Medical Image Classification

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Latest papers 486

53 papers in the last four weeks, up 8% on the four weeks before. 0.3% of all new papers.

Feb 26, 2026

PRIMA: Pre-Training with Risk-Integrated Image--Metadata Alignment for Medical Diagnosis with LLM-Based Feature Aggregation

Medical diagnosis requires the effective synthesis of visual manifestations and clinical metadata. However, existing methods often treat metadata as isolated tags, failing to exploit the rich semantic knowledge embedded in clinical descriptions. We propose PRIMA (Pre-training with Risk-integrated Image-Metadata Alignment), a framework that integrates domain-specific knowledge into multi-modal representation learning. We first curate a corpus of risk--disease correlations via Retrieval-Augmented Generation (RAG) to refine Clinical ModernBERT, embedding diagnostic priors into the text encoder. To bridge the modality gap, we introduce a dual-encoder pre-training strategy utilizing DINOv3 and our refined Clinical ModernBERT, optimized by a suite of four complementary loss functions. These losses are designed to capture multi-granular semantic alignment and handle the ambiguity of clinical correlations through soft labels. Finally, we leverage Qwen3 to fuse these aligned features for precise disease classification. Extensive experiments demonstrate that PRIMA effectively harmonizes pixel-level features with abstract clinical expertise. Across PAD-UFES-20 and AQUA, PRIMA achieves average F1-scores of 72.04% and 85.22%, outperforming strong image-only, metadata-fusion, and medical vision-language baselines. Notably, our framework achieves strong performance without requiring massive data collection or exhaustive computational resources. Our code is available at https://github.com/yqwang01/PRIMA.

Yiqing Wang, Chunming He, Ziyun Yang +5

Department of Biomedical Engineering, Duke University 101 Science Drive, Durham, NC 27705 USA · Department of Ophthalmology and Visual Sciences, University of Michigan 1000 Wall Street, Ann Arbor, MI, USA

Cross-Modal Alignment Multimodal Pretraining Medical Image Classification Medical VLMs

Feb 26, 2026

FairQuant: Fairness-Aware Mixed-Precision Quantization for Medical Image Classification

Compressing neural networks by quantizing model parameters offers useful trade-off between performance and efficiency. Methods like quantization-aware training and post-training quantization strive to maintain the downstream performance of compressed models compared to the full precision models. However, these techniques do not explicitly consider the impact on algorithmic fairness. In this work, we study fairness-aware mixed-precision quantization schemes for medical image classification under explicit bit budgets. We introduce FairQuant, a framework that combines group-aware importance analysis, budgeted mixed-precision allocation, and a learnable Bit-Aware Quantization (BAQ) mode that jointly optimizes weights and per-unit bit allocations under bitrate and fairness regularization. We evaluate the method on Fitzpatrick17k and ISIC2019 across ResNet18/50, DeiT-Tiny, and TinyViT. Results show that FairQuant configurations with average precision near 4-6 bits recover much of the Uniform 8-bit accuracy while improving worst-group performance relative to Uniform 4- and 8-bit baselines, with comparable fairness metrics under shared budgets.

Thomas Woergaard, Raghavendra Selvan

Department of Computer Science, University of Copenhagen, Denmark

Mixed-Precision Quantization Algorithmic Fairness Medical Image Classification Quantization-Aware Training

Feb 26, 2026

Can Agents Distinguish Visually Hard-to-Separate Diseases in a Zero-Shot Setting? A Pilot Study

The rapid progress of multimodal large language models (MLLMs) has led to increasing interest in agent-based systems. While most prior work in medical imaging concentrates on automating routine clinical workflows, we study an underexplored yet clinically significant setting: distinguishing visually hard-to-separate diseases in a zero-shot setting. We benchmark representative agents on two imaging-only proxy diagnostic tasks, (1) melanoma vs. atypical nevus and (2) pulmonary edema vs. pneumonia, where visual features are highly confounded despite substantial differences in clinical management. We introduce a multi-agent framework based on contrastive adjudication. Experimental results show improved diagnostic performance (an 11-percentage-point gain in accuracy on dermoscopy data) and reduced unsupported claims on qualitative samples, although overall performance remains insufficient for clinical deployment. We acknowledge the inherent uncertainty in human annotations and the absence of clinical context, which further limit the translation to real-world settings. Within this controlled setting, this pilot study provides preliminary insights into zero-shot agent performance in visually confounded scenarios.

Zihao Zhao, Frederik Hauke, Juliana De Castilhos +2

Department of Diagnostic and Interventional Radiology, University Hospital Aachen, 52074 Aachen, Germany

Medical Image Classification Multimodal Agents Differential Diagnosis Multi-Agent LLMs

Feb 25, 2026

MammoWise: Multi-Model Local RAG Pipeline for Mammography Report Generation

Screening mammography is high volume, time sensitive, and documentation heavy. Radiologists must translate subtle visual findings into consistent BI-RADS assessments, breast density categories, and structured narrative reports. While recent Vision Language Models (VLMs) enable image-to-text reporting, many rely on closed cloud systems or tightly coupled architectures that limit privacy, reproducibility, and adaptability. We present MammoWise, a local multi-model pipeline that transforms open source VLMs into mammogram report generators and multi-task classifiers. MammoWise supports any Ollama-hosted VLM and mammography dataset, and enables zero-shot, few-shot, and Chain-of-Thought prompting, with optional multimodal Retrieval Augmented Generation (RAG) using a vector database for case-specific context. We evaluate MedGemma, LLaVA-Med, and Qwen2.5-VL on VinDr-Mammo and DMID datasets, assessing report quality (BERTScore, ROUGE-L), BI-RADS classification, breast density, and key findings. Report generation is consistently strong and improves with few-shot prompting and RAG. Classification is feasible but sensitive to model and dataset choice. Parameter-efficient fine-tuning (QLoRA) of MedGemma improves reliability, achieving BI-RADS accuracy of 0.7545, density accuracy of 0.8840, and calcification accuracy of 0.9341 while preserving report quality. MammoWise provides a practical and extensible framework for deploying local VLMs for mammography reporting within a unified and reproducible workflow.

