Daily Papers

Accurate segmentation of Multiple Sclerosis (MS) lesions in longitudinal MRI scans is crucial for monitoring disease progression and treatment efficacy. Although changes across time are taken into account when assessing images in clinical practice, most existing deep learning methods treat scans from different timepoints separately. Among studies utilizing longitudinal images, a simple channel-wise concatenation is the primary albeit suboptimal method employed to integrate timepoints. We introduce a novel approach that explicitly incorporates temporal differences between baseline and follow-up scans through a unique architectural inductive bias called Difference Weighting Block. It merges features from two timepoints, emphasizing changes between scans. We achieve superior scores in lesion segmentation (Dice Score, Hausdorff distance) as well as lesion detection (lesion-level F_1 score) as compared to state-of-the-art longitudinal and single timepoint models across two datasets. Our code is made publicly available at www.github.com/MIC-DKFZ/Longitudinal-Difference-Weighting.

Detailed Geant4 simulation of calorimeter showers dominates the computing budget of high-energy physics experiments. Deep generative surrogates reduce this cost, but they have remained tied to the detector they were trained on, so each new geometry needs a large in-domain dataset. We study whether a single point cloud shower generator can be pre-trained on multiple detectors and transferred to unseen calorimeters. The pre-training geometries come from synthetic geometric variation rather than real-detector data. We introduce SimpleBox, a family of 10^4 box calorimeters spanning the plane of sampling fraction and longitudinal segmentation, and benchmark it against pre-training on realistic detectors. On a calorimeter unseen in pre-training, with 10^3 target showers for fine-tuning, the two priors reduce the aggregated sliced Wasserstein distance to Geant4 by factors of 5.2 (synthetic) and 8.0 (realistic) relative to training from scratch. At larger target sizes the synthetic prior performs better than the realistic one. Geometric diversity alone is therefore a practical way to pre-train a transferable shower generator.

Diagnosing and treating skin diseases require advanced visual skills across domains and the ability to synthesize information from multiple imaging modalities. While current deep learning models excel at specific tasks like skin cancer diagnosis from dermoscopic images, they struggle to meet the complex, multimodal requirements of clinical practice. Here, we introduce PanDerm, a multimodal dermatology foundation model pretrained through self-supervised learning on over 2 million real-world skin disease images from 11 clinical institutions across 4 imaging modalities. We evaluated PanDerm on 28 diverse benchmarks, including skin cancer screening, risk stratification, differential diagnosis of common and rare skin conditions, lesion segmentation, longitudinal monitoring, and metastasis prediction and prognosis. PanDerm achieved state-of-the-art performance across all evaluated tasks, often outperforming existing models when using only 10% of labeled data. We conducted three reader studies to assess PanDerm's potential clinical utility. PanDerm outperformed clinicians by 10.2% in early-stage melanoma detection through longitudinal analysis, improved clinicians' skin cancer diagnostic accuracy by 11% on dermoscopy images, and enhanced non-dermatologist healthcare providers' differential diagnosis by 16.5% across 128 skin conditions on clinical photographs. These results demonstrate PanDerm's potential to improve patient care across diverse clinical scenarios and serve as a model for developing multimodal foundation models in other medical specialties, potentially accelerating the integration of AI support in healthcare. The code can be found at https://github.com/SiyuanYan1/PanDerm.

Brain tissue segmentation is essential for neuroscience and clinical studies. However, segmentation on longitudinal data is challenging due to dynamic brain changes across the lifespan. Previous researches mainly focus on self-supervision with regularizations and will lose longitudinal generalization when fine-tuning on a specific age group. In this paper, we propose a dual meta-learning paradigm to learn longitudinally consistent representations and persist when fine-tuning. Specifically, we learn a plug-and-play feature extractor to extract longitudinal-consistent anatomical representations by meta-feature learning and a well-initialized task head for fine-tuning by meta-initialization learning. Besides, two class-aware regularizations are proposed to encourage longitudinal consistency. Experimental results on the iSeg2019 and ADNI datasets demonstrate the effectiveness of our method. Our code is available at https://github.com/ladderlab-xjtu/DuMeta.

Longitudinal analysis has great potential to reveal developmental trajectories and monitor disease progression in medical imaging. This process relies on consistent and robust joint 4D segmentation. Traditional techniques are dependent on the similarity of images over time and the use of subject-specific priors to reduce random variation and improve the robustness and sensitivity of the overall longitudinal analysis. This is however slow and computationally intensive as subject-specific templates need to be rebuilt every time. The focus of this work to accelerate this analysis with the use of deep learning. The proposed approach is based on deep CNNs and incorporates semantic segmentation and provides a longitudinal relationship for the same subject. The proposed approach is based on deep CNNs and incorporates semantic segmentation and provides a longitudinal relationship for the same subject. The state of art using 3D patches as inputs to modified Unet provides results around {0.91 pm 0.5} Dice and using multi-view atlas in CNNs provide around the same results. In this work, different models are explored, each offers better accuracy and fast results while increasing the segmentation quality. These methods are evaluated on 135 scans from the EADC-ADNI Harmonized Hippocampus Protocol. Proposed CNN based segmentation approaches demonstrate how 2D segmentation using prior slices can provide similar results to 3D segmentation while maintaining good continuity in the 3D dimension and improved speed. Just using 2D modified sagittal slices provide us a better Dice and longitudinal analysis for a given subject. For the ADNI dataset, using the simple UNet CNN technique gives us {0.84 pm 0.5} and while using modified CNN techniques on the same input yields {0.89 pm 0.5}. Rate of atrophy and RMS error are calculated for several test cases using various methods and analyzed.

Monitoring cow body weight is crucial to support farm management decisions due to its direct relationship with the growth, nutritional status, and health of dairy cows. Cow body weight is a repeated trait, however, the majority of previous body weight prediction research only used data collected at a single point in time. Furthermore, the utility of deep learning-based segmentation for body weight prediction using videos remains unanswered. Therefore, the objectives of this study were to predict cow body weight from repeatedly measured video data, to compare the performance of the thresholding and Mask R-CNN deep learning approaches, to evaluate the predictive ability of body weight regression models, and to promote open science in the animal science community by releasing the source code for video-based body weight prediction. A total of 40,405 depth images and depth map files were obtained from 10 lactating Holstein cows and 2 non-lactating Jersey cows. Three approaches were investigated to segment the cow's body from the background, including single thresholding, adaptive thresholding, and Mask R-CNN. Four image-derived biometric features, such as dorsal length, abdominal width, height, and volume, were estimated from the segmented images. On average, the Mask-RCNN approach combined with a linear mixed model resulted in the best prediction coefficient of determination and mean absolute percentage error of 0.98 and 2.03%, respectively, in the forecasting cross-validation. The Mask-RCNN approach was also the best in the leave-three-cows-out cross-validation. The prediction coefficients of determination and mean absolute percentage error of the Mask-RCNN coupled with the linear mixed model were 0.90 and 4.70%, respectively. Our results suggest that deep learning-based segmentation improves the prediction performance of cow body weight from longitudinal depth video data.

In this work, we present LesionLocator, a framework for zero-shot longitudinal lesion tracking and segmentation in 3D medical imaging, establishing the first end-to-end model capable of 4D tracking with dense spatial prompts. Our model leverages an extensive dataset of 23,262 annotated medical scans, as well as synthesized longitudinal data across diverse lesion types. The diversity and scale of our dataset significantly enhances model generalizability to real-world medical imaging challenges and addresses key limitations in longitudinal data availability. LesionLocator outperforms all existing promptable models in lesion segmentation by nearly 10 dice points, reaching human-level performance, and achieves state-of-the-art results in lesion tracking, with superior lesion retrieval and segmentation accuracy. LesionLocator not only sets a new benchmark in universal promptable lesion segmentation and automated longitudinal lesion tracking but also provides the first open-access solution of its kind, releasing our synthetic 4D dataset and model to the community, empowering future advancements in medical imaging. Code is available at: www.github.com/MIC-DKFZ/LesionLocator

Tracking tumor lesions across serial CT scans is essential for oncological response assessment. Existing automated methods face a fundamental trade-off: end-to-end trackers achieve high automation but offer no opportunity to correct silent tracking failures, while decoupled registration-segmentation pipelines permit user verification yet discard the lesion's prior appearance, limiting accuracy in ambiguous cases. In this work, we propose a Verified Tracking paradigm: a clinician verifies a registration-proposed prompt, which the model leverages alongside the baseline lesion appearance to resolve segmentation ambiguities. We present a unified framework combining early spatial prompt fusion with latent temporal difference weighting for longitudinally-informed segmentation. To address data scarcity, we leverage large-scale synthetic pretraining, proving essential for exploiting longitudinal context, improving performance by up to 4.5 Dice points over training from scratch. Our approach secured first place in the MICCAI autoPET IV challenge. We further curate and release PanTrack, a new longitudinal pancreatic cancer benchmark, to assess out-of-distribution generalization. Experiments show that our model outperforms prior work in both fully automatic and the proposed verified tracking setting offering a clinically safe middle ground between automation and control. Code, model and dataset will be released at https://github.com/MIC-DKFZ/LongiSeg

Stroke remains a leading cause of global morbidity and mortality, placing a heavy socioeconomic burden. Over the past decade, advances in endovascular reperfusion therapy and the use of CT and MRI imaging for treatment guidance have significantly improved patient outcomes and are now standard in clinical practice. To develop machine learning algorithms that can extract meaningful and reproducible models of brain function for both clinical and research purposes from stroke images - particularly for lesion identification, brain health quantification, and prognosis - large, diverse, and well-annotated public datasets are essential. While only a few datasets with (sub-)acute stroke data were previously available, several large, high-quality datasets have recently been made publicly accessible. However, these existing datasets include only MRI data. In contrast, our dataset is the first to offer comprehensive longitudinal stroke data, including acute CT imaging with angiography and perfusion, follow-up MRI at 2-9 days, as well as acute and longitudinal clinical data up to a three-month outcome. The dataset includes a training dataset of n = 150 and a test dataset of n = 100 scans. Training data is publicly available, while test data will be used exclusively for model validation. We are making this dataset available as part of the 2024 edition of the Ischemic Stroke Lesion Segmentation (ISLES) challenge (https://www.isles-challenge.org/), which continuously aims to establish benchmark methods for acute and sub-acute ischemic stroke lesion segmentation, aiding in creating open stroke imaging datasets and evaluating cutting-edge image processing algorithms.

Gliomas are the most common primary brain malignancies, with different degrees of aggressiveness, variable prognosis and various heterogeneous histologic sub-regions, i.e., peritumoral edematous/invaded tissue, necrotic core, active and non-enhancing core. This intrinsic heterogeneity is also portrayed in their radio-phenotype, as their sub-regions are depicted by varying intensity profiles disseminated across multi-parametric magnetic resonance imaging (mpMRI) scans, reflecting varying biological properties. Their heterogeneous shape, extent, and location are some of the factors that make these tumors difficult to resect, and in some cases inoperable. The amount of resected tumor is a factor also considered in longitudinal scans, when evaluating the apparent tumor for potential diagnosis of progression. Furthermore, there is mounting evidence that accurate segmentation of the various tumor sub-regions can offer the basis for quantitative image analysis towards prediction of patient overall survival. This study assesses the state-of-the-art machine learning (ML) methods used for brain tumor image analysis in mpMRI scans, during the last seven instances of the International Brain Tumor Segmentation (BraTS) challenge, i.e., 2012-2018. Specifically, we focus on i) evaluating segmentations of the various glioma sub-regions in pre-operative mpMRI scans, ii) assessing potential tumor progression by virtue of longitudinal growth of tumor sub-regions, beyond use of the RECIST/RANO criteria, and iii) predicting the overall survival from pre-operative mpMRI scans of patients that underwent gross total resection. Finally, we investigate the challenge of identifying the best ML algorithms for each of these tasks, considering that apart from being diverse on each instance of the challenge, the multi-institutional mpMRI BraTS dataset has also been a continuously evolving/growing dataset.

Longitudinal brain analysis is essential for understanding healthy aging and identifying pathological deviations. Longitudinal registration of sequential brain MRI underpins such analyses. However, existing methods are limited by reliance on densely sampled time series, a trade-off between accuracy and temporal smoothness, and an inability to prospectively forecast future brain states. To overcome these challenges, we introduce TimeFlow, a learning-based framework for longitudinal brain MRI registration. TimeFlow uses a U-Net backbone with temporal conditioning to model neuroanatomy as a continuous function of age. Given only two scans from an individual, TimeFlow estimates accurate and temporally coherent deformation fields, enabling non-linear extrapolation to predict future brain states. This is achieved by our proposed inter-/extra-polation consistency constraints applied to both the deformation fields and deformed images. Remarkably, these constraints preserve temporal consistency and continuity without requiring explicit smoothness regularizers or densely sampled sequential data. Extensive experiments demonstrate that TimeFlow outperforms state-of-the-art methods in terms of both future timepoint forecasting and registration accuracy. Moreover, TimeFlow supports novel biological brain aging analyses by differentiating neurodegenerative trajectories from normal aging without requiring segmentation, thereby eliminating the need for labor-intensive annotations and mitigating segmentation inconsistency. TimeFlow offers an accurate, data-efficient, and annotation-free framework for longitudinal analysis of brain aging and chronic diseases, capable of forecasting brain changes beyond the observed study period.

Meningiomas are the most common primary intracranial tumor in adults and can be associated with significant morbidity and mortality. Radiologists, neurosurgeons, neuro-oncologists, and radiation oncologists rely on multiparametric MRI (mpMRI) for diagnosis, treatment planning, and longitudinal treatment monitoring; yet automated, objective, and quantitative tools for non-invasive assessment of meningiomas on mpMRI are lacking. The BraTS meningioma 2023 challenge will provide a community standard and benchmark for state-of-the-art automated intracranial meningioma segmentation models based on the largest expert annotated multilabel meningioma mpMRI dataset to date. Challenge competitors will develop automated segmentation models to predict three distinct meningioma sub-regions on MRI including enhancing tumor, non-enhancing tumor core, and surrounding nonenhancing T2/FLAIR hyperintensity. Models will be evaluated on separate validation and held-out test datasets using standardized metrics utilized across the BraTS 2023 series of challenges including the Dice similarity coefficient and Hausdorff distance. The models developed during the course of this challenge will aid in incorporation of automated meningioma MRI segmentation into clinical practice, which will ultimately improve care of patients with meningioma.

Automated pavement distress assessment requires more than image-level classification or coarse bounding box detection, demanding precise localization of thin, branching, and irregular cracks to achieve the geometric precision necessary for maintenance-relevant quantification. This paper presents a vision-based pavement distress analysis system based on Mask R-CNN instance segmentation and evaluates it on UWGB-StreetCrack, a custom field-collected roadway image dataset acquired with a vehicle-mounted smartphone and manually annotated with polygon labels for longitudinal cracks, transverse cracks, alligator cracks, and potholes. Five Detectron2-based Mask R-CNN backbone variants were considered under a consistent fine-tuning protocol. The best-performing model, Mask R-CNN with a ResNet-101 FPN backbone, achieved 84.23% precision, 90.04% recall, and an F1 score of 87.04% under the project-specific bounding-box matching protocol. The same model produced an aggregate predicted crack-area fraction of 2.164%, closely matching the 2.170% ground-truth crack-area fraction. To contextualize the segmentation system against a detector-oriented alternative, a CSPDarknet53-based YOLO detector was also adapted and retrained on the dataset, reaching 27.5% precision and 20.7% recall on the validation protocol. The results show that instance segmentation is a practical direction for field pavement imagery and aggregate crack-area estimation, while also exposing open challenges in annotation consistency, class imbalance, confounder rejection, and mask-level benchmarking.

