Medical Image Segmentation

Medical image segmentation faces fundamental challenges including restricted access, costly annotation, and data shortage to clinical datasets through Picture Archiving and Communication Systems (PACS). These systemic barriers significantly impede the development of robust segmentation algorithms. To address these challenges, we propose FOSCU, which integrates Duo-Diffusion, a 3D latent diffusion model with ControlNet that simultaneously generates high-resolution, anatomically realistic synthetic MRI volumes and corresponding segmentation labels, and an enhanced 3D U-Net training pipeline. Duo-Diffusion employs segmentation-conditioned diffusion to ensure spatial consistency and precise anatomical detail in the generated data. Experimental evaluation on 720 abdominal MRI scans shows that models trained with combined real and synthetic data yield a mean Dice score gain of 0.67% over those using only real data, and achieve a 36.4% reduction in Fréchet Inception Distance (FID), reflecting enhanced image fidelity.

Accurate segmentation of brain tissues such as gray matter and white matter from magnetic resonance imaging is essential for studying brain anatomy, diagnosing neurological disorders, and monitoring disease progression. Traditional methods, such as FSL FAST, produce tissue probability maps but often require task-specific adjustments and face challenges with diverse imaging conditions. Recent foundation models, such as MedSAM, offer a prompt-based approach that leverages large-scale pretraining. In this paper, we propose a modified MedSAM model designed for multi-class brain tissue segmentation. Our preprocessing pipeline includes skull stripping with FSL BET, tissue probability mapping with FSL FAST, and converting these into 2D axial, sagittal, coronal slices with multi-class labels (background, gray matter, and white matter). We extend MedSAM's mask decoder to three classes, freezing the pre-trained image encoder and fine-tuning the prompt encoder and decoder. Experiments on the IXI dataset achieve Dice scores up to 0.8751. This work demonstrates that foundation models like MedSAM can be adapted for multi-class medical image segmentation with minimal architectural modifications. Our findings suggest that such models can be extended to more diverse medical imaging scenarios in future work.

Identification and quantification of myocardial scar is important for diagnosis and prognosis of cardiovascular diseases. However, reliable scar segmentation from Late Gadolinium Enhancement Cardiac Magnetic Resonance (LGE-CMR) images remains a challenge due to variations in contrast enhancement across patients, suboptimal imaging conditions such as post contrast washout, and inconsistencies in ground truth annotations on diffuse scars caused by inter observer variability. In this work, we propose a curriculum learning-based framework designed to improve segmentation performance under these challenging conditions. The method introduces a progressive training strategy that guides the model from high-confidence, clearly defined scar regions to low confidence or visually ambiguous samples with limited scar burden. By structuring the learning process in this manner, the network develops robustness to uncertain labels and subtle scar appearances that are often underrepresented in conventional training pipelines. Experimental results show that the proposed approach enhances segmentation accuracy and consistency, particularly for cases with minimal or diffuse scar, outperforming standard training baselines. This strategy provides a principled way to leverage imperfect data for improved myocardial scar quantification in clinical applications. Our code is publicly available on GitHub.

Domain generalization in fundus imaging is challenging due to variations in acquisition conditions across devices and clinical settings. The inability to adapt to these variations causes performance degradation on unseen domains for deep learning models. Besides, obtaining annotated data across domains is often expensive and privacy constraints restricts their availability. Although single-source domain generalization (SDG) offers a realistic solution to this problem, the existing approaches frequently fail to capture anatomical topology or decouple appearance from anatomical features. This research introduces WaveSDG, a new wavelet-guided segmentation network for SDG. It decouples anatomical structure from domain-specific appearance through a wavelet sub-band decomposition. A novel Wavelet-based Invariant Structure Extraction and Refinement (WISER) module is proposed to process encoder features by leveraging distinct semantic roles of each wavelet sub-band. The module refines low-frequency components to anchor global anatomy, while selectively enhancing directional edges and suppressing noise within the high-frequency sub-bands. Extensive ablation studies validate the effectiveness of the WISER module and its decoupling strategy. Our evaluations on optic cup and optic disc segmentation across one source and five unseen target datasets show that WaveSDG consistently outperforms seven state-of-the-art methods. Notably, it achieves the best balanced Dice score and lowest 95th percentile Hausdorff distance with reduced variance, indicating improved accuracy, robustness, and cross-domain stability.