Raiyan Jahangir, Nafiz Imtiaz Khan, Amritanand Sudheerkumar +1

University of California, Davis, CA, USA

Radiology Report Generation Mammography Medical Image Classification Multimodal RAG

Feb 25, 2026

Enhancing Renal Tumor Malignancy Prediction: Deep Learning with Automatic 3D CT Organ Focused Attention

Accurate prediction of malignancy in renal tumors is crucial for informing clinical decisions and optimizing treatment strategies. However, existing imaging modalities lack the necessary accuracy to reliably predict malignancy before surgical intervention. While deep learning has shown promise in malignancy prediction using 3D CT images, traditional approaches often rely on manual segmentation to isolate the tumor region and reduce noise, which enhances predictive performance. Manual segmentation, however, is labor-intensive, costly, and dependent on expert knowledge. In this study, a deep learning framework was developed utilizing an Organ Focused Attention (OFA) loss function to modify the attention of image patches so that organ patches attend only to other organ patches. Hence, no segmentation of 3D renal CT images is required at deployment time for malignancy prediction. The proposed framework achieved an AUC of 0.685 and an F1-score of 0.872 on a private dataset from the UF Integrated Data Repository (IDR), and an AUC of 0.760 and an F1-score of 0.852 on the publicly available KiTS21 dataset. These results surpass the performance of conventional models that rely on segmentation-based cropping for noise reduction, demonstrating the frameworks ability to enhance predictive accuracy without explicit segmentation input. The findings suggest that this approach offers a more efficient and reliable method for malignancy prediction, thereby enhancing clinical decision-making in renal cancer diagnosis.

Zhengkang Fan, Chengkun Sun, Russell Terry +2

Department of Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, FL, USA · Department of Computer & Information Sciences, Temple University, Philadelphia, PA, USA · Department of Urology, University of Florida, Gainesville, FL, USA

Medical Image Classification 3D Medical Imaging Attention Mechanisms

Feb 25, 2026

Mobile-Ready Automated Triage of Diabetic Retinopathy Using Digital Fundus Images

Diabetic Retinopathy (DR) is a major cause of vision impairment worldwide. However, manual diagnosis is often time-consuming and prone to errors, leading to delays in screening. This paper presents a lightweight automated deep learning framework for efficient assessment of DR severity from digital fundus images. We use a MobileNetV3 architecture with a Consistent Rank Logits (CORAL) head to model the ordered progression of disease while maintaining computational efficiency for resource-constrained environments. The model is trained and validated on a combined dataset of APTOS 2019 and IDRiD images using a preprocessing pipeline including circular cropping and illumination normalization. Extensive experiments including 3-fold cross-validation and ablation studies demonstrate strong performance. The model achieves a Quadratic Weighted Kappa (QWK) score of 0.9019 and an accuracy of 80.03 percent. Additionally, we address real-world deployment challenges through model calibration to reduce overconfidence and optimization for mobile devices. The proposed system provides a scalable and practical tool for early-stage diabetic retinopathy screening.

Aadi Joshi, Manav S. Sharma, Vijay Uttam Rathod +3

Vishwakarma Institute Of Technology, Computer Engineering Department, Pune , India · Vishwakarma Institute Of Technology, Computer Science and Engineering (AI & ML ) Department, Pune , India

Diabetic Retinopathy Grading Medical Image Classification

Feb 25, 2026

Axial-Centric Cross-Plane Attention for 3D Medical Image Classification

Abridged: Clinicians commonly interpret 3D medical images by examining multiple anatomical planes rather than relying on volumetric views. In clinical CT workflows, the axial plane often serves as the primary diagnostic reference, while the auxiliary planes provide complementary spatial context. However, many existing 3D deep learning approaches either process volumetric data holistically or assign equal importance to all planes, failing to reflect this asymmetric, axial-centric interpretation strategy. To address this, we propose an axial-centric cross-plane attention architecture for 3D medical image classification that models asymmetric dependencies between anatomical planes. The architecture employs large-scale axial CT images pretrained MedDINOv3 as a frozen feature extractor for axial, coronal, and sagittal planes. RICA blocks and intra-plane transformer encoders capture plane-specific positional and contextual information, while axial-centric cross-plane transformer encoders selectively condition axial representations on complementary auxiliary representations. Experiments on six datasets from the MedMNIST3D benchmark show that the proposed method consistently outperforms existing 3D and multi-plane models in ACC and AUC. A lightweight variant, AC-Tiny, achieves competitive performance with substantially fewer trainable parameters, suggesting that architectural design contributes more to performance gains than increased model scale. Ablation studies further validate the importance of axial-centric querying, QKV allocation, directional cross-plane fusion, residual-free cross-attention, and classification head design. Slice-level Grad-CAM visualizations demonstrate that the model identifies diagnostically relevant regions across all planes. These findings highlight the value of aligning architectural design with clinical interpretation workflows for robust 3D medical image analysis.

Doyoung Park, Jinsoo Kim, Lohendran Baskaran

National Heart Centre Singapore, Singapore · CVS.AI, National Heart Research Institute of Singapore, Singapore · Independent Researcher, Republic of Korea

Medical Image Classification 3D Medical Imaging 3D ViTs Medical Image Representation Learning

Feb 24, 2026

The Mean is the Mirage: Entropy-Adaptive Model Merging under Heterogeneous Domain Shifts in Medical Imaging

Model merging under unseen test-time distribution shifts often renders naive strategies, such as mean averaging unreliable. This challenge is especially acute in medical imaging, where models are fine-tuned locally at clinics on private data, producing domain-specific models that differ by scanner, protocol, and population. When deployed at an unseen clinical site, test cases arrive in unlabeled, non-i.i.d. batches, and the model must adapt immediately without labels. In this work, we introduce an entropy-adaptive, fully online model-merging method that yields a batch-specific merged model via only forward passes, effectively leveraging target information. We further demonstrate why mean merging is prone to failure and misaligned under heterogeneous domain shifts. Next, we mitigate encoder classifier mismatch by decoupling the encoder and classification head, merging with separate merging coefficients. We extensively evaluate our method with state-of-the-art baselines using two backbones across nine medical and natural-domain generalization image classification datasets, showing consistent gains across standard evaluation and challenging scenarios. These performance gains are achieved while retaining single-model inference at test-time, thereby demonstrating the effectiveness of our method.

