our system twice using: (a) 5-fold cross validation; and (b) the original training/test division of the dataset. Our technique reached an AUC of 0.9344 using 5-fold cross validation (accuracy, sensitivity and specificity are 85.13% at the equal error rate point of ROC). Using the original dataset division, our technique achieved an AUC of 0.8483, as far as we know the highest reported AUC for this problem, although the subtle differences in the testing conditions of each work do not allow for an accurate comparison. The inference code and model are available at https://github.com/dpetrini/two-views-classifier

We propose a new graph neural network (GNN) module, based on relaxations of recently proposed geometric scattering transforms, which consist of a cascade of graph wavelet filters. Our learnable geometric scattering (LEGS) module enables adaptive tuning of the wavelets to encourage band-pass features to emerge in learned representations. The incorporation of our LEGS-module in GNNs enables the learning of longer-range graph relations compared to many popular GNNs, which often rely on encoding graph structure via smoothness or similarity between neighbors. Further, its wavelet priors result in simplified architectures with significantly fewer learned parameters compared to competing GNNs. We demonstrate the predictive performance of LEGS-based networks on graph classification benchmarks, as well as the descriptive quality of their learned features in biochemical graph data exploration tasks. Our results show that LEGS-based networks match or outperforms popular GNNs, as well as the original geometric scattering construction, on many datasets, in particular in biochemical domains, while retaining certain mathematical properties of handcrafted (non-learned) geometric scattering.

Automated detection of cervical cancer cells or cell clumps has the potential to significantly reduce error rate and increase productivity in cervical cancer screening. However, most traditional methods rely on the success of accurate cell segmentation and discriminative hand-crafted features extraction. Recently there are emerging deep learning-based methods which train convolutional neural networks (CNN) to classify image patches, but they are computationally expensive. In this paper we propose an efficient CNN-based object detection methods for cervical cancer cells/clumps detection. Specifically, we utilize the state-of-the-art two-stage object detection method, the Faster-RCNN with Feature Pyramid Network (FPN) as the baseline and propose a novel comparison detector to deal with the limited data problem. The key idea is that classify the proposals by comparing with the reference samples of each category in object detection. In addition, we propose to learn the reference samples of the background from data instead of manually choosing them by some heuristic rules. Experimental results show that the proposed Comparison Detector yields significant improvement on the small dataset, achieving a mean Average Precision (mAP) of 26.3% and an Average Recall (AR) of 35.7%, both improving about 20 points compared to the baseline. Moreover, Comparison Detector improved AR by 4.6 points and achieved marginally better performance in terms of mAP compared with baseline model when training on the medium dataset. Our method is promising for the development of automation-assisted cervical cancer screening systems. Code is available at https://github.com/kuku-sichuan/ComparisonDetector.

AI models for lung cancer screening are limited by data scarcity, impacting generalizability and clinical applicability. Generative models address this issue but are constrained by training data variability. We introduce SYN-LUNGS, a framework for generating high-quality 3D CT images with detailed annotations. SYN-LUNGS integrates XCAT3 phantoms for digital twin generation, X-Lesions for nodule simulation (varying size, location, and appearance), and DukeSim for CT image formation with vendor and parameter variability. The dataset includes 3,072 nodule images from 1,044 simulated CT scans, with 512 lesions and 174 digital twins. Models trained on clinical + simulated data outperform clinical only models, achieving 10% improvement in detection, 2-9% in segmentation and classification, and enhanced synthesis. By incorporating anatomy-informed simulations, SYN-LUNGS provides a scalable approach for AI model development, particularly in rare disease representation and improving model reliability.

Reconstructing 3D shapes from planar cross-sections is a challenge inspired by downstream applications like medical imaging and geographic informatics. The input is an in/out indicator function fully defined on a sparse collection of planes in space, and the output is an interpolation of the indicator function to the entire volume. Previous works addressing this sparse and ill-posed problem either produce low quality results, or rely on additional priors such as target topology, appearance information, or input normal directions. In this paper, we present OReX, a method for 3D shape reconstruction from slices alone, featuring a Neural Field as the interpolation prior. A modest neural network is trained on the input planes to return an inside/outside estimate for a given 3D coordinate, yielding a powerful prior that induces smoothness and self-similarities. The main challenge for this approach is high-frequency details, as the neural prior is overly smoothing. To alleviate this, we offer an iterative estimation architecture and a hierarchical input sampling scheme that encourage coarse-to-fine training, allowing the training process to focus on high frequencies at later stages. In addition, we identify and analyze a ripple-like effect stemming from the mesh extraction step. We mitigate it by regularizing the spatial gradients of the indicator function around input in/out boundaries during network training, tackling the problem at the root. Through extensive qualitative and quantitative experimentation, we demonstrate our method is robust, accurate, and scales well with the size of the input. We report state-of-the-art results compared to previous approaches and recent potential solutions, and demonstrate the benefit of our individual contributions through analysis and ablation studies.