Medical Image Retrieval

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18 papers4 papers in the last four weeks, against 1 the four weeks before. 0.0% of all new papers.

Oct 15, 2026

Pathology foundation models for training-free case retrieval in salivary gland tumors

In pathology, pattern recognition relies on a frame of reference built through extensive training and experience, which may still fall short when encountering rare cancer subtypes. Archives of previously diagnosed tumors often contain relevant precedents, yet identifying the most relevant cases remains challenging. Here we explore whether content-based retrieval with current pathology foundation models facilitates rare cancer diagnostics without any task-specific training. Pathologists can query a digitized archive using a region of interest (ROI) from a whole slide image (WSI) and retrieve morphologically similar cases, along with their ICD-O codes and corresponding WSIs. The ROI can be selected manually or automatically using a gated attention-based multiple instance learning model. We evaluate our approach by leave-one-case-out on an imbalanced dataset of 137 salivary gland tumor cases spanning 12 ICD-O morphology categories, comparing four pathology foundation models (Atlas2, Atlas2-B, Atlas2-S, and UNI2h). Top-1/3/5 retrieval was 62.5%/76.7%/81.3% for Atlas2, 50.2/66.6/72.9% for UNI2h, 52.3%/71.5%/77.6% for Atlas2-B and 54.4/65.2/73.7% for Atlas2-S. Macro-averaged F1 ranged from 69.0% for the smallest model Atlas2-S to 76.6% for the largest model Atlas2 across the five classes with at least ten cases. Our modified Chamfer similarity separated correct from incorrect matches among the Top-5 more reliably for Atlas2 (AUC 0.754) than for Atlas2-B (0.679, p = 0.020) and Atlas2-S (0.653, p = 0.003), but not UNI2h (0.697, p = 0.196). Requiring no additional training or manual annotation, this approach makes departmental archives searchable with pathology foundation models, providing a low-barrier route to case-based differential diagnosis and extending the individual frame of reference to the collective experience of the department.

Maximilian J. Roesel, Niklas Kiermeyer, Philipp Keyl +1

Institute of Pathology, Ludwig-Maximilians-Universität München · German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Munich partner site · Institute of Pathology, Charité-Universitätsmedizin Berlin +1

Computational Pathology Medical Image Retrieval Pathology Foundation Models Whole-Slide Image Analysis Fine-Grained Image Retrieval Oncology

Oct 9, 2026

CAPTOR: a vision-language foundation model for Chest-Abdomen-Pelvis Oncologic CT

Purpose : To develop and evaluate CAPTOR, a deep-learning vision-language foundation model for oncologic chest-abdomen-pelvis (CAP) CT interpretation. Materials & Methods : CAPTOR (Chest-Abdomen-Pelvis foundaTion model for Oncologic Radiology) is a contrastive vision-language model, trained using a pretraining strategy for oncologic CAP CT (in single- or multiple-series acquisitions), on a multicenter retrospective dataset from North America, Europe and Asia, predominantly from tumor lesion examinations. CAPTOR was compared with state-of-the-art CT foundation models on three downstream tasks: disease detection, survival prediction using TumorImagingBench and image retrieval. Classification and retrieval were both evaluated on held-out internal and public test sets, stratified by anatomical coverage and indication. Bootstrap resampling was used to estimate confidence intervals, and pairwise comparisons were performed using permutation tests. Results : CAPTOR was trained and tested on 25,512 and 10,794 CT-report pairs respectively. TumorImagingBench datasets comprised between 134 and 421 studies each. CAPTOR outperformed all baseline models, on the classification task, on the CAP subset (AUC 0.767, 95%CI: 0.734-0.793, vs. 0.695, 95%CI: 0.645-0.736 for the next-best, p<0.001) and oncologic subset (AUC 0.784, 95%CI: 0.759-0.805, vs. 0.734, 95%CI: 0.703-0.767 p<0.001), ranked first on three of the four oncologic prognostic benchmarks, and achieved superior retrieval performance on CAP and oncologic subsets. Conclusion : A foundation model trained on oncology-enriched CAP CT data outperformed relevant state-of-the-art models in its target clinical context, underscoring the importance of clinically aligned pretraining. We release our preprocessing, training and inference code : https://github.com/Guerbet-AI/CAPTOR and model weights : https://huggingface.co/Guerbet-AI/CAPTOR