Sameer Ambekar, Reza Nasirigerdeh, Peter J. Schuffler +3

School of Computation, Information and Technology, Technical University of Munich, Germany · Institute of Machine Learning in Biomedical Imaging, Helmholtz Munich, Germany · relAI – Konrad Zuse School of Excellence in Reliable AI +3

Model Merging Domain Generalization Test-Time Adaptation Medical Image Classification

Feb 24, 2026

OrthoDiffusion: A Generalizable Multi-Task Diffusion Foundation Model for Musculoskeletal MRI Interpretation

Musculoskeletal disorders represent a significant global health burden and are a leading cause of disability worldwide. While MRI is essential for accurate diagnosis, its interpretation remains exceptionally challenging. Radiologists must identify multiple potential abnormalities within complex anatomical structures across different imaging planes, a process that requires significant expertise and is prone to variability. We developed OrthoDiffusion, a unified diffusion-based foundation model designed for multi-task musculoskeletal MRI interpretation. The framework utilizes three orientation-specific 3D diffusion models, pre-trained in a self-supervised manner on 15,948 unlabeled knee MRI scans, to learn robust anatomical features from sagittal, coronal, and axial views. These view-specific representations are integrated to support diverse clinical tasks, including anatomical segmentation and multi-label diagnosis. Our evaluation demonstrates that OrthoDiffusion achieves excellent performance in the segmentation of 11 knee structures and the detection of 8 knee abnormalities. The model exhibited remarkable robustness across different clinical centers and MRI field strengths, consistently outperforming traditional supervised models. Notably, in settings where labeled data was scarce, OrthoDiffusion maintained high diagnostic precision using only 10% of training labels. Furthermore, the anatomical representations learned from knee imaging proved highly transferable to other joints, achieving strong diagnostic performance across 11 diseases of the ankle and shoulder. These findings suggest that diffusion-based foundation models can serve as a unified platform for multi-disease diagnosis and anatomical segmentation, potentially improving the efficiency and accuracy of musculoskeletal MRI interpretation in real-world clinical workflows.

Tian Lan, Lei Xu, Zimu Yuan +8

Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China. · Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China. · Beijing Key Laboratory of Research and Translation for Drugs and Medical Devices in Precision Diagnosis and Treatment of Sports Injuries, Beijing, China. +4

Medical Imaging Foundation Models Diffusion Models Magnetic Resonance Imaging Medical Image Segmentation Medical Image Classification

Feb 22, 2026

RetinaVision: XAI-Driven Augmented Regulation for Precise Retinal Disease Classification using deep learning framework

Early and accurate classification of retinal diseases is critical to counter vision loss and for guiding clinical management of retinal diseases. In this study, we proposed a deep learning method for retinal disease classification utilizing optical coherence tomography (OCT) images from the Retinal OCT Image Classification - C8 dataset (comprising 24,000 labeled images spanning eight conditions). Images were resized to 224x224 px and tested on convolutional neural network (CNN) architectures: Xception and InceptionV3. Data augmentation techniques (CutMix, MixUp) were employed to enhance model generalization. Additionally, we applied GradCAM and LIME for interpretability evaluation. We implemented this in a real-world scenario via our web application named RetinaVision. This study found that Xception was the most accurate network (95.25%), followed closely by InceptionV3 (94.82%). These results suggest that deep learning methods allow effective OCT retinal disease classification and highlight the importance of implementing accuracy and interpretability for clinical applications.

Mohammad Tahmid Noor, Shayan Abrar, Jannatul Adan Mahi +3

Dept. of CSE East West University Dhaka, Bangladesh · Dept. of CSE American International University-Bangladesh Dhaka, Bangladesh · Dept. of ICT Bangladesh Army University of Engineering and Technology Dhaka, Bangladesh

Medical Image Classification Image Classification Explainable Medical Image Analysis

Feb 22, 2026

GUIDE-US: Grade-Informed Unpaired Distillation of Encoder Knowledge from Histopathology to Micro-UltraSound

Purpose: Non-invasive grading of prostate cancer (PCa) from micro-ultrasound (micro-US) could expedite triage and guide biopsies toward the most aggressive regions, yet current models struggle to infer tissue micro-structure at coarse imaging resolutions. Methods: We introduce an unpaired histopathology knowledge-distillation strategy that trains a micro-US encoder to emulate the embedding distribution of a pretrained histopathology foundation model, conditioned on International Society of Urological Pathology (ISUP) grades. Training requires no patient-level pairing or image registration, and histopathology inputs are not used at inference. Results: Compared to the current state of the art, our approach increases sensitivity to clinically significant PCa (csPCa) at 60% specificity by 3.5% and improves overall sensitivity at 60% specificity by 1.2%. Conclusion: By enabling earlier and more dependable cancer risk stratification solely from imaging, our method advances clinical feasibility. Source code will be publicly released upon publication.

Emma Willis, Tarek Elghareb, Paul F. R. Wilson +6

Queen’s University, Kingston, Canada. · University of British Columbia, Vancouver, Canada∗. · Exact Imaging, Markham, Canada.

