Medical Image Anomaly Detection

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8 papers in the last four weeks, against 1 the four weeks before. 0.1% of all new papers.

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Jun 21, 2026cs.CV

HiMatch-AD: DINOv3-driven Hierarchical Matching for Training-free Medical Anomaly Detection

Anomaly detection is essential for medical image analysis, where pathological regions often appear as rare deviations from normal anatomical structures. While training-based methods have achieved promising performance, they require task-specific optimization and extensive normal data, which limits scalability across modalities and institutions. Training-free approaches offer greater flexibility by leveraging pretrained visual representations, yet existing methods typically rely on simple nearest-neighbor retrieval and naive aggregation strategies, which may fail to capture hierarchical semantics and ignore the reliability of multiple anomaly responses. In this work, we propose HiMatch-AD, a DINOv3-driven hierarchical matching framework for training-free medical anomaly detection. Our method first retrieves semantically relevant normal references via dual-branch matching that jointly considers global CLS-token similarity and patch-level representations. Hierarchical anomaly maps are then generated across multiple transformer stages by comparing clustered normal features with query representations. To robustly aggregate anomaly responses, we introduce a unified uncertainty-based fusion mechanism that adaptively weights maps according to their reliability. The entire framework operates without any task-specific training. Extensive experiments on the BMAD benchmark, including brain MRI, liver CT, and retinal OCT datasets, demonstrate that HiMatch-AD consistently outperforms both training-based and DINO-based state-of-the-art methods, which highlights the effectiveness of multi-level matching and uncertainty-aware fusion for scalable medical anomaly detection.

Jiayu Huo, Jingyuan Hong, Meng Zhou +2

Imperial College London, London, UK · King’s College London, London, UK · SonoScape Medical Corp. +1

Medical Image Anomaly Detection

Jun 19, 2026cs.CV

NoduLoCC2026: Lung Nodule Localization and Classification Contest from Chest X-Ray Images

We propose NoduLoCC2026, a challenge on lung nodule detection and localization in chest X-ray images. We have provided a dataset for both tasks and received submissions from 5 international teams. The participating teams' solutions are presented in this work along with results on an external dataset used for testing. Proposed methods show good performance on the classification task. The best method shows a balanced accuracy score of 0.72 and AUC-ROC of 0.79. We highlight the limitations of current approaches for the localization task, with the best approach having predicted the correct number of nodules on 53% of the test images with a median distance of 12.83mm, showing that it is a more challenging task than the first one. The challenge website is available via https://gt-i2mdp.github.io/website/nodule_challenge.html.

Adnan Mustafic, Halim Benhabiles, Adnane Cabani +19

Universit´e de Haute-Alsace, IRIMAS, 68100 Mulhouse, France

Chest X-Ray Classification Medical Image Anomaly Detection Medical Image Localization Medical Image Benchmarks

Jun 17, 2026cs.CV

Toward Training-Free Zero-Shot Anomaly Detection in 3D Medical Images: A Batch-Based Approach Using 2D Foundation Models

Zero-shot anomaly detection (ZSAD) is attractive for medical imaging because clinical systems must handle heterogeneous acquisition protocols, changing patient populations, and pathologies for which annotated training data may be unavailable. Most existing zero-shot anomaly detection methods are designed for 2D images, and their direct extension to 3D medical volumes is limited by the scarcity of large-scale volumetric foundation models or by the difficulty of utilizing volumetric context. We propose CS3F, a training-free batch-based framework for ZSAD in 3D medical images using 2D foundation models. Each volume is decomposed along multiple anatomical axes and encoded slice-wise by a 2D vision transformer. These are then converted into localized volumetric tokens by pooling neighboring slice features. Anomaly scores are obtained from cross-subject mutual similarity: tokens that lack close analogues in other subjects are assigned higher anomaly scores. To reduce the attenuation of focal lesion signals caused by depth pooling, we introduce a coarse-to-fine tokenization strategy that enables fine-resolution volumetric scoring without exhaustive matching. CS3F is evaluated on brain MRI across metastases, glioma, and stroke, as well as validated on lung CT to test generalizability beyond atlas-aligned brain MRI. The results show that frozen 2D foundation models can support anomaly localization in 3D medical images, and that the benefit of fine tokenization depends strongly on lesion contrast and imaging modality.

Tai Le-Gia

Department of Mathematics, Chungnam National University, Daejeon, Republic of Korea

Medical Image Anomaly Detection Zero-Shot Anomaly Detection Medical Image Localization Anomaly Detection

Jun 15, 2026cs.LG

When Confidence Lacks Concepts: Interpretable OOD Detection via Representation Perturbations

Deep neural networks have achieved remarkable performance across medical imaging tasks, yet their tendency to overgeneralize under distributional shifts poses a major obstacle to safe clinical deployment. Out-of-Distribution (OOD) detection methods aim to mitigate this risk, but most existing approaches rely on opaque internal signals with poorly understood semantic meaning, limiting trust in safety-critical settings. In this work, we propose an interpretable OOD detection framework that probes the stability of model predictions under class-conditioned semantic perturbations. Leveraging sparse autoencoders (SAEs), we learn class-specific concept vectors from in-distribution data that disentangle dense intermediate representations into sparse, semantically meaningful components. At inference, we perturb deeper-layer representations using the concept vectors associated with the model's predicted class and measure the class logits stability. We hypothesize that in-distribution samples exhibit low sensitivity to such perturbations, as their representations align with class-specific semantic directions, whereas OOD samples show amplified deviations due to representational misalignment. By framing OOD detection as a concept conditioned stability analysis, our approach provides both a discriminative OOD signal and an interpretable lens into the internal mechanisms driving model uncertainty, making it particularly suitable for high stakes medical applications.

Anju Chhetri, Pratik Shrestha, Ramesh Rana +3

NepAl Applied Mathematics and Informatics Institute for research, Nepal · Kathmandu University, Nepal · NHS Grampian, UK +3

Medical Image Anomaly Detection Neural Network Interpretability OOD Detection

Jun 7, 2026cs.CV

AUCp: Pseudo-AUC for Inference Model Selection with Unlabeled Validation Data in Abnormality Detection

Abnormality detection is a crucial yet challenging task in medical image analysis. Distinguishing abnormalities from normal data by learning to reconstruct normal-only data alleviates the reliance on labeled datasets. However, many studies, even if unsupervised, rely on a labeled validation set to select the best model for inference from multiple training iterations. For many diseases labeled data are unavailable and substantially time consuming to obtain. To address this, AUCp - a novel metric that supports abnormality detection for unsupervised and self-supervised methods is proposed. Instead of evaluating the realism of reconstructed images to select the best of model for inference, it focuses on actual detection performance and without requiring an annotated test set. Assuming the pseudo ground truth of all unannotated samples in the test set as abnormal/positive and using traditional AUC calculation, AUCp scores are derived. Given a large and representative training set of normal samples, we show mathematical and empirical evidence that model selection using AUCp scores improves disease detection in terms of unsupervised and self-supervised methods over conventional metrics. Using two unsupervised methods for neurologic disease detection and self-supervised methods on diverse datasets, our results demonstrate that the AUCp score effectively identifies the optimal model for inference, significantly enhancing abnormality and disease detection. The corresponding implementations are available in https://github.com/mahfuzmohammad/AUCp.

Md Mahfuzur Rahman Siddiquee, Fazle Rafsani, Jay Shah +4

School of Computing and Augmented Intelligence, Arizona State University, Tempe, AZ 85281 · Mayo Clinic, Arizona

Medical Image Anomaly Detection Reconstruction-Based Anomaly Detection Unsupervised Anomaly Detection

Jun 5, 2026cs.CV

DALE-CT: Depth-Aware Foundation Models for Computed Tomography

Recent breakthroughs in self-supervised learning (SSL), such as the Latent-Euclidean Joint-Embedding Predictive Architecture (LeJEPA), alongside successes in integrating visual encoders with language models, have driven the demand for adaptable, high-capacity vision encoders in Computed Tomography (CT). In this work, we explore 2D slice-based architectures as a flexible alternative to native 3D models for processing volumetric CT data. Using the CT-RATE dataset, we trained DALE-CT (Depth-Aware Latent-Euclidean Computed Tomography), a 2D model family built entirely from scratch using LeJEPA, and compared its performance against a continually pre-trained DINOv2 baseline. To enhance representation quality, we developed a novel 3D depth-aware pre-training strategy anchored by dense auxiliary supervision from both automated anatomical masks and human-annotated abnormalities. Under linear probe evaluation with Multiple Instance Learning (MIL) for multi-abnormality detection, the frozen backbone of this dual-supervised model (DALE-CT-2S) achieves a Macro AUROC of 0.833. This performance demonstrates near-parity with state-of-the-art 3D vision-language models, achieved entirely from scratch with significantly less data and no textual supervision. To ensure reproducibility, all training code, evaluation scripts, and model weights have been made publicly available.

Evan W. Damron, Mahmut S. Gokmen, Mitchell A. Klusty +3

College of Medicine Office of Research, University of Kentucky, Lexington, KY 40506 USA

Medical Imaging Foundation Models Self-Supervised Pre-Training Medical Image Anomaly Detection Computed Tomography

Jun 5, 2026eess.IV

Impact of Synthetic Lesional MR Images in Automated Focal Cortical Dysplasia Detection in Low-Data Scenarios

Background and Purpose: Automated detection of focal cortical dysplasia (FCD) requires large volumes of voxelwise lesion-delineated MRI data, which are difficult to acquire. This study aims to generate synthetic MRI data exhibiting FCD, assess their realism, and evaluate their impact on automated FCD detection, particularly in reducing the need for manual annotations. Methods: T1-weighted (T1w) and T2-weighted Fluid-Attenuated Inversion Recovery (FLAIR) MRI scans from 131 FCD patients and 90 healthy controls from multiple (3) sites were retrospectively studied. Synthetic MRIs were generated by conditioning a generative network on binary FCD masks. Two neuroradiologists identified real images from a random set of 14 real and 14 synthetic scans. Three nnU-Net models were trained to detect FCD using: (i) real-only (35 FCD / 35 controls), (ii) real (35 FCD / 35 controls) plus synthetic augmentation, and (iii) expanded real data (70 FCD / 70 controls). Results: Experts showed limited ability to distinguish real from synthetic images, with classification accuracy of 60% for T1w and 70% for FLAIR (inter-rater agreement kappa = 0.86). Augmenting automated FCD detection with synthetic data increased sensitivity by 8.14% (p = 0.12) and improved model confidence at true lesion sites (0.83 +/- 0.11 to 0.89 +/- 0.12; p = 0.02). The expanded real-data model further improved sensitivity to 73.8% (p < 0.001) and confidence to 0.90 +/- 0.14 (p = 0.01). Conclusion: Conditional generative networks can generate realistic synthetic FCD-MRIs, reducing labeled data needs by approximately 20% while maintaining equivalent sensitivity. Equivalent amounts of real data, when available, remain more effective than synthetic augmentation.

Prabhjot Kaur, Hakim Ouaalam, Sedat Kandemirli +2

Computational Radiology Laboratory, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

Synthetic Data Augmentation Medical Image Anomaly Detection Medical Image Synthesis Conditional Generative Modeling Synthetic Data Evaluation

Jun 5, 2026cs.CV

Mitosis Detection in the Wild: Multi-Tumor and Context-Aware Generalization in the MIDOG 2025 Challenge

Automated mitosis detection is a well-established task in computational pathology. While previous benchmarks focused on scanner-induced domain shift, clinical "real-world" application requires models to be robust across the vast variance to be expected in the histological landscape. The MItosis DOmain Generalization (MIDOG) 2025 challenge was designed to evaluate algorithmic performance across unprecedented biological and contextual diversity. We curated a test dataset of 365 cases, encompassing 12 distinct human, canine and feline tumor types, digitized across multiple scanning platforms. Moving beyond hand-selected hotspots, the challenge required detection also in random tissue areas (representative of the whole slide detection situation) and challenging areas (areas rich in hard negatives). In the second track, we introduced the classification of atypical mitotic figures (AMFs). There were 18 teams submitting to the detection track, with F1 scores ranging up to 0.740. In the AMF detection track, we had 21 submissions with balanced accuracy values up to 0.908. Our analysis reveals that while most models perform reliably in traditional hotspots, significant performance degradation occurs in challenging ROIs, where false positive rates tripled. Furthermore, performance varied significantly across the 12 tumor types, highlighting "blind spots" in current state-of-the-art architectures when encountering rare or highly pleomorphic malignancies. Moreover, we evaluated the effectiveness of ensembling and found a mean increases of 1.5 and 1.3 percentage points in F1 score and balanced accuracy, respectively. In contrast, TTA showed no relevant improvement. MIDOG 2025 demonstrates that "in the wild" mitosis detection remains a significant hurdle. The transition from hotspot-only evaluation to a multi-contextual framework provides a more realistic proxy for clinical reliability.

Marc Aubreville, Jonas Ammeling, Sweta Banerjee +64

Computational Pathology Domain Generalization Medical Image Anomaly Detection Oncology Medical Image Benchmarks Whole-Slide Image Analysis

Jun 4, 2026cs.CV

EasyLens: A Training-Free Plug-and-Play Subtle-Lesion Representation Amplifier for Medical Vision-Language Models

Medical vision-language models (VLMs) have shown increasing potential for clinical image interpretation, including lesion detection and report generation. However, their practical utility remains limited by insufficient sensitivity to subtle lesions, whose visual evidence is often sparse, low-contrast, and embedded within complex anatomical context. As local visual tokens are aggregated, these weak lesion cues can become underrepresented in global image representations, making them difficult for medical VLMs to recognize. Existing efforts to improve lesion sensitivity mainly rely on medical-domain vision-encoder pre-training, clinical-term-guided alignment, or trainable pathological representation enhancement. Although effective, these approaches usually require additional training or model-specific adaptation and may overfit to particular disease morphologies, limiting their applicability to frozen medical VLMs. To address these limitations, we propose EasyLens, a training-free plug-and-play subtle-lesion representation amplifier for medical VLMs. EasyLens first constructs EasyBank, a pathology-anatomy prototype space that provides lesion-related prototypes and anatomy-aware normal references for comparing suspicious patches against both pathological and normal anatomical patterns. To avoid blindly amplifying normal tissues, EasyTag selects lesion-relevant patches through counterfactual prototype reasoning. To counteract the dilution of subtle lesion cues in global image representations, EasyAmplifier strengthens the selected lesion-relevant patch representations through morphology-guided residual enhancement, thereby increasing their contribution to the global image embedding. Experiments on multiple medical image datasets and frozen medical VLM backbones show that EasyLens improves subtle-lesion detection and outperforms existing encoder-enhancement baselines.

Hao Wang, Qiwei Zeng, Jinghao Lin +6

School of Computer Science, The University of Sydney, Sydney, NSW, Australia · Jilin University, Changchun, China · Northeastern University, Shenyang, China +1

VLM Adaptation Medical Image Anomaly Detection Medical VLMs Medical Image Representation Learning

May 27, 2026cs.CV

EntroAD: Structural Entropy-Guided Prompt Adaptation for Zero-Shot Anomaly Detection

Zero-Shot Anomaly Detection (ZSAD) aims to detect anomalies in unseen domains without target-domain adaptation. Recent CLIP-based methods have shown promising performance by leveraging prompt learning and visual-text alignment. However, most existing approaches rely on a single adaptation pathway, which may be insufficient for heterogeneous anomaly patterns across domains. In practice, anomalies exhibit vastly different characteristics, ranging from salient, localized structural disruptions to subtle, diffuse, and irregular variations. To address this challenge, we propose EntroAD, a structural entropy-guided zero-shot anomaly detection framework. Unlike previous methods, EntroAD introduces a dynamic routing mechanism to process different types of anomalies with specialized adaptation strategies. Specifically, we estimate patch-level structural entropy from self-attention-induced patch relations and use it as a proxy for relational uncertainty to guide anomaly-aware token routing. Based on this routing signal, we construct anomaly-aware routed tokens to better capture anomaly cues with different structural characteristics. We further introduce a confidence-aware dual-branch prompt adaptation module to stabilize visual-text alignment while preserving CLIP's transferable prior. Extensive experiments on 10 industrial and medical benchmarks show that EntroAD achieves state-of-the-art performance in challenging cross-dataset ZSAD settings.

Xinyu Zhao, Qingyun Sun, Jiayi Luo +1

Beihang University Beijing, China

VLM Adaptation Medical Image Anomaly Detection Industrial Anomaly Detection Prompt Tuning Zero-Shot Anomaly Detection

May 23, 2026physics.med-ph

Catching magnetic resonance imaging outliers in artificial intelligence-supported radiotherapy workflows: unsupervised detection and localization of image anomalies using deep learning

Artificial intelligence is increasingly integrated into radiotherapy workflows, yet such pipelines remain vulnerable to out-of-distribution image data that may introduce unexpected behavior in clinical tasks. Deep learning-based anomaly detection for pelvic magnetic resonance imaging (MRI) remains largely unexplored, and transparent evaluation of its feasibility for full automation is limited. We developed and evaluated a fully automated, unsupervised anomaly-detection framework for pelvic and brain MRI. A two-stage framework was trained on reference images from public datasets: LUND-PROBE for pelvic MRI, and IXI, fastMRI, and fastMRI+ for brain MRI. In the first stage, MRI slices were compressed into discrete tokens; in the second, the distribution of normal tokens was modeled. Anomaly evidence was estimated by combining perceptual image differences with token-surprisal scores based on negative log-likelihood. Automated detection was evaluated on pelvic MRI with synthetic global and real clinical anomalies, and on brain MRI with clinically annotated fastMRI+ abnormalities. Sensitivity, specificity, area under the receiver operating characteristic curve (AUC), and false-positive behavior in held-out normal cases were assessed. The framework achieved robust detection across hidden evaluation cohorts, with AUCs of 0.97 (95% CI, 0.95-0.98) and 0.81 (95% CI, 0.74-0.87) for pelvic and brain MRI, respectively. Heatmap analysis showed strong spatial agreement between detected anomalies and ground-truth locations, supporting localization accuracy and interpretability. These results support the potential of unsupervised anomaly detection as an automated MRI quality-control layer for radiotherapy workflows, with transparent visualization of image regions likely to compromise downstream AI-based tasks.

Mustafa Kadhim, Viktor Rogowski, Emilia Persson +7

Medical Radiation Physics, Lund University, Lund, Sweden. · Radiation Physics, Department of Hematology, Oncology, and Radiation Physics, Skåne University Hospital, Lund, Sweden. · Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden +4

Medical Image Anomaly Detection Anomaly Localization Magnetic Resonance Imaging Unsupervised Anomaly Detection OOD Detection

May 19, 2026cs.CV

Regulating Anatomy-Aware Rewards via Trajectory-Integral Feedback for Volumetric Computed Tomography Analysis

Medical vision-language models (VLMs) have rapidly advanced as general-purpose multimodal assistants, yet their deployment in 3D Computed Tomography (CT) analysis remains constrained by a persistent mismatch between optimization objectives and clinical rigor. Current Reinforcement Learning (RL) paradigms still rely on lexical proxy signals that induce

\textit{Evaluation Hallucinations}'', where models optimize linguistic fluency rather than factual clinical correctness, leading to diagnostically critical errors. To bridge this gap, we introduce the \textbf{Clinical Abnormality Benchmarking Substrate (CABS)}, a structured system that decomposes radiology reports into verifiable clinical semantic units. Using CABS, we identify a

\textit{Mechanistic Divergence}'' in standard RL, where surface-similarity rewards drive policy gradients to bypass medical facts. We therefore propose \textbf{Trajectory-Integral Feedback GRPO (TIF-GRPO)}, a novel framework integrating control-theoretic principles into policy optimization. By formulating clinical reasoning as a pseudo-temporal trajectory for anomaly discovery, TIF-GRPO regulates anatomy-aware rewards via an integral feedback loop that penalizes persistent omissions as cumulative state errors and suppresses hallucinations as excessive control effort. Experiments on 3D CT benchmarks demonstrate that our approach significantly enhances abnormality detection and clinical faithfulness, establishing a new paradigm for fine-grained regulation in medical VLMs. Our project is available at GitHub.

Tianwei Lin, Zhongwei Qiu, Jie Cao +7

Zhejiang University · DAMO Academy, Alibaba Group · Hupan Lab +1

Radiology Report Generation Radiology VLMs Medical Image Anomaly Detection Computed Tomography Medical Image Benchmarks RL for VLMs

May 13, 2026cs.CV

CA-GCL: Cross-Anatomy Global-Local Contrastive Learning for Robust 3D Medical Image Understanding

Fine-grained Vision-Language Pre-training (FVLP) demonstrates significant potential in 3D medical image understanding by aligning anatomy-level visual representations with corresponding textual descriptions. However, existing FVLP paradigms often suffer from severe representation collapse in the textual embedding space, where text embeddings of distinct anatomical structures become highly clustered and indistinguishable. This distributional degeneracy renders the model hypersensitive to prompt variations, hindering reliable clinical deployment. To address these challenges, we propose a novel Cross-Anatomy Global-Local Contrastive Learning framework (CA-GCL). CA-GCL introduces a global contrastive objective that enforces separation between anatomical categories in the latent space, effectively counteracting the aggregation tendency induced by local alignment. Furthermore, we incorporate a clinical-aware text augmentation strategy based on permutation invariance and partial completeness to enhance robustness against descriptive incompleteness. Extensive evaluations on the CT-RATE and Rad-ChestCT datasets show that CA-GCL achieves comparable zero-shot abnormality detection performance to existing VLP paradigms, while demonstrating substantially better robustness to prompt variations: on canonical templates it obtains higher mean AUC with lower variance, and on non-canonical templates it remains stable whereas baselines degrade markedly. These results validate CA-GCL as an effective framework for robust 3D medical image understanding.

Hanwen Zhang, Yao Liu, Die Dai +4

University of Electronic Science and Technology of China, Chengdu, China · Mohamed bin Zayed University of Artificial Intelligence, Abu Dhabi, UAE

VLM Robustness Medical Image Anomaly Detection Medical VLMs Multimodal Contrastive Learning Vision-Language Pretraining

May 12, 2026cs.CV

Anomaly-Aware Vision-Language Adapters for Zero-Shot Anomaly Detection

Zero-shot anomaly detection aims to identify defects in unseen categories without target-specific training. Existing methods usually apply the same feature transformation to all samples, treating normal and anomalous data uniformly despite their fundamentally asymmetric distributions, compact normals versus diverse anomalies. We instead exploit this natural asymmetry by proposing AVA-DINO, an anomaly-aware vision-language adaptation framework with dual specialized branches for normal and anomalous patterns that adapt frozen DINOv3 visual features. During training on auxiliary data, the two branches are learned jointly with a text-guided routing mechanism and explicit routing regularization that encourages branch specialization. At test time, only the input image and fixed, predefined language descriptions are used to dynamically combine the two branches, enabling an asymmetric activation. This design prevents degenerate uniform routing and allows context-specific feature transformations. Experiments across nine industrial and medical benchmarks demonstrate state-of-the-art performance, achieving 93.5% image-AUROC on MVTec-AD and strong cross-domain generalization to medical imaging without domain-specific fine-tuning. https://github.com/aqeeelmirza/AVA-DINO

Muhammad Aqeel, Maham Nazir, Uzair Khan +2

Dept. of Engineering for Innovation Medicine, University of Verona, Italy · School of Computer Science and Engineering, Beihang University, China · Dept. of Engineering for Innovation +1

VLM Adaptation Medical Image Anomaly Detection Industrial Anomaly Detection Vision Foundation Model Adaptation Multimodal Anomaly Detection Zero-Shot Anomaly Detection

May 11, 2026cs.CV

Hypergraph-Enhanced Training-Free and Language-Free Few-Shot Anomaly Detection

Few-shot anomaly detection (FSAD) has made significant strides, yet existing methods still face critical challenges: (i) dependence on task- or dataset-specific training/fine-tuning, (ii) reliance on language supervision or carefully hand-crafted prompts, and (iii) limited robustness across domains. In this paper, we introduce HyperFSAD, a novel FSAD framework that is training-free, language-free, and robust across domains, offering a powerful solution to these challenges. Built upon DINOv3 and a hypergraph-based inference mechanism, our approach performs inference without any task-specific optimization or text prompts, while remaining competitive. Specifically, we replace sensitive nearest-neighbor / top-

n

matching with \textbf{Sparse Hyper Matching}: \textit{sparsemax} first selects the most relevant support patches, which are then aggregated into a \textit{hyperedge} as compact normal evidence to suppress background noise and distractors. We further introduce \textbf{Dual-Branch Image Scoring}, which fuses \emph{spatial anomaly evidence} from the patch-grid anomaly map with \emph{global semantic deviation} captured by support-aware CLS matching, yielding a robust image-level anomaly score in a strictly visual manner. Notably, all components of HyperFSAD are purely visual, eliminating the need for labor-intensive hand-crafted text prompts. Under the stringent training-free and language-free setting, HyperFSAD achieves state-of-the-art performance across six datasets spanning four industrial datasets (MVTecAD, VisA, MPDD, BTAD) and two medical datasets (RESC, BraTS).

Guohuan Xie, Xin He, Dingying Fan +2

Nankai University · Tianjin University of Technology · Tsinghua University

Few-Shot Anomaly Detection Medical Image Anomaly Detection Industrial Anomaly Detection Anomaly Detection

May 10, 2026eess.IV

Annotation-free deep learning for detection and segmentation of fetal germinal matrix-intraventricular hemorrhage in brain MRI

Prenatal germinal matrix-intraventricular hemorrhage (GMH-IVH) is a leading cause of infant mortality and neurodevelopmental impairment, yet its manual diagnosis and lesion segmentation on fetal brain MRI are labor-intensive and error-prone. Although supervised deep learning offers potential for automation, it typically requires large amounts of annotated GMH-IVH data, which are challenging to obtain for such a rare condition (0.5-0.9 per 1000 pregnancies). To address these problems, an annotation-free deep learning framework, FreeHemoSeg, was developed for automated detection and segmentation of GMH-IVH without any real patient annotations. Instead of learning from expert labels, FreeHemoSeg was trained on pseudo GMH-IVH images synthesized from normal fetal data guided by medical priors. The framework was evaluated in a retrospective multicentre study of 1,674 stacks of 2D T2-weighted MRI from 558 pregnant women, using data from one hospital for internal training and validation and two hospitals for external validation. FreeHemoSeg achieved the highest diagnostic and segmentation performance in both internal validation (AUROC: 0.959; AUPR: 0.928; sensitivity: 0.914; specificity: 0.966; DSC: 0.559) and external validation (AUROC: 0.930; AUPR: 0.884; sensitivity: 0.824; specificity: 0.943; DSC: 0.512), outperforming a supervised model trained on limited empirical data and unsupervised anomaly detection methods. Moreover, FreeHemoSeg assistance improved radiologists' sensitivity (from 0.882 to 0.941-1.000) and diagnostic confidence, while reducing interpretation time by 16.0-52.7%. We anticipate its immediate utility in supporting earlier diagnosis, prognostic counselling, and perinatal planning for fetal GMH-IVH. Code: https://github.com/Arktis2022/FreeHemoSeg.

Mingxuan Liu, Yingqi Hao, Yi Liao +17

Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China · School of Biomedical Engineering, Tsinghua Medicine, Tsinghua University, Beijing, China · Department of Radiology, Sichuan Provincial Women’s and Children’s Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College, Chengdu, China +3

Medical Image Anomaly Detection Medical Image Segmentation Brain MRI

May 7, 2026cs.CV

MTL-MAD: Multi-Task Learners are Effective Medical Anomaly Detectors

Anomaly detection in medical images is a challenging task, since anomalies are not typically available during training. Recent methods leverage a single pretext task coupled with a large-scale pre-trained model to reach state-of-the-art performance. Instead, we propose to learn multiple self-supervised and pseudo-labeling tasks from scratch, using a joint model based on Mixture-of-Experts (MoE). By carefully integrating multiple proxy tasks, the joint model effectively learns a robust representation of normal anatomical structures, so that anomaly scores can be derived based on how well the multi-task learner (MTL) solves each task during inference. We perform comprehensive experiments on BMAD, a recent benchmark that comprises a broad range of medical image modalities. The empirical results indicate that our multi-task learner is an effective anomaly detector, outperforming all state-of-the-art competitors on BMAD. Moreover, our model produces interpretable anomaly maps, potentially helping physicians in providing more accurate diagnoses.

Bogdan Alexandru Bercean, Florinel Alin Croitoru, Vlad Hondru +3

1Rayscape · 3Polytechnic University of Timi¸soara · University of Bucharest +2

Medical Image Anomaly Detection Multi-Task Learning Self-Supervised Visual Representation Learning

May 6, 2026cs.CV

Wasserstein-Aligned Localisation for VLM-Based Distributional OOD Detection in Medical Imaging

Zero-shot anomaly localisation via vision-language models (VLMs) offers a compelling approach for rare pathology detection, yet its performance is fundamentally limited by the absence of healthy anatomical context. We reformulate zero-shot localisation as a comparative inference problem in which anomalies are identified through structured comparison against reference distributions of normal anatomy. We introduce WALDO, a training-free framework grounded in optimal transport theory that enables comparative reasoning through: (i) entropy-weighted Sliced Wasserstein distances for anatomically-aware reference selection from DINOv2 patch distributions, (ii) Goldilocks zone sampling exploiting the non-monotonic relationship between reference similarity and localisation accuracy, and (iii) self-consistency aggregation via weighted non-maximum suppression. We theoretically analyse the Goldilocks effect through distributional divergence, and show that references with moderate similarity minimize a bias-variance trade-off in comparative visual reasoning. On the NOVA brain MRI benchmark, WALDO with Qwen2.5-VL-72B achieves

43.5_{\pm1.6}\%

mAP@30 (95% CI: [40.4, 46.7]), representing a 19% relative improvement over zero-shot baselines. Cross-model evaluation shows consistent gains: GPT-4o achieves

32.0_{\pm6.5}\%

and Qwen3-VL-32B achieves

32.0_{\pm6.6}\%

mAP@30. Paired McNemar tests confirm statistical significance (

p<0.01

). Source code is available at https://github.com/bkainz/WALDO_MICCAI26_demo .

Bernhard Kainz, Johanna P Mueller, Matthew Baugh +1

Dept. AIBE, Friedrich–Alexander University Erlangen–Nürnberg, DE · Department of Computing, Imperial College London, UK · Technical University Munich, DE +1

Medical Image Anomaly Detection Anomaly Localization OOD Detection Zero-Shot Anomaly Detection

May 1, 2026eess.IV

Reconstruction Interval Z-Phase Dependence of AI Detection Sensitivity in CT Lung Nodule Screening

Background: Sensitivity of AI-assisted lung nodule detection systems is known to vary with CT acquisition parameters including radiation dose, reconstruction kernel, and slice thickness. However, the dependence of detection probability on nodule position within the reconstruction cycle -- the z-phase -- has not, to the author's knowledge, been characterized for deep learning-based detection systems. Methods: A retrospective analysis was performed using the LIDC-IDRI dataset. Detection results from a previously validated 154-case perturbation study were re-analyzed. For each consensus nodule (>=4-reader agreement), z-phase was defined as the fractional position of the nodule center within the reconstruction cycle, folded to [0, 0.5]. Detection sensitivity was stratified by z-phase bin, reconstruction interval (1mm, 3mm, 5mm), and by the ratio of reconstruction interval to nodule diameter (d/D). Results: At 5mm reconstruction interval, sensitivity was 71.6% vs 84.8% at 1mm baseline. Within the 5mm condition, sensitivity varied by 17.6 percentage points across z-phase bins. Stratified by d/D ratio, sensitivity was 92.4% for d/D < 0.5, 78.0% for 0.5 <= d/D < 1.0, and 61.4% for d/D >= 1.0, with a systematic z-phase effect present only in the d/D >= 1.0 stratum. Conclusions: AI detection sensitivity depends on the ratio of reconstruction interval to nodule diameter. When this ratio approaches or exceeds 1.0 -- as occurs for 3-6mm nodules at 5mm reconstruction -- z-phase becomes the dominant source of per-study detection variance. This stochastic effect is invisible to protocol-level quality metrics and not reflected in AI confidence scores.

Dan Soliman

GammaMetric Medical Physics, Independent Medical Physics Consultancy

Medical Image Anomaly Detection Computed Tomography Medical Image Localization

May 1, 2026cs.CV

Learning from Compressed CT: Feature Attention Style Transfer and Structured Factorized Projections for Resource-Efficient Medical Image Analysis

The deployment of artificial intelligence in medical imaging is hindered by high computational complexity and resource-intensive processing of volumetric data. Although chest computed tomography (CT) volumes offer richer diagnostic information than projection radiography, their use in AI-based diagnosis remains limited due to the computational burden of processing uncompressed volumetric images (typically stored in NIfTI or DICOM format). Addressing the growing need for low-resource deployment and efficient electronic data transfer, we investigate the utilization of JPEG-compressed chest CT volumes for thoracic abnormality detection. We propose Feature Attention Style Transfer (FAST), a novel distillation framework that transfers both activation patterns and structural relationships from high-fidelity CT representations to a spatiotemporal visual encoder operating on compressed inputs. By combining Gram-matrix-based attention style preservation with dual-attention feature alignment, FAST enables robust feature extraction from degraded volumes. Furthermore, we introduce Structured Factorized Projection (SFP), leveraging Block Tensor Train decomposition as a parameter-efficient alternative to dense projection layers, reducing projection-head parameters by almost half. Our contrastive learning pipeline, CT-Lite, integrates these components with a SigLIP-based multimodal alignment objective. Experiments on CT-RATE, NIDCH, and Rad-ChestCT demonstrate that CT-Lite achieves AUROC within 5-7% of the uncompressed-input baseline across all three datasets, despite operating on compressed inputs with significantly fewer parameters, paving the way for AI-based clinical evaluation under resource constraints.

Shadid Yousuf, S. M. Mahbubur Rahman, Mohammed Imamul Hassan Bhuiyan

Department of Electrical and Electronic Engineering, Bangladesh University of Engineering and Technology

Model Compression Medical Image Analysis Medical Image Anomaly Detection Computed Tomography Knowledge Distillation

Apr 27, 2026cs.CV

EXACT: an explainable anomaly-aware vision foundation model for analysis of 3D chest CT

Chest computed tomography (CT) is central to the detection and management of thoracic disease, yet the growing scale and complexity of volumetric imaging increasingly exceed what can be addressed by scan-level prediction alone. Clinically useful AI for CT must not only recognize disease across the whole volume, but also localize abnormalities and provide interpretable visual evidence. Existing vision-language foundation models typically compress scans and reports into global image-text representations, limiting their ability to preserve spatial evidence and support clinically meaningful interpretation. Here we developed EXACT, an explainable anomaly-aware foundation model for three-dimensional chest CT that learns spatially resolved representations from paired clinical scans and radiology reports. EXACT was pre-trained on 25,692 CT-reports pairs using anatomy-aware weak supervision, jointly learning organ segmentation and multi-instance anomaly localization without manual voxel-level annotations. The resulting organ-specific anomaly-aware maps assign each voxel a disease-specific anomaly score confined to its corresponding anatomy, jointly encoding lesion extent and organ-level context. In retrospective multinational and multi-center evaluations, EXACT showed broad and consistent improvements across clinically relevant CT tasks, spanning multi-disease diagnosis, zero-shot anomaly localization, downstream adaptation, and visually grounded report generation, outperforming existing three-dimensional medical foundation models. By transforming routine clinical CT scans and free-text reports into explainable voxel-level representations, EXACT establishes a scalable paradigm for trustworthy volumetric medical AI.

Xuguang Bai, Mingxuan Liu, Tongxi Song +6

School of Biomedical Engineering, Tsinghua University, Beijing, China. · Department of Radiology, Mianyang Central Hospital, Mianyang, China. · Center for Biomedical Imaging Research, Tsinghua University, 30 Shuangqing Road, Haidian District, Beijing, China, 100084

Medical Imaging Foundation Models Radiology VLMs 3D Medical Imaging Medical Image Anomaly Detection Explainable Medical Image Analysis Computed Tomography

Apr 24, 2026cs.CV

Anatomy-Aware Unsupervised Detection and Localization of Retinal Abnormalities in Optical Coherence Tomography

Reliable automated analysis of Optical Coherence Tomography (OCT) imaging is crucial for diagnosing retinal disorders but faces a critical barrier: the need for expensive, labor-intensive expert annotations. Supervised deep learning models struggle to generalize across diverse pathologies, imaging devices, and patient populations due to their restricted vocabulary of annotated abnormalities. We propose an unsupervised anomaly detection framework that learns the normative distribution of healthy retinal anatomy without lesion annotations, directly addressing annotation efficiency challenges in clinical deployment. Our approach leverages a discrete latent model trained on normal B-scans to capture OCT-specific structural patterns. To enhance clinical robustness, we incorporate retinal layer-aware supervision and structured triplet learning to separate healthy from pathological representations, improving model reliability across varied imaging conditions. During inference, anomalies are detected and localized via reconstruction discrepancies, enabling both image and pixel-level identification without requiring disease-specific labels. On the Kermany dataset (AUROC: 0.799), our method substantially outperforms VAE, VQVAE, VQGAN, and f-AnoGAN baselines. Critically, cross-dataset evaluation on Srinivasan achieves AUROC 0.884 with superior generalization, demonstrating robust domain adaptation. On the external RETOUCH benchmark, unsupervised anomaly segmentation achieves competitive Dice (0.200) and mIoU (0.117) scores, validating reproducibility across institutions.

Tania Haghighi, Sina Gholami, Hamed Tabkhi +1

University of North Carolina at Charlotte Charlotte, NC, USA

Medical Imaging Medical Image Anomaly Detection Optical Coherence Tomography Anomaly Localization Reconstruction-Based Anomaly Detection Unsupervised Anomaly Detection

Apr 21, 2026cs.CV

Towards Modality-Agnostic Medical Image Anomaly Detection: A Training-Free Manifold Refinement Approach

Deploying AI-based anomaly detection across diverse clinical imaging settings remains challenging because most existing methods rely on modality-specific architectures, anatomical priors, or extensive retraining, limiting their use as general-purpose screening tools. One-class classification (OCC) offers a label-efficient alternative by training exclusively on normal data, but conventional two-stage pipelines fit a density estimator directly on raw pretrained embeddings, leaving substantial discriminative structure in the latent space unexploited. We introduce a training-free, modality-agnostic framework that inserts an explicit manifold-refinement stage between feature extraction and anomaly scoring. Empirical density weights, estimated via a UMAP-derived neighborhood graph, guide an iterative shift of embeddings toward locally dense regions, compacting normal samples, leaving anomalies relatively isolated prior to Gaussian density estimation and Mahalanobis-based scoring. This refinement introduces no additional trainable parameters and no architectural modification, allowing it to be layered onto any pretrained encoder. Evaluated on the MedIAnomaly benchmark across seven datasets spanning five imaging modalities (X-ray, MRI, fundus, dermatoscopy, histopathology), the framework achieves the best AUC on four datasets and the best Average Precision on five datasets among methods evaluated in the benchmark, outperforming specialized reconstruction and diffusion-based methods with a single fixed hyperparameter configuration across all modalities. These results demonstrate that meaningful gains can be achieved through post-hoc geometric refinement of existing representations rather than bespoke encoders, offering a practical and scalable AI screening framework for real-world, multi-modality clinical workflows where retraining and abnormal-case annotation are costly or infeasible.

Pritam Kar, Gouri Lakshmi S, Saptarshi Bej

aSchool of Data Science, Indian Institute of Science Education and Research, Thiruvananthapuram, 695551, Kerala, India

Medical Image Anomaly Detection Manifold Learning Unsupervised Anomaly Detection One-Class Classification

Apr 16, 2026cs.CV

H2VLR: Heterogeneous Hypergraph Vision-Language Reasoning for Few-Shot Anomaly Detection

As a classic vision task, anomaly detection has been widely applied in industrial inspection and medical imaging. In this task, data scarcity is often a frequently-faced issue. To solve it, the few-shot anomaly detection (FSAD) scheme is attracting increasing attention. In recent years, beyond traditional visual paradigm, Vision-Language Model (VLM) has been extensively explored to boost this field. However, in currently-existing VLM-based FSAD schemes, almost all perform anomaly inference only by pairwise feature matching, ignoring structural dependencies and global consistency. To further redound to FSAD via VLM, we propose a Heterogeneous Hypergraph Vision-Language Reasoning (H2VLR) framework. It reformulates the FSAD as a high-order inference problem of visual-semantic relations, by jointly modeling visual regions and semantic concepts in a unified hypergraph. Experimental comparisons verify the effectiveness and advantages of H2VLR. It could often achieve state-of-the-art (SOTA) performance on representative industrial and medical benchmarks. Our code will be released upon acceptance.

Jianghong Huang, Luping Ji, Weiwei Duan +1

School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China

Few-Shot Anomaly Detection Medical Image Anomaly Detection Industrial Anomaly Detection VLM Reasoning Anomaly Detection

Mar 25, 2026cs.CV

CORA: Generalizable coronary artery disease assessment and risk stratification from coronary CT angiography using pathology-centric representation learning

Coronary artery disease, a leading cause of cardiovascular mortality worldwide, can be assessed non-invasively by coronary computed tomography angiography (CCTA). Although deep learning has advanced automated CCTA analysis, clinical translation remains constrained by the scarcity of expert-annotated data and by the spatial sparsity of coronary pathology, which occupies only a small fraction of each scan. Widely used label-free pretraining strategies, such as masked image modeling and contrastive learning, optimize for global anatomical reconstruction and tend to under-represent these tiny localized pathological features. Here we present CORA, an annotation-efficient model for comprehensive coronary artery disease assessment. Rather than reconstructing background anatomy, CORA learns from volumetric CCTA through a synthesis-driven self-supervised strategy: an anatomy-guided engine inserts diverse synthetic calcified and non-calcified lesions into unlabeled scans, reframing pretraining as an abnormality-detection task that biases representation learning toward clinically relevant disease features. We pretrained CORA on 10,138 unlabeled CCTA volumes and evaluated it across datasets from nine independent hospitals. Across plaque characterization, stenosis detection, and coronary artery segmentation, CORA consistently outperformed strong self-supervised pretraining baselines, with the largest gains on external multi-center data, indicating robust generalization under distributional shift. Coupling the imaging encoder with structured clinical variables further enabled near-term major adverse cardiac event (MACE) risk stratification. Our results show that pathology-centric, synthesis-driven pretraining is an effective and scalable strategy for annotation-efficient coronary artery disease assessment from CCTA.

Jinkui Hao, Gorkem Durak, Halil Ertugrul Aktas +4

Department of Radiology, Northwestern University, Chicago, IL, USA · Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA · Department of Cardiology, Northwestern University, Chicago, IL, USA +1

Synthetic Data Pretraining Coronary Angiography Medical Diagnosis Medical Image Anomaly Detection Medical Image Segmentation Coronary Artery Segmentation+2

Mar 3, 2026cs.CV

Spatial Autoregressive Modeling of DINOv3 Embeddings for Unsupervised Anomaly Detection

DINO models provide rich patch-level representations that have recently enabled strong performance in unsupervised anomaly detection (UAD). Most existing methods extract patch embeddings from normal images and model them independently, ignoring spatial and neighborhood relationships between patches. This implicitly assumes that self-attention and positional encodings sufficiently encode contextual information within each patch embedding. In addition, the normative distribution is often modeled as memory banks or prototype-based representations, which require storing large numbers of features and performing costly comparisons at inference time, leading to substantial memory and computational overhead. In this work, we explicitly model spatial and contextual dependencies between patch embeddings using a 2D autoregressive (AR) model, allowing us to use a simple and efficient model for normative modeling. Instead of storing embeddings or clustering prototypes, our approach learns a compact parametric model of the normative distribution via an AR convolutional neural network (CNN). At test time, anomaly detection reduces to a single forward pass through the network and enables fast and memory-efficient inference. We evaluate our method on the BMAD benchmark, comprising three medical imaging datasets, and the VisA dataset, comprising 12 industrial object categories, and compare it against existing methods, including recent DINO-based approaches. Experimental results demonstrate that explicitly modeling spatial dependencies achieves competitive anomaly detection performance while substantially reducing inference time and memory requirements. Code is available at the project page: https://eerdil.github.io/spatial-ar-dinov3-uad/

Ertunc Erdil, Nico Schulthess, Guney Tombak +1

Computer Vision Lab. ETH Zurich, Zurich, Switzerland

Medical Image Anomaly Detection Industrial Anomaly Detection Unsupervised Anomaly Detection Autoregressive Modeling

Feb 2, 2026cs.CV

Toxicity Assessment in Preclinical Histopathology via Class-Aware Mahalanobis Distance for Known and Novel Anomalies

Drug-induced toxicity is a leading cause of preclinical and early-clinical failure, making early detection critical. Histopathology is the gold standard for toxicity assessment but relies on expert pathologists, creating a bottleneck for large-scale screening. We introduce an AI-based anomaly detection framework for whole-slide images (WSIs) of rodent liver that identifies healthy tissue and known pathologies (anomalies) and flags samples without training data as out-of-distribution (OOD). We evaluate OOD detection on two held-out categories: apoptosis (single-cell, near-OOD) and staining/processing artifacts (heterogeneous, far-OOD). We build a novel pixelwise-annotated dataset and fine-tune a pre-trained Vision Transformer (DINOv2) via Low-Rank Adaptation (LoRA) for segmentation, then use the Mahalanobis distance for OOD detection with class-specific thresholds. Optimizing the false positive rate subject to a predefined constraint on the false negative rate yields only 0.16% of pathological tissue classified as healthy and 0.35% of healthy tissue classified as pathological. Our false negative rate does not penalise cross-type errors, reflecting the safety-first objective of never overlooking a lesion; under the stricter correct-class criterion our method assigns 93.93% of ID and 89.38% of OOD findings to their own class. The study demonstrates technical feasibility of pixel-level anomaly detection for mouse liver histopathology, indicating possible applications in improving preclinical workflows and drug development efficiency.