Quantitative susceptibility maps from magnetic resonance images can provide both prognostic and diagnostic information in multiple sclerosis, a neurodegenerative disease characterized by the formation of lesions in white matter brain tissue. In particular, susceptibility maps provide adequate contrast to distinguish between "rim" lesions, surrounded by deposited paramagnetic iron, and "non-rim" lesion types. These paramagnetic rim lesions (PRLs) are an emerging biomarker in multiple sclerosis. Much effort has been devoted to both detection and segmentation of such lesions to monitor longitudinal change. As paramagnetic rim lesions are rare, addressing this problem requires confronting the class imbalance between rim and non-rim lesions. We produce synthetic quantitative susceptibility maps of paramagnetic rim lesions and show that inclusion of such synthetic data improves classifier performance and provide a multi-channel extension to generate accompanying contrasts and probabilistic segmentation maps. We exploit the projection capability of our trained generative network to demonstrate a novel denoising approach that allows us to train on ambiguous rim cases and substantially increase the minority class. We show that both synthetic lesion synthesis and our proposed rim lesion label denoising method best approximate the unseen rim lesion distribution and improve detection in a clinically interpretable manner. We release our code and generated data at https://github.com/agr78/PRLx-GAN upon publication.

In clinical practice, patients often undergo multiple imaging examinations over successive visits, yielding longitudinal data. Modeling such temporal information is crucial for reliable assessment of disease progression and treatment response. However, despite the rapid advancement of multimodal large language models (MLLMs), longitudinal medical visual reasoning remains largely underexplored. To fill this gap, we propose LoMeVQA, a comprehensive benchmark consisting of 206K longitudinal visual question answering (VQA) pairs for temporal medical image analysis. LoMeVQA covers five tasks: progress classification, progress description, progress report generation, differential region grounding, and differential region description. To construct the dataset, we develop an automated pipeline that (1) organizes patient records chronologically, (2) extracts clinically meaningful entities via a medical knowledge graph, and (3) models their temporal evolution to guide large language models in generating high-quality longitudinal VQA pairs. Extensive evaluations demonstrate that both general-purpose and medical-domain MLLMs perform poorly on LoMeVQA, revealing substantial limitations in temporal reasoning. To address these limitations, we introduce MedLong-8B, which achieves state-of-the-art performance across all tasks. Beyond benchmarking, we conduct detailed analyses that uncover key failure modes and shed light on how to improve longitudinal medical visual reasoning. Our data is available at: https://github.com/pepperbubble/LoMeVQA

We consider the problem of segmenting objects in videos based on their motion and no other forms of supervision. Prior work has often approached this problem by using the principle of common fate, namely the fact that the motion of points that belong to the same object is strongly correlated. However, most authors have only considered instantaneous motion from optical flow. In this work, we present a way to train a segmentation network using long-term point trajectories as a supervisory signal to complement optical flow. The key difficulty is that long-term motion, unlike instantaneous motion, is difficult to model -- any parametric approximation is unlikely to capture complex motion patterns over long periods of time. We instead draw inspiration from subspace clustering approaches, proposing a loss function that seeks to group the trajectories into low-rank matrices where the motion of object points can be approximately explained as a linear combination of other point tracks. Our method outperforms the prior art on motion-based segmentation, which shows the utility of long-term motion and the effectiveness of our formulation.

Automated radiology report generation offers an effective solution to alleviate radiologists' workload. However, most existing methods focus primarily on single or fixed-view images to model current disease conditions, which limits diagnostic accuracy and overlooks disease progression. Although some approaches utilize longitudinal data to track disease progression, they still rely on single images to analyze current visits. To address these issues, we propose enhanced contrastive learning with Multi-view Longitudinal data to facilitate chest X-ray Report Generation, named MLRG. Specifically, we introduce a multi-view longitudinal contrastive learning method that integrates spatial information from current multi-view images and temporal information from longitudinal data. This method also utilizes the inherent spatiotemporal information of radiology reports to supervise the pre-training of visual and textual representations. Subsequently, we present a tokenized absence encoding technique to flexibly handle missing patient-specific prior knowledge, allowing the model to produce more accurate radiology reports based on available prior knowledge. Extensive experiments on MIMIC-CXR, MIMIC-ABN, and Two-view CXR datasets demonstrate that our MLRG outperforms recent state-of-the-art methods, achieving a 2.3% BLEU-4 improvement on MIMIC-CXR, a 5.5% F1 score improvement on MIMIC-ABN, and a 2.7% F1 RadGraph improvement on Two-view CXR.

The growing availability of longitudinal Magnetic Resonance Imaging (MRI) datasets has facilitated Artificial Intelligence (AI)-driven modeling of disease progression, making it possible to predict future medical scans for individual patients. However, despite significant advancements in AI, current methods continue to face challenges including achieving patient-specific individualization, ensuring spatiotemporal consistency, efficiently utilizing longitudinal data, and managing the substantial memory demands of 3D scans. To address these challenges, we propose Brain Latent Progression (BrLP), a novel spatiotemporal model designed to predict individual-level disease progression in 3D brain MRIs. The key contributions in BrLP are fourfold: (i) it operates in a small latent space, mitigating the computational challenges posed by high-dimensional imaging data; (ii) it explicitly integrates subject metadata to enhance the individualization of predictions; (iii) it incorporates prior knowledge of disease dynamics through an auxiliary model, facilitating the integration of longitudinal data; and (iv) it introduces the Latent Average Stabilization (LAS) algorithm, which (a) enforces spatiotemporal consistency in the predicted progression at inference time and (b) allows us to derive a measure of the uncertainty for the prediction at the global and voxel level. We train and evaluate BrLP on 11,730 T1-weighted (T1w) brain MRIs from 2,805 subjects and validate its generalizability on an external test set comprising 2,257 MRIs from 962 subjects. Our experiments compare BrLP-generated MRI scans with real follow-up MRIs, demonstrating state-of-the-art accuracy compared to existing methods. The code is publicly available at: https://github.com/LemuelPuglisi/BrLP.

We propose a novel AutoRegressive Generation-based paradigm for image Segmentation (ARGenSeg), achieving multimodal understanding and pixel-level perception within a unified framework. Prior works integrating image segmentation into multimodal large language models (MLLMs) typically employ either boundary points representation or dedicated segmentation heads. These methods rely on discrete representations or semantic prompts fed into task-specific decoders, which limits the ability of the MLLM to capture fine-grained visual details. To address these challenges, we introduce a segmentation framework for MLLM based on image generation, which naturally produces dense masks for target objects. We leverage MLLM to output visual tokens and detokenize them into images using an universal VQ-VAE, making the segmentation fully dependent on the pixel-level understanding of the MLLM. To reduce inference latency, we employ a next-scale-prediction strategy to generate required visual tokens in parallel. Extensive experiments demonstrate that our method surpasses prior state-of-the-art approaches on multiple segmentation datasets with a remarkable boost in inference speed, while maintaining strong understanding capabilities.

Human organs constantly undergo anatomical changes due to a complex mix of short-term (e.g., heartbeat) and long-term (e.g., aging) factors. Evidently, prior knowledge of these factors will be beneficial when modeling their future state, i.e., via image generation. However, most of the medical image generation tasks only rely on the input from a single image, thus ignoring the sequential dependency even when longitudinal data is available. Sequence-aware deep generative models, where model input is a sequence of ordered and timestamped images, are still underexplored in the medical imaging domain that is featured by several unique challenges: 1) Sequences with various lengths; 2) Missing data or frame, and 3) High dimensionality. To this end, we propose a sequence-aware diffusion model (SADM) for the generation of longitudinal medical images. Recently, diffusion models have shown promising results in high-fidelity image generation. Our method extends this new technique by introducing a sequence-aware transformer as the conditional module in a diffusion model. The novel design enables learning longitudinal dependency even with missing data during training and allows autoregressive generation of a sequence of images during inference. Our extensive experiments on 3D longitudinal medical images demonstrate the effectiveness of SADM compared with baselines and alternative methods. The code is available at https://github.com/ubc-tea/SADM-Longitudinal-Medical-Image-Generation.

Web platforms, mobile applications, and connected sensing systems generate multivariate time series with states at multiple levels of granularity, from coarse regimes to fine-grained events. Effective segmentation in these settings requires integrating across granularities while supporting iterative refinement through sparse prompt signals, which provide a compact mechanism for injecting domain knowledge. Yet existing prompting approaches for time series segmentation operate only within local contexts, so the effect of a prompt quickly fades and cannot guide predictions across the entire sequence. To overcome this limitation, we propose MemPromptTSS, a framework for iterative multi-granularity segmentation that introduces persistent prompt memory. A memory encoder transforms prompts and their surrounding subsequences into memory tokens stored in a bank. This persistent memory enables each new prediction to condition not only on local cues but also on all prompts accumulated across iterations, ensuring their influence persists across the entire sequence. Experiments on six datasets covering wearable sensing and industrial monitoring show that MemPromptTSS achieves 23% and 85% accuracy improvements over the best baseline in single- and multi-granularity segmentation under single iteration inference, and provides stronger refinement in iterative inference with average per-iteration gains of 2.66 percentage points compared to 1.19 for PromptTSS. These results highlight the importance of persistent memory for prompt-guided segmentation, establishing MemPromptTSS as a practical and effective framework for real-world applications.

Medical image segmentation faces a fundamental challenge in continual learning: data arrives sequentially from heterogeneous sources, yet effective continual learning requires discovering which tasks share sufficient structure to benefit from joint learning. Existing methods either apply uniform constraints across all tasks, causing catastrophic forgetting when tasks conflict, or require predefined task groupings that cannot anticipate future task diversity. We introduce MedCRP-CL, a framework that performs online task structure discovery and structure-aware continual learning. Leveraging the Chinese Restaurant Process (CRP), our method dynamically infers task groupings from clinical text prompts as tasks arrive, without requiring predefined cluster counts or access to future tasks. We term these discovered groupings semantic modalities, as they capture finer-grained structure than physical imaging modalities by integrating anatomical region and pathological context. Guided by this discovered structure, we maintain semantic modality-specific LoRA adapters regularized by intra-modality EWC, ensuring parameter isolation across dissimilar task groups while facilitating knowledge transfer within similar ones. The framework is also replay-free, storing only aggregate statistics rather than raw patient data. Experiments on 16 medical segmentation tasks across four imaging modalities demonstrate that MedCRP-CL achieves 73.3% Dice score with only 4.1% forgetting, outperforming the best baseline by 8.0% while requiring 6times fewer parameters. Code is available at https://github.com/zygao930/MedCRP-CL.

Chest Xray imaging is a widely used diagnostic tool in modern medicine, and its high utilization creates substantial workloads for radiologists. To alleviate this burden, vision language models are increasingly applied to automate Chest Xray radiology report generation (CXRRRG), aiming for clinically accurate descriptions while reducing manual effort. Conventional approaches, however, typically rely on single images, failing to capture the longitudinal context necessary for producing clinically faithful comparison statements. Recently, growing attention has been directed toward incorporating longitudinal data into CXR RRG, enabling models to leverage historical studies in ways that mirror radiologists diagnostic workflows. Nevertheless, existing surveys primarily address single image CXRRRG and offer limited guidance for longitudinal settings, leaving researchers without a systematic framework for model design. To address this gap, this survey provides the first comprehensive review of longitudinal radiology report generation (LRRG). Specifically, we examine dataset construction strategies, report generation architectures alongside longitudinally tailored designs, and evaluation protocols encompassing both longitudinal specific measures and widely used benchmarks. We further summarize LRRG methods performance, alongside analyses of different ablation studies, which collectively highlight the critical role of longitudinal information and architectural design choices in improving model performance. Finally, we summarize five major limitations of current research and outline promising directions for future development, aiming to lay a foundation for advancing this emerging field.

Deep learning in the presence of noisy annotations has been studied extensively in classification, but much less in segmentation tasks. In this work, we study the learning dynamics of deep segmentation networks trained on inaccurately-annotated data. We discover a phenomenon that has been previously reported in the context of classification: the networks tend to first fit the clean pixel-level labels during an "early-learning" phase, before eventually memorizing the false annotations. However, in contrast to classification, memorization in segmentation does not arise simultaneously for all semantic categories. Inspired by these findings, we propose a new method for segmentation from noisy annotations with two key elements. First, we detect the beginning of the memorization phase separately for each category during training. This allows us to adaptively correct the noisy annotations in order to exploit early learning. Second, we incorporate a regularization term that enforces consistency across scales to boost robustness against annotation noise. Our method outperforms standard approaches on a medical-imaging segmentation task where noises are synthesized to mimic human annotation errors. It also provides robustness to realistic noisy annotations present in weakly-supervised semantic segmentation, achieving state-of-the-art results on PASCAL VOC 2012. Code is available at https://github.com/Kangningthu/ADELE

Longitudinal multimodal data, including electronic health records (EHR) and sequential chest X-rays (CXRs), is critical for modeling disease progression, yet remains underutilized due to two key challenges: (1) redundancy in consecutive CXR sequences, where static anatomical regions dominate over clinically-meaningful dynamics, and (2) temporal misalignment between sparse, irregular imaging and continuous EHR data. We introduce DiPro, a novel framework that addresses these challenges through region-aware disentanglement and multi-timescale alignment. First, we disentangle static (anatomy) and dynamic (pathology progression) features in sequential CXRs, prioritizing disease-relevant changes. Second, we hierarchically align these static and dynamic CXR features with asynchronous EHR data via local (pairwise interval-level) and global (full-sequence) synchronization to model coherent progression pathways. Extensive experiments on the MIMIC dataset demonstrate that DiPro could effectively extract temporal clinical dynamics and achieve state-of-the-art performance on both disease progression identification and general ICU prediction tasks.

Real-world objects are composed of distinctive, object-specific parts. Identifying these parts is key to performing fine-grained, compositional reasoning-yet, large multimodal models (LMMs) struggle to perform this seemingly straightforward task. In this work, we introduce PARTONOMY, an LMM benchmark designed for pixel-level part grounding. We construct PARTONOMY from existing part datasets and our own rigorously annotated set of images, encompassing 862 part labels and 534 object labels for evaluation. Unlike existing datasets that simply ask models to identify generic parts, PARTONOMY uses specialized concepts (e.g., agricultural airplane), and challenges models to compare objects' parts, consider part-whole relationships, and justify textual predictions with visual segmentations. Our experiments demonstrate significant limitations in state-of-the-art LMMs (e.g., LISA-13B achieves only 5.9% gIoU), highlighting a critical gap in their part grounding abilities. We note that existing segmentation-enabled LMMs (segmenting LMMs) have two key architectural shortcomings: they use special [SEG] tokens not seen during pretraining which induce distribution shift, and they discard predicted segmentations instead of using past predictions to guide future ones. To address these deficiencies, we train several part-centric LMMs and propose PLUM, a novel segmenting LMM that uses span tagging instead of segmentation tokens and that conditions on prior predictions in a feedback loop. We find that pretrained PLUM outperforms existing segmenting LMMs on reasoning segmentation, VQA, and visual hallucination benchmarks. In addition, PLUM finetuned on our proposed Explanatory Part Segmentation task is competitive with segmenting LMMs trained on significantly more segmentation data. Our work opens up new avenues towards enabling fine-grained, grounded visual understanding in LMMs.

Advances in medical imaging technologies have enabled the collection of longitudinal images, which involve repeated scanning of the same patients over time, to monitor disease progression. However, predictive modeling of such data remains challenging due to high dimensionality, irregular sampling, and data sparsity. To address these issues, we propose ImageFlowNet, a novel model designed to forecast disease trajectories from initial images while preserving spatial details. ImageFlowNet first learns multiscale joint representation spaces across patients and time points, then optimizes deterministic or stochastic flow fields within these spaces using a position-parameterized neural ODE/SDE framework. The model leverages a UNet architecture to create robust multiscale representations and mitigates data scarcity by combining knowledge from all patients. We provide theoretical insights that support our formulation of ODEs, and motivate our regularizations involving high-level visual features, latent space organization, and trajectory smoothness. We validate ImageFlowNet on three longitudinal medical image datasets depicting progression in geographic atrophy, multiple sclerosis, and glioblastoma, demonstrating its ability to effectively forecast disease progression and outperform existing methods. Our contributions include the development of ImageFlowNet, its theoretical underpinnings, and empirical validation on real-world datasets. The official implementation is available at https://github.com/KrishnaswamyLab/ImageFlowNet.