Medical Image Classification Ultrasound Imaging Cross-Modal Knowledge Distillation Medical Imaging Foundation Models

Feb 21, 2026

Similarity-as-Evidence: Calibrating Overconfident VLMs for Interpretable and Label-Efficient Medical Active Learning

Active Learning (AL) reduces annotation costs in medical imaging by selecting only the most informative samples for labeling, but suffers from cold-start when labeled data are scarce. Vision-Language Models (VLMs) address the cold-start problem via zero-shot predictions, yet their temperature-scaled softmax outputs treat text-image similarities as deterministic scores while ignoring inherent uncertainty, leading to overconfidence. This overconfidence misleads sample selection, wasting annotation budgets on uninformative cases. To overcome these limitations, the Similarity-as-Evidence (SaE) framework calibrates text-image similarities by introducing a Similarity Evidence Head (SEH), which reinterprets the similarity vector as evidence and parameterizes a Dirichlet distribution over labels. In contrast to a standard softmax that enforces confident predictions even under weak signals, the Dirichlet formulation explicitly quantifies lack of evidence (vacuity) and conflicting evidence (dissonance), thereby mitigating overconfidence caused by rigid softmax normalization. Building on this, SaE employs a dual-factor acquisition strategy: high-vacuity samples (e.g., rare diseases) are prioritized in early rounds to ensure coverage, while high-dissonance samples (e.g., ambiguous diagnoses) are prioritized later to refine boundaries, providing clinically interpretable selection rationales. Experiments on ten public medical imaging datasets with a 20% label budget show that SaE attains state-of-the-art macro-averaged accuracy of 82.57%. On the representative BTMRI dataset, SaE also achieves superior calibration, with a negative log-likelihood (NLL) of 0.425.

Zhuofan Xie, Zishan Lin, Jinliang Lin +3

School of Electronic Technology and Engineering, Xiamen University, Xiamen, China · School of Informatics, Xiamen University, Xiamen, China · School of Engineering, Case Western Reserve University, Cleveland, USA

Active Learning VLM Calibration Medical VLMs Medical Image Classification Evidential Deep Learning Explainable Medical Image Analysis

Feb 20, 2026

Effect of Patch Size on Fine-Tuning Vision Transformers in Two-Dimensional and Three-Dimensional Medical Image Classification

Vision Transformers (ViTs) and their variants have become state-of-the-art in many computer vision tasks and are widely used as backbones in large-scale vision and vision-language foundation models. While substantial research has focused on architectural improvements, the impact of patch size, a crucial initial design choice in ViTs, remains underexplored, particularly in medical domains where both two-dimensional (2D) and three-dimensional (3D) imaging modalities exist. In this study, using 12 medical imaging datasets from various imaging modalities (including seven 2D and five 3D datasets), we conduct a thorough evaluation of how different patch sizes affect ViT classification performance. Using a single graphical processing unit (GPU) and a range of patch sizes (1, 2, 4, 7, 14, 28), we fine-tune ViT models and observe consistent improvements in classification performance with smaller patch sizes (1, 2, and 4), which achieve the best results across nearly all datasets. More specifically, our results indicate improvements in balanced accuracy of up to 12.78% for 2D datasets (patch size 2 vs. 28) and up to 23.78% for 3D datasets (patch size 1 vs. 14), at the cost of increased computational expense. Moreover, by applying a straightforward ensemble strategy that fuses the predictions of the models trained with patch sizes 1, 2, and 4, we demonstrate a further boost in performance in most cases, especially for the 2D datasets. Our implementation is publicly available on GitHub: https://github.com/HealMaDe/MedViT

Massoud Dehghan, Ramona Woitek, Amirreza Mahbod

Research Center for Medical Image Analysis and Artificial Intelligence, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, Krems an der Donau, 3500, Austria

Vision Transformer Medical Image Classification

Feb 20, 2026

G-LoG Bi-filtration for Medical Image Classification

Building practical filtrations on objects to detect topological and geometric features is an important task in the field of Topological Data Analysis (TDA). In this paper, leveraging the ability of the Laplacian of Gaussian operator to enhance the boundaries of medical images, we define the G-LoG (Gaussian-Laplacian of Gaussian) bi-filtration to generate the features more suitable for multi-parameter persistence module. By modeling volumetric images as bounded functions, then we prove the interleaving distance on the persistence modules obtained from our bi-filtrations on the bounded functions is stable with respect to the maximum norm of the bounded functions. Finally, we conduct experiments on the MedMNIST dataset, comparing our bi-filtration against single-parameter filtration and the established deep learning baselines, including Google AutoML Vision, ResNet, AutoKeras and auto-sklearn. Experiments results demonstrate that our bi-filtration significantly outperforms single-parameter filtration. Notably, a simple Multi-Layer Perceptron (MLP) trained on the topological features generated by our bi-filtration achieves performance comparable to complex deep learning models trained on the original dataset.

Qingsong Wang, Jiaxing He, Bingzhe Hou +3

Topological Data Analysis Medical Image Classification Persistent Homology

Feb 19, 2026

Deep Learning for Dermatology: An Innovative Framework for Approaching Precise Skin Cancer Detection

Skin cancer can be life-threatening if not diagnosed early, a prevalent yet preventable disease. Globally, skin cancer is perceived among the finest prevailing cancers and millions of people are diagnosed each year. For the allotment of benign and malignant skin spots, an area of critical importance in dermatological diagnostics, the application of two prominent deep learning models, VGG16 and DenseNet201 are investigated by this paper. We evaluate these CNN architectures for their efficacy in differentiating benign from malignant skin lesions leveraging enhancements in deep learning enforced to skin cancer spotting. Our objective is to assess model accuracy and computational efficiency, offering insights into how these models could assist in early detection, diagnosis, and streamlined workflows in dermatology. We used two deep learning methods DenseNet201 and VGG16 model on a binary class dataset containing 3297 images. The best result with an accuracy of 93.79% achieved by DenseNet201. All images were resized to 224x224 by rescaling. Although both models provide excellent accuracy, there is still some room for improvement. In future using new datasets, we tend to improve our work by achieving great accuracy.