Olga Graf, Dhrupal Patel, Peter Groß +3

Tübingen AI Center, University of Tübingen, Tübingen, Germany · Toxicologic Pathologist, Gujarat, India · Boehringer Ingelheim Pharma GmbH and Co., Biberach an der Riß, Germany +1

Histopathology Image Segmentation Mahalanobis Distance Medical Image Anomaly Detection Toxicity Detection OOD Detection Whole-Slide Image Analysis

Feb 1, 2026cs.CV

MedAD-R1: Consistency-Reinforced Policy Optimization for Interpretable Medical Anomaly Detection

Medical Anomaly Detection (MedAD) offers a promising direction for medical image analysis with Large Multimodal Models (LMMs). However, progress is limited by fragmented datasets and the tendency of Supervised Fine-Tuning (SFT) to learn superficial image-text correlations rather than verifiable diagnostic reasoning. Consequently, current models often generate fluent explanations that are either insufficiently grounded in the image or inconsistent with their final answers, limiting their reliability in high-stakes medical applications. To address these issues, we introduce MedAD-38K, a large-scale, multimodal, and multicenter benchmark containing structured Visual Question Answering pairs and quality-controlled diagnostic Chain-of-Thought annotations across five core MedAD tasks. Based on this benchmark, we propose a two-stage framework. Cognitive Injection first uses SFT to inject domain-specific medical knowledge and establish a structured think-then-answer format. Consistency Group Relative Policy Optimization (Con-GRPO) then employs an Evidence-Aware Consistency Reward to reinforce reasoning that remains grounded in the image and logically supports the final answer. The resulting MedAD-R1 achieves state-of-the-art performance on MedAD-38K and consistently outperforms all evaluated baselines across five source-disjoint external datasets spanning diverse imaging modalities. Beyond accuracy, it achieves higher reasoning-answer consistency and visual-grounding scores across multiple backbones. With only 0.8B parameters, MedAD-R1 offers practical potential for resource-constrained deployment. These results demonstrate the generality of evidence-aware consistency optimization for interpretable MedAD. Project resources are available at https://github.com/zhtstar/MedAD-R1.

Haitao Zhang, Yingying Wang, Jiaxiang Wang +5

School of Informatics, Xiamen University · Institute of Artificial Intelligence, Xiamen University · Zhejiang Expressway Co., Ltd. +3

Healthcare Group Relative Policy Optimization Medical Image Anomaly Detection Multimodal Large Language Models Medical VQA Multimodal Anomaly Detection+2

Aug 27, 2025cs.CV

Diverse Normal Prototypes-Guided Contrastive Reconstruction for Medical Anomaly Detection

Anomaly detection in medical images is challenging due to limited annotations and the domain gap. Existing reconstruction-based methods often rely on frozen pre-trained encoders, restricting adaptation to domain-specific patterns and degrading localization accuracy. Meanwhile, prototype-based learning offers interpretable representations but commonly suffers from prototype collapse, where a few prototypes dominate training and reduce diversity. To address these issues, we propose DNP-ConFormer, a unified framework that integrates a trainable encoder with prototype-guided reconstruction and a Diversity-Aware Alignment Loss. A momentum encoder enables stable domain-adaptive representation learning, while a lightweight Prototype Extractor discovers informative normal prototypes and injects them into the decoder via attention to guide reconstruction. The proposed alignment objective further encourages balanced feature-to-prototype assignments, effectively mitigating prototype collapse. Extensive experiments on multiple medical imaging benchmarks demonstrate improved representation quality and anomaly localization compared with prior methods. Visualization and prototype assignment analyses further validate the effectiveness and interpretability of our approach. The code is available at https://github.com/liluhu0/DNP-ConFormer.

Luhu Li, Bin Liu, Bowen Lin +3

School of Mathematics, Shandong University, Jinan 250100, China · Department of Interventional Medicine and Minimally Invasive Oncology, The Second Qilu Hospital of Shandong University, Jinan 250033, China · Department of Neurosurgery, The Second Qilu Hospital of Shandong University,2026 Jinan 250033, China

Prototype Learning Medical Image Anomaly Detection Anomaly Localization Reconstruction-Based Anomaly Detection Medical Image Representation Learning

Jul 25, 2025cs.LG

OCSVM-Guided Representation Learning for Unsupervised Anomaly Detection

Unsupervised anomaly detection (UAD) aims to detect anomalies without labeled data, a necessity in many machine learning applications where anomalous samples are rare or not available. Most state-of-the-art methods fall into two categories: reconstruction-based approaches, which often reconstruct anomalies too well, and decoupled representation learning with density estimators, which can suffer from suboptimal feature spaces. While some recent methods attempt to couple feature learning and anomaly detection, they often rely on surrogate objectives, restrict kernel choices, or introduce approximations that limit their expressiveness and robustness. To address this challenge, we propose a novel method that couples representation learning the exact One-Class SVM (OCSVM) optimization problem, through a custom loss formulation that directly aligns latent features with the OCSVM decision boundary. The model is evaluated on two tasks: a benchmark based on MNIST-C, and a challenging brain MRI lesion detection task. Unlike most methods that focus on large, hyperintense lesions at the image level, our approach succeeds to target small, non-hyperintense lesions, while we evaluate voxel-wise metrics, addressing a more clinically relevant scenario. Both experiments evaluate a form of robustness to domain shifts, including corruption types in MNIST-C and texture or population age variations in MRI. Results demonstrate performance and robustness of our proposed model, highlighting its potential for general UAD and real-world medical imaging applications. The source code is available at https://github.com/Nicolas-Pinon/uad\_ocsvm\_guided\_repr\_learning.

Nicolas Pinon, Robin Trombetta, Carole Lartizien

MYRIAD

Medical Image Anomaly Detection Unsupervised Representation Learning Anomaly Localization Support Vector Machines Unsupervised Anomaly Detection