Séléna Jean-Mactoux, Sophie Loizillon, Ghina Jardali +3

Biomaps, UMR1281, INSERM, CNRS, CEA, Université Paris-Saclay, Villejuif, France · Guerbet Research, Villepinte, France · Department of Diagnostic Oncologic Imaging, Gustave Roussy Institute, Villejuif, France +2

Medical Image Retrieval Radiology VLMs Medical Image Classification Computed Tomography Cancer Survival Prediction

Oct 5, 2026

NeuroCBIR: A Fast and Accurate Image Retrieval System for Whole-Brain and Region-Specific MRI

Content-based image retrieval (CBIR) in neuroimaging enables the identification of structurally similar brain scans, supporting diagnosis, prognosis, and treatment planning; however, existing methods are often limited to small datasets, single brain regions, or coarse class labels, thereby restricting their clinical utility and generalizability. Here, we present NeuroCBIR, a framework for fast and flexible retrieval of both whole-brain and region-specific 3D T1w MRI scans. A total of 103 cortical and subcortical regions are extracted to enable both whole-brain and region-level queries. NeuroCBIR leverages latent representations learned by a variational autoencoder (VAE) combined with contrastive learning, producing scan-specific embeddings that capture anatomical patterns. These embeddings were evaluated for subject re-identification, zero-shot age prediction, and zero-shot multi-class pathology stratification. Re-identification performance was high across both whole-brain and brain-region levels (mean average precision across the top-5 retrieved images (mAP@5) >= 98.4%), with robust generalization across datasets and acquisition conditions. While NeuroCBIR is not trained for age prediction or pathology stratification, zero-shot evaluations for these two tasks demonstrate that the embeddings encode meaningful information for downstream tasks. Embedding extraction on a 4-core CPU required approximately 18.7 s per scan, whereas similarity search was effectively instantaneous (less than 0.01 s). NeuroCBIR is publicly available for brain MRI with more than 26,000 precomputed T1w MRI embeddings. It supports reproducible research, region-specific flexibility, and clinically meaningful personalized diagnostic support. The software is available at https://github.com/minnelab/NeuroCBIR.

Felix Nieto-del-Amor, Jingru Fu, J. -Sebastian Muehlboeck +3

Image Retrieval Medical Image Representation Learning Brain MRI Medical Image Retrieval

Sep 27, 2026

QuPID: Quantum Parameter-Efficient Input-Dependent Retrieval Adaptation for Medical RAG

Fidelity-based quantum retrieval ranks candidates by the fidelity between query and archive states. Applying a shared input-independent unitary after fixed state encoding leaves that fidelity unchanged, so training the circuit cannot alter the ranking. Quantum parameter-efficient input-dependent retrieval adaptation (QuPID) repairs this by making the circuit input-dependent through data re-uploading and by comparing measurement readouts, vectors of local Pauli expectations, rather than states. The result is a small readout for adapting frozen image features to a local archive with limited data: training simulates the circuit classically, and inference runs on a GPU with fixed learned parameters. We characterize the class as a structured factorization of input-modulated quadratic feature maps, bound the frequency support of its re-uploading channel, and give a parameter-count generalization bound that motivates its small budget. Under a shared frozen backbone and a label-free protocol, QuPID's 60 parameters give higher precision-at-5 (P@5) on ChestX-ray14 and MURA than frozen medical encoders, and than adapters and low-rank adaptation (LoRA) with up to 5.25 million trainable parameters. On ChestX-ray14, the P@5 gain over the frozen encoder is +0.116, the lead over retuned adapters is widest at 512 adaptation examples (+0.040), and the full-budget margin over an equally compact classical rotation-plane head is +0.023 with a 95% interval excluding zero. Medical imaging is the primary testbed; the pattern recurs on two non-medical benchmarks, in report generation, and under simulated gate noise and finite-shot readout.