Mohammad Tahmid Noor, B. M. Shahria Alam, Tasmiah Rahman Orpa +3

Department of Computer Science and Engineering, East West University, Dhaka, Bangladesh

Skin Lesion Classification Medical Diagnosis Medical Image Classification Convolutional Neural Networks

Feb 17, 2026

Bayesian Optimization for Design Parameters of 3D Image Data Analysis

Deep learning-based segmentation and classification are crucial to large-scale biomedical imaging, particularly for 3D data, where manual analysis is impractical. Although many methods exist, selecting suitable models and tuning parameters remains a major bottleneck in practice. Hence, we introduce the 3D data Analysis Optimization Pipeline, a method designed to facilitate the design and parameterization of segmentation and classification using two Bayesian Optimization stages. First, the pipeline selects a segmentation model and optimizes postprocessing parameters using a domain-adapted syntactic benchmark dataset. To ensure a concise evaluation of segmentation performance, we introduce a segmentation quality metric that serves as the objective function. Second, the pipeline optimizes design choices of a classifier, such as encoder and classifier head architectures, incorporation of prior knowledge, and pretraining strategies. To reduce manual annotation effort, this stage includes an assisted class-annotation workflow that extracts predicted instances from the segmentation results and sequentially presents them to the operator, eliminating the need for manual tracking. In four case studies, the 3D data Analysis Optimization Pipeline efficiently identifies effective model and parameter configurations for individual datasets.

David Exler, Joaquin Eduardo Urrutia Gómez, Martin Krüger +5

Institute for Automation and Applied Informatics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany. · Institute of Biological and Chemical Systems, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany. · CeMOS Research and Transfer Center, Technische Hochschule Mannheim, Paul-Wittsack-Straße 10, 68163 Mannheim, Germany.

3D Medical Image Segmentation Automated Machine Learning Medical Image Classification Hyperparameter Optimization

Feb 17, 2026

Intracoronary Optical Coherence Tomography Image Processing and Vessel Classification Using Machine Learning

Intracoronary Optical Coherence Tomography (OCT) enables high-resolution visualization of coronary vessel anatomy but presents challenges due to noise, imaging artifacts, and complex tissue structures. This paper proposes a fully automated pipeline for vessel segmentation and classification in OCT images using machine learning techniques. The proposed method integrates image preprocessing, guidewire artifact removal, polar-to-Cartesian transformation, unsupervised K-means clustering, and local feature extraction. These features are used to train Logistic Regression and Support Vector Machine classifiers for pixel-wise vessel classification. Experimental results demonstrate excellent performance, achieving precision, recall, and F1-score values up to 1.00 and overall classification accuracy of 99.68%. The proposed approach provides accurate vessel boundary detection while maintaining low computational complexity and requiring minimal manual annotation. This method offers a reliable and efficient solution for automated OCT image analysis and has potential applications in clinical decision support and real-time medical image processing.

Amal Lahchim, Lambros Athanasiou

¹²Electrical and Computer Engineering Department, University of Patras, Greece

Coronary Artery Segmentation Medical Image Classification Optical Coherence Tomography

Feb 17, 2026

Mitigating Shortcut Learning via Feature Disentanglement in Medical Imaging: A Benchmark Study

Although deep learning models in medical imaging often achieve excellent classification performance, they can rely on shortcut learning, exploiting spurious correlations or confounding factors that are not causally related to the target task. This poses risks in clinical settings, where models must generalize across institutions, populations, and acquisition conditions. Feature disentanglement is a promising approach to mitigate shortcut learning by separating task-relevant information from confounder-related features in latent representations. In this study, we systematically evaluated feature disentanglement methods for mitigating shortcuts in medical imaging, including adversarial learning and latent space splitting based on dependence minimization. We assessed classification performance and disentanglement quality using latent space analyses across one artificial and two medical datasets with natural and synthetic confounders. We also examined robustness under varying levels of confounding and compared computational efficiency across methods. We found that shortcut mitigation methods improved classification performance under strong spurious correlations during training. Latent space analyses revealed differences in representation quality not captured by classification metrics, highlighting the strengths and limitations of each method. Model reliance on shortcuts depended on the degree of confounding in the training data. The best-performing models combine data-centric rebalancing with model-centric disentanglement, achieving stronger and more robust shortcut mitigation than rebalancing alone while maintaining similar computational efficiency. The project code is publicly available at https://github.com/berenslab/medical-shortcut-mitigation.

Sarah Müller, Philipp Berens

Hertie Institute for AI in Brain Health, Faculty of Medicine, University of Tübingen, Germany · Tübingen AI Center, University of Tübingen, Germany

Shortcut Learning Disentangled Representation Learning Medical Image Classification Adversarial Representation Learning

Feb 16, 2026

Is Mamba Reliable for Medical Imaging?

State-space models like Mamba offer linear-time sequence processing and low memory, making them attractive for medical imaging. However, their robustness under realistic software and hardware threat models remains underexplored. This paper evaluates Mamba on multiple MedM-NIST classification benchmarks under input-level attacks, including white-box adversarial perturbations (FGSM/PGD), occlusion-based PatchDrop, and common acquisition corruptions (Gaussian noise and defocus blur) as well as hardware-inspired fault attacks emulated in software via targeted and random bit-flip injections into weights and activations. We profile vulnerabilities and quantify impacts on accuracy indicating that defenses are needed for deployment.

Banafsheh Saber Latibari, Najmeh Nazari, Daniel Brignac +3

Department of Electrical and Computer Engineering, University of Arizona, Tucson, AZ, USA · Department of Electrical and Computer Engineering, University of California, Davis, CA, USA · Department of Computer Engineering and Computer Science, California State University, Long Beach, Long Beach, CA, USA

Adversarial Robustness Mamba Corruption Robustness Adversarial Attacks Medical Image Classification

Feb 16, 2026

StrokeNeXt: A Siamese-encoder Approach for Brain Stroke Classification in Computed Tomography Imagery

We present StrokeNeXt, a model for stroke classification in 2D Computed Tomography (CT) images. StrokeNeXt employs a dual-branch design with two ConvNeXt encoders, whose features are fused through a lightweight convolutional decoder based on stacked 1D operations, including a bottleneck projection and transformation layers, and a compact classification head. The model is evaluated on a curated dataset of 6,774 CT images, addressing both stroke detection and subtype classification between ischemic and hemorrhage cases. StrokeNeXt consistently outperforms convolutional and Transformer-based baselines, reaching accuracies and F1-scores of up to 0.988. Paired statistical tests confirm that the performance gains are statistically significant, while class-wise sensitivity and specificity demonstrate robust behavior across diagnostic categories. Calibration analysis shows reduced prediction error compared to competing methods, and confusion matrix results indicate low misclassification rates. In addition, the model exhibits low inference time and fast convergence.

Leo Thomas Ramos, Angel D. Sappa

Computer Vision Center · Universitat Aut`onoma de Barcelona · ESPOL Polytechnic University

Medical Image Classification Classification Convolutional Neural Networks Computed Tomography Siamese Neural Networks

Feb 16, 2026

VariViT: A Vision Transformer for Variable Image Sizes

Vision Transformers (ViTs) have emerged as the state-of-the-art architecture in representation learning, leveraging self-attention mechanisms to excel in various tasks. ViTs split images into fixed-size patches, constraining them to a predefined size and necessitating pre-processing steps like resizing, padding, or cropping. This poses challenges in medical imaging, particularly with irregularly shaped structures like tumors. A fixed bounding box crop size produces input images with highly variable foreground-to-background ratios. Resizing medical images can degrade information and introduce artefacts, impacting diagnosis. Hence, tailoring variable-sized crops to regions of interest can enhance feature representation capabilities. Moreover, large images are computationally expensive, and smaller sizes risk information loss, presenting a computation-accuracy tradeoff. We propose VariViT, an improved ViT model crafted to handle variable image sizes while maintaining a consistent patch size. VariViT employs a novel positional embedding resizing scheme for a variable number of patches. We also implement a new batching strategy within VariViT to reduce computational complexity, resulting in faster training and inference times. In our evaluations on two 3D brain MRI datasets, VariViT surpasses vanilla ViTs and ResNet in glioma genotype prediction and brain tumor classification. It achieves F1-scores of 75.5% and 76.3%, respectively, learning more discriminative features. Our proposed batching strategy reduces computation time by up to 30% compared to conventional architectures. These findings underscore the efficacy of VariViT in image representation learning. Our code can be found here: https://github.com/Aswathi-Varma/varivit

Aswathi Varma, Suprosanna Shit, Chinmay Prabhakar +5

Department of Neuroradiology, Technical University of Munich · Institute for Artificial Intelligence and Informatics in Medicine, Technical University of Munich · Department of Quantitative Biomedicine, University of Zurich +1

Vision Transformer Medical Image Representation Learning Efficient ViTs Medical Image Classification Brain Tumor Classification

Feb 16, 2026

Image-based Joint-level Detection for Inflammation in Rheumatoid Arthritis from Small and Imbalanced Data

Rheumatoid arthritis (RA) is an autoimmune disease characterized by systemic joint inflammation. Early diagnosis and tight follow-up are essential to the management of RA, as ongoing inflammation can cause irreversible joint damage. The detection of arthritis is important for diagnosis and assessment of disease activity; however, it often takes a long time for patients to receive appropriate specialist care. Therefore, there is a strong need to develop systems that can detect joint inflammation easily using RGB images captured at home. Consequently, we tackle the task of RA inflammation detection from RGB hand images. This task is highly challenging due to general issues in medical imaging, such as the scarcity of positive samples, data imbalance, and the inherent difficulty of the task itself. However, to the best of our knowledge, no existing work has explicitly addressed these challenges in RGB-based RA inflammation detection. This paper quantitatively demonstrates the difficulty of visually detecting inflammation by constructing a dedicated dataset, and we propose a inflammation detection framework with global local encoder that combines self-supervised pretraining on large-scale healthy hand images with imbalance-aware training to detect RA-related joint inflammation from RGB hand images. Our experiments demonstrated that the proposed approach improves F1-score by 0.2 points and Gmean by 0.25 points compared with the baseline model.

Shun Kato, Yasushi Kondo, Shuntaro Saito +2

Keio University, Japan · Keio University

Medical Diagnosis Medical Image Classification

Feb 12, 2026

Confidence-Uncertainty Boundary Calibration for Bayesian Deep Learning in Medical Image Analysis

In critical decision support systems based on medical imaging, the reliability of AI-assisted decision-making is as relevant as predictive accuracy. Although deep learning models have demonstrated significant accuracy, they frequently suffer from miscalibration, manifested as overconfidence in erroneous predictions. To facilitate clinical acceptance, it is imperative that models quantify uncertainty in a manner that correlates with prediction correctness, allowing clinicians to identify unreliable outputs for further review. To address this necessity, this paper proposes a probabilistic optimization framework grounded in Bayesian deep learning. Specifically, the Confidence-Uncertainty Boundary Curve (CUBC) is first explored as an intermediate operational target. Grounded in this target, a novel Confidence-Uncertainty Boundary Loss (CUB-Loss) is proposed to regularize the alignment between prediction confidence and uncertainty estimates during training, imposing penalties on high-certainty errors and low-certainty correct predictions. Upon completion of training optimization, a Boundary Curve Calibration Error (BCCE) metric is further introduced to measure the degree of boundary alignment in the calibrated model. Building on this measurement, a Dual Temperature Scaling (DTS) strategy is devised to perform post-hoc refinement, further adjusting the posterior predictive distribution across different confidence-uncertainty regions. The proposed framework is validated on three distinct medical imaging tasks: automatic screening of pneumonia, diabetic retinopathy detection, and identification of skin lesions. Empirical results demonstrate that the proposed approach improves uncertainty calibration across diverse modalities, maintains robust performance in data-scarce scenarios, and remains effective on severely imbalanced datasets, underscoring its potential for real clinical deployment.