Despite there now being more than 1,000 FDA-authorised AI medical devices, formal equity assessments -- whether model performance is uniform across patient subgroups -- are rare. Here, we evaluate the equity of 18 open-source brain tumour segmentation models across 648 glioma patients from two independent datasets (n = 11,664 model inferences) along distinct univariate, Bayesian multivariate, spatial, and representational dimensions. We find that patient identity consistently explains more performance variance than model choice, with clinical factors, including molecular diagnosis, tumour grade, and extent of resection, predicting segmentation accuracy more strongly than model architecture. A voxel-wise spatial meta-analysis identifies neuroanatomically localised biases that are compartment-specific yet often consistent across models. Within a high-dimensional latent space of lesion masks and clinic-demographic features, model performance clusters significantly, indicating that the patient feature space contains axes of algorithmic vulnerability. Although newer models tend toward greater equity, none provide a formal fairness guarantee. Lastly, we release Fairboard, an open-source, no-code dashboard that lowers barriers to equitable model monitoring in medical imaging.

Few-shot medical image segmentation (FSMIS) has achieved notable progress, yet most existing methods mainly rely on semantic correspondences from scarce annotations while under-utilizing a key property of medical imagery: anatomical targets exhibit repeatable high-frequency morphology (e.g., boundary geometry and spatial layout) across patients and acquisitions. We propose RAP, a training-free framework that retrieves, adapts, and prompts Segment Anything Model 2 (SAM2) for FSMIS. First, RAP retrieves morphologically compatible supports from an archive using DINOv3 features to reduce brittleness in single-support choice. Second, it adapts the retrieved support mask to the query by fitting boundary-aware structural cues, yielding an anatomy-consistent pre-mask under domain shifts. Third, RAP converts the pre-mask into prompts by sampling positive points via Voronoi partitioning and negative points via sector-based sampling, and feeds them into SAM2 for final refinement without any fine-tuning. Extensive experiments on multiple medical segmentation benchmarks show that RAP consistently surpasses prior FSMIS baselines and achieves state-of-the-art performance. Overall, RAP demonstrates that explicit structural fitting combined with retrieval-augmented prompting offers a simple and effective route to robust training-free few-shot medical segmentation.

Accurate wound classification (WC) and boundary segmentation are essential for guiding clinical decisions in chronic and acute wound management. However, most existing artificial intelligence (AI) models are limited, focusing on a narrow set of wound types, limited variations in wound severity, or a single task (segmentation or classification), which reduces their clinical applicability. This study presents two dedicated instance segmentation models based on You Only Look Once (YOLO)v11 that perform wound boundary segmentation (WBS) and WC across five clinically relevant wound types: burn injury (BI), pressure injury, diabetic foot ulcer, vascular ulcer, and surgical wound. A wound-type balanced dataset of 2,963 annotated images was created to train the models for both tasks, using five-fold cross-validation. Models trained on the original, non-augmented dataset performed consistently across folds, though BI detection accuracy was relatively low; augmenting the dataset with rotation, flipping, and variations in brightness, saturation, and exposure significantly improved performance, particularly for visually subtle BI cases. Among the tested variants, YOLOv11x achieved the best WBS performance (F1-score: 0.9341; mAP50: 0.9629). For WC, YOLOv11m achieved the highest mAP50 (0.9194) and mAP50-95 (0.6950), whereas YOLOv11l achieved the highest F1-score (0.8797). The lightweight YOLOv11n provided comparable accuracy at lower computational cost, making it suitable for resource-constrained deployments. Supported by confusion matrices and visual detection outputs, the results confirm robustness against complex backgrounds and high intra-class variability, demonstrating the potential of YOLOv11-based architectures for accurate, real-time wound analysis in clinical and remote care settings.

In the field of Large Language Models (LLMs), Attention Residuals have recently demonstrated that learned, selective aggregation over all preceding layer outputs can outperform fixed residual connections. We propose Cross-Stage Attention Residuals (XAttnRes), a mechanism that maintains a global feature history pool accumulating both encoder and decoder stage outputs. Through lightweight pseudo-query attention, each stage selectively aggregates from all preceding representations. To bridge the gap between the same-dimensional Transformer layers in LLMs and the multi-scale encoder-decoder stages in segmentation networks, XAttnRes introduces spatial alignment and channel projection steps that handle cross-resolution features with negligible overhead. When added to existing segmentation networks, XAttnRes consistently improves performance across four datasets and three imaging modalities. We further observe that XAttnRes alone, even without skip connections, achieves performance on par with the baseline, suggesting that learned aggregation can recover the inter-stage information flow traditionally provided by predetermined connections.

Multi-organ segmentation in medical imaging remains challenging due to large anatomical variability, complex inter-organ dependencies, and diverse organ scales and shapes. Conventional encoder-decoder architectures often struggle to capture both fine-grained local details and long-range context, which are crucial for accurate delineation - especially for small or deformable organs. To address these limitations, we propose MD-RWKV-UNet, a dynamic encoder network that enables scale-aware representation and spatially adaptive context modeling. At its core is the MD-RWKV block, a dual-path module that integrates deformable spatial shifts with the Receptance Weighted Key Value mechanism, allowing the receptive field to adapt dynamically to local structural cues. We further incorporate Selective Kernel Attention to enable adaptive selection of convolutional kernels with varying receptive fields, enhancing multi-scale interaction and improving robustness to organ size and shape variation. In parallel, a cross-stage dual-attention fusion strategy aggregates multi-level features across the encoder, preserving low-level structure while enhancing semantic consistency. Unlike methods that stack static convolutions or rely heavily on global attention, our approach provides a lightweight yet expressive solution for dynamic organ modeling. Experiments on Synapse and ACDC demonstrate state-of-the-art performance, particularly in boundary precision and small-organ segmentation.

Lesion detection, symptom tracking, and visual explainability are central to real-world medical image analysis, yet current medical Vision-Language Models (VLMs) still lack mechanisms that translate their broad knowledge into clinically actionable outputs. To bridge this gap, we present MEDIC-AD, a clinically oriented VLM that strengthens these three capabilities through a stage-wise framework. First, learnable anomaly-aware tokens (<Ano>) encourage the model to focus on abnormal regions and build more discriminative lesion centered representations. Second, inter image difference tokens (<Diff>) explicitly encode temporal changes between studies, allowing the model to distinguish worsening, improvement, and stability in disease burden. Finally, a dedicated explainability stage trains the model to generate heatmaps that highlight lesion-related regions, offering clear visual evidence that is consistent with the model's reasoning. Through our staged design, MEDIC-AD steadily boosts performance across anomaly detection, symptom tracking, and anomaly segmentation, achieving state-of-the-art results compared with both closed source and medical-specialized baselines. Evaluations on real longitudinal clinical data collected from real hospital workflows further show that MEDIC-AD delivers stable predictions and clinically faithful explanations in practical patient-monitoring and decision-support workflows

Cardiac MRI late gadolinium enhancement (LGE) enables non-invasive identification of left atrial (LA) scar, whose spatial distribution is strongly associated with atrial fibrillation (AF) severity and recurrence. However, automatic LA scar segmentation remains challenging due to low contrast, annotation variability, and the lack of anatomical constraints, often leading to non-reliable predictions. Accordingly, our aim was to propose a progressive learning strategy to segment LA scar from LGE images inspired from a clinical workflow. A 3-stage framework based on SwinUNETR was implemented, comprising: 1) a first LA cavity pre-learning model, 2) dual-task model which further learns spatial relationship between LA geometry and scar patterns, and 3) fine-tuning on precise segmentation of the scar. Furthermore, we introduced an anatomy-aware spatially weighted loss that incorporates prior clinical knowledge by constraining scar predictions to anatomically plausible LA wall regions while mitigating annotation bias. Our preliminary results obtained on validation LGE volumes from LASCARQS public dataset after 5-fold cross validation, LA segmentation had Dice score of 0.94, LA scar segmentation achieved Dice score of 0.50, Hausdorff Distance of 11.84 mm, Average Surface Distance of 1.80 mm, outperforming only a one-stage scar segmentation with 0.49, 13.02 mm, 1.96 mm, repectively. By explicitly embedding clinical anatomical priors and diagnostic reasoning into deep learning, the proposed approach improved the accuracy and reliability of LA scar segmentation from LGE, revealing the importance of clinically informed model design.

