Medical Images

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6 papers in the last four weeks, down 40% on the four weeks before. 0.1% of all new papers.

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Latest papers 78

Oct 1, 2026cs.CV

PhaseAT: Fourier Phase Adversarial Training for Medical Image Domain Generalization

Reliable clinical deployment of deep medical image models is hindered by distribution shifts across scanners, sites, and acquisition protocols. Existing domain generalization (DG) methods often focus on style or intensity diversification, but they can still leave networks dependent on domain-specific texture correlations. Inspired by evidence that Fourier phase encodes semantic structure, we introduce PhaseAT, a phase-aware adversarial training framework for medical DG. PhaseAT forms phase-perturbed training views in the Fourier domain by iteratively updating a bounded phase perturbation while keeping the amplitude spectrum unchanged, thereby stressing spatial organization under matched appearance statistics. Perturbations are applied only to the luminance channel in YCbCr color space to avoid chromatic artifacts. Additionally, a simple phase-saliency mask concentrates updates on the most influential frequencies. The model is trained with a weighted combination of losses on clean and phase-perturbed samples, supporting both single-source and multi-source DG. We validate our method on two challenging medical datasets and demonstrate that PhaseAT achieves over 20% improvement in single-source domain generalization, outperforming several state-of-the-art DG methods. The code implementation is available at: https://github.com/ahmed-sharshar/PhaseAT.

Ahmed Sharshar, Asif Hanif, Naveen Kumar Kummari +2

Division of Computing and Mathematical Sciences Mohamed bin Zayed University of Artificial Intelligence, Abu Dhabi, UAE

Multimodal Domain Generalization Medical Images Adversarial Training Fourier

Sep 28, 2026cs.CV

SentZero: An Enhanced Sentence-Centric Vision-Language Pretraining for Multi-Task Zero-Shot Chest X-Ray Analysis

Vision-language (VL) pretraining using paired chest X-ray (CXR) images and radiology reports has shown strong potential for medical image understanding. However, existing methods often remain dependent on task-specific finetuning because radiology reports are lengthy, clinically dense, and difficult to align with simple zero-shot prompts. Recent sentence-level approaches partially address this limitation using clinical phrases extracted by large language models (LLMs), but they largely overlook the intrinsic characteristics of radiology discourse. In particular, limited positive-pair diversity constrains further gains, while clinically equivalent sentences frequently recur across patients, creating false negatives in contrastive learning. To address these issues, we propose SentZero, an enhanced sentence-centric VL pretraining framework for zero-shot, multi-task CXR analysis. SentZero introduces LLM-based abstract-level sentence structuring and mapping to expand positive-pair diversity, together with an additional loss term to mitigate false negatives. We further introduce sentence-conditioned residual modulation of visual embeddings, enabling visual features to adapt to the semantic characteristics of each input sentence. Across diverse downstream tasks and datasets, SentZero improves zero-shot generalization and outperforms prior multi-task zero-shot methods.

Hangyul Yoon, Hyungyung Lee, Edward Choi +1

Kim Jaechul Graduate School of AI, Korea Advanced Institute of Science and Technology (KAIST)

Chest X-Ray Recent Vision-Language Models Zero-Shot Radiology Report Generation Multimodal Pretraining Medical Images+1

Sep 21, 2026cs.CV

Applications of Neural Cellular Automata: State of the Art, Challenges and Opportunities

Neural Cellular Automata (NCAs) are a new type of neural network architecture which enable accurate and robust inference at extremely small model sizes. Recently, NCAs have advanced to become interesting low-resource alternatives to convolution- and attention-based architectures for various tasks such as image analysis, synthetic image generation, and simulation. The rapid development and increased research interest necessitate a comprehensive review of the emerging technology. This review provides an overview of the fundamentals of NCAs, applications to medical imaging, as well as insights into the state of the art. We analyze recent modifications to the originally proposed NCA architecture with respect to their efficiency and accuracy. Furthermore, we review practical applications in real-world scenarios with a focus on medical image analysis, segmentation, classification, registration, depth estimation, and image synthesis. Finally, we identify several advantages of NCAs, research gaps, and conclude with an analysis of future opportunities for NCAs in medical applications in confined settings or areas that have particular demands for robustness or efficient data processing.