The objective of this paper is motion segmentation -- discovering and segmenting the moving objects in a video. This is a much studied area with numerous careful,and sometimes complex, approaches and training schemes including: self-supervised learning, learning from synthetic datasets, object-centric representations, amodal representations, and many more. Our interest in this paper is to determine if the Segment Anything model (SAM) can contribute to this task. We investigate two models for combining SAM with optical flow that harness the segmentation power of SAM with the ability of flow to discover and group moving objects. In the first model, we adapt SAM to take optical flow, rather than RGB, as an input. In the second, SAM takes RGB as an input, and flow is used as a segmentation prompt. These surprisingly simple methods, without any further modifications, outperform all previous approaches by a considerable margin in both single and multi-object benchmarks. We also extend these frame-level segmentations to sequence-level segmentations that maintain object identity. Again, this simple model outperforms previous methods on multiple video object segmentation benchmarks.

Due to the inherent flexibility of prompting, foundation models have emerged as the predominant force in the fields of natural language processing and computer vision. The recent introduction of the Segment Anything Model (SAM) signifies a noteworthy expansion of the prompt-driven paradigm into the domain of image segmentation, thereby introducing a plethora of previously unexplored capabilities. However, the viability of its application to medical image segmentation remains uncertain, given the substantial distinctions between natural and medical images. In this work, we provide a comprehensive overview of recent endeavors aimed at extending the efficacy of SAM to medical image segmentation tasks, encompassing both empirical benchmarking and methodological adaptations. Additionally, we explore potential avenues for future research directions in SAM's role within medical image segmentation. While direct application of SAM to medical image segmentation does not yield satisfactory performance on multi-modal and multi-target medical datasets so far, numerous insights gleaned from these efforts serve as valuable guidance for shaping the trajectory of foundational models in the realm of medical image analysis. To support ongoing research endeavors, we maintain an active repository that contains an up-to-date paper list and a succinct summary of open-source projects at https://github.com/YichiZhang98/SAM4MIS.

In the domain of medical imaging, many supervised learning based methods for segmentation face several challenges such as high variability in annotations from multiple experts, paucity of labelled data and class imbalanced datasets. These issues may result in segmentations that lack the requisite precision for clinical analysis and can be misleadingly overconfident without associated uncertainty quantification. We propose the PULASki for biomedical image segmentation that accurately captures variability in expert annotations, even in small datasets. Our approach makes use of an improved loss function based on statistical distances in a conditional variational autoencoder structure (Probabilistic UNet), which improves learning of the conditional decoder compared to the standard cross-entropy particularly in class imbalanced problems. We analyse our method for two structurally different segmentation tasks (intracranial vessel and multiple sclerosis (MS) lesion) and compare our results to four well-established baselines in terms of quantitative metrics and qualitative output. Empirical results demonstrate the PULASKi method outperforms all baselines at the 5\% significance level. The generated segmentations are shown to be much more anatomically plausible than in the 2D case, particularly for the vessel task. Our method can also be applied to a wide range of multi-label segmentation tasks and and is useful for downstream tasks such as hemodynamic modelling (computational fluid dynamics and data assimilation), clinical decision making, and treatment planning.

Forecasting the future anatomy of slow-evolving neurodegenerative diseases could enable earlier, more targeted intervention and improve clinical trial design, but it remains challenging because true progression signals are subtle in longitudinal MRI. In this low-signal regime, transferring modern generative sequence models directly is unreliable: training is dominated by stable baseline anatomy and confounded by dense, sample-specific nuisance variation. We first provide a theoretical analysis that explains these failures through two modes. Identity collapse occurs when optimization is driven toward reproducing the current anatomy, which prevents the model from learning faint temporal change. The continuous interpolation trap arises when standard smooth networks cannot separate localized biological drift from pervasive noise, which leads to spurious changes that diffuse across the volume. To address both issues, we propose Latent Drift, a progressive generative framework that learns change in a compressed semantic representation rather than synthesizing full-resolution anatomy. This design removes pixel-level identity from the prediction target and concentrates model capacity on progression-relevant dynamics. We further apply Finite Scalar Quantization to the learned change representation, which suppresses small, high-frequency nuisance fluctuations while preserving consistent structural drift. Experiments on longitudinal 3D brain MRI show that Latent Drift improves patient-specific neuro-forecasting over diffusion and autoregressive transformer baselines across generative fidelity and clinically relevant evaluation metrics. Project page: https://cutepkq.github.io/latent-drift{https://cutepkq.github.io/latent-drift}.

Recent works on click-based interactive segmentation have demonstrated state-of-the-art results by using various inference-time optimization schemes. These methods are considerably more computationally expensive compared to feedforward approaches, as they require performing backward passes through a network during inference and are hard to deploy on mobile frameworks that usually support only forward passes. In this paper, we extensively evaluate various design choices for interactive segmentation and discover that new state-of-the-art results can be obtained without any additional optimization schemes. Thus, we propose a simple feedforward model for click-based interactive segmentation that employs the segmentation masks from previous steps. It allows not only to segment an entirely new object, but also to start with an external mask and correct it. When analyzing the performance of models trained on different datasets, we observe that the choice of a training dataset greatly impacts the quality of interactive segmentation. We find that the models trained on a combination of COCO and LVIS with diverse and high-quality annotations show performance superior to all existing models. The code and trained models are available at https://github.com/saic-vul/ritm_interactive_segmentation.

Segmentation based on language has been a popular topic in computer vision. While recent advances in multimodal large language models (MLLMs) have endowed segmentation systems with reasoning capabilities, these efforts remain confined by the frozen internal knowledge of MLLMs, which limits their potential for real-world scenarios that involve up-to-date information or domain-specific concepts. In this work, we propose Seg-ReSearch, a novel segmentation paradigm that overcomes the knowledge bottleneck of existing approaches. By enabling interleaved reasoning and external search, Seg-ReSearch empowers segmentation systems to handle dynamic, open-world queries that extend beyond the frozen knowledge of MLLMs. To effectively train this capability, we introduce a hierarchical reward design that harmonizes initial guidance with progressive incentives, mitigating the dilemma between sparse outcome signals and rigid step-wise supervision. For evaluation, we construct OK-VOS, a challenging benchmark that explicitly requires outside knowledge for video object segmentation. Experiments on OK-VOS and two existing reasoning segmentation benchmarks demonstrate that our Seg-ReSearch improves state-of-the-art approaches by a substantial margin. Code and data will be released at https://github.com/iSEE-Laboratory/Seg-ReSearch.

Learning long-term spatial-temporal features are critical for many video analysis tasks. However, existing video segmentation methods predominantly rely on static image segmentation techniques, and methods capturing temporal dependency for segmentation have to depend on pretrained optical flow models, leading to suboptimal solutions for the problem. End-to-end sequential learning to explore spatialtemporal features for video segmentation is largely limited by the scale of available video segmentation datasets, i.e., even the largest video segmentation dataset only contains 90 short video clips. To solve this problem, we build a new large-scale video object segmentation dataset called YouTube Video Object Segmentation dataset (YouTube-VOS). Our dataset contains 4,453 YouTube video clips and 94 object categories. This is by far the largest video object segmentation dataset to our knowledge and has been released at http://youtube-vos.org. We further evaluate several existing state-of-the-art video object segmentation algorithms on this dataset which aims to establish baselines for the development of new algorithms in the future.

We present LlamaSeg, a visual autoregressive framework that unifies multiple image segmentation tasks via natural language instructions. We reformulate image segmentation as a visual generation problem, representing masks as "visual" tokens and employing a LLaMA-style Transformer to predict them directly from image inputs. By adhering to the next-token prediction paradigm, our approach naturally integrates segmentation tasks into autoregressive architectures. To support large-scale training, we introduce a data annotation pipeline and construct the SA-OVRS dataset, which contains 2M segmentation masks annotated with over 5,800 open-vocabulary labels or diverse textual descriptions, covering a wide spectrum of real-world scenarios. This enables our model to localize objects in images based on text prompts and to generate fine-grained masks. To more accurately evaluate the quality of masks produced by visual generative models, we further propose a composite metric that combines Intersection over Union (IoU) with Average Hausdorff Distance (AHD), offering a more precise assessment of contour fidelity. Experimental results demonstrate that our method surpasses existing generative models across multiple datasets and yields more detailed segmentation masks.

Reliable end-to-end clinical report generation has been a longstanding goal of medical ML research. The end goal for this process is to alleviate radiologists' workloads and provide second opinions to clinicians or patients. Thus, a necessary prerequisite for report generation models is a strong general performance and some type of innate grounding capability, to convince clinicians or patients of the veracity of the generated reports. In this paper, we present ASaRG (Automatic Segmentation-assisted Report Generation), an extension of the popular LLaVA architecture that aims to tackle both of these problems. ASaRG proposes to fuse intermediate features and fine-grained segmentation maps created by specialist radiological models into LLaVA's multi-modal projection layer via simple concatenation. With a small number of added parameters, our approach achieves a +0.89\% performance gain (p=0.012) in CE F1 score compared to the LLaVA baseline when using only intermediate features, and +2.77\% performance gain (p<0.001) when adding a combination of intermediate features and fine-grained segmentation maps. Compared with COMG and ORID, two other report generation methods that utilize segmentations, the performance gain amounts to 6.98\% and 6.28\% in F1 score, respectively. ASaRG is not mutually exclusive with other changes made to the LLaVA architecture, potentially allowing our method to be combined with other advances in the field. Finally, the use of an arbitrary number of segmentations as part of the input demonstrably allows tracing elements of the report to the corresponding segmentation maps and verifying the groundedness of assessments. Our code will be made publicly available at a later date.

Accurate segmentation is essential for echocardiography-based assessment of cardiovascular diseases (CVDs). However, the variability among sonographers and the inherent challenges of ultrasound images hinder precise segmentation. By leveraging the joint representation of image and text modalities, Vision-Language Segmentation Models (VLSMs) can incorporate rich contextual information, potentially aiding in accurate and explainable segmentation. However, the lack of readily available data in echocardiography hampers the training of VLSMs. In this study, we explore using synthetic datasets from Semantic Diffusion Models (SDMs) to enhance VLSMs for echocardiography segmentation. We evaluate results for two popular VLSMs (CLIPSeg and CRIS) using seven different kinds of language prompts derived from several attributes, automatically extracted from echocardiography images, segmentation masks, and their metadata. Our results show improved metrics and faster convergence when pretraining VLSMs on SDM-generated synthetic images before finetuning on real images. The code, configs, and prompts are available at https://github.com/naamiinepal/synthetic-boost.

In this work, we introduce Brain Latent Progression (BrLP), a novel spatiotemporal disease progression model based on latent diffusion. BrLP is designed to predict the evolution of diseases at the individual level on 3D brain MRIs. Existing deep generative models developed for this task are primarily data-driven and face challenges in learning disease progressions. BrLP addresses these challenges by incorporating prior knowledge from disease models to enhance the accuracy of predictions. To implement this, we propose to integrate an auxiliary model that infers volumetric changes in various brain regions. Additionally, we introduce Latent Average Stabilization (LAS), a novel technique to improve spatiotemporal consistency of the predicted progression. BrLP is trained and evaluated on a large dataset comprising 11,730 T1-weighted brain MRIs from 2,805 subjects, collected from three publicly available, longitudinal Alzheimer's Disease (AD) studies. In our experiments, we compare the MRI scans generated by BrLP with the actual follow-up MRIs available from the subjects, in both cross-sectional and longitudinal settings. BrLP demonstrates significant improvements over existing methods, with an increase of 22% in volumetric accuracy across AD-related brain regions and 43% in image similarity to the ground-truth scans. The ability of BrLP to generate conditioned 3D scans at the subject level, along with the novelty of integrating prior knowledge to enhance accuracy, represents a significant advancement in disease progression modeling, opening new avenues for precision medicine. The code of BrLP is available at the following link: https://github.com/LemuelPuglisi/BrLP.

Camouflaged object segmentation presents unique challenges compared to traditional segmentation tasks, primarily due to the high similarity in patterns and colors between camouflaged objects and their backgrounds. Effective solutions to this problem have significant implications in critical areas such as pest control, defect detection, and lesion segmentation in medical imaging. Prior research has predominantly emphasized supervised or unsupervised pre-training methods, leaving zero-shot approaches significantly underdeveloped. Existing zero-shot techniques commonly utilize the Segment Anything Model (SAM) in automatic mode or rely on vision-language models to generate cues for segmentation; however, their performances remain unsatisfactory, due to the similarity of the camouflaged object and the background. This work studies how to avoid training by integrating large pre-trained models like SAM-2 and Owl-v2 with temporal information into a modular pipeline. Evaluated on the MoCA-Mask dataset, our approach achieves outstanding performance improvements, significantly outperforming existing zero-shot methods by raising the F-measure (F_beta^w) from 0.296 to 0.628. Our approach also surpasses supervised methods, increasing the F-measure from 0.476 to 0.628. Additionally, evaluation on the MoCA-Filter dataset demonstrates an increase in the success rate from 0.628 to 0.697 when compared with FlowSAM, a supervised transfer method. A thorough ablation study further validates the individual contributions of each component. Besides our main contributions, we also highlight inconsistencies in previous work regarding metrics and settings. Code can be found in https://github.com/weathon/vcos.

Longitudinal modelling of Alzheimer's disease progression is clinically useful only if it can describe not just the most likely next diagnosis, but how a patient may evolve over time and how reliable that forecast is. Most deep learning approaches reduce this problem to single-step classification, treating cognitively normal, mild cognitive impairment, and dementia as flat categories while providing limited insight into how uncertainty accumulates across future visits. We propose a probabilistic framework that combines ordinal diagnosis prediction, multi-horizon trajectory generation, and decomposed uncertainty estimation. A Temporal Fusion Transformer encoder is adapted with a CORAL ordinal output layer, asymmetric loss weighting, and converter oversampling to respect disease-stage ordering and improve sensitivity to MCI-to-dementia transitions. Conditioned on the learned patient-context representation, an autoregressive Mixture Density Network generates five-year probabilistic trajectories for diagnosis state, CDR Sum of Boxes, MMSE orientation, and hippocampal volume. On ADNI, the model outperforms linear, recurrent, and transformer baselines for next-visit diagnosis prediction, with the strongest gains on MCI-versus-dementia discrimination. Generated trajectories achieve near-nominal 90% credible interval coverage, widening uncertainty across the forecast horizon, and biomarker dynamics consistent with expected Alzheimer's disease progression. We further separate aleatoric from epistemic uncertainty using analytic mixture variance and a five-member bootstrap ensemble, which provides the strongest encoder diversity and output-level epistemic signal. Epistemic uncertainty is higher for rare progression archetypes, MCI and dementia patients, and under external evaluation on OASIS-3, where it increases alongside prediction error.

Longitudinal treatment decisions require predicting potential outcomes under future treatment sequences in the presence of time-varying confounding, heterogeneous patient dynamics, and limited domain-specific data. Existing longitudinal causal estimators typically train a new model for each cohort or simulator. We introduce Causal Longitudinal Prior-Fitted Networks (CausalLongPFN), a prior-fitted in-context predictor for longitudinal causal prediction. The model is pretrained entirely on synthetic episodes sampled from a broad prior over temporal structural causal models, exposing it to treatment-confounder feedback, latent heterogeneity, nonlinear state evolution, delayed effects, and cumulative treatment responses. At test time, CausalLongPFN is frozen: it conditions on support trajectories, a query history, and a proposed future treatment sequence, and returns a predictive distribution over future outcomes without gradient updates or propensity-model fitting. Multi-step predictions are obtained by recursively applying the one-step predictor under the specified treatment sequence. We evaluate on branchable cancer, HIV, and warfarin benchmarks with ground-truth counterfactual labels, and on factual-only rolling-origin prediction in MIMIC-III ICU trajectories. CausalLongPFN is competitive with domain-trained longitudinal baselines on counterfactual benchmarks and performs strongly on factual MIMIC-III prediction, suggesting that broad synthetic causal pretraining can provide a useful frozen alternative when repeated domain-specific training is costly or impractical.