Type A Aortic Dissection (TAAD) is a life-threatening cardiovascular emergency that demands rapid and precise preoperative evaluation. While key anatomical and pathological features are decisive for surgical planning, current research focuses predominantly on improving segmentation accuracy, leaving the reliable, quantitative extraction of clinically actionable features largely under-explored. Furthermore, constructing comprehensive TAAD datasets requires labor-intensive, expert level pixel-wise annotations, which is impractical for most clinical institutions. Due to significant domain shift, models trained on a single center dataset also suffer from severe performance degradation during cross-institutional deployment. This study addresses a clinically critical challenge: the accurate extraction of key TAAD clinical features during cross-institutional deployment in the total absence of target-domain annotations. To this end, we propose an unsupervised domain adaptation (UDA)-driven framework for the automated extraction of TAAD clinical features. The framework leverages limited source-domain labels while effectively adapting to unlabeled data from target domains. Tailored for real-world emergency workflows, our framework aims to achieve stable cross-institutional multi-class segmentation, reliable and quantifiable clinical feature extraction, and practical deployability independent of high-cost annotations. Extensive experiments demonstrate that our method significantly improves cross-domain segmentation performance compared to existing state-of-the-art approaches. More importantly, a reader study involving multiple cardiovascular surgeons confirms that the automatically extracted clinical features provide meaningful assistance for preoperative assessment, highlighting the practical utility of the proposed end-to-end segmentation-to-feature pipeline.

Accurate lesion segmentation is essential in medical image analysis, yet most existing methods are designed for specific anatomical sites or imaging modalities, limiting their generalizability. Recent vision-language foundation models enable concept-driven segmentation in natural images, offering a promising direction for more flexible medical image analysis. However, concept-prompt-based lesion segmentation, particularly with the latest Segment Anything Model 3 (SAM3), remains underexplored. In this work, we present a systematic evaluation of SAM3 for lesion segmentation. We assess its performance using geometric bounding boxes and concept-based text and image prompts across multiple modalities, including multiparametric MRI, CT, ultrasound, dermoscopy, and endoscopy. To improve robustness, we incorporate additional prior knowledge, such as adjacent-slice predictions, multiparametric information, and prior annotations. We further compare different fine-tuning strategies, including partial module tuning, adapter-based methods, and full-model optimization. Experiments on 13 datasets covering 11 lesion types demonstrate that SAM3 achieves strong cross-modality generalization, reliable concept-driven segmentation, and accurate lesion delineation. These results highlight the potential of concept-based foundation models for scalable and practical medical image segmentation. Code and trained models will be released at: https://github.com/apple1986/lesion-sam3

Accurate segmentation of the left atrial (LA) wall in 3D late gadolinium-enhanced MRI (LGE-MRI) is essential for wall thickness mapping and fibrosis quantification, yet it remains challenging due to the wall's thin geometry, complex anatomy, and low contrast. We propose C2W-Tune, a two-stage cavity-to-wall transfer framework that leverages a high-accuracy LA cavity model as an anatomical prior to improve thin-wall delineation. Using a 3D U-Net with a ResNeXt encoder and instance normalization, Stage 1 pre-trains the network to segment the LA cavity, learning robust atrial representations. Stage 2 transfers these weights and adapts the network to LA wall segmentation using a progressive layer-unfreezing schedule to preserve cavity features while enabling wall-specific refinement. On the 2018 LA Segmentation Challenge dataset, C2W-Tune outperformed an architecture-matched baseline trained from scratch. The wall Dice score increased from 0.623 to 0.814, surface Dice at 1 mm increased from 0.553 to 0.731, 95th-percentile Hausdorff distance (HD95) decreased from 2.95 mm to 2.55 mm, and average symmetric surface distance (ASSD) decreased from 0.71 mm to 0.63 mm. Under reduced supervision using 70 training volumes sampled from the same training set, C2W-Tune achieved a Dice of 0.78, remaining competitive with recent multi-class bi-atrial benchmarks, typically 0.6-0.7. These results show that anatomically grounded task transfer with controlled fine-tuning improves accuracy for thin LA wall segmentation in 3D LGE-MRI.

