Daily Papers

Intraoperative pathology is pivotal to precision surgery, yet its clinical impact is constrained by diagnostic complexity and the limited availability of high-quality frozen-section data. While computational pathology has made significant strides, the lack of large-scale, prospective validation has impeded its routine adoption in surgical workflows. Here, we introduce CRISP, a clinical-grade foundation model developed on over 100,000 frozen sections from eight medical centers, specifically designed to provide Clinical-grade Robust Intraoperative Support for Pathology (CRISP). CRISP was comprehensively evaluated on more than 15,000 intraoperative slides across nearly 100 retrospective diagnostic tasks, including benign-malignant discrimination, key intraoperative decision-making, and pan-cancer detection, etc. The model demonstrated robust generalization across diverse institutions, tumor types, and anatomical sites-including previously unseen sites and rare cancers. In a prospective cohort of over 2,000 patients, CRISP sustained high diagnostic accuracy under real-world conditions, directly informing surgical decisions in 92.6% of cases. Human-AI collaboration further reduced diagnostic workload by 35%, avoided 105 ancillary tests and enhanced detection of micrometastases with 87.5% accuracy. Together, these findings position CRISP as a clinical-grade paradigm for AI-driven intraoperative pathology, bridging computational advances with surgical precision and accelerating the translation of artificial intelligence into routine clinical practice.

Current challenges in developing foundational models for volumetric imaging data, such as magnetic resonance imaging (MRI), stem from the computational complexity of training state-of-the-art architectures in high dimensions and curating sufficiently large datasets of volumes. To address these challenges, we introduce Raptor (Random Planar Tensor Reduction), a train-free method for generating semantically rich embeddings for volumetric data. Raptor leverages a frozen 2D foundation model, pretrained on natural images, to extract visual tokens from individual cross-sections of medical volumes. These tokens are then spatially compressed using random projections, significantly reducing computational complexity while retaining semantic information. Extensive experiments on ten diverse medical volume tasks verify the superior performance of Raptor over state-of-the-art methods, including those pretrained exclusively on medical volumes (+3% SuPreM, +6% MISFM, +10% Merlin, +13% VoCo, and +14% SLIViT), while entirely bypassing the need for costly training. Our results highlight the effectiveness and versatility of Raptor as a foundation for advancing deep learning-based methods for medical volumes.

Open-vocabulary segmentation poses significant challenges, as it requires segmenting and recognizing objects across an open set of categories in unconstrained environments. Building on the success of powerful vision-language (ViL) foundation models, such as CLIP, recent efforts sought to harness their zero-short capabilities to recognize unseen categories. Despite notable performance improvements, these models still encounter the critical issue of generating precise mask proposals for unseen categories and scenarios, resulting in inferior segmentation performance eventually. To address this challenge, we introduce a novel approach, FrozenSeg, designed to integrate spatial knowledge from a localization foundation model (e.g., SAM) and semantic knowledge extracted from a ViL model (e.g., CLIP), in a synergistic framework. Taking the ViL model's visual encoder as the feature backbone, we inject the space-aware feature into the learnable queries and CLIP features within the transformer decoder. In addition, we devise a mask proposal ensemble strategy for further improving the recall rate and mask quality. To fully exploit pre-trained knowledge while minimizing training overhead, we freeze both foundation models, focusing optimization efforts solely on a lightweight transformer decoder for mask proposal generation-the performance bottleneck. Extensive experiments demonstrate that FrozenSeg advances state-of-the-art results across various segmentation benchmarks, trained exclusively on COCO panoptic data, and tested in a zero-shot manner. Code is available at https://github.com/chenxi52/FrozenSeg.