Nick Lemke, Niklas Ihm, John Kalkhof +11

Technical University of Darmstadt, Darmstadt, Germany · ImFusion GmbH, Munich, Germany · Inria Center at University Cˆote d’Azur, Sophia Antipolis, France +9

Neural Cellular Automata Medical Images Challenges Art

Sep 21, 2026cs.AI

Representation-guided in-context learning for medical image interpretation with multimodal large language models

Medical image interpretation is central to diagnosis and care, yet adapting general-purpose multimodal large language models (MLLMs) often requires resource-intensive domain-specific fine-tuning. Here we introduce representation-guided in-context learning (RG-ICL), a training-free inference framework that retrieves query-aligned demonstrations using frozen encoders, without task-specific parameter updates. Across eight datasets spanning histopathology, radiology and retinal fundoscopy, RG-ICL improved classification (mean gain 20 percentage points) and visual question answering (VQA) (mean gain 13 percentage points) over no-context and conventional ICL, approaching or exceeding training-based comparators. Which cases were retrieved mattered more than how many: 6 query-aligned cases outperformed up to 32 randomly selected ones, whereas fixed or random cases often reduced accuracy below baseline. For VQA, aligning reference cases with both image content and question intent produced further gains. These findings indicate that for medical image interpretation, curating which reference cases an MLLM sees is a practical alternative to retraining it.

Minda Zhao, Fangyu Hu, Yan Luo +8

Harvard AI and Robotics Lab, Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA · Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA · Department of Ophthalmology, National Taiwan University Hospital, Taipei City, Taiwan +6

Medical Vision-Language Models Multimodal Clinical Data Medical Images Multimodal Large Language Models In-Context Learning In-Context+1

Sep 14, 2026cs.CV

Bridging Vision Foundation Model Priors with CLIP for Spatial-aware Few-shot Anomaly Detection in Medical Images

Vision-Language Models such as CLIP enable effective few-shot medical anomaly detection (AD) via strong image-text semantic alignment. However, their globally contrastive pretraining lacks explicit spatial supervision, limiting precise lesion localization. In contrast, Vision Foundation Models (VFMs) such as DINO learn spatially coherent patch representations via self-distillation and local-to-global consistency, better capturing fine-grained anatomical structures. Leveraging this complementarity, we propose Spatial-FAD, a spatial-aware few-shot medical AD framework that improves lesion localization by combining VFM spatial priors with CLIP semantics. Specifically, we introduce a VFM-enhanced adapter that injects a structural affinity prior derived from DINO into CLIP features. This structure-guided refinement encourages visual embeddings to better adhere to lesion boundaries while maintaining semantic alignment. To address the loss of spatial detail from patchification and the limited input resolution of CLIP, we adopt a sliding-window aggregation strategy. This generates high-resolution, spatially dense embeddings to further enhance localization granularity. Moreover, we introduce a prototype-enhanced support memory scheme to efficiently exploit the few-shot support set. This module stores compact prototypes for normal and abnormal patterns, reducing memory costs while boosting performance by fusing patch-to-prototype and image-text similarities. Extensive experiments on three benchmark datasets, including Liver CT, Retinal OCT, and Brain MRI, demonstrate that Spatial-FAD significantly outperforms state-of-the-art methods, especially in lesion segmentation. Notably, in the 4-shot scenario, our method achieves an average improvement of over 11.4% in Dice score and 1.8% in AUC. Code is available at: https://github.com/JuzhengMiao/Spatial-FAD.

Juzheng Miao, Yuchen Yuan, Cheng Chen +1

Department of Computer Science and Engineering, The Chinese University of Hong Kong, Hong Kong, China · Department of Electrical and Computer Engineering, The University of Hong Kong, Hong Kong, China · School of Biomedical Engineering, The University of Hong Kong, Hong Kong, China +1

Medical Images Lesion Recent Vision Foundation Models Contrastive Language-Image Pre-Training Model Vision Foundation Models

Sep 11, 2026cs.LG

Artificial Intelligence Algorithms for the Detection of Pathologies Related to Lung Cancer through Image Analysis using Convolutional Neural Networks and Data Augmentation: a systematic mapping of the literature

Lung cancer is one of the leading causes of death worldwide, and its early diagnosis is crucial to improving patients prognosis and quality of life. However, the process of interpreting medical images for the detection of lung cancer is complex and requires trained experts. In this context, artificial intelligence (AI) and deep learning (DL) emerge as potential tools to automate and optimize image analysis. The objective of this work is to review the most recent and relevant applications of AI and DL in the field of radiology for the detection of lung cancer. To this end, an exhaustive search was carried out in scientific databases such as PubMed,IEEEXPLORE, Scopus and Web of Science, and 96 articles published from 2015 to the present addressing the use of AI and DL in biomedical engineering were selected. Emphasis is placed on the use of convolutional neural networks (CNN) with transfer learning and Data Augmentation as promising techniques to improve the accuracy and efficiency of the image interpretation process. The results show that the use of AI and DL can offer an effective alternative for the early diagnosis of lung cancer, with high sensitivity and specificity. However, current limitations and challenges that must be addressed to guarantee its responsible and safe application in clinical practice are also identified, such as the lack of standardized data, the ex plainability of the models, patient privacy, and the ethical and social implications. It is concluded that the use of AI and DL can have a positive impact on the care of patients with lung cancer, but further research and regulation are required to ensure its quality and reliability.

Pablo Ramirez Amador

Universidad Abierta Interamericana. Faculty of Computer Technology. