Organizations: School of Biological Science and Medical Engineering, Southeast University, Nanjing, China · Jiangsu Key Laboratory of Biomaterials and Devices, Southeast University, Nanjing, China · State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, China · Nanjing Medical University First Affiliated Hospital, Nanjing, China
Abdominal ultrasound is indispensable for rapid, noninvasive trauma triage. However, interpreting the subtle dynamic cues embedded in continuous scanning is time-intensive and operator-dependent. Parameter-Efficient Image-to-Video Transfer Learning (PEIVTL), which efficiently adapts pre-trained image models to the video domain, notably through visual-textual alignment, offers a promising paradigm for ultrasound video analysis. Nevertheless, substantial spatiotemporal and semantic variations arising from physician-dependent scanning practices continue to limit the effectiveness and generalizability of this framework. We propose TRUST, a scan-aware PEIVTL framework that explicitly models fine-grained spatiotemporal variations to enable reliable ultrasound video understanding. First, we introduce a Cross-Frequency Collaborative Adapter (CFCA) that establishes mutual constraints between low- and high-frequency components, enhancing discriminative spatial feature extraction under heavy speckle corruption. Second, we design a Multi-Granularity Motion-Aware (MGMA) module that integrates local temporal convolutions with motion-prior-guided global self-attention, jointly capturing stable intra-view patterns and abrupt inter-view transitions to characterize complex scanning dynamics. Third, a Visual Query Semantic Aggregation (VQSA) module dynamically generates text prototypes conditioned on visual features, enabling adaptive visual-textual alignment robust to intra-class variability under diverse scanning conditions. Experiments on in-house ultrasound trauma datasets demonstrate that TRUST outperforms state-of-the-art methods by 9.63% with superior computational efficiency.
Ultrasound video segmentation is clinically valuable yet difficult due to speckle noise, weak boundaries, and rapid anatomical deformation. Recent promptable foundation models enable point-guided segmentation, but their direct deployment in ultrasound remains unreliable: a single point provides insufficient spatial context to resolve scale ambiguity, and greedy memory updates amplify early errors into severe temporal drift. We present EchoPilot, a training-free framework for ultrasound video segmentation under sparse first-frame interaction, requiring only a single point click and an anatomical category name. EchoPilot orchestrates a frozen medical vision-language model (VLM) for semantic localization, a vision foundation model (VFM) for dense geometric feature extraction, and a promptable video segmentor for mask prediction and propagation. To resolve initialization ambiguity, we propose Scale-Space Semantic Prompting, which first selects an optimal contextual view via a parameter-free S.E.E.D. (Semantic Energy-Entropy Density) criterion, and then synthesizes geometrically precise auxiliary point prompts from dense foundation features without additional user interaction. To reduce propagation drift, a Reliability-Gated Memory update is further introduced to selectively freeze the segmentor's memory bank under uncertain predictions, preventing error accumulation. We also contribute the first dynamic fetal placenta ultrasound video segmentation dataset with 671 annotated frames. Across three ultrasound video datasets, EchoPilot achieves state-of-the-art performance under the sparse-interactive setting, consistently outperforming training-free baselines and finetuned specialists.
Real-time video segmentation of the prostate in Transrectal Ultrasound (TRUS) is essential for image-guided interventions. While conventional 2D methods suffer from inter-frame inconsistencies by disregarding temporal context, 3D architectures incur prohibitive latency. To resolve this dilemma, we present a Temporally Consistent Learning Framework that distills temporal coherence into a 2D network during training, preserving single-frame inference efficiency. Our design is driven by a key clinical observation: the prostate exhibits geometric stability, whereas the surrounding acoustic environment fluctuates due to physiological motion and transducer pressure. Because conventional temporal constraints propagate erroneous gradients from these unstable regions, we introduce a Confidence-Weighted Temporal Consistency objective derived from optical flow warping residuals, selectively attenuating contributions from unreliable regions. Complementing this pixel-wise constraint, a Dual-scale Prototype Alignment Module enforces semantic coherence through contrastive optimization of local boundary and global semantic features. Furthermore, to eliminate the need for dense per-frame video annotations, we employ geometric equivariance-based pseudo-labeling with knowledge distillation from a pretrained teacher. Extensive experiments on SUN-SEG and our newly introduced TRUS-V benchmark (2,679 frames) demonstrate state-of-the-art accuracy and temporal consistency at real-time speed. Code and dataset are available at https://github.com/DYDevelop/DTC-TRUS.
Ultrasound is the most widely used real-time imaging modality in clinical practice, yet per-frame video annotation remains a major bottleneck: expert labels are scarce and costly, and image appearance varies with speckle, shadowing, attenuation, and operator-dependent probe pose. This is especially limiting because clinically relevant information is often dynamic, from left-ventricular motion in echocardiography to muscle and bone kinematics in musculoskeletal imaging. Population atlases can amortize annotation cost by registering observations to a shared canonical coordinate system, but existing neural atlas methods mainly target single videos, small test-time image sets, or object-centric image collections. We introduce a cohort-scale neural atlas for ultrasound video: a single canonical chart with per-video Generative Latent Optimization embeddings, trained jointly over thousands of frames in DINOv3 feature space. Across five cardiac and musculoskeletal datasets with point landmarks and segmentation masks, our method learns coherent canonical templates and enables accurate atlas-space annotation transfer. On EchoNet-Dynamic and MSK-Bone, it supports single- and few-shot transfer with accuracy competitive with strong dense-correspondence baselines, while training in minutes on a single consumer GPU. The learned embeddings are interpretable: linear projections reveal structured cohort variation, image-decoder interpolation produces anatomically plausible intermediate frames, and test-time latent inversion reconstructs held-out frames through the atlas. These results suggest that cohort-scale neural atlases offer a practical, interpretable representation for reducing expert annotation burden in ultrasound video analysis.