Video Object Segmentation and Tracking (VOST) presents a complex yet critical challenge in computer vision, requiring robust integration of segmentation and tracking across temporally dynamic frames. Traditional methods have struggled with domain generalization, temporal consistency, and computational efficiency. The emergence of foundation models like the Segment Anything Model (SAM) and its successor, SAM2, has introduced a paradigm shift, enabling prompt-driven segmentation with strong generalization capabilities. Building upon these advances, this survey provides a comprehensive review of SAM/SAM2-based methods for VOST, structured along three temporal dimensions: past, present, and future. We examine strategies for retaining and updating historical information (past), approaches for extracting and optimizing discriminative features from the current frame (present), and motion prediction and trajectory estimation mechanisms for anticipating object dynamics in subsequent frames (future). In doing so, we highlight the evolution from early memory-based architectures to the streaming memory and real-time segmentation capabilities of SAM2. We also discuss recent innovations such as motion-aware memory selection and trajectory-guided prompting, which aim to enhance both accuracy and efficiency. Finally, we identify remaining challenges including memory redundancy, error accumulation, and prompt inefficiency, and suggest promising directions for future research. This survey offers a timely and structured overview of the field, aiming to guide researchers and practitioners in advancing the state of VOST through the lens of foundation models.

Interactive image segmentation enables annotators to efficiently perform pixel-level annotation for segmentation tasks. However, the existing interactive segmentation pipeline suffers from inefficient computations of interactive models because of the following two issues. First, annotators' later click is based on models' feedback of annotators' former click. This serial interaction is unable to utilize model's parallelism capabilities. Second, in each interaction step, the model handles the invariant image along with the sparse variable clicks, resulting in a process that's highly repetitive and redundant. For efficient computations, we propose a method named InterFormer that follows a new pipeline to address these issues. InterFormer extracts and preprocesses the computationally time-consuming part i.e. image processing from the existing process. Specifically, InterFormer employs a large vision transformer (ViT) on high-performance devices to preprocess images in parallel, and then uses a lightweight module called interactive multi-head self attention (I-MSA) for interactive segmentation. Furthermore, the I-MSA module's deployment on low-power devices extends the practical application of interactive segmentation. The I-MSA module utilizes the preprocessed features to efficiently response to the annotator inputs in real-time. The experiments on several datasets demonstrate the effectiveness of InterFormer, which outperforms previous interactive segmentation models in terms of computational efficiency and segmentation quality, achieve real-time high-quality interactive segmentation on CPU-only devices. The code is available at https://github.com/YouHuang67/InterFormer.

Video segmentation requires consistently segmenting and tracking objects over time. Due to the quadratic dependency on input size, directly applying self-attention to video segmentation with high-resolution input features poses significant challenges, often leading to insufficient GPU memory capacity. Consequently, modern video segmenters either extend an image segmenter without incorporating any temporal attention or resort to window space-time attention in a naive manner. In this work, we present Axial-VS, a general and simple framework that enhances video segmenters by tracking objects along axial trajectories. The framework tackles video segmentation through two sub-tasks: short-term within-clip segmentation and long-term cross-clip tracking. In the first step, Axial-VS augments an off-the-shelf clip-level video segmenter with the proposed axial-trajectory attention, sequentially tracking objects along the height- and width-trajectories within a clip, thereby enhancing temporal consistency by capturing motion trajectories. The axial decomposition significantly reduces the computational complexity for dense features, and outperforms the window space-time attention in segmentation quality. In the second step, we further employ axial-trajectory attention to the object queries in clip-level segmenters, which are learned to encode object information, thereby aiding object tracking across different clips and achieving consistent segmentation throughout the video. Without bells and whistles, Axial-VS showcases state-of-the-art results on video segmentation benchmarks, emphasizing its effectiveness in addressing the limitations of modern clip-level video segmenters. Code and models are available at https://github.com/TACJu/Axial-VS.

Medical image segmentation plays a vital role in clinical decision-making, enabling precise localization of lesions and guiding interventions. Despite significant advances in segmentation accuracy, the black-box nature of most deep models has raised growing concerns about their trustworthiness in high-stakes medical scenarios. Current explanation techniques have primarily focused on classification tasks, leaving the segmentation domain relatively underexplored. We introduced an explanation model for segmentation task which employs the causal inference framework and backpropagates the average treatment effect (ATE) into a quantification metric to determine the influence of input regions, as well as network components, on target segmentation areas. Through comparison with recent segmentation explainability techniques on two representative medical imaging datasets, we demonstrated that our approach provides more faithful explanations than existing approaches. Furthermore, we carried out a systematic causal analysis of multiple foundational segmentation models using our method, which reveals significant heterogeneity in perceptual strategies across different models, and even between different inputs for the same model. Suggesting the potential of our method to provide notable insights for optimizing segmentation models. Our code can be found at https://github.com/lcmmai/PdCR.

The goal of interactive image segmentation is to delineate specific regions within an image via visual or language prompts. Low-latency and high-quality interactive segmentation with diverse prompts remain challenging for existing specialist and generalist models. Specialist models, with their limited prompts and task-specific designs, experience high latency because the image must be recomputed every time the prompt is updated, due to the joint encoding of image and visual prompts. Generalist models, exemplified by the Segment Anything Model (SAM), have recently excelled in prompt diversity and efficiency, lifting image segmentation to the foundation model era. However, for high-quality segmentations, SAM still lags behind state-of-the-art specialist models despite SAM being trained with x100 more segmentation masks. In this work, we delve deep into the architectural differences between the two types of models. We observe that dense representation and fusion of visual prompts are the key design choices contributing to the high segmentation quality of specialist models. In light of this, we reintroduce this dense design into the generalist models, to facilitate the development of generalist models with high segmentation quality. To densely represent diverse visual prompts, we propose to use a dense map to capture five types: clicks, boxes, polygons, scribbles, and masks. Thus, we propose SegNext, a next-generation interactive segmentation approach offering low latency, high quality, and diverse prompt support. Our method outperforms current state-of-the-art methods on HQSeg-44K and DAVIS, both quantitatively and qualitatively.

We address the problem of discovering part segmentations of articulated objects without supervision. In contrast to keypoints, part segmentations provide information about part localizations on the level of individual pixels. Capturing both locations and semantics, they are an attractive target for supervised learning approaches. However, large annotation costs limit the scalability of supervised algorithms to other object categories than humans. Unsupervised approaches potentially allow to use much more data at a lower cost. Most existing unsupervised approaches focus on learning abstract representations to be refined with supervision into the final representation. Our approach leverages a generative model consisting of two disentangled representations for an object's shape and appearance and a latent variable for the part segmentation. From a single image, the trained model infers a semantic part segmentation map. In experiments, we compare our approach to previous state-of-the-art approaches and observe significant gains in segmentation accuracy and shape consistency. Our work demonstrates the feasibility to discover semantic part segmentations without supervision.

Autoregressive modeling has been a huge success in the field of natural language processing (NLP). Recently, autoregressive models have emerged as a significant area of focus in computer vision, where they excel in producing high-quality visual content. Autoregressive models in NLP typically operate on subword tokens. However, the representation strategy in computer vision can vary in different levels, i.e., pixel-level, token-level, or scale-level, reflecting the diverse and hierarchical nature of visual data compared to the sequential structure of language. This survey comprehensively examines the literature on autoregressive models applied to vision. To improve readability for researchers from diverse research backgrounds, we start with preliminary sequence representation and modeling in vision. Next, we divide the fundamental frameworks of visual autoregressive models into three general sub-categories, including pixel-based, token-based, and scale-based models based on the strategy of representation. We then explore the interconnections between autoregressive models and other generative models. Furthermore, we present a multi-faceted categorization of autoregressive models in computer vision, including image generation, video generation, 3D generation, and multi-modal generation. We also elaborate on their applications in diverse domains, including emerging domains such as embodied AI and 3D medical AI, with about 250 related references. Finally, we highlight the current challenges to autoregressive models in vision with suggestions about potential research directions. We have also set up a Github repository to organize the papers included in this survey at: https://github.com/ChaofanTao/Autoregressive-Models-in-Vision-Survey.

Recent state-of-the-art semi-supervised Video Object Segmentation (VOS) methods have shown significant improvements in target object segmentation accuracy when information from preceding frames is used in segmenting the current frame. In particular, such memory-based approaches can help a model to more effectively handle appearance changes (representation drift) or occlusions. Ideally, for maximum performance, Online VOS methods would need all or most of the preceding frames (or their extracted information) to be stored in memory and be used for online learning in later frames. Such a solution is not feasible for long videos, as the required memory size grows without bound, and such methods can fail when memory is limited and a target object experiences repeated representation drifts throughout a video. We propose two novel techniques to reduce the memory requirement of Online VOS methods while improving modeling accuracy and generalization on long videos. Motivated by the success of continual learning techniques in preserving previously-learned knowledge, here we propose Gated-Regularizer Continual Learning (GRCL), which improves the performance of any Online VOS subject to limited memory, and a Reconstruction-based Memory Selection Continual Learning (RMSCL), which empowers Online VOS methods to efficiently benefit from stored information in memory. We also analyze the performance of a hybrid combination of the two proposed methods. Experimental results show that the proposed methods are able to improve the performance of Online VOS models by more than 8%, with improved robustness on long-video datasets while maintaining comparable performance on short-video datasets such as DAVIS16, DAVIS17, and YouTube-VOS18.

Large Language Models (LLMs) demonstrate strong capabilities in broad knowledge representation, yet they are inherently deficient in pixel-level perceptual understanding. Although the Segment Anything Model (SAM) represents a significant advancement in visual-prompt-driven image segmentation, it exhibits notable limitations in multi-mask prediction and category-specific segmentation tasks, and it cannot integrate all segmentation tasks within a unified model architecture. To address these limitations, we present X-SAM, a streamlined Multimodal Large Language Model (MLLM) framework that extends the segmentation paradigm from segment anything to any segmentation. Specifically, we introduce a novel unified framework that enables more advanced pixel-level perceptual comprehension for MLLMs. Furthermore, we propose a new segmentation task, termed Visual GrounDed (VGD) segmentation, which segments all instance objects with interactive visual prompts and empowers MLLMs with visual grounded, pixel-wise interpretative capabilities. To enable effective training on diverse data sources, we present a unified training strategy that supports co-training across multiple datasets. Experimental results demonstrate that X-SAM achieves state-of-the-art performance on a wide range of image segmentation benchmarks, highlighting its efficiency for multimodal, pixel-level visual understanding. Code is available at https://github.com/wanghao9610/X-SAM.

We introduce SegviGen, a framework that repurposes native 3D generative models for 3D part segmentation. Existing pipelines either lift strong 2D priors into 3D via distillation or multi-view mask aggregation, often suffering from cross-view inconsistency and blurred boundaries, or explore native 3D discriminative segmentation, which typically requires large-scale annotated 3D data and substantial training resources. In contrast, SegviGen leverages the structured priors encoded in pretrained 3D generative model to induce segmentation through distinctive part colorization, establishing a novel and efficient framework for part segmentation. Specifically, SegviGen encodes a 3D asset and predicts part-indicative colors on active voxels of a geometry-aligned reconstruction. It supports interactive part segmentation, full segmentation, and full segmentation with 2D guidance in a unified framework. Extensive experiments show that SegviGen improves over the prior state of the art by 40% on interactive part segmentation and by 15% on full segmentation, while using only 0.32% of the labeled training data. It demonstrates that pretrained 3D generative priors transfer effectively to 3D part segmentation, enabling strong performance with limited supervision. See our project page at https://fenghora.github.io/SegviGen-Page/.

The application of methods based on Neural Radiance Fields (NeRF) and 3D Gaussian Splatting (3D GS) have steadily gained popularity in the field of 3D object segmentation in static scenes. These approaches demonstrate efficacy in a range of 3D scene understanding and editing tasks. Nevertheless, the 4D object segmentation of dynamic scenes remains an underexplored field due to the absence of a sufficiently extensive and accurately labelled multi-view video dataset. In this paper, we present MUVOD, a new multi-view video dataset for training and evaluating object segmentation in reconstructed real-world scenarios. The 17 selected scenes, describing various indoor or outdoor activities, are collected from different sources of datasets originating from various types of camera rigs. Each scene contains a minimum of 9 views and a maximum of 46 views. We provide 7830 RGB images (30 frames per video) with their corresponding segmentation mask in 4D motion, meaning that any object of interest in the scene could be tracked across temporal frames of a given view or across different views belonging to the same camera rig. This dataset, which contains 459 instances of 73 categories, is intended as a basic benchmark for the evaluation of multi-view video segmentation methods. We also present an evaluation metric and a baseline segmentation approach to encourage and evaluate progress in this evolving field. Additionally, we propose a new benchmark for 3D object segmentation task with a subset of annotated multi-view images selected from our MUVOD dataset. This subset contains 50 objects of different conditions in different scenarios, providing a more comprehensive analysis of state-of-the-art 3D object segmentation methods. Our proposed MUVOD dataset is available at https://volumetric-repository.labs.b-com.com/#/muvod.

Changepoints are abrupt variations in the generative parameters of a data sequence. Online detection of changepoints is useful in modelling and prediction of time series in application areas such as finance, biometrics, and robotics. While frequentist methods have yielded online filtering and prediction techniques, most Bayesian papers have focused on the retrospective segmentation problem. Here we examine the case where the model parameters before and after the changepoint are independent and we derive an online algorithm for exact inference of the most recent changepoint. We compute the probability distribution of the length of the current ``run,'' or time since the last changepoint, using a simple message-passing algorithm. Our implementation is highly modular so that the algorithm may be applied to a variety of types of data. We illustrate this modularity by demonstrating the algorithm on three different real-world data sets.

The Segment Anything Model 2 (SAM 2) has emerged as a powerful foundation model for object segmentation in both images and videos, paving the way for various downstream video applications. The crucial design of SAM 2 for video segmentation is its memory module, which prompts object-aware memories from previous frames for current frame prediction. However, its greedy-selection memory design suffers from the "error accumulation" problem, where an errored or missed mask will cascade and influence the segmentation of the subsequent frames, which limits the performance of SAM 2 toward complex long-term videos. To this end, we introduce SAM2Long, an improved training-free video object segmentation strategy, which considers the segmentation uncertainty within each frame and chooses the video-level optimal results from multiple segmentation pathways in a constrained tree search manner. In practice, we maintain a fixed number of segmentation pathways throughout the video. For each frame, multiple masks are proposed based on the existing pathways, creating various candidate branches. We then select the same fixed number of branches with higher cumulative scores as the new pathways for the next frame. After processing the final frame, the pathway with the highest cumulative score is chosen as the final segmentation result. Benefiting from its heuristic search design, SAM2Long is robust toward occlusions and object reappearances, and can effectively segment and track objects for complex long-term videos. Notably, SAM2Long achieves an average improvement of 3.0 points across all 24 head-to-head comparisons, with gains of up to 5.3 points in J&F on long-term video object segmentation benchmarks such as SA-V and LVOS. The code is released at https://github.com/Mark12Ding/SAM2Long.

Chest X-Ray (CXR) report generation is a promising approach to improving the efficiency of CXR interpretation. However, a significant increase in diagnostic accuracy is required before that can be realised. Motivated by this, we propose a framework that is more inline with a radiologist's workflow by considering longitudinal data. Here, the decoder is additionally conditioned on the report from the subject's previous imaging study via a prompt. We also propose a new reward for reinforcement learning based on CXR-BERT, which computes the similarity between reports. We conduct experiments on the MIMIC-CXR dataset. The results indicate that longitudinal data improves CXR report generation. CXR-BERT is also shown to be a promising alternative to the current state-of-the-art reward based on RadGraph. This investigation indicates that longitudinal CXR report generation can offer a substantial increase in diagnostic accuracy. Our Hugging Face model is available at: https://huggingface.co/aehrc/cxrmate and code is available at: https://github.com/aehrc/cxrmate.