Hyojun Ahn, Emily Jimin Roh, Soohyun Park +3

Korea University · Sookmyung Women’s University · Virginia Tech +2

Quantum Feature Maps Medical Image Retrieval Retrieval-Augmented Generation Quantum Machine Learning Parameter-Efficient Fine-Tuning

Aug 28, 2026

CheXtriev: Anatomy-Centered Representation for Case-Based Retrieval of Chest Radiographs

We present CheXtriev, a graph-based, anatomy-aware framework for chest radiograph retrieval. Unlike prior methods focussed on global features, our method leverages graph transformers to extract informative features from specific anatomical regions. Furthermore, it captures spatial context and the interplay between anatomical location and findings. This contextualization, grounded in evidence-based anatomy, results in a richer anatomy-aware representation and leads to more accurate, effective and efficient retrieval, particularly for less prevalent findings. CheXtriv outperforms state-of-the-art global and local approaches by 18% to 26% in retrieval accuracy and 11% to 23% in ranking quality. The code is available at https://github.com/cvit-mip/chextriev.

Naren Akash, Arihanth Tadanki, Jayanthi Sivaswamy

Center for Visual Information Technology, International Institute of Information Technology Hyderabad, India

Medical Image Retrieval Medical Imaging Medical Image Representation Learning Fine-Grained Image Retrieval

Jul 30, 2026

CXR-Retrieve: Compositional Text-to-Image Retrieval in Chest Radiography

Large chest radiography archives are difficult to search because most studies are paired only with free-text reports rather than structured clinical annotations. Vision-language models offer a natural interface for text-to-image retrieval, but current biomedical models are primarily optimized for report-to-image matching rather than for satisfying short clinical search queries. This creates an objective mismatch: a model may retrieve images related to words in the query while failing to satisfy the full clinical constraint, especially for conjunctions and negations such as ``atelectasis and no pneumonia.'' We introduce CXR-Retrieve, a structured benchmark for compositional chest X-ray text-to-image retrieval. The benchmark contains 5,159 test images from the official test-split of MIMIC-CXR-JPG and 145 textual queries spanning single and conjunction findings, both positive and negative. Relevance is defined by whether a retrieved image satisfies all asserted pathology constraints, rather than by whether it matches a paired report. We further propose a label-aware contrastive fine-tuning objective for clinical retrieval. Our method attracts image-text pairs with compatible asserted pathology constraints, including shared confirmed absences, while explicitly repelling contradictory pairs. Starting from the in-domain CXR-CLIP checkpoint, our method improves Precision@5 over CXR-CLIP by 8.5 percentage points on two-pathology conjunctions and by 22.0 percentage points on negation queries. These results show that reliable chest X-ray retrieval requires training objectives that model not only which findings are mentioned, but also how they are clinically asserted.

Tomer Erez, Moshe Kimhi, Chaim Baskin +1

Technion – Israel Institute of Technology · Ben-Gurion University of the Negev

Contrastive Learning Medical Imaging Image-Text Retrieval Medical Image Benchmarks Medical Image Retrieval

Jul 21, 2026

Weakly Supervised Pathology-Informed Representation Learning for PET-Based Content Retrieval of Intra-Tumour Heterogeneity

We propose a weakly supervised 18FFDG PET representation-learning framework for content based medical image retrieval, using H&E derived information during training while preserving PET-only inference. The proposed method was designed to use H&E derived information during training while maintaining PET only inference. A teacher student training strategy was used to learn the PET tumour derived voxel representations, from which global and hotspot conditioned embeddings were generated along with maps of intra tumour heterogeneity in our oesophegeal cancer test case. A progressive ablation strategy was used to evaluate the contribution of different supervision mechanisms. Retrieval performance was assessed across cross-validation folds using metrics including mean average precision, normalised discounted cumulative gain and mean reciprocal rank. Additional analyses evaluated ablation performance, hotspot faithfulness through perturbation/deletion experiments, prototype-specific PET uptake behaviour and indirect patient level concordance between learned PET prototype classes and selected histomic features. Progressive introduction of pathology informed supervision and hotspot modelling improved PET retrieval performance compared with global PET representations and conventional PET baselines. Across the ablation ladder, PET hotspot conditioned representations consistently provided stronger retrieval than global embeddings, indicating that focusing on informative tumour subregions improved sensitivity to intra tumour heterogeneity. Histopathology concordance further showed that the learned classes were not simply high uptake PET regions; instead, they demonstrated distinct heterogeneity in 18F FDG uptake.

Rajat Vashistha, Sandra Brosda, Lauren G. Aoude +8

School of Human Movement and Nutrition Sciences, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Australia · 2Frazer Institute, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Australia · Department of Surgical Sciences, Uppsala University, Uppsala, Sweden. +2

Medical Image Retrieval Cross-Modal Representation Learning Oncology Medical Image Representation Learning

Jun 22, 2026

Evo-RAD: Navigating Rare Retinal Disease Diagnosis via Self-Evolving Agentic Retrieval

Large-scale pretrained foundation models have revolutionized general medical screening, but often falter on rare diseases because such conditions are underrepresented in real-world clinical datasets. While retrieval-augmented diagnosis attempts to mitigate this, conventional static methods frequently succumb to the hubness problem, retrieving visually similar but semantically incorrect common diseases. To address this, we propose Evo-RAD, a self-evolving agentic framework that transforms evidence acquisition into a dynamic decision-making task. We formulate retrieval as a Markov Decision Process (MDP) where a graphbased agent observes the reference set state and executes actions to purge discordant evidence (DELETE), acquire pathologically consistent samples (INSERT), or conclude the evolution (TERMINATE). Optimized via Group Relative Policy Optimization (GRPO) with a homogeneityaware reward, the agent learns to maximize the diagnostic homogeneity of the support reference set. Experiments on retinal disease benchmarks show that Evo-RAD substantially improves rare-disease diagnosis, outperforming retinal foundation models by +21.04%, while also surpassing retrieval-based and parameter-efficient fine-tuning methods by +3.56%. Code is available at https://github.com/SDH-Lab/Evo-RAD.

Wangding Xia, Ye Du, Jiashi Lin +3

Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China · School of Computer Science, Northwestern Polytechnical University, Xi’an, China · Centre for Innovation and Precision Eye Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore +3

Medical Image Retrieval Reinforcement Learning Rare Disease Diagnosis Medical Diagnosis Retinal Disease Classification

Jun 19, 2026

Graph-of-Differences: Anatomy-Structured Difference Alignment for Medical Image Re-Identification

Medical image re-identification (MedReID) enables longitudinal patient linkage but remains vulnerable to shortcut learning and often produces decisions that clinicians cannot audit against named anatomy. We propose Graph-of-Differences (GoD), which grounds identity comparisons in explicit anatomical structure. Each image is represented as an anatomy graph whose nodes correspond to named anatomical regions; given an image pair, soft node correspondence is established, and differences are computed over matched anatomy. A graph-level difference alignment objective ties these anatomy-matched differences to the global backbone difference, ensuring the retrieval signal is anchored in homologous structures rather than arbitrary spatial tokens. Explanations are defined over named graph nodes and quantitatively audited via node insertion/deletion tests, replacing unstable pixel heatmaps with verifiable structure-level evidence. On internal benchmarks, GoD improves Rank-1 by +7.1 pp on fundus and +3.1 pp on CXR over a strong frozen-backbone baseline, with further gains on zero-shot external transfers confirming that anatomy grounding improves both accuracy and generalization. Code is available at https://github.com/GenMI-Lab/GoD.git.

Nichula Wasalathilaka, Abhijit Das, Imran Razzak +1

Khalifa University, Abu Dhabi, UAE. · MBZUAI, Abu Dhabi, UAE. · MedOS, Abu Dhabi, UAE. +1

Graph Matching Image Matching Medical Image Analysis Person Re-Identification Medical Image Grounding Explainable Medical Image Analysis+1

Jun 4, 2026

A Vision-language Framework for Comparative Reasoning in Radiology

Medical imaging artificial intelligence has achieved strong performance in isolated image interpretation, but remains poorly aligned with radiological practice, where diagnosis and follow-up rely on comparison across prior studies and analogous reference cases. Here we formulate radiological comparison as an entity-aware cross-image reasoning problem and introduce a framework that supports both reference-case retrieval and temporal comparative interpretation. We construct MedReCo-DB, a large-scale comparative imaging resource derived from routine image-report pairs, comprising more than 690,000 images from over 160,000 patients across eight institutions, four countries and seven imaging modalities. Reports are decomposed into anatomical structures, abnormal findings and pathological conditions to provide supervision for entity-conditioned retrieval and comparative visual question answering. Using this resource, we develop MedReCo, an entity-aware visual encoder for controllable retrieval of clinically analogous cases, and MedReCo-VLM, a vision--language extension for generative interpretation of interval change. Across internal, external and cross-center evaluations, MedReCo achieved the highest Recall@1 in all 12 internal retrieval settings and improved external retrieval by a mean of 6.0 percentage points. In clinically confusable differential groups, it consistently outperformed the strongest baselines. MedReCo-VLM achieved the best performance across all comparative generation evaluations and improved longitudinal follow-up accuracy by 14.5-46.5 percentage points on chest radiographs and 13.0-27.9 percentage points on CT. These findings suggest that entity-aware comparative reasoning can be learned from routine clinical data at scale and may provide a more clinically aligned foundation for medical imaging AI.

Tengfei Zhang, Ziheng Zhao, Xiaoman Zhang +5

University of Science and Technology of China · 3Shanghai Artificial Intelligence Laboratory · School of Artificial Intelligence, Shanghai Jiao Tong University +3

Medical Image Retrieval Radiology VLMs Longitudinal Medical Image Analysis Medical Image Representation Learning Medical Image Benchmarks

Jun 1, 2026

Predicting the risk of colorectal anastomotic leak based on preoperative mapping of the blood supply of the bowel

Anastomotic leak remains one of the most serious complications following colorectal cancer surgery, substantially affecting patient outcomes, recovery trajectories, and healthcare costs. Despite advances in imaging technology, current preoperative assessment relies only on clinical assessment, a process that is subjective, error-prone, and highly dependent on individual expertise. To date, no validated CT-based method exists to predict anastomotic leak risk prior to surgery. This protocol paper outlines a comprehensive framework for developing and validating an AI-driven system for preoperative risk assessment using pre- and post-contrast CT imaging. The study describes the stages of data collection, ethical handling, and preprocessing of patient data in accordance with GDPR, image preprocessing, and the exploration of deep learning architectures designed to generate clinically interpretable outputs. Two integrated tools constitute the main deliverables of this workflow: 1) a risk assessment module, which quantifies the likelihood of leakage by analyzing vascular and tissue features in CT scans, and 2) a Content-Based Medical Image Retrieval (CBMIR) module, which identifies and displays similar historical cases to support evidence-based surgical decision making. The protocol paper requires close collaboration between hospitals and universities; this protocol demonstrates that such a system is technically feasible and clinically implementable within existing healthcare infrastructures. By following the proposed methodological stages and regulatory principles, other institutions can reproduce this workflow to develop analogous decision-support tools. Ultimately, this interdisciplinary framework aims to enhance surgical planning, reduce leak incidence, and contribute to a broader paradigm shift toward explainable, data-driven precision surgery.

Zahra Tabatabaei, Jon Sporring, Mark Bremholm Ellebæk +1

Computer Science Department, Københavns Universitet (KU), Copenhagen, Denmark. · Department of Clinical Research, University of Southern Denmark, Odense, Denmark. · Research Unit of Surgery, Odense University Hospital, Odense, Denmark. +1

Medical Image Retrieval Medical Image Analysis Clinical Outcome Prediction Clinical Risk Prediction

May 6, 2026

MIRAGE: Retrieval and Generation of Multimodal Images and Texts for Medical Education

Access to diverse, well-annotated medical images with interactive learning tools is fundamental for training practitioners in medicine and related fields to improve their diagnostic skills and understanding of anatomical structures. While medical atlases are valuable, they are often impractical due to their size and lack of interactivity, whereas online image search may provide mislabeled or incomplete material. To address this, we propose MIRAGE, a multimodal medical text and image retrieval and generation system that allows users to find and generate clinically relevant images from trustworthy sources by mapping both text and images to a shared latent space, enabling semantically meaningful queries. The system is based on a fine-tuned medical version of CLIP (MedICaT-ROCO), trained with the ROCO dataset, obtained from PubMed Central. MIRAGE allows users to give prompts to retrieve images, generate synthetic ones through a medical diffusion model (Prompt2MedImage) and receive enriched descriptions from a large language model (Dolly-v2-3b). It also supports a dual search option, enabling the visual comparison of different medical conditions. A key advantage of the system is that it relies entirely on publicly available pretrained models, ensuring reproducibility and accessibility. Our goal is to provide a free, transparent and easy-to-use didactic tool for medical students, especially those without programming skills. The system features an interface that enables interactive and personalized visual learning through medical image retrieval and generation. The system is accessible to medical students worldwide without requiring local computational resources or technical expertise, and is currently deployed on Kaggle: http://www-vpu.eps.uam.es/mirage

Miguel Diaz Benito, Cecilia Diana Albelda, Alvaro Garcia Martin +3

Universidad Autónoma de Madrid, 28049 Madrid, Spain

Multimodal IR Medical Education Medical Image Retrieval Educational Technology Medical VLMs

Mar 31, 2026

Assessing Multimodal Chronic Wound Embeddings with Expert Triplet Agreement

Recessive dystrophic epidermolysis bullosa (RDEB) is a rare genetic skin disorder for which clinicians greatly benefit from finding similar cases using images and clinical text. However, off-the-shelf foundation models do not reliably capture clinically meaningful features for this heterogeneous, long-tail disease, and structured measurement of agreement with experts is challenging. To address these gaps, we propose evaluating embedding spaces with expert ordinal comparisons (triplet judgments), which are fast to collect and encode implicit clinical similarity knowledge. We further introduce TriDerm, a multimodal framework that learns interpretable wound representations from small cohorts by integrating wound imagery, boundary masks, and expert reports. On the vision side, TriDerm adapts visual foundation models to RDEB using wound-level attention pooling and non-contrastive representation learning. For text, we prompt large language models with comparison queries and recover medically meaningful representations via soft ordinal embeddings (SOE). We show that visual and textual modalities capture complementary aspects of wound phenotype, and that fusing both modalities yields 73.5% agreement with experts, outperforming the best off-the-shelf single-modality foundation model by over 5.6 percentage points. We make the expert annotation tool, model code and representative dataset samples publicly available.

