CurvSegFlow: Time-Conditioned Flow Matching for Robust Segmentation of Curvilinear Structures in Noisy Biomedical Images

Accurate quantification of the geometry of curvilinear biological structures is essential for understanding cellular mechanics and disease-related morphological alterations. Microtubule curvature is a key descriptor of filament rigidity and mechanical perturbations. However, reliable curvature extraction from fluorescence microscopy images remains challenging due to noise, low contrast, and partial filament visibility. Existing approaches rely on segmentation pipelines with pre or post-processing, which are highly sensitive to segmentation errors and often fail under adverse imaging conditions. In this work, we propose MTCurv, a deep learning framework for direct, segmenta-tion-free regression of microtubule curvature maps from noisy microscopy images. Leveraging a synthetic dataset with pixel-wise curvature annotations, we reformulated curvature estimation as a regression problem and adapted an attention-based residual U-Net. To reduce hallucinations and enforce spatial coherence, we introduced a gradient-aware loss combining Mean Squared Error with a gradient consistency term. Beyond model and loss design, we evaluated commonly used regression and image quality metrics, revealing that many perceptual and blind metrics are poorly suited for curvature estimation. Correlation-based metrics, particularly Spearman correlation, emerged as more reliable indicators of curvature prediction quality. Experiments on two datasets of increasing difficulty demonstrated that MTCurv accurately recovers local microtubule curvatures, even in the presence of background fluorescence. Ablation studies highlighted the contribution of both residual encoding and attention-based decoding. Overall, this work provides a practical tool for filament curvature analysis and methodological insights for geometry-aware regression in biomedical imaging. Datasets and code are made available.

Accurate segmentation of thin, tortuous anatomical structures, such as retinal vessels, cerebral vasculature, and facial wrinkles, remains challenging due to low contrast, frequent discontinuities, and severe class imbalance. Although recent convolutional and Transformer-based models have improved performance, they often yield fragmented predictions and fail to recover fine branches. We propose CSWinUNETR, a general-purpose backbone for 2D and 3D thin-structure segmentation. It employs cross-shaped stripe self-attention to model long-range principal-axis context and incorporates cyclic shifts to enhance information exchange across stripes. To better preserve fine-grained details, we further introduce a detail-enhanced multi-scale self-attention module that aggregates contextual features from multi-resolution representations. In addition, we propose sparse-control dynamic snake convolution, which reconstructs reliable dense curvilinear kernels from sparsely predicted control points to better follow tortuous geometry. Extensive experiments on four benchmarks across ophthalmology, neurovascular imaging, and dermatology demonstrate that CSWinUNETR consistently outperforms state-of-the-art methods without task-specific post-processing or topology-aware losses. The code is available at https://github.com/labhai/CSWinUNETR.

Flow matching has recently emerged as a principled framework for learning continuous-time transport maps, enabling efficient ODE-based sampling without relying on stochastic diffusion processes. While generative modeling has shown promise for medical image segmentation, particularly in capturing uncertainty and complex anatomical variability, existing approaches are predominantly based on diffusion models, which require iterative sampling and incur substantial computational overhead. In this work, we propose MedFlowSeg, a conditional flow matching framework that formulates medical image segmentation as learning a time-dependent vector field that transports a simple prior distribution to the target segmentation distribution. Compared to diffusion-based methods, our formulation enables more efficient inference through solving an ordinary differential equation, while preserving the flexibility of generative modeling. To effectively incorporate conditional information, we introduce a dual-conditioning mechanism. Specifically, we propose a Dual-Branch Spatial Attention (DB-SA) module to inject multi-frequency structural priors, and a Frequency-Aware Attention (FA-Attention) module to model interactions between spatial and spectral representations via discrepancy-aware fusion and time-dependent modulation. These components improve the alignment between noisy intermediate states and clean semantic features, leading to better structural consistency and boundary delineation. We conduct extensive experiments across multiple medical imaging modalities, where MedFlowSeg consistently outperforms prior state-of-the-art (SOTA) baselines, including diffusion-based and flow-based methods.