Segmenting the left atrial (LA) wall from late gadolinium enhancement magnetic resonance imaging (LGE-MRI) is challenging because of its thin geometry, low contrast, and limited expert annotations. We propose a model-agnostic meta-learning (MAML) framework with a 3D residual U-Net backbone for K-shot (K = 5, 10, 20) LA wall segmentation. The framework is meta-trained on LA wall tasks together with auxiliary LA and right atrial (RA) cavity tasks and uses a boundary-aware composite loss to improve thin-structure delineation. We evaluated MAML on a held-out clean test set and assessed its robustness under an unseen synthetic domain shift and on a local cohort. On the held-out clean test set, MAML outperformed the K-shot fine-tuning baseline at 5-shot, achieving Dice coefficient (DSC) = 0.54 versus 0.48 and Hausdorff distance (HD95) = 4.60 versus 6.40 mm. At 20-shot, MAML approached the fully supervised model trained from scratch, with DSC = 0.59 versus 0.61. Under unseen shifts, performance decreased relative to clean testing but improved consistently as K increased. At 5-shot, MAML achieved DSC = 0.52 and HD95 = 5.02 mm under the unseen synthetic shift, and DSC = 0.50 and HD95 = 5.43 mm on the local cohort. These results suggest that meta-learning can improve thin-wall delineation in low-shot adaptation and may reduce the annotation burden for atrial remodeling assessment.

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.

Computed tomography image segmentation of complex abdominal aortic aneurysms (AAA) often fails because the models assign internal focus to irrelevant structures or do not focus on thin, low-contrast targets. Where the model looks is the primary training signal, and thus we propose an Explainable AI (XAI) guided encoder shaping framework. Our method computes a dense, attribution-based encoder focus map ("XAI field") from the final encoder block and uses it in two complementary ways: (i) we align the predicted probability mass to the XAI field to promote agreement between focus and output; and (ii) we route the field into a lightweight refinement pathway and a confidence prior that modulates logits at inference, suppressing distractors while preserving subtle structures. The objective terms serve only as control signals; the contribution is the integration of attribution guidance into representation and decoding. We evaluate clinically validated challenging cases curated for failure-prone scenarios. Compared to a base SAM setup, our implementation yields substantial improvements. The observed gains suggest that explicitly optimizing encoder focus via XAI guidance is a practical and effective principle for reliable segmentation in complex scenarios.

For accurate glaucoma diagnosis and monitoring, reliable retinal layer segmentation in OCT images is essential. However, existing 2D segmentation methods often suffer from slice-to-slice inconsistencies due to the lack of contextual information across adjacent B-scans. 3D segmentation methods are better for capturing slice-to-slice context, but they require expensive computational resources. To address these limitations, we propose a 2.5D segmentation framework that incorporates a novel cross-slice feature fusion (CFF) module into a U-Net-like architecture. The CFF module fuses inter-slice features to effectively capture contextual information, enabling consistent boundary detection across slices and improved robustness in noisy regions. The framework was validated on both a clinical dataset and the publicly available DUKE DME dataset. Compared to other segmentation methods without the CFF module, the proposed method achieved an 8.56% reduction in mean absolute distance and a 13.92% reduction in root mean square error, demonstrating improved segmentation accuracy and robustness. Overall, the proposed 2.5D framework balances contextual awareness and computational efficiency, enabling anatomically reliable retinal layer delineation for automated glaucoma evaluation and potential clinical applications.

Deep learning and generative models are advancing rapidly, with synthetic data increasingly being integrated into training pipelines for downstream analysis tasks. However, in medical imaging, their adoption remains constrained by the scarcity of reliable annotated datasets. To address this limitation, we propose 3D-LLDM, a label-guided 3D latent diffusion model that generates high-quality synthetic magnetic resonance (MR) volumes with corresponding anatomical segmentation masks. Our approach uses hepatobiliary phase MR images enhanced with the Gd-EOB-DTPA contrast agent to derive structural masks for the liver, portal vein, hepatic vein, and hepatocellular carcinoma, which then guide volumetric synthesis through a ControlNet-based architecture. Trained on 720 real clinical hepatobiliary phase MR scans from Samsung Medical Center, 3D-LLDM achieves a Fréchet Inception Distance (FID) of 28.31, improving over GANs by 70.9% and over state-of-the-art diffusion baselines by 26.7%. When used for data augmentation, the synthetic volumes improve hepatocellular carcinoma segmentation by up to 11.153% Dice score across five CNN architectures.

Segmenting fetal head structures from prenatal ultrasound remains a practical bottleneck in obstetric imaging. The current state-of-the-art baseline, proposed alongside the published dataset, adapts the Segment Anything Model with per-class Dice and Lovász losses but still depends on bounding-box prompts at test time. We build a prompt-free pipeline on top of YOLO26-Seg that jointly detects and segments three structures, Brain, Cavum Septi Pellucidi (CSP), and Lateral Ventricles (LV), in a single forward pass. Three modifications are central to our approach: (i) a composite BCE-Dice-Lovász segmentation loss with inverse-frequency class weighting, injected into the YOLO26 training loop via runtime monkey-patching; (ii) domain-guided copy-paste augmentation that transplants minority-class structures while respecting their anatomical location relative to the brain boundary; and (iii) inter-patient stratified splitting to prevent data leakage. On 575 held-out test images, the composite loss variant reaches a mean Dice coefficient of 0.9253, exceeding the baseline (0.9012) by 2.68 percentage points, despite reporting over three foreground classes only, whereas the baseline's reported mean includes the easy background class. We further ablate each component and discuss annotation-quality and class-imbalance effects on CSP and LV performance.

Unsupervised Domain Adaptation (UDA) is essential for deploying medical segmentation models across diverse clinical environments. Existing methods are fundamentally limited, suffering from semantically unaware feature alignment that results in poor distributional fidelity and from pseudo-label validation that disregards global anatomical constraints, thus failing to prevent the formation of globally implausible structures. To address these issues, we propose SHAPE (Structure-aware Hierarchical Unsupervised Domain Adaptation with Plausibility Evaluation), a framework that reframes adaptation towards global anatomical plausibility. Built on a DINOv3 foundation, its Hierarchical Feature Modulation (HFM) module first generates features with both high fidelity and class-awareness. This shifts the core challenge to robustly validating pseudo-labels. To augment conventional pixel-level validation, we introduce Hypergraph Plausibility Estimation (HPE), which leverages hypergraphs to assess the global anatomical plausibility that standard graphs cannot capture. This is complemented by Structural Anomaly Pruning (SAP) to purge remaining artifacts via cross-view stability. SHAPE significantly outperforms prior methods on cardiac and abdominal cross-modality benchmarks, achieving state-of-the-art average Dice scores of 90.08% (MRI->CT) and 78.51% (CT->MRI) on cardiac data, and 87.48% (MRI->CT) and 86.89% (CT->MRI) on abdominal data. The code is available at https://github.com/BioMedIA-repo/SHAPE.

Gastrointestinal (GI) tract image analysis plays a crucial role in medical diagnosis. This research addresses the challenge of accurately classifying and segmenting GI images for real-time applications, where traditional methods often struggle due to the diversity and complexity of abnormalities. The high computational demands of this domain require efficient and adaptable solutions. This PhD thesis presents a multifaceted approach to GI image analysis. Initially, texture-based feature extraction and classification methods were explored, achieving high processing speed (over 4000 FPS) and strong performance (F1-score: 0.76, Accuracy: 0.98) on the Kvasir V2 dataset. The study then transitions to deep learning, where an optimized model combined with data bagging techniques improved performance, reaching an accuracy of 0.92 and an F1-score of 0.60 on the HyperKvasir dataset, and an F1-score of 0.88 on Kvasir V2. To support real-time detection, a streamlined neural network integrating texture and local binary patterns was developed. By addressing inter-class similarity and intra-class variation through a learned threshold, the system achieved 41 FPS with high accuracy (0.99) and an F1-score of 0.91 on HyperKvasir. Additionally, two segmentation tools are proposed to enhance usability, leveraging Depth-Wise Separable Convolution and neural network ensembles for improved detection, particularly in low-FPS scenarios. Overall, this research introduces novel and adaptable methodologies, progressing from traditional texture-based techniques to deep learning and ensemble approaches, providing a comprehensive framework for advancing GI image analysis.

We present CataractSAM-2, a domain-adapted extension of Meta's Segment Anything Model 2, designed for real-time semantic segmentation of cataract ophthalmic surgery videos with high accuracy. Positioned at the intersection of computer vision and medical robotics, CataractSAM-2 enables precise intraoperative perception crucial for robotic-assisted and computer-guided surgical systems. Furthermore, to alleviate the burden of manual labeling, we introduce an interactive annotation framework that combines sparse prompts with video-based mask propagation. This tool significantly reduces annotation time and facilitates the scalable creation of high-quality ground-truth masks, accelerating dataset development for ocular anterior segment surgeries. We also demonstrate the model's strong zero-shot generalization to glaucoma trabeculectomy procedures, confirming its cross-procedural utility and potential for broader surgical applications. The trained model and annotation toolkit are released as open-source resources, establishing CataractSAM-2 as a foundation for expanding anterior ophthalmic surgical datasets and advancing real-time AI-driven solutions in medical robotics, as well as surgical video understanding.