Fabian Kabus, Julia Hindel, Jelena Bratulić +6

Institute of Medical Biometry and Statistics (IMBI), Medical Faculty and Medical Center, University of Freiburg · Department of Computer Science, Faculty of Engineering, University of Freiburg · Department of Dermatology, Medical Faculty and Medical Center, University of Freiburg

Medical Image Retrieval Multimodal Embedding Dermatology Multimodal Model Evaluation

Mar 24, 2026

Sparse Autoencoders for Interpretable Medical Image Representation Learning

Vision foundation models (FMs) achieve state-of-the-art performance in medical imaging. However, they encode information in abstract latent representations that clinicians cannot interrogate or verify. The goal of this study is to investigate Sparse Autoencoders (SAEs) for replacing opaque FM image representations with human-interpretable, sparse features. We train SAEs on embeddings from BiomedParse (biomedical) and DINOv3 (general-purpose) using 909,873 CT and MRI 2D image slices from the TotalSegmentator dataset. We find that learned sparse features: (a) reconstruct original embeddings with high fidelity (R2 up to 0.941) and recover up to 87.8% of downstream performance using only 10 features (99.4% dimensionality reduction), (b) preserve semantic fidelity in image retrieval tasks, (c) correspond to specific concepts that can be expressed in language using large language model (LLM)-based auto-interpretation. (d) bridge clinical language and abstract latent representations in zero-shot language-driven image retrieval. Our work indicates SAEs are a promising pathway towards interpretable, concept-driven medical vision systems. Code repository: https://github.com/pwesp/sail.

Philipp Wesp, Robbie Holland, Vasiliki Sideri-Lampretsa +1

Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University, Stanford, CA, USA · Department of Radiology, Stanford University, Stanford, CA, USA · Chair of AI in Healthcare and Medicine, Technical University of Munich, Munich, Germany +1

Medical Image Retrieval Explainable Medical Image Analysis Medical Image Representation Learning Sparse Autoencoders Medical Imaging Foundation Models

Mar 17, 2026

HMAR: Hierarchical Modality-Aware Expert and Dynamic Routing Medical Image Retrieval Architecture

Medical image retrieval (MIR) is a critical component of computer-aided diagnosis, yet existing systems suffer from three persistent limitations: uniform feature encoding that fails to account for the varying clinical importance of anatomical structures, ambiguous similarity metrics based on coarse classification labels, and an exclusive focus on global image similarity that cannot meet the clinical demand for fine-grained region-specific retrieval. We propose HMAR (Hierarchical Modality-Aware Expert and Dynamic Routing), an adaptive retrieval framework built on a Mixture-of-Experts (MoE) architecture. HMAR employs a dual-expert mechanism: Expert0 extracts global features for holistic similarity matching, while Expert1 learns position-invariant local representations for precise lesion-region retrieval. A two-stage contrastive learning strategy eliminates the need for expensive bounding-box annotations, and a sliding-window matching algorithm enables dense local comparison at inference time. Hash codes are generated via Kolmogorov-Arnold Network (KAN) layers for efficient Hamming-distance search. Experiments on the RadioImageNet-CT dataset (16 clinical patterns, 29,903 images) show that HMAR achieves mean Average Precision (mAP) of 0.711 and 0.724 for 64-bit and 128-bit hash codes, improving over the state-of-the-art ACIR method by 0.7% and 1.1%, respectively.

Aojie Yuan

Shanghai Jiao Tong University

Medical Image Retrieval Image Retrieval Fine-Grained Image Retrieval

Mar 10, 2026

Composed Vision-Language Retrieval for Skin Cancer Case Search via Joint Alignment of Global and Local Representations

Medical image retrieval aims to identify clinically relevant lesion cases to support diagnostic decision making, education, and quality control. In practice, retrieval queries often combine a reference lesion image with textual descriptors such as dermoscopic features. We study composed vision-language retrieval for skin cancer, where each query consists of an image to text pair and the database contains biopsy-confirmed, multi-class disease cases. We propose a transformer based framework that learns hierarchical composed query representations and performs joint global-local alignment between queries and candidate images. Local alignment aggregates discriminative regions via multiple spatial attention masks, while global alignment provides holistic semantic supervision. The final similarity is computed through a convex, domain-informed weighting that emphasizes clinically salient local evidence while preserving global consistency. Experiments on the public Derm7pt dataset demonstrate consistent improvements over state-of-the-art methods. The proposed framework enables efficient access to relevant medical records and supports practical clinical deployment.

