Accurately quantifying vitiligo extent in routine clinical photographs is crucial for longitudinal monitoring of treatment response. We propose a trustworthy, frequency-aware segmentation framework built on three synergistic pillars: (1) a data-efficient training strategy combining domain-adaptive pre-training on the ISIC 2019 dataset with an ROI-constrained dual-task loss to suppress background noise; (2) an architectural refinement via a ConvNeXt V2-based encoder enhanced with a novel High-Frequency Spectral Gating (HFSG) module and stem-skip connections to capture subtle textures; and (3) a clinical trust mechanism employing K-fold ensemble and Test-Time Augmentation (TTA) to generate pixel-wise uncertainty maps. Extensive validation on an expert-annotated clinical cohort demonstrates superior performance, achieving a Dice score of 85.05% and significantly reducing boundary error (95% Hausdorff Distance improved from 44.79 px to 29.95 px), consistently outperforming strong CNN (ResNet-50 and UNet++) and Transformer (MiT-B5) baselines. Notably, our framework demonstrates high reliability with zero catastrophic failures and provides interpretable entropy maps to identify ambiguous regions for clinician review. Our approach suggests that the proposed framework establishes a robust and reliable standard for automated vitiligo assessment.
Accurate skin lesion segmentation is vital for dermoscopic Computer-Aided Diagnosis. However, visual ambiguity and morphological irregularity often defeat spatial modeling, necessitating multi-domain architectures. Existing paradigms frequently overlook the active use of prediction uncertainty, leading to deterministic frameworks that suffer from blind cross-domain fusion and overfit to label noise. To address these issues, we propose the Uncertainty-Guided Dual-Domain Network (UGDD-Net). UGDD-Net introduces a novel "Glance-and-Gaze" mechanism to transform uncertainty into an active guiding signal. Specifically, the Uncertainty-Guided Bi-directional Feature Fusion (UGBFF) module uses pixel-level uncertainty to modulate spatial-spectral interactions. The Uncertainty-Guided Graph Refinement (UGGR) module constructs a topology-aware graph to propagate reliable semantic consensus and refine uncertain nodes. Finally, the Uncertainty-Guided Margin-Adaptive Loss (UGML) enforces strict constraints on confident pixels while relaxing penalties on uncertain ones to improve statistical calibration. Extensive experiments on ISIC2017, ISIC2018, PH2, and HAM10000 datasets demonstrate that UGDD-Net achieves state-of-the-art performance, especially on "Hard Samples". Our uncertainty maps align with expert inter-observer variability, providing robust interpretability for human-machine collaborative diagnosis.
Semantic segmentation is essential for analysing anatomical features in biomedical research, yet a performance gap remains for Vision Transformers (ViTs) in the field, particularly for sparse, fine-structured, and low signal-to-noise targets. We attribute this challenge in part to the lightweight pixel decoders commonly used in promptable ViT models, who may lack the local inductive bias needed for high-precision biomedical masks. We bridge this gap by introducing ViTC-UNet, which conditions a UNet on frozen pre-trained ViT representations through learnable tokens and a two-way attention decoder. This combines ViT global visual priors with the local inductive bias and high-resolution decoding capacity of UNets, while avoiding end-to-end ViT fine-tuning even in cross-domain settings. ViTC-UNet outperforms baseline results in semantic segmentation tasks across MRI and CT modalities, demonstrating that structure-conditioned UNet decoding can efficiently adapt large-scale visual priors to high-complexity biomedical segmentation.
Joel Valdivia Ortega, Tingying Peng, Marion Jasnin
Vision foundation models (VFMs) have achieved strong performance across various vision tasks. However, it still remains challenging to apply VFMs for cross-domain few-shot segmentation (CD-FSS), which segments objects of novel classes under domain shifts using only a few labeled exemplars. The challenge is mainly driven by two factors: (1) limited labeled exemplars per novel class relative to the scale of VFM pre-training, making the model prone to overfitting during retraining, and (2) target-domain shifts underrepresented during pre-training, inducing cross-domain inconsistency and layer-wise sensitivity. To address these issues, we propose Hierarchical Exemplar Representation Adaptation (HERA), a three-stage select-regularize-calibrate VFM-based segmentation framework that learns effectively from limited labels and adapts to novel domains without source-data retraining. We first design Hierarchical Layer Selection (HLS) to adaptively identify the most informative VFM layer using a data-dependent Exemplar Transfer Risk (ETR) computed for each candidate layer. Then, Prior-Guided Regularization (PGR) regularizes interactions on the selected representation, yielding well-structured local signals for the subsequent stage. Furthermore, Pixelwise Adaptive Calibration (PAC) combines the selected representation with the refined interaction maps to calibrate pixel-wise predictions, producing consistent masks. Together, these stages form a hierarchical select-regularize-calibrate pipeline that guides frozen VFM features in new domains while fine-tuning less than 2.7% of parameters at test time. Extensive experiments show that HERA surpasses the state of the art by more than 4.1 mIoU across multiple CD-FSS benchmarks.