Exemplar Diffusion: Improving Medical Object Detection with Opportunistic Labels

Medical image segmentation remains difficult to scale because high-performing methods typically rely on dense expert annotations and task-specific training. We introduce GazeRefine, a training-free framework that uses gaze as an inference-time prompt for zero-shot medical image segmentation. Sparse, duration-weighted fixations are converted into foreground and background priors that initialize semantic prototypes in frozen DINOv3 feature space. These prototypes are iteratively refined through foreground-background discrimination, feature-space affinity propagation, and anchoring to the initial gaze guidance, allowing segmentation to extend beyond directly fixated regions while limiting semantic drift. GazeRefine requires no segmentation masks, fine-tuning, adapters, prompt encoders, or gradient updates. We evaluate the method on gaze-annotated polyp segmentation and prostate MRI segmentation. The results show strong performance on colonoscopy images and competitive performance on prostate MRI, supporting gaze-guided prototype refinement as a promising approach for segmentation-label-efficient, human-in-the-loop medical image segmentation. Our tools and code can be found in the following repository: https://github.com/MohammedOussamaBEN/GazeRefine.git

We propose Differences in Detection (DnD), an intuitive method to compare two object detection models. Based on the same matching algorithm, it complements the standard metrics of mean Average Precision ($mAP$) and TIDE error analysis with the ability to compare two models directly. More specifically, we calculate the intersection of ground truth labels that are recognized by both models, followed by the corresponding difference sets and the complement set of ground truth labels that are missed by both models. The resulting comparison is more direct and intuitive than a comparison of independent summary statistics. It reveals individual and shared mistakes and becomes particularly interesting when combined with error types. In this case, the differences in detection errors can be analyzed naturally in a standard confusion matrix. While valuable in itself, we believe that one of the best applications of DnD is to guide explainability methods such as ODAM towards metric-relevant examples, grounded in structured subsets. The code for our method is available here: https://github.com/JohannesTheo/differences-in-detection

Deep learning has shown strong potential in medical image analysis, but most existing methods rely on large-scale annotations and a closed-world assumption that rarely holds in clinical practice. Although Generalized Category Discovery (GCD) has advanced rapidly on natural images, it remains underexplored in medical imaging. To address this issue, we propose MedXplore, a unified framework for reliable and unbiased medical GCD, optimizing from both perceptual and decision levels. Specifically, at the perceptual level, taking a frequency domain perspective, Frequency-SNR Adaptive Attention and Consistency (FAAC) performs learnable full-spectrum filtering and global-local energy contrast activation to not only highlight local abnormal signals relative to the global context, but also provide reliable semantic anchors for patch consistency learning. At the decision level, Adaptive Cosine-Angular Margin (ACAM) adjusts angular margins using semantic difficulty and feature confidence to balance intra-class compactness and inter-class separability. Together, the two modules improve lesion-sensitive representation learning and mitigate old-class bias. Experiments on multiple benchmarks show an average 8.5% gain in All accuracy over the strongest competing methods. On Kvasir, MedXplore reduces false-old errors from 14.50% to 0.80%, demonstrating strong robustness under severe old-new ambiguity.