Medical Image Analysis

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Overview

Medical image analysis develops methods to detect disease, segment anatomy, track changes over time, reconstruct images, and estimate clinically useful measurements from modalities such as CT, MRI, X-rays, ultrasound, and retinal imaging. Common approaches include U-Net-style segmentation, transformers, self-supervised and foundation-model learning, multimodal vision-language systems, and methods that incorporate anatomical or physical constraints. Models are tested on tasks and benchmarks such as BraTS for brain tumors, ACDC for cardiac MRI, and EchoNet for echocardiography, with growing attention to external-site testing, calibration, and clinical workflow. A central challenge is that strong benchmark results may not transfer across scanners, hospitals, patient groups, or acquisition protocols, so reliable deployment requires better validation, uncertainty estimates, and safeguards against bias and privacy risks.

Latest papers

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292 papers27 papers in the last four weeks, down 13% on the four weeks before. 0.2% of all new papers.

Mar 19, 2026

MedQ-UNI: Toward Unified Medical Image Quality Assessment and Restoration via Vision-Language Modeling

Existing medical image restoration (Med-IR) methods are typically modality-specific or degradation-specific, failing to generalize across the heterogeneous degradations encountered in clinical practice. We argue this limitation stems from the isolation of Med-IR from medical image quality assessment (Med-IQA), as restoration models without explicit quality understanding struggle to adapt to diverse degradation types across modalities. To address these challenges, we propose MedQ-UNI, a unified vision-language model that follows an assess-then-restore paradigm, explicitly leveraging Med-IQA to guide Med-IR across arbitrary modalities and degradation types. MedQ-UNI adopts a multimodal autoregressive dual-expert architecture with shared attention: a quality assessment expert first identifies degradation issues through structured natural language descriptions, and a restoration expert then conditions on these descriptions to perform targeted image restoration. To support this paradigm, we construct a large-scale dataset of approximately 50K paired samples spanning three imaging modalities and five restoration tasks, each annotated with structured quality descriptions for joint Med-IQA and Med-IR training, along with a 2K-sample benchmark for evaluation. Extensive experiments demonstrate that a single MedQ-UNI model, without any task-specific adaptation, achieves state-of-the-art restoration performance across all tasks while generating superior descriptions, confirming that explicit quality understanding meaningfully improves restoration fidelity and interpretability.

Jiyao Liu, Junzhi Ning, Wanying Qu +4

Fudan University, Shanghai, China · Shanghai Artificial Intelligence Laboratory, Shanghai, China

Medical Image Quality AssessmentMedical Image AnalysisMedical VLMsAll-in-One Image Restoration
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Mar 18, 2026

Robust-ComBat: Mitigating Outlier Effects in Diffusion MRI Data Harmonization

Harmonization methods such as ComBat and its variants are widely used to mitigate diffusion MRI (dMRI) site-specific biases. However, ComBat assumes that subject distributions exhibit a Gaussian profile. In practice, patients with neurological disorders often present diffusion metrics that deviate markedly from those of healthy controls, introducing pathological outliers that distort site-effect estimation. This problem is particularly challenging in clinical practice as most patients undergoing brain imaging have an underlying and yet undiagnosed condition, making it difficult to exclude them from harmonization cohorts, as their scans were precisely prescribed to establish a diagnosis. In this paper, we show that harmonizing data to a normative reference population with ComBat while including pathological cases induces significant distortions. Across 7 neurological conditions, we evaluated 10 outlier rejection methods with 4 ComBat variants over a wide range of scenarios, revealing that many filtering strategies fail in the presence of pathology. In contrast, a simple MLP provides robust outlier compensation enabling reliable harmonization while preserving disease-related signal. Experiments on both control and real multi-site cohorts, comprising up to 80% of subjects with neurological disorders, demonstrate that Robust-ComBat consistently outperforms conventional statistical baselines with lower harmonization error across all ComBat variants.

Yoan David, Pierre-Marc Jodoin, Alzheimer's Disease Neuroimaging Initiative +1

VitaLab, Dep of Computer Science, University of Sherbrooke, Sherbrooke, QC, J1K 2R1, Canada · Imeka Solutions Inc., Sherbrooke, J1H 4A7, QC, Canada · A comprehensive list of authors and affiliations of this consortium appear at the end of the paper.

Medical Image HarmonizationMedical Image AnalysisDiffusion MRIDistribution Matching
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Mar 17, 2026

Volumetrically Consistent Implicit Atlas Learning via Neural Diffeomorphic Flow for Placenta MRI

Establishing dense volumetric correspondences across anatomical shapes is essential for group-level analysis but remains challenging for implicit neural representations. Most existing implicit registration methods rely on supervision near the zero-level set and thus capture only surface correspondences, leaving interior deformations under-constrained. We introduce a volumetrically consistent implicit model that couples reconstruction of signed distance functions (SDFs) with neural diffeomorphic flow to learn a shared canonical template of the placenta. Volumetric regularization, including Jacobian-determinant and biharmonic penalties, suppresses local folding and promotes globally coherent deformations. In the motivating application to placenta MRI, our formulation jointly reconstructs individual placentas, aligns them to a population-derived implicit template, and enables voxel-wise intensity mapping in a unified canonical space. Experiments on in-vivo placenta MRI scans demonstrate improved geometric fidelity and volumetric alignment over surface-based implicit baseline methods, yielding anatomically interpretable and topologically consistent flattening suitable for group analysis.

Athena Taymourtash, S. Mazdak Abulnaga, Esra Abaci Turk +2

MIT Computer Science and Artificial Intelligence Laboratory · Massachusetts General Hospital, Harvard Medical School · Boston Children’s Hospital, Harvard Medical School

Medical Image AnalysisMedical Image RegistrationDeformable Image RegistrationImplicit Neural Representations
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Mar 16, 2026

Standardizing Medical Images at Scale for AI

Deep learning has achieved remarkable success in medical image analysis, yet its performance remains highly sensitive to the heterogeneity of clinical data. Differences in imaging hardware, staining protocols, and acquisition conditions produce substantial domain shifts that degrade model generalization across institutions. Here we present a physics-based data preprocessing framework based on the PhyCV (Physics-Inspired Computer Vision) family of algorithms, which standardizes medical images through deterministic transformations derived from optical physics. The framework models images as spatially varying optical fields that undergo a virtual diffractive propagation followed by coherent phase detection. This process suppresses non-semantic variability such as color and illumination differences while preserving diagnostically relevant texture and structural features. When applied to histopathological images from the Camelyon17-WILDS benchmark, PhyCV preprocessing improves out-of-distribution breast-cancer classification accuracy from 70.8% (Empirical Risk Minimization baseline) to 90.9%, matching or exceeding data-augmentation and domain-generalization approaches at negligible computational cost. Because the transform is physically interpretable, parameterizable, and differentiable, it can be deployed as a fixed preprocessing stage or integrated into end-to-end learning. These results establish PhyCV as a generalizable data refinery for medical imaging-one that harmonizes heterogeneous datasets through first-principles physics, improving robustness, interpretability, and reproducibility in clinical AI systems.

Callen MacPhee, Yiming Zhou, Koichiro Kishima +1

ECE Department, UCLA, 405 Hilgard Ave., Los Angeles, California 90095, USA · Pinpoint Photonics, Inc., 803 Marine Bldg., 4-23 Kaigan-dori, Naka, Yokohama 231-0002, Japan · Adventure Photonics, 889 N. Douglas Ave, El Segundo, California 90245, USA

Medical Image HarmonizationMedical Image AnalysisDomain Generalization
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Mar 16, 2026

NAMD: Virtual Follow-up Computed Tomography Synthesis via Nodule-Aligned Multimodal Diffusion Models for Early Lung Cancer Diagnosis

Lung cancer remains the leading cause of cancer-related mortality worldwide, with survival outcomes critically dependent on early and accurate detection. When low-dose computed tomography (LDCT) findings are indeterminate, clinicians typically defer diagnosis pending follow-up CT imaging obtained up to 12 months later, inevitably delaying treatment for patients with malignant nodules. To address this clinical gap, we propose Nodule-Aligned Multimodal (Latent) Diffusion (NAMD), a novel generative framework that synthesizes one-year follow-up nodule CT images conditioned on the baseline CT scan, quantitative nodule biomarkers, and patient-level Electronic Health Records (EHR), enabling timely prediction of nodule malignant progression without requiring actual follow-up scans. NAMD introduces two key contributions: (i) a nodule-aligned latent space regularized so that embedding distances reflect clinically meaningful biomarker changes, and (ii) an LLM-driven multimodal conditioning mechanism encoding heterogeneous EHR data into the diffusion backbone. Evaluated on the National Lung Screening Trial (NLST), our method's synthetic follow-up images achieve an AUROC of 0.805 and an AUPRC of 0.346 for lung nodule malignancy prediction, outperforming both the baseline LDCT performance without virtual follow-up generation, and existing state-of-the-art conditional generation methods, while maintaining competitive image quality. These findings suggest that NAMD enables earlier and more accurate lung cancer diagnosis by capturing clinically meaningful features of nodule progression.

James Song, Yifan Wang, Chuan Zhou +1

University of Michigan · University of Michigan Medical School

Medical Image AnalysisLongitudinal Medical Image AnalysisMedical Image SynthesisComputed TomographyMultimodal Diffusion Models
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Mar 16, 2026

TopoVST: Toward Topology-fidelitous Vessel Skeleton Tracking

Automatic extraction of vessel skeletons is crucial for many clinical applications. However, achieving topologically faithful delineation of thin vessel skeletons remains highly challenging, primarily due to frequent discontinuities and the presence of spurious skeleton segments. To address these difficulties, we propose TopoVST, a topology-fidelitious vessel skeleton tracker. TopoVST constructs multi-scale sphere graphs to sample the input image and employs graph neural networks to jointly estimate tracking directions and vessel radii. The utilization of multi-scale representations is enhanced through a gating-based feature fusion mechanism, while the issue of class imbalance during training is mitigated by embedding a geometry-aware weighting scheme into the directional loss. In addition, we design a wave-propagation-based skeleton tracking algorithm that explicitly mitigates the generation of spurious skeletons through space-occupancy filtering. We evaluate TopoVST on two vessel datasets with different geometries. Extensive comparisons with state-of-the-art baselines demonstrate that TopoVST achieves competitive performance in both overlapping and topological metrics. Our source code is available at: https://github.com/EndoluminalSurgicalVision-IMR/TopoVST.

Yaoyu Liu, Minghui Zhang, Junjun He +1

Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China. · School of Automation and Intelligent Sensing, Shanghai Jiao Tong University, Shanghai, China. · Shanghai AI Lab, Shanghai, China.

Medical Image AnalysisTopology-Preserving Image Segmentation
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Mar 16, 2026

Automated Diabetic Screening via Anterior Segment Ocular Imaging: A Deep Learning and Explainable AI Approach

Diabetic retinopathy screening traditionally relies on fundus photography, requiring specialized equipment and expertise often unavailable in primary care and resource limited settings. We developed and validated a deep learning (DL) system for automated diabetic classification using anterior segment ocular imaging a readily accessible alternative utilizing standard photography equipment. The system leverages visible biomarkers in the iris, sclera, and conjunctiva that correlate with systemic diabetic status. We systematically evaluated five contemporary architectures (EfficientNet-V2-S with self-supervised learning (SSL), Vision Transformer, Swin Transformer, ConvNeXt-Base, and ResNet-50) on 2,640 clinically annotated anterior segment images spanning Normal, Controlled Diabetic, and Uncontrolled Diabetic categories. A tailored preprocessing pipeline combining specular reflection mitigation and contrast limited adaptive histogram equalization (CLAHE) was implemented to enhance subtle vascular and textural patterns critical for classification. SSL using SimCLR on domain specific ocular images substantially improved model performance.EfficientNet-V2-S with SSL achieved optimal performance with an F1-score of 98.21%, precision of 97.90%, and recall of 98.55% a substantial improvement over ImageNet only initialization (94.63% F1). Notably, the model attained near perfect precision (100%) for Normal classification, critical for minimizing unnecessary clinical referrals.

Hasaan Maqsood, Saif Ur Rehman Khan, Sebastian Vollmer +2

BiogentX (biogentx.com, Renala Khurd, District Okara, Punjab, Pakistan. · Department of Computer Science, Rhineland-Palatinate Technical University of Kaiserslautern-Landau, Kaiserslautern, 67663, Germany. · German Research Center for Artificial Intelligence, Kaiserslautern, 67663, Germany. +2

Medical Image ClassificationMedical Image Analysis
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Mar 15, 2026

Comparative Analysis of 3D Convolutional and 2.5D Slice-Conditioned U-Net Architectures for MRI Super-Resolution via Elucidated Diffusion Models

Magnetic resonance imaging (MRI) super-resolution (SR) methods that computationally enhance low-resolution acquisitions to approximate high-resolution quality offer a compelling alternative to expensive high-field scanners. In this work we investigate an elucidated diffusion model (EDM) framework for brain MRI SR and compare two U-Net backbone architectures: (i) a full 3D convolutional U-Net that processes volumetric patches with 3D convolutions and multi-head self-attention, and (ii) a 2.5D slice-conditioned U-Net that super-resolves each slice independently while conditioning on an adjacent slice for inter-slice context. Both models employ continuous-sigma noise conditioning following Karras et al. and are trained on the NKI cohort of the FOMO60K dataset. On a held-out test set of 5 subjects (6 volumes, 993 slices), the 3D model achieves 37.75 dB PSNR, 0.997 SSIM, and 0.020 LPIPS, improving on the off-the-shelf pretrained EDSR baseline (35.57 dB / 0.024 LPIPS) and the 2.5D variant (35.82 dB) across all three metrics under the same test data and degradation pipeline.

Hendrik Chiche, Ludovic Corcos, Logan Rouge

GENCI (Grand Équipement National de Calcul Intensif), France

Medical Image Super-ResolutionMedical Image AnalysisMagnetic Resonance ImagingDiffusion Models for Image RestorationU-Net
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Mar 15, 2026

LUMINA: A Multi-Vendor Mammography Benchmark with Energy Harmonization Protocol

Publicly available full-field digital mammography (FFDM) datasets remain limited in size, clinical annotations, and vendor diversity, hindering the development of robust models. We introduce LUMINA, a curated, multi-vendor FFDM dataset that explicitly encodes acquisition energy and vendor metadata to capture clinically relevant appearance variations often overlooked in existing benchmarks. This dataset contains 1824 images from 468 patients (960 benign, 864 malignant), with pathology-confirmed labels, BI-RADS assessments, and breast-density annotations. LUMINA spans six acquisition systems and includes both high- and low-energy imaging styles, enabling systematic analysis of vendor- and energy-induced domain shifts. To address these variations, we propose a foreground-only pixel-space alignment method (''energy harmonization'') that maps images to a low-energy reference while preserving lesion morphology. We benchmark CNN and transformer models on three clinically relevant tasks: diagnosis (benign vs. malignant), BI-RADS classification, and density estimation. Two-view models consistently outperform single-view models. EfficientNet-B0 achieves an AUC of 93.54% for diagnosis, while Swin-T achieves the best macro-AUC of 89.43% for density prediction. Harmonization improves performance across architectures and produces more localized Grad-CAM responses. Overall, LUMINA provides (1) a vendor-diverse benchmark and (2) a model-agnostic harmonization framework for reliable and deployable mammography AI.

Hongyi Pan, Gorkem Durak, Halil Ertugrul Aktas +9

Department of Radiology, Northwestern University, Chicago, IL, USA · Department of Radiation Oncology, University of Health Sciences Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey · Department of Radiology, Istanbul University, Istanbul, Turkey

Mammography Image ClassificationMedical Image HarmonizationMammographyMedical Image AnalysisMedical Image BenchmarksMedical Image Classification+1
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Mar 15, 2026

ITKIT: Feasible CT Image Analysis based on SimpleITK and MMEngine

CT images are widely used in clinical diagnosis and treatment, and their data have formed a de facto standard - DICOM. It is clear and easy to use, and can be efficiently utilized by data-driven analysis methods such as deep learning. In the past decade, many program frameworks for medical image analysis have emerged in the open-source community. ITKIT analyzed the characteristics of these frameworks and hopes to provide a better choice in terms of ease of use and configurability. ITKIT offers a complete pipeline from DICOM to 3D segmentation inference. Its basic practice only includes some essential steps, enabling users with relatively weak computing capabilities to quickly get started using the CLI according to the documentation. For advanced users, the OneDL-MMEngine framework provides a flexible model configuration and deployment entry. This paper conducted 12 typical experiments to verify that ITKIT can meet the needs of most basic scenarios.

Yiqin Zhang, Meiling Chen

Medical Image Analysis3D Medical Image SegmentationComputed Tomography
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Mar 14, 2026

EyeWorld: A Generative World Model of Ocular State and Dynamics

Ophthalmic decision-making depends on subtle lesion-scale cues interpreted across multimodal imaging and over time, yet most medical foundation models remain static and degrade under modality and acquisition shifts. Here we introduce EyeWorld, a generative world model that conceptualizes the eye as a partially observed dynamical system grounded in clinical imaging. EyeWorld learns an observation-stable latent ocular state shared across modalities, unifying fine-grained parsing, structure-preserving cross-modality translation and quality-robust enhancement within a single framework. Longitudinal supervision further enables time-conditioned state transitions, supporting forecasting of clinically meaningful progression while preserving stable anatomy. By moving from static representation learning to explicit dynamical modeling, EyeWorld provides a unified approach to robust multimodal interpretation and prognosis-oriented simulation in medicine.

Ziyu Gao, Xinyuan Wu, Xiaolan Chen +10

School of Optometry, The Hong Kong Polytechnic University, Hong Kong. · Eye Center of Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China · Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute On Eye Diseases, Hangzhou, 310009, Zhejiang, China +5

Ophthalmic Image AnalysisMedical Image AnalysisMedical Image Representation LearningLatent World ModelsWorld Model LearningOphthalmology+1
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Mar 14, 2026

Leveraging a Statistical Shape Model for Efficient Generation of Annotated Training Data: A Case Study on Liver Landmarks Segmentation

Anatomical landmark segmentation serves as a critical initial step for robust multimodal registration during computer-assisted interventions. Current approaches predominantly rely on deep learning, which often necessitates the extensive manual generation of annotated datasets. In this paper, we present a novel strategy for creating large annotated datasets using a statistical shape model (SSM) based on a mean shape that is manually labeled only once. We demonstrate the method's efficacy through its application to deep-learning-based anatomical landmark segmentation, specifically targeting the detection of the anterior ridge and the falciform ligament in 3D liver shapes. A specialized deep learning network was trained with 8,800 annotated liver shapes generated by the SSM. The network's performance was evaluated on 500 unseen synthetic SSM shapes, yielding a mean Intersection over Union of 91.4% (87.4% for the anterior ridge and 87.6% for the falciform ligament). Subsequently, the network was applied to clinical patient liver shapes, with qualitative evaluation indicating promising results and highlighting the generalizability of the proposed approach. Our findings suggest that the SSM-based data generation approach alleviates the labor-intensive process of manual labeling while enabling the creation of large annotated training datasets for machine learning. Although our study focuses on liver anatomy, the proposed methodology holds potential for a broad range of applications where annotated training datasets play a pivotal role in developing accurate deep-learning models.

Denis Krnjaca, Lorena Krames, Werner Nahm

Karlsruhe Institute of Technology, Karlsruhe, Germany

Medical Image AnalysisSynthetic Data GenerationMedical Image Segmentation3D Medical Image Segmentation
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Mar 12, 2026

CT-VDETR: Semi-supervised 3D Trauma Detection in Computed Tomography (CT) scans using Dense Vertex Relative Position Encoding

Accurate detection and localization of traumatic injuries in abdominal CT remain challenging because voxel-level annotations are limited and expensive to obtain. We present a label-efficient framework for 3D abdominal trauma detection that combines self-supervised pretraining with semi-supervised transformer-based detection. First, we use Masked Image Modeling (MIM) on 1098 CT volumes to pretrain a 3D U-Net encoder for anatomical representation learning. Next, we adapt V-DETR to dense volumetric CT through a feature adapter that converts the encoder feature grid into a compact token sequence for transformer decoding. The pretrained encoder is then integrated with V-DETR and 3D Vertex Relative Position Encoding (3D V-RPE) to improve the localization of irregularly shaped injuries. Finally, semi-supervised teacher-student consistency regularization leverages 2,000 additional unlabeled volumes during detector training. To the best of our knowledge, this is the first application of a 3D DETR-style detector to the RSNA abdominal trauma detection task. On this benchmark, the proposed method achieves 31.33% test [email protected] using only 78 labeled training volumes, corresponding to a 1.53x improvement over supervised-only training. These results show that combining medical-domain pretraining with semi-supervised learning is an effective strategy for label-scarce 3D medical detection.

Shivam Chaudhary, Sheethal Bhat, Andreas Maier

Pattern Recognition Lab, FAU Erlangen-Nürnberg

Medical Image AnalysisMedical ImagingObject Detection3D Object DetectionDetection Transformer
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Mar 12, 2026

Nyxus: A Next Generation Image Feature Extraction Library for the Big Data and AI Era

Modern imaging instruments can produce terabytes to petabytes of data for a single experiment. The biggest barrier to processing big image datasets has been computational, where image analysis algorithms often lack the efficiency needed to process such large datasets or make tradeoffs in robustness and accuracy. Deep learning algorithms have vastly improved the accuracy of the first step in an analysis workflow (region segmentation), but the expansion of domain specific feature extraction libraries across scientific disciplines has made it difficult to compare the performance and accuracy of extracted features. To address these needs, we developed a novel feature extraction library called Nyxus. Nyxus is designed from the ground up for scalable out-of-core feature extraction for 2D and 3D image data and rigorously tested against established standards. The comprehensive feature set of Nyxus covers multiple biomedical domains including radiomics and cellular analysis, and is designed for computational scalability across CPUs and GPUs. Nyxus has been packaged to be accessible to users of various skill sets and needs: as a Python package for code developers, a command line tool, as a Napari plugin for low to no-code users or users that want to visualize results, and as an Open Container Initiative (OCI) compliant container that can be used in cloud or super-computing workflows aimed at processing large data sets. Further, Nyxus enables a new methodological approach to feature extraction allowing for programmatic tuning of many features sets for optimal computational efficiency or coverage for use in novel machine learning and deep learning applications.

Nicholas Schaub, Andriy Kharchenko, Hamdah Abbasi +3

DSBU, Axle Research, 6116 Executive Blvd Suite 400, Rockville, 20852, MD, USA. · NGRF, NovaGen Research Fund, 6116 Executive Blvd Suite 400, Rockville, 20852, MD, USA. · NCATS, 9800 Medical Center Dr, Rockville, 20850, MD, USA.

Medical Image AnalysisMicroscopy Image Analysis
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Mar 11, 2026

Novel Architecture of RPA In Oral Cancer Lesion Detection

Accurate and early detection of oral cancer lesions is crucial for effective diagnosis and treatment. This study evaluates two RPA implementations, OC-RPAv1 and OC-RPAv2, using a test set of 31 images. OC-RPAv1 processes one image per prediction in an average of 0.29 seconds, while OCRPAv2 employs a Singleton design pattern and batch processing, reducing prediction time to just 0.06 seconds per image. This represents a 60-100x efficiency improvement over standard RPA methods, showcasing that design patterns and batch processing can enhance scalability and reduce costs in oral cancer detection

Revana Magdy, Joy Naoum, Ali Hamdi

MSA University, Giza, Egypt

Medical Image AnalysisEfficient Object Detection
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Mar 10, 2026

GIIM: Graph-based Learning of Inter- and Intra-view Dependencies for Multi-view Medical Image Diagnosis

Computer-aided diagnosis (CADx) has become vital in medical imaging, but automated systems often struggle to replicate the nuanced process of clinical interpretation. Expert diagnosis requires a comprehensive analysis of how abnormalities relate to each other across various views and time points, but current multi-view CADx methods frequently overlook these complex dependencies. Specifically, they fail to model the crucial relationships within a single view and the dynamic changes lesions exhibit across different views. This limitation, combined with the common challenge of incomplete data, greatly reduces their predictive reliability. To address these gaps, we reframe the diagnostic task as one of relationship modeling and propose GIIM, a novel graph-based approach. Our framework is uniquely designed to simultaneously capture both critical intra-view dependencies between abnormalities and inter-view dynamics. Furthermore, it ensures diagnostic robustness by incorporating specific techniques to effectively handle missing data, a common clinical issue. We demonstrate the generality of this approach through extensive evaluations on diverse imaging modalities, including CT, MRI, and mammography. The results confirm that our GIIM model significantly enhances diagnostic accuracy and robustness over existing methods, establishing a more effective framework for future CADx systems.

Tran Bao Sam, Hung Vu, Dao Trung Kien +3

NVIDIA, Ho Chi Minh City, Vietnam

Medical Image AnalysisMedical Image ClassificationMulti-View LearningGraph Neural Networks
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Mar 10, 2026

Evidential Perfusion Physics-Informed Neural Networks with Residual Uncertainty Quantification

Physics-informed neural networks (PINNs) have shown promise in addressing the ill-posed deconvolution problem in computed tomography perfusion (CTP) imaging for acute ischemic stroke assessment. However, existing PINN-based approaches remain deterministic and do not quantify uncertainty associated with violations of physics constraints, limiting reliability assessment. We propose Evidential Perfusion Physics-Informed Neural Networks (EPPINN), a framework that integrates evidential deep learning with physics-informed modeling to enable uncertainty-aware perfusion parameter estimation. EPPINN models arterial input, tissue concentration, and perfusion parameters using coordinate-based networks, and places a Normal--Inverse--Gamma distribution over the physics residual to characterize voxel-wise aleatoric and epistemic uncertainty in physics consistency without requiring Bayesian sampling or ensemble inference. The framework further incorporates physiologically constrained parameterization and stabilization strategies to promote robust per-case optimization. We evaluate EPPINN on digital phantom data, the ISLES 2018 benchmark, and a clinical cohort. On the evaluated datasets, EPPINN achieves lower normalized mean absolute error than classical deconvolution and PINN baselines, particularly under sparse temporal sampling and low signal-to-noise conditions, while providing conservative uncertainty estimates with high empirical coverage. On clinical data, EPPINN attains the highest voxel-level and case-level infarct-core detection sensitivity. These results suggest that evidential physics-informed learning can improve both accuracy and reliability of CTP analysis for time-critical stroke assessment. Source code is available at https://github.com/jhlee0619/EPPINN.

Junhyeok Lee, Minseo Choi, Han Jang +5

Cancer Biology, Seoul National University College of Medicine, Seoul, Korea · Radiology, Seoul National University Hospital, Seoul, Korea · Bioengineering, Seoul National University, Seoul, Korea +3

Evidential Deep LearningUncertainty QuantificationMedical Image AnalysisPhysics-Informed MLComputed Tomography
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Mar 6, 2026

OPTED: Open Preprocessed Trachoma Eye Dataset Using Zero-Shot SAM 3 Segmentation

Trachoma remains the leading infectious cause of blindness worldwide, with Sub-Saharan Africa bearing over 85% of the global burden and Ethiopia alone accounting for more than half of all cases. Yet publicly available preprocessed datasets for automated trachoma classification are scarce, and none originate from the most affected region. Raw clinical photographs of eyelids contain significant background noise that hinders direct use in machine learning pipelines. We present OPTED, an open-source preprocessed trachoma eye dataset constructed using the Segment Anything Model 3 (SAM 3) for automated region-of-interest extraction. We describe a reproducible four-step pipeline: (1) text-prompt-based zero-shot segmentation of the tarsal conjunctiva using SAM 3, (2) background removal and bounding-box cropping with alignment, (3) quality filtering based on confidence scores, and (4) Lanczos resizing to 224x224 pixels. A separate prompt-selection stage identifies the optimal text prompt, and manual quality assurance verifies outputs. Through comparison of five candidate prompts on all 2,832 known-label images, we identify "inner surface of eyelid with red tissue" as optimal, achieving a mean confidence of 0.872 (std 0.070) and 99.5% detection rate (the remaining 13 images are recovered via fallback prompts). The pipeline produces outputs in two formats: cropped and aligned images preserving the original aspect ratio, and standardized 224x224 images ready for pre-trained architectures. The OPTED dataset, preprocessing code, and all experimental artifacts are released as open source to facilitate reproducible trachoma classification research.

Kibrom Gebremedhin, Hadush Hailu, Bruk Gebregziabher

Department of Computer Science, Mekelle University, Mekelle, Ethiopia · Department of Computer Science, Maharishi International University, Fairfield, IA, USA · Signal Technologies, Germany

Ophthalmic Image AnalysisMedical Image AnalysisMedical Image Benchmarks
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Mar 6, 2026

OralGPT-Plus: Learning to Use Visual Tools via Reinforcement Learning for Panoramic X-ray Analysis

Panoramic dental radiographs require fine-grained spatial reasoning, bilateral symmetry understanding, and multi-step diagnostic verification, yet existing vision-language models operate under a static single-pass paradigm that limits their clinical reliability. In this paper, we introduce OralGPT-Plus, an agentic vision-language model designed to perform iterative and symmetry-aware diagnostic reasoning for panoramic dental radiograph analysis. To support this paradigm, we construct DentalProbe, a five-thousand-image dataset with expert-curated diagnostic trajectories that provide structured supervision for localized inspection and contralateral comparison. We further develop a Reinspection-driven reinforcement learning framework that encourages clinically meaningful re-examination and stabilizes long-horizon reasoning with rubric-based reward and conditioned diagnostic-driven reward. In parallel, we present MMOral-X, the first benchmark for holistic panoramic diagnosis, containing 300 open-ended questions and region-level annotations across multiple difficulty levels. OralGPT-Plus demonstrates consistent and reliable improvements over strong baselines on MMOral-X and established panoramic benchmarks, indicating the effectiveness of interactive and symmetry-informed reasoning. Our work highlights the value of agentic modeling for dental imaging and provides a foundation for future research in clinically aligned panoramic radiograph analysis.

Yuxuan Fan, Jing Hao, Hong Chen +5

The Hong Kong University of Science and Technology (GZ) · School of Computer Science, Peking University · Faculty of Dentistry, The University of Hong Kong +3

Medical Image AnalysisMedical VLMsDental ImagingTool Use in VLMsRL for VLMs
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Mar 6, 2026

SpaCRD: Multimodal Deep Fusion of Histology and Spatial Transcriptomics for Cancer Region Detection

Accurate detection of cancer tissue regions (CTR) enables deeper analysis of the tumor microenvironment and offers crucial insights into treatment response. Traditional CTR detection methods, which typically rely on the rich cellular morphology in histology images, are susceptible to a high rate of false positives due to morphological similarities across different tissue regions. The groundbreaking advances in spatial transcriptomics (ST) provide detailed cellular phenotypes and spatial localization information, offering new opportunities for more accurate cancer region detection. However, current methods are unable to effectively integrate histology images with ST data, especially in the context of cross-sample and cross-platform/batch settings for accomplishing the CTR detection. To address this challenge, we propose SpaCRD, a transfer learning-based method that deeply integrates histology images and ST data to enable reliable CTR detection across diverse samples, platforms, and batches. Once trained on source data, SpaCRD can be readily generalized to accurately detect cancerous regions across samples from different platforms and batches. The core of SpaCRD is a category-regularized variational reconstruction-guided bidirectional cross-attention fusion network, which enables the model to adaptively capture latent co-expression patterns between histological features and gene expression from multiple perspectives. Extensive benchmark analysis on 23 matched histology-ST datasets spanning various disease types, platforms, and batches demonstrates that SpaCRD consistently outperforms existing eight state-of-the-art methods in CTR detection.

Shuailin Xue, Jun Wan, Lihua Zhang +1

School of Information Science and Engineering, Yunnan University, Kunming 650500, China · Yunnan Key Laboratory of Intelligent Systems and Computing, Yunnan University, Kunming 650500, China · School of Information Engineering, Zhongnan University of Economics and Law, Wuhan 430073, China +1

Medical Image AnalysisComputational PathologyMultimodal FusionSpatial Transcriptomics
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Mar 6, 2026

Vessel-Aware Deep Learning for OCTA-Based Detection of AMD

Age-related macular degeneration (AMD) is characterized by early micro-vascular alterations that can be captured non-invasively using optical coherence tomography angiography (OCTA), yet most deep learning (DL) models rely on global features and fail to exploit clinically meaningful vascular biomarkers. We introduce an external multiplicative attention framework that incorporates vessel-specific tortuosity maps and vasculature dropout maps derived from arteries, veins, and capillaries. These biomarker maps are generated from vessel segmentations and smoothed across multiple spatial scales to highlight coherent patterns of vascular remodeling and capillary rarefaction. Tortuosity reflects abnormalities in vessel geometry linked to impaired auto-regulation, while dropout maps capture localized perfusion deficits that precede structural retinal damage. The maps are fused with the OCTA projection to guide a deep classifier toward physiologically relevant regions. Arterial tortuosity provided the most consistent discriminative value, while capillary dropout maps performed best among density-based variants, especially at larger smoothing scales. Our proposed method offers interpretable insights aligned with known AMD pathophysiology.

Margalit G. Mitzner, Moinak Bhattacharya, Zhilin Zou +2

Stony Brook University, Stony Brook, NY, USA

Medical Image AnalysisExplainable Medical Image AnalysisOptical Coherence TomographyAttention Mechanisms
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Mar 5, 2026

Meta-D: Metadata-Aware Architectures for Brain Tumor Analysis and Missing-Modality Segmentation

We present Meta-D, an architecture that explicitly leverages categorical scanner metadata such as MRI sequence and plane orientation to guide feature extraction for brain tumor analysis. We aim to improve the performance of medical image deep learning pipelines by integrating explicit metadata to stabilize feature representations. We first evaluate this in 2D tumor detection, where injecting sequence (e.g., T1, T2) and plane (e.g., axial) metadata dynamically modulates convolutional features, yielding an absolute increase of up to 2.62% in F1-score over image-only baselines. Because metadata grounds feature extraction when data are available, we hypothesize it can serve as a robust anchor when data are missing. We apply this to 3D missing-modality tumor segmentation. Our Transformer Maximizer utilizes metadata-based cross-attention to isolate and route available modalities, ensuring the network focuses on valid slices. This targeted attention improves brain tumor segmentation Dice scores by up to 5.12% under extreme modality scarcity while reducing model parameters by 24.1%.

SangHyuk Kim, Daniel Haehn, Sumientra Rampersad

University of Massachusetts Boston

Missing-Modality Medical Image SegmentationMedical Image AnalysisBrain Tumor SegmentationMedical Image Segmentation3D Medical Image Segmentation
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Mar 5, 2026

HARP: HARmonizing in-vivo diffusion MRI using Phantom-only training

Purpose: Combining multi-site diffusion MRI (dMRI) data is hindered by inter-scanner variability, which confounds subsequent analysis. Previous harmonization methods require large, matched or traveling human subjects from multiple sites, which are impractical to acquire in many situations. This study aims to develop a deep learning-based dMRI harmonization framework that eliminates the reliance on multi-site in-vivo traveling human data for training. Methods: HARP employs a voxel-wise 1D neural network trained on an easily transportable diffusion phantom. The model learns relationships between spherical harmonics coefficients of different sites without memorizing spatial structures. Results: HARP reduced inter-scanner variability levels significantly in various measures. Quantitatively, it decreased inter-scanner variability as measured by standard error in FA (12%), MD (10%), and GFA (30%) with scan-rescan standard error as the baseline, while preserving fiber orientations and tractography after harmonization. Conclusion: We believe that HARP represents an important first step toward dMRI harmonization using only phantom data, thereby obviating the need for complex, matched in vivo multi-site cohorts. This phantom-only strategy substantially enhances the feasibility and scalability of quantitative dMRI for large-scale clinical studies.

Hwihun Jeong, Qiang Liu, Kathryn E. Keenan +7

Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America · College of Engineering, Northeastern University, Boston, Massachusetts, United States of America · Physical Measurement Laboratory, National Institute of Standards and Technology, Boulder, Colorado, United States of America +6

Medical Image HarmonizationDiffusion MRIMedical Image Analysis
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Mar 4, 2026

A multi-center analysis of deep learning methods for video polyp detection and segmentation

Colonic polyps are well-recognized precursors to colorectal cancer (CRC), typically detected during colonoscopy. However, the variability in appearance, location, and size of these polyps complicates their detection and removal, leading to challenges in effective surveillance, intervention, and subsequently CRC prevention. The processes of colonoscopy surveillance and polyp removal are highly reliant on the expertise of gastroenterologists and occur within the complexities of the colonic structure. As a result, there is a high rate of missed detections and incomplete removal of colonic polyps, which can adversely impact patient outcomes. Recently, automated methods that use machine learning have been developed to enhance polyps detection and segmentation, thus helping clinical processes and reducing missed rates. These advancements highlight the potential for improving diagnostic accuracy in real-time applications, which ultimately facilitates more effective patient management. Furthermore, integrating sequence data and temporal information could significantly enhance the precision of these methods by capturing the dynamic nature of polyp growth and the changes that occur over time. To rigorously investigate these challenges, data scientists and experts gastroenterologists collaborated to compile a comprehensive dataset that spans multiple centers and diverse populations. This initiative aims to underscore the critical importance of incorporating sequence data and temporal information in the development of robust automated detection and segmentation methods. This study evaluates the applicability of deep learning techniques developed in real-time clinical colonoscopy tasks using sequence data, highlighting the critical role of temporal relationships between frames in improving diagnostic precision.

Noha Ghatwary, Pedro Chavarias Solano, Mohamed Ramzy Ibrahim +24

Computer Engineering Department, Arab Academy for Science and Technology,Egypt · AI in Medicine and Surgery Group, School of Computer Science, University of Leeds, Leeds, LS2 9JT, UK · Department of Artificial Intelligence and Knowledge Systems, University of Würzburg, Germany +13

Medical Image AnalysisPolyp SegmentationVideo Object DetectionVideo Object Segmentation
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Mar 4, 2026

DeNuC: Decoupling Nuclei Detection and Classification in Histopathology

Pathology Foundation Models (FMs) have shown strong performance across a wide range of pathology image representation and diagnostic tasks. However, FMs do not exhibit the expected performance advantage over traditional specialized models in Nuclei Detection and Classification (NDC). In this work, we reveal that jointly optimizing nuclei detection and classification leads to severe representation degradation in FMs. Moreover, we identify that the substantial intrinsic disparity in task difficulty between nuclei detection and nuclei classification renders joint NDC optimization unnecessarily computationally burdensome for the detection stage. To address these challenges, we propose DeNuC, a simple yet effective method designed to break through existing bottlenecks by Decoupling Nuclei detection and Classification. DeNuC employs a lightweight model for accurate nuclei localization, subsequently leveraging a pathology FM to encode input images and query nucleus-specific features based on the detected coordinates for classification. Extensive experiments on three widely used benchmarks demonstrate that DeNuC effectively unlocks the representational potential of FMs for NDC and significantly outperforms state-of-the-art methods. Notably, DeNuC improves F1 scores by 4.2% and 3.6% (or higher) on the BRCAM2C and PUMA datasets, respectively, while using only 16% (or fewer) trainable parameters compared to other methods. Code is available at https://github.com/ZijiangY1116/DeNuC.

Zijiang Yang, Chen Kuang, Dongmei Fu

School of Automation and Electrical Engineering, University of Science and Technology Beijing, Beijing 100083, China · Beijing Engineering Research Center of Industrial Spectrum Imaging

Medical Image AnalysisPathology Foundation Models
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Mar 4, 2026

Understanding Sources of Demographic Predictability in Brain MRI via Disentangling Anatomy and Contrast

Demographic attributes can be predicted from medical images, raising concerns about bias in clinical AI systems. In X-ray imaging, acquisition characteristics have been shown to contribute substantially to this predictability. Whether the same holds in brain MRI remains unclear, as anatomical variation and acquisition-dependent contrast are deeply entangled in the image formation process, obscuring the origins of demographic signal. To address this, we propose a controlled framework based on disentangled representation learning, decomposing brain MRI into anatomy-focused representations that suppress acquisition influence and contrast embeddings that capture acquisition-dependent characteristics. Training predictive models for age, sex, and race on full images, anatomical representations, and contrast embeddings allows us to quantify the relative contributions of structure and acquisition to the demographic signal. Across three datasets and multiple MRI sequences, demographic predictability is found to be driven primarily by anatomical variation, with anatomy-focused representations largely preserving the performance of models trained on raw images. Contrast embeddings retain a weaker signal that is dataset-specific and does not generalize across sites. These findings suggest that effective mitigation must explicitly account for the primarily anatomical and secondarily acquisition-dependent origins of demographic signal, ensuring that any bias reduction generalizes robustly across domains.

Mehmet Yigit Avci, Akshit Achara, Andrew King +1

and for the Alzheimer's Disease Neuroimaging Initiative · King’s College London, UK

Medical Image AnalysisAlgorithmic BiasMedical Image Representation LearningBrain MRI
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Feb 28, 2026

Efficient Conformal Volumetry for Template-Based Segmentation

Template-based segmentation, a widely used paradigm in medical imaging, propagates anatomical labels via deformable registration from a labeled atlas to a target image, and is often used to compute volumetric biomarkers for downstream decision-making. While conformal prediction (CP) provides finite-sample valid intervals for scalar metrics, existing segmentation-based uncertainty quantification (UQ) approaches either rely on learned model features, often unavailable in classic template-based pipelines, or treat the registration process as a black box, resulting in overly conservative intervals when applied directly in output space. We introduce ConVOLT, a CP framework that achieves efficient volumetric UQ by conditioning calibration on properties of the estimated deformation field from template-based segmentation. ConVOLT calibrates a learned volumetric scaling factor from deformation space features. We evaluate ConVOLT on template-based segmentation tasks involving global, regional, and label volumetry across multiple datasets and registration methods. ConVOLT achieves target coverage while producing substantially tighter intervals than output-space conformal baselines. Our work paves way to exploit the registration process for efficient UQ in medical imaging pipelines.

Matt Y. Cheung, Ashok Veeraraghavan, Guha Balakrishnan

Department of Electrical & Computer Engineering Rice University Houston, TX 77005, USA

Segmentation Uncertainty EstimationMedical Image AnalysisConformal PredictionMedical Image Segmentation
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Feb 28, 2026

TAP-SLF: Parameter-Efficient Adaptation of Vision Foundation Models for Multi-Task Ultrasound Image Analysis

Executing multiple tasks simultaneously in medical image analysis, including segmentation, classification, detection, and regression, often introduces significant challenges regarding model generalizability and the optimization of shared feature representations. While Vision Foundation Models (VFMs) provide powerful general representations, full fine-tuning on limited medical data is prone to overfitting and incurs high computational costs. Moreover, existing parameter-efficient fine-tuning approaches typically adopt task-agnostic adaptation protocols, overlooking both task-specific mechanisms and the varying sensitivity of model layers during fine-tuning. In this work, we propose Task-Aware Prompting and Selective Layer Fine-Tuning (TAP-SLF), a unified framework for multi-task ultrasound image analysis. TAP-SLF incorporates task-aware soft prompts to encode task-specific priors into the input token sequence and applies LoRA to selected specific top layers of the encoder. This strategy updates only a small fraction of the VFM parameters while keeping the pre-trained backbone frozen. By combining task-aware prompts with selective high-layer fine-tuning, TAP-SLF enables efficient VFM adaptation to diverse medical tasks within a shared backbone. Results on the FMC_UIA 2026 Challenge test set, where TAP-SLF wins fifth place, combined with evaluations on the officially released training dataset using an 8:2 train-test split, demonstrate that task-aware prompting and selective layer tuning are effective strategies for efficient VFM adaptation.

Hui Wan, Libin Lan

College of Computer Science and Engineering, Chongqing University of Technology, Chongqing, China

Vision Foundation Model AdaptationMedical Image AnalysisParameter-Efficient Fine-TuningMulti-Task Learning
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Feb 26, 2026

SALIENT: Frequency-Aware Paired Diffusion for Controllable Long-Tail CT Detection

Detection of rare lesions in whole-body CT is fundamentally limited by extreme class imbalance and low target-to-volume ratios, producing precision collapse despite high AUROC. Synthetic augmentation with diffusion models offers promise, yet pixel-space diffusion is computationally expensive, and existing mask-conditioned approaches lack controllable attribute-level regulation and paired supervision for accountable training. We introduce SALIENT, a mask-conditioned wavelet-domain diffusion framework that synthesizes paired lesion-masking volumes for controllable CT augmentation under long-tail regimes. Instead of denoising in pixel space, SALIENT performs structured diffusion over discrete wavelet coefficients, explicitly separating low-frequency brightness from high-frequency structural detail. Learnable frequency-aware objectives disentangle target and background attributes (structure, contrast, edge fidelity), enabling interpretable and stable optimization. A 3D VAE generates diverse volumetric lesion masks, and a semi-supervised teacher produces paired slice-level pseudo-labels for downstream mask-guided detection. SALIENT improves generative realism, as reflected by higher MS-SSIM (0.63 to 0.83) and lower FID (118.4 to 46.5). In a separate downstream evaluation, SALIENT-augmented training improves long-tail detection performance, yielding disproportionate AUPRC gains across low prevalences and target-to-volume ratios. Optimal synthetic ratios shift from 2x to 4x as labeled seed size decreases, indicating a seed-dependent augmentation regime under low-label conditions. SALIENT demonstrates that frequency-aware diffusion enables controllable, computationally efficient precision rescue in long-tail CT detection.

Yifan Li, Mehrdad Salimitari, Taiyu Zhang +2

Trauma Radiology AI Laboratory (TRAIL), Department of Radiology and Nuclear Medicine, University of Maryland School of Medicine · Department of Radiology and Nuclear Medicine, University of Maryland School of Medicine

Medical Image AnalysisSynthetic Data AugmentationMedical Image SynthesisDiffusion ModelsMasked Diffusion Models
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Feb 26, 2026

Interactive Medical-SAM2 GUI: A Napari-based semi-automatic annotation tool for medical images

Interactive Medical-SAM2 GUI is an open-source desktop application for semi-automatic annotation of 2D and 3D medical images. Built on the Napari multi-dimensional viewer, box/point prompting is integrated with SAM2-style propagation by treating a 3D volume as a slice sequence, enabling mask propagation from sparse prompts using Medical-SAM2 on top of SAM2. Voxel-level annotation remains essential for developing and validating medical imaging algorithms, yet manual labeling is slow and expensive for 3D scans, and existing integrations frequently emphasize per-slice interaction without providing a unified, cohort-oriented workflow for navigation, propagation, interactive correction, and quantitative export in a single local pipeline. To address this practical limitation, a local-first Napari workflow is provided for efficient 3D annotation across multiple studies using standard DICOM series and/or NIfTI volumes. Users can annotate cases sequentially under a single root folder with explicit proceed/skip actions, initialize objects via box-first prompting (including first/last-slice initialization for single-object propagation), refine predictions with point prompts, and finalize labels through prompt-first correction prior to saving. During export, per-object volumetry and 3D volume rendering are supported, and image geometry is preserved via SimpleITK. The GUI is implemented in Python using Napari and PyTorch, with optional N4 bias-field correction, and is intended exclusively for research annotation workflows. The code is released on the project page: https://github.com/SKKU-IBE/Medical-SAM2GUI/.

Woojae Hong, Jong Ha Hwang, Jiyong Chung +3

Department of Biomechatronic Engineering, Sungkyunkwan University, Suwon, Gyeonggi, Republic of Korea · Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

Interactive Medical Image SegmentationHuman-in-the-Loop AnnotationMedical Image Analysis3D Medical Image Segmentation
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