We present MeshSegmenter, a simple yet effective framework designed for zero-shot 3D semantic segmentation. This model successfully extends the powerful capabilities of 2D segmentation models to 3D meshes, delivering accurate 3D segmentation across diverse meshes and segment descriptions. Specifically, our model leverages the Segment Anything Model (SAM) model to segment the target regions from images rendered from the 3D shape. In light of the importance of the texture for segmentation, we also leverage the pretrained stable diffusion model to generate images with textures from 3D shape, and leverage SAM to segment the target regions from images with textures. Textures supplement the shape for segmentation and facilitate accurate 3D segmentation even in geometrically non-prominent areas, such as segmenting a car door within a car mesh. To achieve the 3D segments, we render 2D images from different views and conduct segmentation for both textured and untextured images. Lastly, we develop a multi-view revoting scheme that integrates 2D segmentation results and confidence scores from various views onto the 3D mesh, ensuring the 3D consistency of segmentation results and eliminating inaccuracies from specific perspectives. Through these innovations, MeshSegmenter offers stable and reliable 3D segmentation results both quantitatively and qualitatively, highlighting its potential as a transformative tool in the field of 3D zero-shot segmentation. The code is available at https://github.com/zimingzhong/MeshSegmenter.

We introduce Medal S, a medical segmentation foundation model that supports native-resolution spatial and textual prompts within an end-to-end trainable framework. Unlike text-only methods lacking spatial awareness, Medal S achieves channel-wise alignment between volumetric prompts and text embeddings, mitigating inaccuracies from resolution mismatches. By preserving full 3D context, it efficiently processes multiple native-resolution masks in parallel, enhancing multi-class segmentation performance. A lightweight 3D convolutional module enables precise voxel-space refinement guided by both prompt types, supporting up to 243 classes across CT, MRI, PET, ultrasound, and microscopy modalities in the BiomedSegFM dataset. Medal S offers two prompting modes: a text-only mode, where model predictions serve as spatial prompts for self-refinement without human input, and a hybrid mode, incorporating manual annotations for enhanced flexibility. For 24-class segmentation, parallel spatial prompting reduces inference time by more than 90% compared to sequential prompting. We propose dynamic resampling to address target-patch ratio imbalance, extending SAT and nnU-Net for data augmentation. Furthermore, we develop optimized text preprocessing, a two-stage inference strategy, and post-processing techniques to improve memory efficiency, precision, and inference speed. On the five-modality average on the validation set, Medal S outperforms SAT with a DSC of 75.44 (vs. 69.83), NSD of 77.34 (vs. 71.06), F1 of 38.24 (vs. 24.88), and DSC TP of 65.46 (vs. 46.97). Medal S achieves excellent performance by harmonizing spatial precision with semantic textual guidance, demonstrating superior efficiency and accuracy in multi-class medical segmentation tasks compared to sequential prompt-based approaches. Medal S will be publicly available at https://github.com/yinghemedical/Medal-S.

Curating datasets for object segmentation is a difficult task. With the advent of large-scale pre-trained generative models, conditional image generation has been given a significant boost in result quality and ease of use. In this paper, we present a novel method that enables the generation of general foreground-background segmentation models from simple textual descriptions, without requiring segmentation labels. We leverage and explore pre-trained latent diffusion models, to automatically generate weak segmentation masks for concepts and objects. The masks are then used to fine-tune the diffusion model on an inpainting task, which enables fine-grained removal of the object, while at the same time providing a synthetic foreground and background dataset. We demonstrate that using this method beats previous methods in both discriminative and generative performance and closes the gap with fully supervised training while requiring no pixel-wise object labels. We show results on the task of segmenting four different objects (humans, dogs, cars, birds) and a use case scenario in medical image analysis. The code is available at https://github.com/MischaD/fobadiffusion.

Pediatric medical imaging presents unique challenges due to significant anatomical and developmental differences compared to adults. Direct application of segmentation models trained on adult data often yields suboptimal performance, particularly for small or rapidly evolving structures. To address these challenges, several strategies leveraging the nnU-Net framework have been proposed, differing along four key axes: (i) the fingerprint dataset (adult, pediatric, or a combination thereof) from which the Training Plan -including the network architecture-is derived; (ii) the Learning Set (adult, pediatric, or mixed), (iii) Data Augmentation parameters, and (iv) the Transfer learning method (finetuning versus continual learning). In this work, we introduce PSAT (Pediatric Segmentation Approaches via Adult Augmentations and Transfer learning), a systematic study that investigates the impact of these axes on segmentation performance. We benchmark the derived strategies on two pediatric CT datasets and compare them with state-of-theart methods, including a commercial radiotherapy solution. PSAT highlights key pitfalls and provides actionable insights for improving pediatric segmentation. Our experiments reveal that a training plan based on an adult fingerprint dataset is misaligned with pediatric anatomy-resulting in significant performance degradation, especially when segmenting fine structures-and that continual learning strategies mitigate institutional shifts, thus enhancing generalization across diverse pediatric datasets. The code is available at https://github.com/ICANS-Strasbourg/PSAT.

Medical image segmentation is a key task in the imaging workflow, influencing many image-based decisions. Traditional, fully-supervised segmentation models rely on large amounts of labeled training data, typically obtained through manual annotation, which can be an expensive, time-consuming, and error-prone process. This signals a need for accurate, automatic, and annotation-efficient methods of training these models. We propose ADA-SAM (automated, domain-specific, and adaptive segment anything model), a novel multitask learning framework for medical image segmentation that leverages class activation maps from an auxiliary classifier to guide the predictions of the semi-supervised segmentation branch, which is based on the Segment Anything (SAM) framework. Additionally, our ADA-SAM model employs a novel gradient feedback mechanism to create a learnable connection between the segmentation and classification branches by using the segmentation gradients to guide and improve the classification predictions. We validate ADA-SAM on real-world clinical data collected during rehabilitation trials, and demonstrate that our proposed method outperforms both fully-supervised and semi-supervised baselines by double digits in limited label settings. Our code is available at: https://github.com/tbwa233/ADA-SAM.

In medical imaging, the clinical value of Computed Tomography (CT) lies not only in depicting current disease status, but crucially in enabling longitudinal comparison of serial scans to determine disease evolution, a process that underpins response assessment, recurrence detection, and ongoing patient management. Yet, despite this central role of temporal comparison in clinical decision-making, existing medical foundation models remain largely confined to single-study understanding, leaving temporally grounded cross-examination insufficiently addressed. To address this gap, we study longitudinal imaging difference reporting, a task in which a model takes two temporally separated scans from the same patient and generates a clinically meaningful report describing interval changes between them. We introduce CT-ΔBench, a dedicated benchmark for this task with patient-level splitting to prevent information leakage. To better evaluate this task beyond surface-level text similarity, we further develop change-aware metrics specifically designed to capture clinically meaningful longitudinal changes, and conduct an independent physician validation to assess the reliability of the synthesized references and event extraction pipeline. We also compare direct paired-CT reasoning with an indirect two-stage pipeline that first generates single-timepoint reports and then performs textual differencing. Finally, we propose DeltaMed, a baseline model for direct paired-CT difference reporting, and train it on the benchmark training set. Together, these contributions lay the groundwork for temporally aware medical foundation models that better reflect real-world longitudinal clinical reasoning.

Large-scale vision foundation models such as Segment Anything (SAM) demonstrate impressive performance in zero-shot image segmentation at multiple levels of granularity. However, these zero-shot predictions are rarely 3D-consistent. As the camera viewpoint changes in a scene, so do the segmentation predictions, as well as the characterizations of "coarse" or "fine" granularity. In this work, we address the challenging task of lifting multi-granular and view-inconsistent image segmentations into a hierarchical and 3D-consistent representation. We learn a novel feature field within a Neural Radiance Field (NeRF) representing a 3D scene, whose segmentation structure can be revealed at different scales by simply using different thresholds on feature distance. Our key idea is to learn an ultrametric feature space, which unlike a Euclidean space, exhibits transitivity in distance-based grouping, naturally leading to a hierarchical clustering. Put together, our method takes view-inconsistent multi-granularity 2D segmentations as input and produces a hierarchy of 3D-consistent segmentations as output. We evaluate our method and several baselines on synthetic datasets with multi-view images and multi-granular segmentation, showcasing improved accuracy and viewpoint-consistency. We additionally provide qualitative examples of our model's 3D hierarchical segmentations in real world scenes. The code and dataset are available at https://github.com/hardyho/ultrametric_feature_fields

Despite the progress in medical image segmentation, most existing methods remain task-specific and lack interactivity. Although recent text-prompt-based segmentation approaches enhance user-driven and reasoning-based segmentation, they remain confined to single-round dialogues and fail to perform multi-round reasoning. In this work, we introduce Multi-Round Entity-Level Medical Reasoning Segmentation (MEMR-Seg), a new task that requires generating segmentation masks through multi-round queries with entity-level reasoning. To support this task, we construct MR-MedSeg, a large-scale dataset of 177K multi-round medical segmentation dialogues, featuring entity-based reasoning across rounds. Furthermore, we propose MediRound, an effective baseline model designed for multi-round medical reasoning segmentation. To mitigate the inherent error propagation in the chain-like pipeline of multi-round segmentation, we introduce a lightweight yet effective Judgment & Correction Mechanism during model inference. Experimental results demonstrate that our method effectively addresses the MEMR-Seg task and outperforms conventional medical referring segmentation methods.

In longitudinal clinical practice, every chest X-ray is read in the context of the patients prior exam, and much of what the radiologist communicates is the change from one visit to the next. To the best of our knowledge, we present the first training-free best-of-N sampling scheme for pre-trained chest X-ray report generators that is explicitly aware of this longitudinal prior to current transition. We call it transition-aware best-of-N sampling, each report is split into sentences and embedded into an unordered set in Rd; each (prior, current) pair is reduced to a fixed-dim directional vector via a set-to-set distance designed to encode the change between the two sets; and candidates are scored by cosine distance from their candidate transition vector to a cached bank of ground-truth training transition vectors, aggregated as min or kNN. We instantiate the framework with four directional set distances (mean-shift, novelty residual, directed-Hausdorff anchor, and cost-weighted optimal transport) and evaluate on a multi-visit AP-PA cohort, running inference under three prompts on three vision-language generators. Transition-aware best-of-N outperforms random selection across the board, with the largest relative gains on the Impression section.

Background. Fully automatic analysis of myocardial perfusion MRI datasets enables rapid and objective reporting of stress/rest studies in patients with suspected ischemic heart disease. Developing deep learning techniques that can analyze multi-center datasets despite limited training data and variations in software and hardware is an ongoing challenge. Methods. Datasets from 3 medical centers acquired at 3T (n = 150 subjects) were included: an internal dataset (inD; n = 95) and two external datasets (exDs; n = 55) used for evaluating the robustness of the trained deep neural network (DNN) models against differences in pulse sequence (exD-1) and scanner vendor (exD-2). A subset of inD (n = 85) was used for training/validation of a pool of DNNs for segmentation, all using the same spatiotemporal U-Net architecture and hyperparameters but with different parameter initializations. We employed a space-time sliding-patch analysis approach that automatically yields a pixel-wise "uncertainty map" as a byproduct of the segmentation process. In our approach, a given test case is segmented by all members of the DNN pool and the resulting uncertainty maps are leveraged to automatically select the "best" one among the pool of solutions. Results. The proposed DAUGS analysis approach performed similarly to the established approach on the internal dataset (p = n.s.) whereas it significantly outperformed on the external datasets (p < 0.005 for exD-1 and exD-2). Moreover, the number of image series with "failed" segmentation was significantly lower for the proposed vs. the established approach (4.3% vs. 17.1%, p < 0.0005). Conclusions. The proposed DAUGS analysis approach has the potential to improve the robustness of deep learning methods for segmentation of multi-center stress perfusion datasets with variations in the choice of pulse sequence, site location or scanner vendor.

In the realm of medical image segmentation, both CNN-based and Transformer-based models have been extensively explored. However, CNNs exhibit limitations in long-range modeling capabilities, whereas Transformers are hampered by their quadratic computational complexity. Recently, State Space Models (SSMs), exemplified by Mamba, have emerged as a promising approach. They not only excel in modeling long-range interactions but also maintain a linear computational complexity. In this paper, leveraging state space models, we propose a U-shape architecture model for medical image segmentation, named Vision Mamba UNet (VM-UNet). Specifically, the Visual State Space (VSS) block is introduced as the foundation block to capture extensive contextual information, and an asymmetrical encoder-decoder structure is constructed with fewer convolution layers to save calculation cost. We conduct comprehensive experiments on the ISIC17, ISIC18, and Synapse datasets, and the results indicate that VM-UNet performs competitively in medical image segmentation tasks. To our best knowledge, this is the first medical image segmentation model constructed based on the pure SSM-based model. We aim to establish a baseline and provide valuable insights for the future development of more efficient and effective SSM-based segmentation systems. Our code is available at https://github.com/JCruan519/VM-UNet.

Consistency learning with feature perturbation is a widely used strategy in semi-supervised medical image segmentation. However, many existing perturbation methods rely on dropout, and thus require a careful manual tuning of the dropout rate, which is a sensitive hyperparameter and often difficult to optimize and may lead to suboptimal regularization. To overcome this limitation, we propose VQ-Seg, the first approach to employ vector quantization (VQ) to discretize the feature space and introduce a novel and controllable Quantized Perturbation Module (QPM) that replaces dropout. Our QPM perturbs discrete representations by shuffling the spatial locations of codebook indices, enabling effective and controllable regularization. To mitigate potential information loss caused by quantization, we design a dual-branch architecture where the post-quantization feature space is shared by both image reconstruction and segmentation tasks. Moreover, we introduce a Post-VQ Feature Adapter (PFA) to incorporate guidance from a foundation model (FM), supplementing the high-level semantic information lost during quantization. Furthermore, we collect a large-scale Lung Cancer (LC) dataset comprising 828 CT scans annotated for central-type lung carcinoma. Extensive experiments on the LC dataset and other public benchmarks demonstrate the effectiveness of our method, which outperforms state-of-the-art approaches. Code available at: https://github.com/script-Yang/VQ-Seg.

We present XMem, a video object segmentation architecture for long videos with unified feature memory stores inspired by the Atkinson-Shiffrin memory model. Prior work on video object segmentation typically only uses one type of feature memory. For videos longer than a minute, a single feature memory model tightly links memory consumption and accuracy. In contrast, following the Atkinson-Shiffrin model, we develop an architecture that incorporates multiple independent yet deeply-connected feature memory stores: a rapidly updated sensory memory, a high-resolution working memory, and a compact thus sustained long-term memory. Crucially, we develop a memory potentiation algorithm that routinely consolidates actively used working memory elements into the long-term memory, which avoids memory explosion and minimizes performance decay for long-term prediction. Combined with a new memory reading mechanism, XMem greatly exceeds state-of-the-art performance on long-video datasets while being on par with state-of-the-art methods (that do not work on long videos) on short-video datasets. Code is available at https://hkchengrex.github.io/XMem

The emergence of Segment Anything (SAM) sparked research interest in the field of interactive segmentation, especially in the context of image editing tasks and speeding up data annotation. Unlike common semantic segmentation, interactive segmentation methods allow users to directly influence their output through prompts (e.g. clicks). However, click patterns in real-world interactive segmentation scenarios remain largely unexplored. Most methods rely on the assumption that users would click in the center of the largest erroneous area. Nevertheless, recent studies show that this is not always the case. Thus, methods may have poor performance in real-world deployment despite high metrics in a baseline benchmark. To accurately simulate real-user clicks, we conducted a large crowdsourcing study of click patterns in an interactive segmentation scenario and collected 475K real-user clicks. Drawing on ideas from saliency tasks, we develop a clickability model that enables sampling clicks, which closely resemble actual user inputs. Using our model and dataset, we propose RClicks benchmark for a comprehensive comparison of existing interactive segmentation methods on realistic clicks. Specifically, we evaluate not only the average quality of methods, but also the robustness w.r.t. click patterns. According to our benchmark, in real-world usage interactive segmentation models may perform worse than it has been reported in the baseline benchmark, and most of the methods are not robust. We believe that RClicks is a significant step towards creating interactive segmentation methods that provide the best user experience in real-world cases.