We present HamVision, a framework for medical image analysis that uses the damped harmonic oscillator, a fundamental building block of signal processing, as a structured inductive bias for both segmentation and classification tasks. The oscillator's phase-space decomposition yields three functionally distinct representations: position~$q$ (feature content), momentum~$p$ (spatial gradients that encode boundary and texture information), and energy $H = \tfrac{1}{2}|z|^2$ (a parameter-free saliency map). These representations emerge from the dynamics, not from supervision, and can be exploited by different task-specific heads without any modification to the oscillator itself. For segmentation, energy gates the skip connections while momentum injects boundary information at every decoder level (HamSeg). For classification, the three representations are globally pooled and concatenated into a phase-space feature vector (HamCls). We evaluate HamVision across ten medical imaging benchmarks spanning five imaging modalities. On segmentation, HamSeg achieves state-of-the-art Dice scores on ISIC,2018 (89.38%), ISIC,2017 (88.40%), TN3K (87.05%), and ACDC (92.40%), outperforming most baselines with only 8.57M parameters. On classification, HamCls achieves state-of-the-art accuracy on BloodMNIST (98.85%) and PathMNIST (96.65%), and competitive results on the remaining MedMNIST datasets against MedMamba and MedViT. Diagnostic analysis confirms that the oscillator's momentum consistently encodes an interior$\,{>}\,$boundary$\,{>}\,$exterior gradient for segmentation and that the energy map correlates with discriminative regions for classification, properties that emerge entirely from the Hamiltonian dynamics. Code is available at https://github.com/Minds-R-Lab/hamvision.

Accurate brain tumor segmentation from MRI scans is critical for diagnosis and treatment planning. Despite the strong performance of recent deep learning approaches, two fundamental limitations remain: (1) the lack of reliable uncertainty quantification in single-model predictions, which is essential for clinical deployment because the level of uncertainty may impact treatment decision-making, and (2) the under-utilization of rich information in radiology reports that can guide segmentation in ambiguous regions. In this paper, we propose the Disagreement-Guided Refinement Network (DGRNet), a novel framework that addresses both limitations through multi-view disagreement-based uncertainty estimation and text-conditioned refinement. DGRNet generates diverse predictions via four lightweight view-specific adapters attached to a shared encoder-decoder, enabling efficient uncertainty quantification within a single forward pass. Afterward, we build disagreement maps to identify regions of high segmentation uncertainty, which are then selectively refined according to clinical reports. Moreover, we introduce a diversity-preserving training strategy that combines pairwise similarity penalties and gradient isolation to prevent view collapse. The experimental results on the TextBraTS dataset show that DGRNet favorably improves state-of-the-art segmentation accuracy by 2.4% and 11% in main metrics Dice and HD95, respectively, while providing meaningful uncertainty estimates.

Brain tumor segmentation remains challenging because the three standard sub-regions, i.e., whole tumor (WT), tumor core (TC), and enhancing tumor (ET), often exhibit ambiguous visual boundaries. Integrating radiological description texts with imaging has shown promise. However, most multimodal approaches typically compress a report into a single global text embedding shared across all sub-regions, overlooking their distinct clinical characteristics. We propose TextCSP (text-modulated soft cascade architecture), a hierarchical text-guided framework that builds on the TextBraTS baseline with three novel components: (1) a text-modulated soft cascade decoder that predicts WT->TC->ET in a coarse-to-fine manner consistent with their anatomical containment hierarchy. (2) sub-region-aware prompt tuning, which uses learnable soft prompts with a LoRA-adapted BioBERT encoder to generate specialized text representations tailored for each sub-region; (3) text-semantic channel modulators that convert the aforementioned representations into channel-wise refinement signals, enabling the decoder to emphasize features aligned with clinically described patterns. Experiments on the TextBraTS dataset demonstrate consistent improvements across all sub-regions against state-of-the-art methods by 1.7% and 6% on the main metrics Dice and HD95.

