Accurate aneurysm segmentation in 3D rotational angiography (3DRA) is hindered by extreme class imbalance, morphological similarity to vessels, and absent large-scale 3D pretraining. 2D vision foundation models encode dense structural priors from 1.7 billion images, yet naïve slice-wise transfer fragments anatomical continuity and destabilises optimisation. We propose DINO-3DRA, a dual-path framework achieving effective cross-dimensional semantic transfer by injecting frozen DINOv3 features into a 3D U-Net backbone via Room-Lite spatial mixing and calibrated residual fusion. On multi-centre 3DRA data, DINO-3DRA achieves state-of-the-art aneurysm segmentation (Dice: 0.758; HD95: 2.75 mm; +13% over nnU-Net) with only 5.72M trainable parameters. Ablation studies confirm that gains arise from structured cross-dimensional transfer rather than loss design alone, with bridged foundation features improving anatomical continuity between aneurysms and parent vessels. Without fine-tuning on CADA and SHINY-ICARUS, DINO-3DRA eliminates all catastrophic failure cases observed in baseline architectures, demonstrating robust generalisation across heterogeneous imaging protocols.
Intracranial aneurysms are often asymptomatic until rupture, which carries high mortality. Rupture risk assessment and treatment planning depend on both aneurysm morphology and anatomical location, yet existing automated methods remain limited to binary detection without fine-grained anatomical classification or multi-class segmentation. We present a multi-task framework that simultaneously performs multi-label classification, multi-class aneurysm segmentation, and multi-class vessel segmentation across 13 anatomical locations and four imaging modalities (CTA, MRA, T2, T1-post). Our two-stage approach combines a fast 2D tri-axial Region of Interest (ROI) extraction method with a 3D multi-task nnU-Net backbone. A dual-decoder design mitigates the extreme volume imbalance between aneurysm and vessel classes, while cross-attention pooling and modality-specific auxiliary heads improve feature learning across heterogeneous inputs. Our two-fold ensemble achieved 2nd place in the RSNA 2025 Intracranial Aneurysm Detection challenge. Code, model weights, and a 3D Slicer plugin are publicly available.
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.
Although DINOv3 has demonstrated remarkable semantic discrimination in natural imagery, its direct application to volumetric medical segmentation is hindered by inherent dimension and domain disparities. To resolve these issues, we propose DINO-Med3D, a two-stage progressive framework that repurpose the pre-trained DINOv3 encoder for 3D medical tasks. In the first stage, we mitigate the dimension gap by introducing a multi-slice embedding module that incorporates pseudo-3D context, while simultaneously employing a segmentation proxy task to adapt representations learned from natural scenes to the medical domain. Subsequently, we further enhance volumetric understanding by adding lightweight 3D adapters into the frozen backbone to enforce global inter-slice continuity. Finally, to compensate for the spatial information loss inherent in the embedding process, we design a parallel detail recovery stream to explicitly preserve high-frequency boundary cues. Extensive experiments on five public datasets demonstrate that our approach successfully adapts DINOv3 to the medical domain and significantly outperforms state-of-the-art baselines.