Longitudinal medical imaging captures temporal evolution of lesions, yet extracting the underlying dynamical parameters governing this evolution remains challenging. We propose an inverse Bayesian framework for inferring lesion dynamics from longitudinal spectral CT. We decompose spectral feature (x) evolution into three components: equation* dx_i{dt} = A_i x_i + B \cdot n + C \cdot Δx_{sat} equation* where A_i captures intrinsic dynamics (lesion-autonomous evolution), B captures local environment tumour burden (organ tumour burden through satellite count coupling), and C captures environment/satellite state change (i.e., whether surrounding lesions move similarly or not). We demonstrate the framework on photon-counting NSCLC CT data from metastases, recovering distinct dynamical regimes: lung lesions exhibit significant satellite count coupling (B=-0.34, p<0.05) suggesting competitive dynamics, while liver lesions show synergistic satellite behaviour coupling (Capprox+1.0, p<0.05). Synthetic validation confirms parameter recovery, and cross-coupling analysis validates that our method detects non-zero coupling when present. This work establishes inverse dynamical inference as a principled methodology for extracting interpretable parameters from longitudinal imaging, moving beyond static feature extraction toward mechanistic characterisation of lesion behaviour. The code and data are available at: https://github.com/lukasf98/inverse-bayesian-inference

Segmentation of the main coronary artery from X-ray coronary angiography (XCA) sequences is crucial for the diagnosis of coronary artery diseases. However, this task is challenging due to issues such as blurred boundaries, inconsistent radiation contrast, complex motion patterns, and a lack of annotated images for training. Although Semi-Supervised Learning (SSL) can alleviate the annotation burden, conventional methods struggle with complicated temporal dynamics and unreliable uncertainty quantification. To address these challenges, we propose SAM3-based Teacher-student framework with Motion-Aware consistency and Progressive Confidence Regularization (SMART), a semi-supervised vessel segmentation approach for X-ray angiography videos. First, our method utilizes SAM3's unique promptable concept segmentation design and innovates a SAM3-based teacher-student framework to maximize the performance potential of both the teacher and the student. Second, we enhance segmentation by integrating the vessel mask warping technique and motion consistency loss to model complex vessel dynamics. To address the issue of unreliable teacher predictions caused by blurred boundaries and minimal contrast, we further propose a progressive confidence-aware consistency regularization to mitigate the risk of unreliable outputs. Extensive experiments on three datasets of XCA sequences from different institutions demonstrate that SMART achieves state-of-the-art performance while requiring significantly fewer annotations, making it particularly valuable for real-world clinical applications where labeled data is scarce. Our code is available at: https://github.com/qimingfan10/SMART.

Intelligent robots need to interact with diverse objects across various environments. The appearance and state of objects frequently undergo complex transformations depending on the object properties, e.g., phase transitions. However, in the vision community, segmenting dynamic objects with phase transitions is overlooked. In light of this, we introduce the concept of phase in segmentation, which categorizes real-world objects based on their visual characteristics and potential morphological and appearance changes. Then, we present a new benchmark, Multi-Phase, Multi-Transition, and Multi-Scenery Video Object Segmentation (M^3-VOS), to verify the ability of models to understand object phases, which consists of 479 high-resolution videos spanning over 10 distinct everyday scenarios. It provides dense instance mask annotations that capture both object phases and their transitions. We evaluate state-of-the-art methods on M^3-VOS, yielding several key insights. Notably, current appearance-based approaches show significant room for improvement when handling objects with phase transitions. The inherent changes in disorder suggest that the predictive performance of the forward entropy-increasing process can be improved through a reverse entropy-reducing process. These findings lead us to propose ReVOS, a new plug-andplay model that improves its performance by reversal refinement. Our data and code will be publicly available at https://zixuan-chen.github.io/M-cube-VOS.github.io/.

Mamba has recently garnered attention as an effective backbone for vision tasks. However, its underlying mechanism in visual domains remains poorly understood. In this work, we systematically investigate Mamba's representational properties and make three primary contributions. First, we theoretically analyze Mamba's relationship to Softmax and Linear Attention, confirming that it can be viewed as a low-rank approximation of Softmax Attention and thereby bridging the representational gap between Softmax and Linear forms. Second, we introduce a novel binary segmentation metric for activation map evaluation, extending qualitative assessments to a quantitative measure that demonstrates Mamba's capacity to model long-range dependencies. Third, by leveraging DINO for self-supervised pretraining, we obtain clearer activation maps than those produced by standard supervised approaches, highlighting Mamba's potential for interpretability. Notably, our model also achieves a 78.5 percent linear probing accuracy on ImageNet, underscoring its strong performance. We hope this work can provide valuable insights for future investigations of Mamba-based vision architectures.

In this paper we approach the novel problem of segmenting an image based on a natural language expression. This is different from traditional semantic segmentation over a predefined set of semantic classes, as e.g., the phrase "two men sitting on the right bench" requires segmenting only the two people on the right bench and no one standing or sitting on another bench. Previous approaches suitable for this task were limited to a fixed set of categories and/or rectangular regions. To produce pixelwise segmentation for the language expression, we propose an end-to-end trainable recurrent and convolutional network model that jointly learns to process visual and linguistic information. In our model, a recurrent LSTM network is used to encode the referential expression into a vector representation, and a fully convolutional network is used to a extract a spatial feature map from the image and output a spatial response map for the target object. We demonstrate on a benchmark dataset that our model can produce quality segmentation output from the natural language expression, and outperforms baseline methods by a large margin.

This paper presents a large publicly available multi-center lumbar spine magnetic resonance imaging (MRI) dataset with reference segmentations of vertebrae, intervertebral discs (IVDs), and spinal canal. The dataset includes 447 sagittal T1 and T2 MRI series from 218 patients with a history of low back pain. It was collected from four different hospitals and was divided into a training (179 patients) and validation (39 patients) set. An iterative data annotation approach was used by training a segmentation algorithm on a small part of the dataset, enabling semi-automatic segmentation of the remaining images. The algorithm provided an initial segmentation, which was subsequently reviewed, manually corrected, and added to the training data. We provide reference performance values for this baseline algorithm and nnU-Net, which performed comparably. We set up a continuous segmentation challenge to allow for a fair comparison of different segmentation algorithms. This study may encourage wider collaboration in the field of spine segmentation, and improve the diagnostic value of lumbar spine MRI.

Semi-supervised learning (SSL) has emerged as an effective paradigm for medical image segmentation, reducing the reliance on extensive expert annotations. Meanwhile, vision-language models (VLMs) have demonstrated strong generalization and few-shot capabilities across diverse visual domains. In this work, we integrate VLM-based segmentation into semi-supervised medical image segmentation by introducing a Vision-Language Enhanced Semi-supervised Segmentation Assistant (VESSA) that incorporates foundation-level visual-semantic understanding into SSL frameworks. Our approach consists of two stages. In Stage 1, the VLM-enhanced segmentation foundation model VESSA is trained as a reference-guided segmentation assistant using a template bank containing gold-standard exemplars, simulating learning from limited labeled data. Given an input-template pair, VESSA performs visual feature matching to extract representative semantic and spatial cues from exemplar segmentations, generating structured prompts for a SAM2-inspired mask decoder to produce segmentation masks. In Stage 2, VESSA is integrated into a state-of-the-art SSL framework, enabling dynamic interaction with the student model: as student predictions become more refined, they are fed back to VESSA as prompts, allowing it to generate higher-quality pseudo-labels and stronger guidance. Extensive experiments across multiple segmentation datasets and domains show that VESSA-augmented SSL significantly enhances segmentation accuracy, outperforming state-of-the-art baselines under extremely limited annotation conditions.

Evaluation metrics are central to binary target segmentation because they determine how progress is measured, compared, and interpreted. In this paper, target denotes the task-defined positive region to be segmented rather than a generic foreground object. It may be salient, camouflaged, transparent, glass-like, mirror-like, shadow-like, lesion-like, or defined by other application-specific semantics. We treat existing metrics as compositions of modular design choices rather than isolated formulas. The proposed framework decomposes each metric into five stages covering prediction representation, target extraction, target matching, score computation, and metric reporting. We use this framework to analyze representative metrics and show how newer metrics address specific limits in earlier protocols. The stage choices keep each metric's assumptions visible. We then discuss the design space opened by the framework and its implications for task-aware evaluation protocols. Reference code is available at https://github.com/lartpang/PySODMetrics.

The medical imaging community generates a wealth of datasets, many of which are openly accessible and annotated for specific diseases and tasks such as multi-organ or lesion segmentation. Current practices continue to limit model training and supervised pre-training to one or a few similar datasets, neglecting the synergistic potential of other available annotated data. We propose MultiTalent, a method that leverages multiple CT datasets with diverse and conflicting class definitions to train a single model for a comprehensive structure segmentation. Our results demonstrate improved segmentation performance compared to previous related approaches, systematically, also compared to single dataset training using state-of-the-art methods, especially for lesion segmentation and other challenging structures. We show that MultiTalent also represents a powerful foundation model that offers a superior pre-training for various segmentation tasks compared to commonly used supervised or unsupervised pre-training baselines. Our findings offer a new direction for the medical imaging community to effectively utilize the wealth of available data for improved segmentation performance. The code and model weights will be published here: [tba]

This paper introduces a network for volumetric segmentation that learns from sparsely annotated volumetric images. We outline two attractive use cases of this method: (1) In a semi-automated setup, the user annotates some slices in the volume to be segmented. The network learns from these sparse annotations and provides a dense 3D segmentation. (2) In a fully-automated setup, we assume that a representative, sparsely annotated training set exists. Trained on this data set, the network densely segments new volumetric images. The proposed network extends the previous u-net architecture from Ronneberger et al. by replacing all 2D operations with their 3D counterparts. The implementation performs on-the-fly elastic deformations for efficient data augmentation during training. It is trained end-to-end from scratch, i.e., no pre-trained network is required. We test the performance of the proposed method on a complex, highly variable 3D structure, the Xenopus kidney, and achieve good results for both use cases.

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.

Advances in unsupervised learning of object-representations have culminated in the development of a broad range of methods for unsupervised object segmentation and interpretable object-centric scene generation. These methods, however, are limited to simulated and real-world datasets with limited visual complexity. Moreover, object representations are often inferred using RNNs which do not scale well to large images or iterative refinement which avoids imposing an unnatural ordering on objects in an image but requires the a priori initialisation of a fixed number of object representations. In contrast to established paradigms, this work proposes an embedding-based approach in which embeddings of pixels are clustered in a differentiable fashion using a stochastic stick-breaking process. Similar to iterative refinement, this clustering procedure also leads to randomly ordered object representations, but without the need of initialising a fixed number of clusters a priori. This is used to develop a new model, GENESIS-v2, which can infer a variable number of object representations without using RNNs or iterative refinement. We show that GENESIS-v2 performs strongly in comparison to recent baselines in terms of unsupervised image segmentation and object-centric scene generation on established synthetic datasets as well as more complex real-world datasets.

Recent video foundation models such as SAM2 excel at prompted video segmentation by treating masks as a general-purpose primitive. However, many real-world settings require unprompted segmentation that aims to detect and track all objects in a video without external cues, leaving today's landscape fragmented across task-specific models and pipelines. We recast streaming video segmentation as sequential mask prediction, analogous to language modeling, and introduce the Autoregressive Universal Segmentation Model (AUSM), a single architecture that unifies both prompted and unprompted video segmentation. Built on recent state-space models, AUSM maintains a fixed-size spatial state and scales to video streams of arbitrary length. Furthermore, all components of AUSM are designed for parallel training across frames, yielding substantial speedups over iterative training. On standard benchmarks (DAVIS17, YouTube-VOS 2018 & 2019, MOSE, YouTube-VIS 2019 & 2021, and OVIS) AUSM outperforms prior universal streaming video segmentation methods and achieves up to 2.5x faster training on 16-frame sequences.

Hierarchical segmentation entails creating segmentations at varying levels of granularity. We introduce the first hierarchical semantic segmentation dataset with subpart annotations for natural images, which we call SPIN (SubPartImageNet). We also introduce two novel evaluation metrics to evaluate how well algorithms capture spatial and semantic relationships across hierarchical levels. We benchmark modern models across three different tasks and analyze their strengths and weaknesses across objects, parts, and subparts. To facilitate community-wide progress, we publicly release our dataset at https://joshmyersdean.github.io/spin/index.html.

This paper presents a new unified approach to semantic segmentation in both images and videos by using language modeling to output the masks as sequences of discrete tokens. We use run length encoding (RLE) to discretize the segmentation masks and then train a modified version of Pix2Seq to output these RLE tokens through autoregression. We propose novel tokenization strategies to compress the length of the token sequence to make it practicable to extend this approach to videos. We also show how instance information can be incorporated into the tokenization process to perform panoptic segmentation. We evaluate our proposed models on two datasets to show that they are competitive with the state of the art in some scenarios in spite of being bottlenecked by our limited computational resources. We make our code and models publicly available to facilitate further work in this domain.

Researchers are usually interested in examining the impact of covariates when separating heterogeneous samples into latent classes that are more homogeneous. The majority of theoretical and empirical studies with such aims have focused on identifying covariates as predictors of class membership in the structural equation modeling framework. In other words, the covariates only indirectly affect the sample heterogeneity. However, the covariates' influence on between-individual differences can also be direct. This article presents a mixture model that investigates covariates to explain within-cluster and between-cluster heterogeneity simultaneously, known as a mixture-of-experts (MoE) model. This study aims to extend the MoE framework to investigate heterogeneity in nonlinear trajectories: to identify latent classes, covariates as predictors to clusters, and covariates that explain within-cluster differences in change patterns over time. Our simulation studies demonstrate that the proposed model generally estimates the parameters unbiasedly, precisely and exhibits appropriate empirical coverage for a nominal 95% confidence interval. This study also proposes implementing structural equation model forests to shrink the covariate space of the proposed mixture model. We illustrate how to select covariates and construct the proposed model with longitudinal mathematics achievement data. Additionally, we demonstrate that the proposed mixture model can be further extended in the structural equation modeling framework by allowing the covariates that have direct effects to be time-varying.

Medical image segmentation faces critical challenges in semi-supervised learning scenarios due to severe annotation scarcity requiring expert radiological knowledge, significant inter-annotator variability across different viewpoints and expertise levels, and inadequate multi-scale feature integration for precise boundary delineation in complex anatomical structures. Existing semi-supervised methods demonstrate substantial performance degradation compared to fully supervised approaches, particularly in small target segmentation and boundary refinement tasks. To address these fundamental challenges, we propose SASNet (Scale-aware Adaptive Supervised Network), a dual-branch architecture that leverages both low-level and high-level feature representations through novel scale-aware adaptive reweight mechanisms. Our approach introduces three key methodological innovations, including the Scale-aware Adaptive Reweight strategy that dynamically weights pixel-wise predictions using temporal confidence accumulation, the View Variance Enhancement mechanism employing 3D Fourier domain transformations to simulate annotation variability, and segmentation-regression consistency learning through signed distance map algorithms for enhanced boundary precision. These innovations collectively address the core limitations of existing semi-supervised approaches by integrating spatial, temporal, and geometric consistency principles within a unified optimization framework. Comprehensive evaluation across LA, Pancreas-CT, and BraTS datasets demonstrates that SASNet achieves superior performance with limited labeled data, surpassing state-of-the-art semi-supervised methods while approaching fully supervised performance levels. The source code for SASNet is available at https://github.com/HUANGLIZI/SASNet.

Moving object segmentation is a crucial task for achieving a high-level understanding of visual scenes and has numerous downstream applications. Humans can effortlessly segment moving objects in videos. Previous work has largely relied on optical flow to provide motion cues; however, this approach often results in imperfect predictions due to challenges such as partial motion, complex deformations, motion blur and background distractions. We propose a novel approach for moving object segmentation that combines long-range trajectory motion cues with DINO-based semantic features and leverages SAM2 for pixel-level mask densification through an iterative prompting strategy. Our model employs Spatio-Temporal Trajectory Attention and Motion-Semantic Decoupled Embedding to prioritize motion while integrating semantic support. Extensive testing on diverse datasets demonstrates state-of-the-art performance, excelling in challenging scenarios and fine-grained segmentation of multiple objects. Our code is available at https://motion-seg.github.io/.

