Organizations: The Hong Kong University of Science and Technology (Guangzhou), Guangzhou, China · Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China · Department of Pancreatobiliary Surgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China · Imperial College London, London, United Kingdom
Self-supervised DINO models provide strong transferable visual representations, yet applying them directly to image segmentation remains challenging. Existing approaches commonly rely on heavy decoders with complex upsampling, introducing substantial parameter and computational overhead. We observe that introducing scale into DINO features is far more critical than increasing decoder capacity. In this work, we present SegDINO, an efficient segmentation framework that integrates a DINOv3 backbone with lightweight scale modeling. SegDINO introduces Token Pyramid Adaptation (TPA) to reorganize intermediate DINO features into a pseudo multi-scale hierarchy, and Scale-Aware Decoding (SAD) for efficient intra-scale refinement and top-down multi-scale propagation. We further curate PanCT, a new CT dataset containing 284 patients with expert-annotated pancreatic tumors, to assess SegDINO's ability to handle difficult small-lesion cases. Extensive experiments on PanCT and three public benchmarks demonstrate that SegDINO achieves state-of-the-art results with high efficiency. The code is available at https://github.com/script-Yang/segdino_v2.
Adapting foundation models to medical segmentation typically requires either backbone fine-tuning or high-capacity task-specific decoders, both of which are difficult to fit reliably when annotations are scarce. We show that frozen DINOv3 features already contain useful structural and boundary cues for medical segmentation, and that the main bottleneck lies in how these features are read out. We propose DINO-MVR, a Multi-View Readout framework for annotation-efficient medical segmentation. DINO-MVR trains only lightweight MLP probes on features from the final three transformer blocks of a frozen DINOv3 backbone, without updating the backbone itself. At inference, each input is interpreted through complementary resolutions and test-time augmentations, whose probability maps are combined by entropy-weighted fusion and refined with simple spatial regularization. For volumetric inputs, Gaussian z-axis smoothing further improves inter-slice consistency. Under fixed evaluation protocols on endoscopy, dermoscopy, and MRI benchmarks, DINO-MVR achieves strong readout-only performance, including 0.895 Dice on Kvasir-SEG, 0.897 Dice on ISIC 2018, and 0.908 Dice on BraTS FLAIR whole-tumor segmentation. With only five annotated BraTS patients, it recovers 98.4% of the performance obtained by the 40-patient BraTS reference run. These results suggest that frozen self-supervised vision backbones can support accurate medical segmentation when paired with an effective multi-view readout.
Anterior eye segment (AES) segmentation is a key component of both ocular biometrics and emerging clinical image analysis applications. However, heterogeneous acquisition conditions and limited annotations in medical settings hinder the robustness and generalization of existing methods. Foundation models (FMs) such as DINOv3 offer strong transfer capabilities, but efficiently adapting their representations to dense prediction tasks remains challenging. In this study, we investigate robust AES segmentation in clinical settings, and propose a lightweight architecture built upon a distilled DINOv3 ViT-Small backbone. We introduce a step-attention feature refinement module that progressively adapts multi-level transformer representations before convolutional decoding, enabling efficient exploitation of pretrained features with few parameters. We evaluate the proposed approach on a private dataset of 333 clinically acquired AES images spanning eight ophthalmic acquisition protocols and annotated for seven anatomical classes. Compared with convolutional and transformer-based baselines, including DINOv3-based methods, our approach achieves the best overall performance, reaching 85.55% mIoU when fully fine-tuned. It also demonstrates the strongest robustness to domain shift across four unseen public AES segmentation datasets. These results establish a strong baseline for robust AES segmentation in clinical settings and highlight the importance of decoder design for effectively adapting FMs representations to medical segmentation tasks.
Philippe Baumstimler, Jean-Mathieu Gagnon, Sébastien Gagné +3
Multi-phase Contrast-Enhanced Computed Tomography (CECT) plays a central role in the diagnosis and characterization of focal lesions by capturing temporal enhancement patterns across multiple acquisition phases. Accurate lesion segmentation from such data remains challenging because clinically relevant contrast kinetics are distributed across phases, while anatomical inconsistencies, respiratory motion, and incomplete acquisitions often lead to inter-phase misalignment and interrupted temporal information. Conventional segmentation frameworks typically process each phase independently or rely on simple fusion strategies, limiting their temporal reasoning capability. To address these challenges, we propose DynoDINO, a unified framework tailored to address the core challenges of multi-phase medical image segmentation. DynoDINO first performs slice-level alignment to establish inter-phase anatomical correspondence and then employs a Multi-phase Fusion Model to jointly enhance temporal correlations across phases. Our fusion model incorporates a Mix-attention (MA) mechanism for efficient multi-phase feature calibration and an Adaptive Gating Mechanism with difference-based residual learning to selectively preserve diagnostically relevant contrast variations while suppressing artifacts caused by residual misalignment. In addition, the adaptive gating mechanism improves training stability by preventing feature degradation caused by unguided subtraction operations. Experiments on three large-scale datasets, including LiTS, PLC-CECT, and WAW-TACE, demonstrate that DynoDINO consistently improves boundary delineation and structural fidelity under standard, shifted, and missing-phase conditions.