Multi-Kernel Gated Decoder Adapters for Robust Multi-Task Thyroid Ultrasound under Cross-Center Shift

Thyroid ultrasound is the first-line exam for assessing thyroid nodules and determining whether biopsy is warranted. In routine reporting, radiologists produce two coupled outputs: a nodule contour for measurement and a TI-RADS risk category based on sonographic criteria. Yet both contouring style and risk grading vary across readers, creating inconsistent supervision that can degrade standard learning pipelines. In this paper, we address this workflow with a clinically guided multitask framework that jointly predicts the nodule mask and TI-RADS category within a single model. To ground risk prediction in clinically meaningful evidence, we guide the classification embedding using a compact TI-RADS aligned radiomics target during training, while preserving complementary deep features for discriminative performance. However, under annotator variability, naive multitask optimization often fails not because the tasks are unrelated, but because their gradients compete within the shared representation. To make this competition explicit and controllable, we introduce RLAR, a representation-level adversarial gradient regularizer. Rather than performing parameter-level gradient surgery, RLAR uses each task's normalized adversarial direction in latent space as a geometric probe of task sensitivity and penalizes excessive angular alignment between task-specific adversarial directions. On a public TI-RADS dataset, our clinically guided multitask model with RLAR consistently improves risk stratification while maintaining segmentation quality compared to single-task training and conventional multitask baselines. Code and pretrained models will be released.

Accurate thyroid ultrasound segmentation is often challenged by low contrast, speckle noise, and unclear boundaries. Although recent methods have improved segmentation accuracy, many rely on resource-intensive architectures or lack explicit integration of multiscale features with global biomedical visual guidance. In this paper, we introduce ThyCLIPNet, a lightweight semantic-guided hybrid encoder-decoder framework that integrates BiomedCLIP-derived biomedical semantic guidance into a lightweight multi-scale CNN segmentation pipeline. The encoder integrates MobileNetV2 with efficient channel attention, while atrous spatial pyramid pooling and a custom convolutional block attention module enrich bottleneck features. The decoder combines hierarchical skip connections and lightweight attention refinement with a BiomedCLIP-guided gated fusion pathway that projects vision-only global biomedical embeddings into decoder feature space and selectively integrates them through semantic-local fusion and spatial gating. To the best of our knowledge, ThyCLIPNet is among the first lightweight thyroid ultrasound segmentation frameworks to use BiomedCLIP's vision encoder alone for image-only global semantic guidance without text prompting. Experiments on TG3K, TN3K, DDTI, and PKTN achieve dice similarity coefficients of 96.22%, 87.58%, 84.73%, and 80.70%; intersection over union scores of 92.72%, 77.91%, 73.51%, and 67.64%; and 95th-percentile hausdorff distances of 3.75, 16.38, 18.23, and 10.86, respectively. ThyCLIPNet uses 8.55M parameters and 22.99G FLOPs. Overall, the results support integrating global biomedical semantic guidance with lightweight multi-scale CNN representations for robust and computationally efficient thyroid ultrasound segmentation. Source code: https://github.com/Tasnim-Jahan/ThyCLIPNet. [Abstract shortened for arXiv. See PDF for full abstract.]

Ultrasound images vary widely across scanners, operators, and anatomical targets, which often causes models trained in one setting to generalize poorly to new hospitals and clinical conditions. The Foundation Model Challenge for Ultrasound Image Analysis (FMC-UIA) reflects this difficulty by requiring a single model to handle multiple tasks, including segmentation, detection, classification, and landmark regression across diverse organs and datasets. We propose a unified multi-task framework based on a transformer visual encoder from the Qwen3-VL family. Intermediate token features are projected into spatial feature maps and fused using a lightweight multi-scale feature pyramid, enabling both pixel-level predictions and global reasoning within a shared representation. Each task is handled by a small task-specific prediction head, while training uses task-aware sampling and selective loss balancing to manage heterogeneous supervision and reduce task imbalance. Our method is designed to be simple to optimize and adaptable across a wide range of ultrasound analysis tasks. The performance improved from 67% to 85% on the validation set and achieved an average score of 81.84% on the official test set across all tasks. The code is publicly available at: https://github.com/saitejalekkala33/FMCUIA-ISBI.git