Medical image segmentation allows quantifying target structure size and shape, aiding in disease diagnosis, prognosis, surgery planning, and comprehension.Building upon recent advancements in foundation Vision-Language Models (VLMs) from natural image-text pairs, several studies have proposed adapting them to Vision-Language Segmentation Models (VLSMs) that allow using language text as an additional input to segmentation models. Introducing auxiliary information via text with human-in-the-loop prompting during inference opens up unique opportunities, such as open vocabulary segmentation and potentially more robust segmentation models against out-of-distribution data. Although transfer learning from natural to medical images has been explored for image-only segmentation models, the joint representation of vision-language in segmentation problems remains underexplored. This study introduces the first systematic study on transferring VLSMs to 2D medical images, using carefully curated 11 datasets encompassing diverse modalities and insightful language prompts and experiments. Our findings demonstrate that although VLSMs show competitive performance compared to image-only models for segmentation after finetuning in limited medical image datasets, not all VLSMs utilize the additional information from language prompts, with image features playing a dominant role. While VLSMs exhibit enhanced performance in handling pooled datasets with diverse modalities and show potential robustness to domain shifts compared to conventional segmentation models, our results suggest that novel approaches are required to enable VLSMs to leverage the various auxiliary information available through language prompts. The code and datasets are available at https://github.com/naamiinepal/medvlsm.

The task of assigning semantic classes and track identities to every pixel in a video is called video panoptic segmentation. Our work is the first that targets this task in a real-world setting requiring dense interpretation in both spatial and temporal domains. As the ground-truth for this task is difficult and expensive to obtain, existing datasets are either constructed synthetically or only sparsely annotated within short video clips. To overcome this, we introduce a new benchmark encompassing two datasets, KITTI-STEP, and MOTChallenge-STEP. The datasets contain long video sequences, providing challenging examples and a test-bed for studying long-term pixel-precise segmentation and tracking under real-world conditions. We further propose a novel evaluation metric Segmentation and Tracking Quality (STQ) that fairly balances semantic and tracking aspects of this task and is more appropriate for evaluating sequences of arbitrary length. Finally, we provide several baselines to evaluate the status of existing methods on this new challenging dataset. We have made our datasets, metric, benchmark servers, and baselines publicly available, and hope this will inspire future research.

We present Segment Anything Model 2 (SAM 2), a foundation model towards solving promptable visual segmentation in images and videos. We build a data engine, which improves model and data via user interaction, to collect the largest video segmentation dataset to date. Our model is a simple transformer architecture with streaming memory for real-time video processing. SAM 2 trained on our data provides strong performance across a wide range of tasks. In video segmentation, we observe better accuracy, using 3x fewer interactions than prior approaches. In image segmentation, our model is more accurate and 6x faster than the Segment Anything Model (SAM). We believe that our data, model, and insights will serve as a significant milestone for video segmentation and related perception tasks. We are releasing a version of our model, the dataset and an interactive demo.

With the development of Deep Neural Networks (DNNs), many efforts have been made to handle medical image segmentation. Traditional methods such as nnUNet train specific segmentation models on the individual datasets. Plenty of recent methods have been proposed to adapt the foundational Segment Anything Model (SAM) to medical image segmentation. However, they still focus on discrete representations to generate pixel-wise predictions, which are spatially inflexible and scale poorly to higher resolution. In contrast, implicit methods learn continuous representations for segmentation, which is crucial for medical image segmentation. In this paper, we propose I-MedSAM, which leverages the benefits of both continuous representations and SAM, to obtain better cross-domain ability and accurate boundary delineation. Since medical image segmentation needs to predict detailed segmentation boundaries, we designed a novel adapter to enhance the SAM features with high-frequency information during Parameter-Efficient Fine-Tuning (PEFT). To convert the SAM features and coordinates into continuous segmentation output, we utilize Implicit Neural Representation (INR) to learn an implicit segmentation decoder. We also propose an uncertainty-guided sampling strategy for efficient learning of INR. Extensive evaluations on 2D medical image segmentation tasks have shown that our proposed method with only 1.6M trainable parameters outperforms existing methods including discrete and implicit methods. The code will be available at: https://github.com/ucwxb/I-MedSAM.

Rotoscoping, the detailed delineation of scene elements through a video shot, is a painstaking task of tremendous importance in professional post-production pipelines. While pixel-wise segmentation techniques can help for this task, professional rotoscoping tools rely on parametric curves that offer the artists a much better interactive control on the definition, editing and manipulation of the segments of interest. Sticking to this prevalent rotoscoping paradigm, we propose a novel framework to capture and track the visual aspect of an arbitrary object in a scene, given a first closed outline of this object. This model combines a collection of local foreground/background appearance models spread along the outline, a global appearance model of the enclosed object and a set of distinctive foreground landmarks. The structure of this rich appearance model allows simple initialization, efficient iterative optimization with exact minimization at each step, and on-line adaptation in videos. We demonstrate qualitatively and quantitatively the merit of this framework through comparisons with tools based on either dynamic segmentation with a closed curve or pixel-wise binary labelling.

Segmenting an object in a video presents significant challenges. Each pixel must be accurately labelled, and these labels must remain consistent across frames. The difficulty increases when the segmentation is with arbitrary granularity, meaning the number of segments can vary arbitrarily, and masks are defined based on only one or a few sample images. In this paper, we address this issue by employing a pre-trained text to image diffusion model supplemented with an additional tracking mechanism. We demonstrate that our approach can effectively manage various segmentation scenarios and outperforms state-of-the-art alternatives.

While MLLMs have demonstrated adequate image understanding capabilities, they still struggle with pixel-level comprehension, limiting their practical applications. Current evaluation tasks like VQA and visual grounding remain too coarse to assess fine-grained pixel comprehension accurately. Though segmentation is foundational for pixel-level understanding, existing methods often require MLLMs to generate implicit tokens, decoded through external pixel decoders. This approach disrupts the MLLM's text output space, potentially compromising language capabilities and reducing flexibility and extensibility, while failing to reflect the model's intrinsic pixel-level understanding. Thus, we introduce the Human-Like Mask Annotation Task (HLMAT), a new paradigm where MLLMs mimic human annotators using interactive segmentation tools. Modeling segmentation as a multi-step Markov Decision Process, HLMAT enables MLLMs to iteratively generate text-based click points, achieving high-quality masks without architectural changes or implicit tokens. Through this setup, we develop SegAgent, a model fine-tuned on human-like annotation trajectories, which achieves performance comparable to state-of-the-art (SOTA) methods and supports additional tasks like mask refinement and annotation filtering. HLMAT provides a protocol for assessing fine-grained pixel understanding in MLLMs and introduces a vision-centric, multi-step decision-making task that facilitates exploration of MLLMs' visual reasoning abilities. Our adaptations of policy improvement method StaR and PRM-guided tree search further enhance model robustness in complex segmentation tasks, laying a foundation for future advancements in fine-grained visual perception and multi-step decision-making for MLLMs.

Existing automatic 3D image segmentation methods usually fail to meet the clinic use. Many studies have explored an interactive strategy to improve the image segmentation performance by iteratively incorporating user hints. However, the dynamic process for successive interactions is largely ignored. We here propose to model the dynamic process of iterative interactive image segmentation as a Markov decision process (MDP) and solve it with reinforcement learning (RL). Unfortunately, it is intractable to use single-agent RL for voxel-wise prediction due to the large exploration space. To reduce the exploration space to a tractable size, we treat each voxel as an agent with a shared voxel-level behavior strategy so that it can be solved with multi-agent reinforcement learning. An additional advantage of this multi-agent model is to capture the dependency among voxels for segmentation task. Meanwhile, to enrich the information of previous segmentations, we reserve the prediction uncertainty in the state space of MDP and derive an adjustment action space leading to a more precise and finer segmentation. In addition, to improve the efficiency of exploration, we design a relative cross-entropy gain-based reward to update the policy in a constrained direction. Experimental results on various medical datasets have shown that our method significantly outperforms existing state-of-the-art methods, with the advantage of fewer interactions and a faster convergence.

Longitudinal chest X-ray (CXR) interpretation requires reasoning over disease evolution across multiple patient visits, yet most existing medical VQA benchmarks focus on single images or short-horizon image pairs. We introduce MI-CXR, a benchmark for standardized evaluation of Multi-Interval longitudinal reasoning over multi-visit CXR sequences, without requiring free-form report generation or additional clinical context. MI-CXR comprises five-way multiple-choice questions over five-visit patient timelines and instantiates three complementary task families: Temporal Event Localization, Interval-wise Change Reasoning, and Global Trajectory Summarization, which assess clinically grounded visual reasoning over time. Evaluating 14 state-of-the-art vision-language models (VLMs) shows low overall performance, with an average accuracy of 29.3%, only modestly above random guessing. Using stage-wise diagnostic probing, we find that models often produce locally plausible interval descriptions but fail to enforce temporal constraints or compose evidence into globally consistent decisions over the full timeline. These findings reveal key limitations of current VLMs and establish MI-CXR as a principled benchmark for longitudinal medical reasoning. The benchmark is available at https://github.com/AIDASLab/MI-CXR

White matter tract segmentation is crucial for studying brain structural connectivity and neurosurgical planning. However, segmentation remains challenging due to issues like class imbalance between major and minor tracts, structural similarity, subject variability, symmetric streamlines between hemispheres etc. To address these challenges, we propose TractoEmbed, a modular multi-level embedding framework, that encodes localized representations through learning tasks in respective encoders. In this paper, TractoEmbed introduces a novel hierarchical streamline data representation that captures maximum spatial information at each level i.e. individual streamlines, clusters, and patches. Experiments show that TractoEmbed outperforms state-of-the-art methods in white matter tract segmentation across different datasets, and spanning various age groups. The modular framework directly allows the integration of additional embeddings in future works.

Learning anatomical segmentation from heterogeneous labels in multi-center datasets is a common situation encountered in clinical scenarios, where certain anatomical structures are only annotated in images coming from particular medical centers, but not in the full database. Here we first show how state-of-the-art pixel-level segmentation models fail in naively learning this task due to domain memorization issues and conflicting labels. We then propose to adopt HybridGNet, a landmark-based segmentation model which learns the available anatomical structures using graph-based representations. By analyzing the latent space learned by both models, we show that HybridGNet naturally learns more domain-invariant feature representations, and provide empirical evidence in the context of chest X-ray multiclass segmentation. We hope these insights will shed light on the training of deep learning models with heterogeneous labels from public and multi-center datasets.

Recent co-part segmentation methods mostly operate in a supervised learning setting, which requires a large amount of annotated data for training. To overcome this limitation, we propose a self-supervised deep learning method for co-part segmentation. Differently from previous works, our approach develops the idea that motion information inferred from videos can be leveraged to discover meaningful object parts. To this end, our method relies on pairs of frames sampled from the same video. The network learns to predict part segments together with a representation of the motion between two frames, which permits reconstruction of the target image. Through extensive experimental evaluation on publicly available video sequences we demonstrate that our approach can produce improved segmentation maps with respect to previous self-supervised co-part segmentation approaches.

We introduce a deep learning image segmentation framework that is extremely robust to missing imaging modalities. Instead of attempting to impute or synthesize missing data, the proposed approach learns, for each modality, an embedding of the input image into a single latent vector space for which arithmetic operations (such as taking the mean) are well defined. Points in that space, which are averaged over modalities available at inference time, can then be further processed to yield the desired segmentation. As such, any combinatorial subset of available modalities can be provided as input, without having to learn a combinatorial number of imputation models. Evaluated on two neurological MRI datasets (brain tumors and MS lesions), the approach yields state-of-the-art segmentation results when provided with all modalities; moreover, its performance degrades remarkably gracefully when modalities are removed, significantly more so than alternative mean-filling or other synthesis approaches.

Diffusion Language Models (DLMs) have recently emerged as a promising alternative to autoregressive models. Unlike standard diffusion-based approaches, DLMs are not explicitly conditioned on a timestep, raising a natural question: do these models internally represent denoising progress, and how is such information used downstream? In this work, we show that DLMs do in fact encode a latent representation related to the diffusion timestep within their residual streams. We find that this signal can be reliably extracted using probes across layers, indicating that denoising progress is decodable from internal activations. We further demonstrate that steering the model along a low-dimensional subspace associated with the inferred timestep allows us to systematically modulate its notion of denoising progress, leading to predictable changes in model confidence and entropy. Finally, we analyse the geometry of the identified representation, showing that it exhibits structured and interpretable properties in activation space, and shedding light on how such a signal is processed by these models.

We propose a new problem called audio-visual segmentation (AVS), in which the goal is to output a pixel-level map of the object(s) that produce sound at the time of the image frame. To facilitate this research, we construct the first audio-visual segmentation benchmark, i.e., AVSBench, providing pixel-wise annotations for sounding objects in audible videos. It contains three subsets: AVSBench-object (Single-source subset, Multi-sources subset) and AVSBench-semantic (Semantic-labels subset). Accordingly, three settings are studied: 1) semi-supervised audio-visual segmentation with a single sound source; 2) fully-supervised audio-visual segmentation with multiple sound sources, and 3) fully-supervised audio-visual semantic segmentation. The first two settings need to generate binary masks of sounding objects indicating pixels corresponding to the audio, while the third setting further requires generating semantic maps indicating the object category. To deal with these problems, we propose a new baseline method that uses a temporal pixel-wise audio-visual interaction module to inject audio semantics as guidance for the visual segmentation process. We also design a regularization loss to encourage audio-visual mapping during training. Quantitative and qualitative experiments on AVSBench compare our approach to several existing methods for related tasks, demonstrating that the proposed method is promising for building a bridge between the audio and pixel-wise visual semantics. Code is available at https://github.com/OpenNLPLab/AVSBench. Online benchmark is available at http://www.avlbench.opennlplab.cn.

This paper investigates data-driven segmentation using Re-Pair or Byte Pair Encoding-techniques. In contrast to previous work which has primarily been focused on subword units for machine translation, we are interested in the general properties of such segments above the word level. We call these segments r-grams, and discuss their properties and the effect they have on the token frequency distribution. The proposed approach is evaluated by demonstrating its viability in embedding techniques, both in monolingual and multilingual test settings. We also provide a number of qualitative examples of the proposed methodology, demonstrating its viability as a language-invariant segmentation procedure.

Text-based image segmentation aims to delineate object boundaries within an image from text prompts, offering higher flexibility and broader application scope compared to traditional fixed-category segmentation tasks. Recent studies have shown that diffusion models (e.g., Stable Diffusion) can provide rich multimodal semantic features, leading to studies of using diffusion models as feature extractors for segmentation tasks. Such methods, however, inherit the generative natures of diffusion models that are harmful to discriminative segmentation tasks. In response, we propose RLFSeg, a novel framework that leverages Rectified Flow to learn direct mapping from the image to the segmentation mask within the latent space. The model is thus freed from the noise-denoise process and the need to optimize the time step of diffusion models, resulting in substantially better performance than previous diffusion-based methods, especially on zero-shot scenarios. By introducing label refinement and an Adaptive One-Step Sampling strategy, the model achieves higher accuracy even on a single inference step. The framework redirects a pretrained generative model to the discriminative segmentation task with zero modification to model structure, thus reveals promising application potential and significant research value.

3D medical image segmentation methods have been successful, but their dependence on large amounts of voxel-level annotated data is a disadvantage that needs to be addressed given the high cost to obtain such annotation. Semi-supervised learning (SSL) solve this issue by training models with a large unlabelled and a small labelled dataset. The most successful SSL approaches are based on consistency learning that minimises the distance between model responses obtained from perturbed views of the unlabelled data. These perturbations usually keep the spatial input context between views fairly consistent, which may cause the model to learn segmentation patterns from the spatial input contexts instead of the segmented objects. In this paper, we introduce the Translation Consistent Co-training (TraCoCo) which is a consistency learning SSL method that perturbs the input data views by varying their spatial input context, allowing the model to learn segmentation patterns from visual objects. Furthermore, we propose the replacement of the commonly used mean squared error (MSE) semi-supervised loss by a new Cross-model confident Binary Cross entropy (CBC) loss, which improves training convergence and keeps the robustness to co-training pseudo-labelling mistakes. We also extend CutMix augmentation to 3D SSL to further improve generalisation. Our TraCoCo shows state-of-the-art results for the Left Atrium (LA) and Brain Tumor Segmentation (BRaTS19) datasets with different backbones. Our code is available at https://github.com/yyliu01/TraCoCo.

The open-vocabulary image segmentation task involves partitioning images into semantically meaningful segments and classifying them with flexible text-defined categories. The recent vision-based foundation models such as the Segment Anything Model (SAM) have shown superior performance in generating class-agnostic image segments. The main challenge in open-vocabulary image segmentation now lies in accurately classifying these segments into text-defined categories. In this paper, we introduce the Universal Segment Embedding (USE) framework to address this challenge. This framework is comprised of two key components: 1) a data pipeline designed to efficiently curate a large amount of segment-text pairs at various granularities, and 2) a universal segment embedding model that enables precise segment classification into a vast range of text-defined categories. The USE model can not only help open-vocabulary image segmentation but also facilitate other downstream tasks (e.g., querying and ranking). Through comprehensive experimental studies on semantic segmentation and part segmentation benchmarks, we demonstrate that the USE framework outperforms state-of-the-art open-vocabulary segmentation methods.

Traditional reference segmentation tasks have predominantly focused on silent visual scenes, neglecting the integral role of multimodal perception and interaction in human experiences. In this work, we introduce a novel task called Reference Audio-Visual Segmentation (Ref-AVS), which seeks to segment objects within the visual domain based on expressions containing multimodal cues. Such expressions are articulated in natural language forms but are enriched with multimodal cues, including audio and visual descriptions. To facilitate this research, we construct the first Ref-AVS benchmark, which provides pixel-level annotations for objects described in corresponding multimodal-cue expressions. To tackle the Ref-AVS task, we propose a new method that adequately utilizes multimodal cues to offer precise segmentation guidance. Finally, we conduct quantitative and qualitative experiments on three test subsets to compare our approach with existing methods from related tasks. The results demonstrate the effectiveness of our method, highlighting its capability to precisely segment objects using multimodal-cue expressions. Dataset is available at https://gewu-lab.github.io/Ref-AVS{https://gewu-lab.github.io/Ref-AVS}.

While large multi-modal models (LMMs) demonstrate promising capabilities in segmentation and comprehension, they still struggle with two limitations: inaccurate segmentation and hallucinated comprehension. These challenges stem primarily from constraints in weak visual comprehension and a lack of fine-grained perception. To alleviate these limitations, we propose LIRA, a framework that capitalizes on the complementary relationship between visual comprehension and segmentation via two key components: (1) Semantic-Enhanced Feature Extractor (SEFE) improves object attribute inference by fusing semantic and pixel-level features, leading to more accurate segmentation; (2) Interleaved Local Visual Coupling (ILVC) autoregressively generates local descriptions after extracting local features based on segmentation masks, offering fine-grained supervision to mitigate hallucinations. Furthermore, we find that the precision of object segmentation is positively correlated with the latent related semantics of the <seg> token. To quantify this relationship and the model's potential semantic inferring ability, we introduce the Attributes Evaluation (AttrEval) dataset. Our experiments show that LIRA achieves state-of-the-art performance in both segmentation and comprehension tasks. Code will be available at https://github.com/echo840/LIRA.

Recent approaches for segmentation have leveraged pretrained generative models as feature extractors, treating segmentation as a downstream adaptation task via indirect feature retrieval. This implicit use suffers from a fundamental misalignment in representation. It also depends heavily on indirect feature extraction pipelines, which complicate the workflow and limit adaptation. In this paper, we argue that instead of indirect adaptation, segmentation tasks should be trained directly in a generative manner. We identify a key obstacle to this unified formulation: VAE latents of binary masks are sharply distributed, noise robust, and linearly separable, distinct from natural image latents. To bridge this gap, we introduce timesteps sampling strategy for binary masks that emphasizes extreme noise levels for segmentation and moderate noise for image generation, enabling harmonious joint training. We present GenMask, a DiT trains to generate black-and-white segmentation masks as well as colorful images in RGB space under the original generative objective. GenMask preserves the original DiT architecture while removing the need of feature extraction pipelines tailored for segmentation tasks. Empirically, GenMask attains state-of-the-art performance on referring and reasoning segmentation benchmarks and ablations quantify the contribution of each component.

Semantic segmentation has made significant progress in recent years thanks to deep neural networks, but the common objective of generating a single segmentation output that accurately matches the image's content may not be suitable for safety-critical domains such as medical diagnostics and autonomous driving. Instead, multiple possible correct segmentation maps may be required to reflect the true distribution of annotation maps. In this context, stochastic semantic segmentation methods must learn to predict conditional distributions of labels given the image, but this is challenging due to the typically multimodal distributions, high-dimensional output spaces, and limited annotation data. To address these challenges, we propose a conditional categorical diffusion model (CCDM) for semantic segmentation based on Denoising Diffusion Probabilistic Models. Our model is conditioned to the input image, enabling it to generate multiple segmentation label maps that account for the aleatoric uncertainty arising from divergent ground truth annotations. Our experimental results show that CCDM achieves state-of-the-art performance on LIDC, a stochastic semantic segmentation dataset, and outperforms established baselines on the classical segmentation dataset Cityscapes.

Integrating segmentation into Multimodal Large Language Models (MLLMs) presents a core trilemma: simultaneously preserving dialogue ability, achieving high segmentation performance, and ensuring fast inference. Prevailing paradigms are forced into a compromise. Embedding prediction methods introduce a conflicting pixel-level objective that degrades the MLLM's general dialogue abilities. The alternative, next-token prediction, reframes segmentation as an autoregressive task, which preserves dialogue but forces a trade-off between poor segmentation performance with sparse outputs or prohibitive inference speeds with rich ones. We resolve this trilemma with all-mask prediction, a novel paradigm that decouples autoregressive dialogue generation from non-autoregressive mask prediction. We present STAMP: Simultaneous Textual All-Mask Prediction, an MLLM that embodies this paradigm. After generating a textual response, STAMP predicts an entire segmentation mask in a single forward pass by treating it as a parallel "fill-in-the-blank" task over image patches. This design maintains the MLLM's dialogue ability by avoiding conflicting objectives, enables high segmentation performance by leveraging rich, bidirectional spatial context for all mask tokens, and achieves exceptional speed. Extensive experiments show that STAMP significantly outperforms state-of-the-art methods across multiple segmentation benchmarks, providing a solution that excels in dialogue, segmentation, and speed without compromise.

Referring Video Object Segmentation (RVOS) requires segmenting specific objects in a video guided by a natural language description. The core challenge of RVOS is to anchor abstract linguistic concepts onto a specific set of pixels and continuously segment them through the complex dynamics of a video. Faced with this difficulty, prior work has often decomposed the task into a pragmatic `locate-then-segment' pipeline. However, this cascaded design creates an information bottleneck by simplifying semantics into coarse geometric prompts (e.g, point), and struggles to maintain temporal consistency as the segmenting process is often decoupled from the initial language grounding. To overcome these fundamental limitations, we propose FlowRVS, a novel framework that reconceptualizes RVOS as a conditional continuous flow problem. This allows us to harness the inherent strengths of pretrained T2V models, fine-grained pixel control, text-video semantic alignment, and temporal coherence. Instead of conventional generating from noise to mask or directly predicting mask, we reformulate the task by learning a direct, language-guided deformation from a video's holistic representation to its target mask. Our one-stage, generative approach achieves new state-of-the-art results across all major RVOS benchmarks. Specifically, achieving a J&F of 51.1 in MeViS (+1.6 over prior SOTA) and 73.3 in the zero shot Ref-DAVIS17 (+2.7), demonstrating the significant potential of modeling video understanding tasks as continuous deformation processes.

The interactive segmentation task consists in the creation of object segmentation masks based on user interactions. The most common way to guide a model towards producing a correct segmentation consists in clicks on the object and background. The recently published Segment Anything Model (SAM) supports a generalized version of the interactive segmentation problem and has been trained on an object segmentation dataset which contains 1.1B masks. Though being trained extensively and with the explicit purpose of serving as a foundation model, we show significant limitations of SAM when being applied for interactive segmentation on novel domains or object types. On the used datasets, SAM displays a failure rate FR_{30}@90 of up to 72.6 %. Since we still want such foundation models to be immediately applicable, we present a framework that can adapt SAM during immediate usage. For this we will leverage the user interactions and masks, which are constructed during the interactive segmentation process. We use this information to generate pseudo-labels, which we use to compute a loss function and optimize a part of the SAM model. The presented method causes a relative reduction of up to 48.1 % in the FR_{20}@85 and 46.6 % in the FR_{30}@90 metrics.

We present an end-to-end deep learning segmentation method by combining a 3D UNet architecture with a graph neural network (GNN) model. In this approach, the convolutional layers at the deepest level of the UNet are replaced by a GNN-based module with a series of graph convolutions. The dense feature maps at this level are transformed into a graph input to the GNN module. The incorporation of graph convolutions in the UNet provides nodes in the graph with information that is based on node connectivity, in addition to the local features learnt through the downsampled paths. This information can help improve segmentation decisions. By stacking several graph convolution layers, the nodes can access higher order neighbourhood information without substantial increase in computational expense. We propose two types of node connectivity in the graph adjacency: i) one predefined and based on a regular node neighbourhood, and ii) one dynamically computed during training and using the nearest neighbour nodes in the feature space. We have applied this method to the task of segmenting the airway tree from chest CT scans. Experiments have been performed on 32 CTs from the Danish Lung Cancer Screening Trial dataset. We evaluate the performance of the UNet-GNN models with two types of graph adjacency and compare it with the baseline UNet.

Multimodal Large Language Models (MLLMs) have demonstrated strong image-level visual understanding and reasoning, yet their pixel-level perception across both images and videos remains limited. Foundation segmentation models such as the SAM series produce high-quality masks, but they rely on low-level visual prompts and cannot natively interpret complex conversational instructions. Existing segmentation MLLMs narrow this gap, but are usually specialized for either images or videos and rarely support both textual and visual prompts in one interface. We introduce X2SAM, a unified segmentation MLLM that extends any-segmentation capabilities from images to videos. Given conversational instructions and visual prompts, X2SAM couples an LLM with a Mask Memory module that stores guided vision features for temporally consistent video mask generation. The same formulation supports generic, open-vocabulary, referring, reasoning, grounded conversation generation, interactive, and visual grounded segmentation across image and video inputs. We further introduce the Video Visual Grounded (V-VGD) segmentation benchmark, which evaluates whether a model can segment object tracks in videos from interactive visual prompts. With a unified joint training strategy over heterogeneous image and video datasets, X2SAM delivers strong video segmentation performance, remains competitive on image segmentation benchmarks, and preserves general image and video chat ability.

Learning similarity is a key aspect in medical image analysis, particularly in recommendation systems or in uncovering the interpretation of anatomical data in images. Most existing methods learn such similarities in the embedding space over image sets using a single metric learner. Images, however, have a variety of object attributes such as color, shape, or artifacts. Encoding such attributes using a single metric learner is inadequate and may fail to generalize. Instead, multiple learners could focus on separate aspects of these attributes in subspaces of an overarching embedding. This, however, implies the number of learners to be found empirically for each new dataset. This work, Dynamic Subspace Learners, proposes to dynamically exploit multiple learners by removing the need of knowing apriori the number of learners and aggregating new subspace learners during training. Furthermore, the visual interpretability of such subspace learning is enforced by integrating an attention module into our method. This integrated attention mechanism provides a visual insight of discriminative image features that contribute to the clustering of image sets and a visual explanation of the embedding features. The benefits of our attention-based dynamic subspace learners are evaluated in the application of image clustering, image retrieval, and weakly supervised segmentation. Our method achieves competitive results with the performances of multiple learners baselines and significantly outperforms the classification network in terms of clustering and retrieval scores on three different public benchmark datasets. Moreover, our attention maps offer a proxy-labels, which improves the segmentation accuracy up to 15% in Dice scores when compared to state-of-the-art interpretation techniques.

Training data for video segmentation are expensive to annotate. This impedes extensions of end-to-end algorithms to new video segmentation tasks, especially in large-vocabulary settings. To 'track anything' without training on video data for every individual task, we develop a decoupled video segmentation approach (DEVA), composed of task-specific image-level segmentation and class/task-agnostic bi-directional temporal propagation. Due to this design, we only need an image-level model for the target task (which is cheaper to train) and a universal temporal propagation model which is trained once and generalizes across tasks. To effectively combine these two modules, we use bi-directional propagation for (semi-)online fusion of segmentation hypotheses from different frames to generate a coherent segmentation. We show that this decoupled formulation compares favorably to end-to-end approaches in several data-scarce tasks including large-vocabulary video panoptic segmentation, open-world video segmentation, referring video segmentation, and unsupervised video object segmentation. Code is available at: https://hkchengrex.github.io/Tracking-Anything-with-DEVA

Despite advancements in user-guided video segmentation, extracting complex objects consistently for highly complex scenes is still a labor-intensive task, especially for production. It is not uncommon that a majority of frames need to be annotated. We introduce a novel semi-supervised video object segmentation (SSVOS) model, XMem++, that improves existing memory-based models, with a permanent memory module. Most existing methods focus on single frame annotations, while our approach can effectively handle multiple user-selected frames with varying appearances of the same object or region. Our method can extract highly consistent results while keeping the required number of frame annotations low. We further introduce an iterative and attention-based frame suggestion mechanism, which computes the next best frame for annotation. Our method is real-time and does not require retraining after each user input. We also introduce a new dataset, PUMaVOS, which covers new challenging use cases not found in previous benchmarks. We demonstrate SOTA performance on challenging (partial and multi-class) segmentation scenarios as well as long videos, while ensuring significantly fewer frame annotations than any existing method. Project page: https://max810.github.io/xmem2-project-page/

Surgical scene segmentation is critical in computer-assisted surgery and is vital for enhancing surgical quality and patient outcomes. Recently, referring surgical segmentation is emerging, given its advantage of providing surgeons with an interactive experience to segment the target object. However, existing methods are limited by low efficiency and short-term tracking, hindering their applicability in complex real-world surgical scenarios. In this paper, we introduce ReSurgSAM2, a two-stage surgical referring segmentation framework that leverages Segment Anything Model 2 to perform text-referred target detection, followed by tracking with reliable initial frame identification and diversity-driven long-term memory. For the detection stage, we propose a cross-modal spatial-temporal Mamba to generate precise detection and segmentation results. Based on these results, our credible initial frame selection strategy identifies the reliable frame for the subsequent tracking. Upon selecting the initial frame, our method transitions to the tracking stage, where it incorporates a diversity-driven memory mechanism that maintains a credible and diverse memory bank, ensuring consistent long-term tracking. Extensive experiments demonstrate that ReSurgSAM2 achieves substantial improvements in accuracy and efficiency compared to existing methods, operating in real-time at 61.2 FPS. Our code and datasets will be available at https://github.com/jinlab-imvr/ReSurgSAM2.

The remarkable performance of large multimodal models (LMMs) has attracted significant interest from the image segmentation community. To align with the next-token-prediction paradigm, current LMM-driven segmentation methods either use object boundary points to represent masks or introduce special segmentation tokens, whose hidden states are decoded by a segmentation model requiring the original image as input. However, these approaches often suffer from inadequate mask representation and complex architectures, limiting the potential of LMMs. In this work, we propose the Hierarchical Mask Tokenizer (HiMTok), which represents segmentation masks with up to 32 tokens and eliminates the need for the original image during mask de-tokenization. HiMTok allows for compact and coarse-to-fine mask representations, aligning well with the LLM next-token-prediction paradigm and facilitating the direct acquisition of segmentation capabilities. We develop a 3-stage training recipe for progressive learning of segmentation and visual capabilities, featuring a hierarchical mask loss for effective coarse-to-fine learning. Additionally, we enable bidirectional information flow, allowing conversion between bounding boxes and mask tokens to fully leverage multi-task training potential. Extensive experiments demonstrate that our method achieves state-of-the-art performance across various segmentation tasks,while also enhancing visual grounding and maintaining overall visual understanding.