Yuheng Wang, Yuji Lin, Jiayue Cai +2

Medical Image Retrieval Image Retrieval Composed Image Retrieval Dermatology

Mar 2, 2026

Learning to Read Where to Look: Disease-Aware Vision-Language Pretraining for 3D CT

Recent 3D CT vision-language models align volumes with reports via contrastive pretraining, but typically rely on limited public data and provide only coarse global supervision. We train a 3D CT vision-language model on 98k report-volume pairs (50k patients) collected at a single hospital, combined with public datasets, using SigLIP-style contrastive pretraining together with prompt-based disease supervision in the shared vision-text embedding space. On CT-RATE, our model achieves state-of-the-art text-to-image retrieval (R@10 31.5 vs. 22.2) and competitive disease classification (AUC 83.8 vs. 83.8), with consistent results on Rad-ChestCT (AUC 77.0 vs. 77.3). We further observe that radiologists routinely reference specific images within their reports (e.g., ``series X, image Y''), linking textual descriptions to precise axial locations. We automatically mine 262k such snippet-slice pairs and introduce the task of intra-scan snippet localization -- predicting the axial depth referred to by a text snippet -- reducing mean absolute error to 36.3 mm at 12 mm feature resolution, compared with 67.0 mm for the best baseline. Adding this localization objective leaves retrieval and classification broadly unchanged within confidence bounds, yielding a single unified model for retrieval, classification, and intra-scan grounding.

Simon Ging, Philipp Arnold, Sebastian Walter +6

Computer Vision Group, University of Freiburg, Germany · Adaptive & Agentic AI · Adaptive & Agentic AI (A3) Lab, Aarhus University, Denmark +5

Medical Image Retrieval Medical VLMs 3D VLMs Medical Image Localization Medical Image Classification

Oct 27, 2025

Accurate and Scalable Multimodal Pathology Retrieval via Attentive Vision-Language Alignment

The rapid digitization of histopathology slides has opened new opportunities for computational tools in clinical and research workflows. Content-based slide retrieval can help pathologists identify morphologically and semantically related precedent cases, supporting expert diagnosis and example-based education. Effective retrieval of whole-slide images (WSIs), however, remains challenging because gigapixel slides contain abundant irrelevant content, focal diagnostic patterns and slide-level semantic information that must be represented at a practicable search cost. Here we present PathSearch, a retrieval framework that combines fine-grained attentive mosaics with slide-level embeddings aligned through vision-language contrastive learning. Trained on 6,926 slide-report pairs, PathSearch captures both fine-grained morphological cues and high-level semantic patterns to enable accurate and flexible retrieval. The framework supports two key functionalities: (1) mosaic-based image-to-image (I2I) retrieval, ensuring accurate and efficient slide search; and (2) multimodal retrieval, where text queries can directly retrieve relevant slides. PathSearch was evaluated on eight tasks comprising 5,021 evaluation slides, spanning malignancy assessment on frozen and hematoxylin and eosin (H&E)-stained slides, lymph-node metastasis detection, tumor subtyping, mixed-gallery rare-cancer retrieval, and hepatocellular carcinoma (HCC) risk stratification. Internal and external experimental results demonstrate that PathSearch consistently outperforms the strongest existing methods without compromising multimodal accuracy. A multi-center reader study further demonstrated increases in task-level mean diagnostic accuracy, confidence, and inter-observer agreement with PathSearch's support. Together, these results support the effectiveness of PathSearch across diverse retrieval tasks and evaluation settings.

Hongyi Wang, Zhengjie Zhu, Junlin Hou +13

Department of Computer Science and Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR, China · College of Computer Science and Technology, Zhejiang University, Hangzhou, China. · School of Medicine, Wake Forest University, Winston-Salem, NC, USA. +11

Multimodal IR Computational Pathology Image-Text Retrieval Medical Image Retrieval