Semantic segmentation consists of assigning a semantic label to each pixel according to predefined classes. This process facilitates the understanding of object appearance and spatial relationships, playing an important role in the global interpretation of image content. Although modern deep learning approaches achieve high accuracy, they often ignore ordinal relationships among classes, which may encode important domain knowledge for scene interpretation. In this work, loss functions that incorporate ordinal relationships into deep neural networks are investigated to promote greater semantic consistency in semantic segmentation tasks. These loss functions are categorized as unimodal, quasi-unimodal, and spatial. Unimodal losses constrain the predicted probability distribution according to the class ordering, while quasi-unimodal losses relax this constraint by allowing small variations while preserving ordinal coherence. Spatial losses penalize semantic inconsistencies between neighboring pixels, encouraging smoother transitions in the image space. In particular, this study adapts loss functions originally proposed for ordinal classification to ordinal semantic segmentation. Among them, the Expanded Mean Squared Error (EXP_MSE), the Quasi-Unimodal Loss (QUL), and the spatial Contact Surface Loss using Signal Distance Function (CSSDF) are investigated. These approaches have shown promising results in medical imaging, improving robustness, generalization, and anatomical consistency.

Automatic tooth segmentation and identification from intra-oral scanned 3D models are fundamental problems in digital dentistry, yet most existing approaches rely on task-specific 3D neural networks trained with densely annotated datasets, resulting in high annotation cost and limited generalization to scans from unseen sources. Thus, we propose TSegAgent, which addresses these challenges by reformulating dental analysis as a zero-shot geometric reasoning problem rather than a purely data-driven recognition task. The key idea is to combine the representational capacity of general-purpose foundation models with explicit geometric inductive biases derived from dental anatomy. Instead of learning dental-specific features, the proposed framework leverages multi-view visual abstraction and geometry-grounded reasoning to infer tooth instances and identities without task-specific training. By explicitly encoding structural constraints such as dental arch organization and volumetric relationships, the method reduces uncertainty in ambiguous cases and mitigates overfitting to particular shape distributions. Experimental results demonstrate that this reasoning-oriented formulation enables accurate and reliable tooth segmentation and identification with low computational and annotation cost, while exhibiting strong generalization across diverse and previously unseen dental scans.

Recently Mamba-based methods have shown promise in abdominal organ segmentation. However, existing approaches neglect cross-channel anatomical semantic collaboration and lack explicit boundary-aware feature fusion mechanisms. To address these limitations, we propose CS-MUNet with two purpose-built modules. The Boundary-Aware State Mamba module employs a Bayesian-attention framework to generate pixel-level boundary posterior maps, injected directly into Mamba's core scan parameters to embed boundary awareness into the SSM state transition mechanism, while dual-branch weight allocation enables complementary modulation between global and local structural representations. The Channel Mamba State Aggregation module redefines the channel dimension as the SSM sequence dimension to explicitly model cross-channel anatomical semantic collaboration in a data-driven manner. Experiments on two public benchmarks demonstrate that CS-MUNet consistently outperforms state-of-the-art methods across multiple metrics, establishing a new SSM modeling paradigm that jointly addresses channel semantic collaboration and boundary-aware feature fusion for abdominal multi-organ segmentation.

Accurate multi-organ segmentation in abdominal CT scans is essential for computer-aided diagnosis and treatment. While convolutional neural networks (CNNs) have long been the standard approach in medical image segmentation, transformer-based architectures have recently gained attention due to their ability to model long-range dependencies. In this study, we systematically benchmark the three hybrid transformer-based models UNETR, SwinUNETR, and UNETR++ against a strong CNN baseline, SegResNet, for volumetric multi-organ segmentation on the heterogeneous RATIC dataset. The dataset comprises 206 annotated CT scans from 23 institutions worldwide, covering five abdominal organs. All models were trained and evaluated under identical preprocessing and training conditions using the Dice Similarity Coefficient (DSC) as the primary metric. The results show that the CNN-based SegResNet achieves the highest overall performance, outperforming all hybrid transformer-based models across all organs. Among the transformer-based approaches, UNETR++ delivers the most competitive results, while UNETR demonstrates notably faster convergence with fewer training iterations. These findings suggest that, for small- to medium-sized heterogeneous datasets, well-optimized CNN architectures remain highly competitive and may outperform hybrid transformer-based designs.