Hua Xu, Julián D. Arias-Londoño, Juan I. Godino-Llorente

Escuela Técnica Superior de Ingenieros de Telecomunicación Universidad Politécnica de Madrid 28040, Madrid, Spain

Bayesian Neural Networks Post-Hoc Calibration Medical Image Analysis Medical Image Classification Uncertainty Calibration

Jan 28, 2026

Quantum Model Parallelism for MRI-Based Classification of Alzheimer's Disease Stages

With increasing life expectancy, AD has become a major global health concern. While classical AI-based methods have been developed for early diagnosis and stage classification of AD, growing data volumes and limited computational resources necessitate faster, more efficient approaches. Quantum-based AI methods, which leverage superposition and entanglement principles along with high-dimensional Hilbert space, can surpass classical approaches' limitations and offer higher accuracy for high-dimensional, heterogeneous, and noisy data. In this study, a Quantum-Based Parallel Model (QBPM) architecture is proposed for the efficient classification of AD stages using MRI datasets, inspired by the principles of classical model parallelism. The proposed model leverages quantum advantages by employing two distinct quantum circuits, each incorporating rotational and entanglement blocks, running in parallel on the same quantum simulator. The classification performance of the model was evaluated on two different datasets to assess its overall robustness and generalization capability. The proposed model demonstrated high classification accuracy across both datasets, highlighting its overall robustness and generalization capability. Results obtained under high-level Gaussian noise, simulating real-world conditions, further provided experimental evidence for the model's applicability not only in theoretical but also in practical scenarios. Moreover, compared with five different classical transfer learning methods, the proposed model demonstrated its efficiency as an alternative to classical approaches by achieving higher classification accuracy and comparable execution time while utilizing fewer circuit parameters. The results indicate that the proposed QBPM architecture represents an innovative and powerful approach for the classification of stages in complex diseases such as Alzheimer's.

Emine Akpinar, Murat Oduncuoglu

Department of Physics, Yildiz Technical University, Istanbul, Turkey

Medical Image Classification Quantum Neural Networks

Jan 27, 2026

The pretraining domain outweighs the training objective in setting the privacy-utility trade-off of differentially private medical image analysis

Differential privacy limits how much each training image can influence a medical imaging model but lowers its diagnostic accuracy. Pretrained weights reduce this loss. It is unknown whether the pretraining objective or domain improves accuracy more. Here we train chest radiograph classifiers under differential privacy from five starting points on 591,884 radiographs from five datasets. We show that supervised pretraining on chest radiographs ranks first in 24 of 25 combinations of dataset and privacy setting. Measured by the area under the receiver operating characteristic curve, its lead over supervised pretraining on natural images is 2.6% without privacy and 15.3% at the strictest budget. From that starting point, changing the domain improves this area 2.2 to 3.7 times more than changing the objective. Private pretraining on chest radiographs lowers this area by about 5% under privacy but outperforms the three starting points without patient data at the strictest budget. Under privacy, supervised chest radiograph pretraining leads in the worst-performing demographic subgroup.

Soroosh Tayebi Arasteh, Mina Farajiamiri, Mahshad Lotfinia +7

Lab for AI in Medicine, RWTH Aachen University, Aachen, Germany · Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany · Department of Urology, Stanford University, Stanford, CA, USA +5

Privacy-Utility Tradeoff Medical Image Classification Differential Privacy Domain-Adaptive Pretraining

Jan 1, 2026

TotalFM: An Organ-Separated 3D-CT Foundation Model Leveraging Large-Scale Routine Clinical Radiology Data

While foundation models in radiology are expected to be applied to various clinical tasks, computational cost constraints remain a major challenge when training on 3D-CT volumetric data. In this study, we propose TotalFM, a radiological foundation model that efficiently learns the correspondence between 3D-CT images and linguistic expressions based on the concept of organ separation, utilizing a large-scale dataset of 140,000 series. By automating the creation of organ volume and finding-sentence pairs through segmentation techniques and Large Language Model (LLM)-based radiology report processing, and by combining self-supervised pre-training via VideoMAE with contrastive learning using volume-text pairs, we aimed to balance computational efficiency and representation capability. In zero-shot organ-wise lesion classification tasks, the proposed model achieved higher F1 scores in 83% (5/6) of organs compared to CT-CLIP and 64% (9/14) of organs compared to Merlin. These results suggest that the proposed model exhibits high generalization performance in a clinical evaluation setting using actual radiology report sentences. Furthermore, in zero-shot finding-wise lesion classification tasks, our model achieved a higher AUROC in 83% (25/30) of finding categories compared to Merlin. We also confirmed performance comparable to existing Vision-Language Models (VLMs) in radiology report generation tasks. Our results demonstrate that the organ-separated learning framework can serve as a realistic and effective design guideline for the practical implementation of 3D-CT foundation models. The source code and pretrained models are publicly available at https://github.com/jichi-labo/TotalFM.

Kohei Yamamoto, Tomohiro Kikuchi

Department of Radiology, Jichi Medical University · Data Science Center, Jichi Medical University

3D Foundation Models Medical Imaging Foundation Models Radiology VLMs Medical Image Classification 3D VLMs

Dec 24, 2025

A Tool Bottleneck Framework for Clinically-Informed and Interpretable Medical Image Understanding

Recent tool-use frameworks powered by vision-language models (VLMs) improve image understanding by grounding model predictions with specialized tools. Broadly, these frameworks leverage VLMs and a pre-specified toolbox to decompose the prediction task into multiple tool calls (often deep learning models) which are composed to make a prediction. The dominant approach to composing tools is using text, via function calls embedded in VLM-generated code or natural language. However, these methods often perform poorly on medical image understanding, where salient information is encoded as spatially-localized features that are difficult to compose or fuse via text alone. To address this, we propose a tool-use framework for medical image understanding called the Tool Bottleneck Framework (TBF), which composes VLM-selected tools using a learned Tool Bottleneck Model (TBM). For a given image and task, TBF leverages an off-the-shelf medical VLM to select tools from a toolbox that each extract clinically-relevant features. Instead of text-based composition, these tools are composed by the TBM, which computes and fuses the tool outputs using a neural network before outputting the final prediction. We propose a simple and effective strategy for TBMs to make predictions with any arbitrary VLM tool selection. Overall, our framework not only improves tool-use in medical imaging contexts, but also yields more interpretable, clinically-grounded predictors. We evaluate TBF on tasks in histopathology and dermatology and find that these advantages enable our framework to perform on par with or better than deep learning-based classifiers, VLMs, and state-of-the-art tool-use frameworks, with particular gains in data-limited regimes. The project details and the code are available at https://christinaliu2020.github.io/tbm/.

Christina Liu, Alan Q. Wang, Joy Hsu +2

California Institute of Technology, Pasadena, CA 91125 · Stanford University, Stanford, CA 94305

Tool Use in VLMs Medical Image Classification Medical VLMs Explainable Medical Image Analysis

Oct 13, 2025

Benchmarking Deep Learning Models for Laryngeal Cancer Staging Using the LaryngealCT Dataset

Laryngeal cancer imaging research lacks standardised public datasets to enable reproducible deep learning (DL) model development. We present LaryngealCT, a curated benchmark of 1,029 computed tomography (CT) scans aggregated from six collections from The Cancer Imaging Archive (TCIA). Uniform 1 mm isotropic volumes of interest encompassing the larynx were extracted using a weakly supervised parameter search framework validated by clinical experts. Six 3D DL architectures (custom 3D CNN, ResNet18,50,101, DenseNet121 and MedicalNet-pretrained ResNet50) were benchmarked on (i) early (Tis,T1,T2) vs. advanced (T3,T4) and (ii) T4 vs. non-T4 classification tasks. On the independent test set, the 3D CNN achieved the strongest overall performance across global and per-class metrics (Accuracy 0.854, F1-macro 0.841) in early vs. advanced classification. In the T4 task, AU-ROC values exceeded 0.82 for most models, but sensitivity for T4 disease remained limited (less than or equal to 0.412), with ResNet101 showing the most promising calibrated T4 recall (0.706. Model explainability assessed using GradCAMpp with thyroid cartilage overlays for T4 classification task revealed anatomically plausible peri-cartilage activations, although spatial overlap was modest. Through open-source data, pretrained models, and integrated explainability tools, LaryngealCT offers a reproducible foundation for AI-driven research to support future clinical decision-making in laryngeal oncology.

Nivea Roy, Son Tran, Atul Sajjanhar +4

School of Information Technology, Deakin University, Burwood, Australia · Department of Head and Neck Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India · Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India +1

Medical Image Classification Oncology Medical Image Benchmarks

Oct 12, 2025

Structured Spectral Graph Representation Learning for Multi-label Abnormality Analysis from 3D CT Scans

With the growing volume of CT examinations, there is an increasing demand for automated tools such as organ segmentation, abnormality detection, and report generation to support radiologists in managing their clinical workload. Multi-label classification of 3D Chest CT scans remains a critical yet challenging problem due to the complex spatial relationships inherent in volumetric data and the wide variability of abnormalities. Existing methods based on 3D convolutional neural networks struggle to capture long-range dependencies, while Vision Transformers often require extensive pre-training on large-scale, domain-specific datasets to perform competitively. In this work, we propose a 2.5D alternative by introducing a new graph-based framework that represents 3D CT volumes as structured graphs, where axial slice triplets serve as nodes processed through spectral graph convolution, enabling the model to reason over inter-slice dependencies while maintaining complexity compatible with clinical deployment. Our method, trained and evaluated on 3 datasets from independent institutions, achieves strong cross-dataset generalization, and shows competitive performance compared to state-of-the-art visual encoders. We further conduct comprehensive ablation studies to evaluate the impact of various aggregation strategies, edge-weighting schemes, and graph connectivity patterns. Additionally, we demonstrate the broader applicability of our approach through transfer experiments on automated radiology report generation and abdominal CT data.

Theo Di Piazza, Carole Lazarus, Olivier Nempont +1

INSA Lyon, University of Lyon, CNRS, INSERM, CREATIS UMR 5220, U1294, Villeurbanne, France · Hospices Civil de Lyon, Lyon, France · Philips Clinical Informatics, Innovation Paris, France

Graph Neural Networks Graph Representation Learning Medical Image Classification Spectral Graph Convolution Computed Tomography

Sep 17, 2025

Invisible Yet Detected: PelFANet with Attention-Guided Anatomical Fusion for Pelvic Fracture Diagnosis

Pelvic fractures pose significant diagnostic challenges, particularly in cases where fracture signs are subtle or invisible on standard radiographs. To address this, we introduce PelFANet, a dual-stream attention network that fuses raw pelvic X-rays with segmented bone images to improve fracture classification. The network employs Fused Attention Blocks (FABlocks) to iteratively exchange and refine features from both inputs, capturing global context and localized anatomical detail. Trained in a two-stage pipeline with a segmentation-guided approach, PelFANet demonstrates superior performance over conventional methods. On the AMERI dataset, it achieves 88.68% accuracy and 0.9334 AUC on visible fractures, while generalizing effectively to invisible fracture cases with 82.29% accuracy and 0.8688 AUC, despite not being trained on them. These results highlight the clinical potential of anatomy-aware dual-input architectures for robust fracture detection, especially in scenarios with subtle radiographic presentations.

Siam Tahsin Bhuiyan, Rashedur Rahman, Sefatul Wasi +4

Center for Computational & Data Sciences, Independent University, Bangladesh · Department of Computer Science and Engineering, Independent University, Bangladesh · Advanced Medical Engineering Research Institute, University of Hyogo, Japan +1

Medical Image Analysis Medical Image Classification Multimodal Fusion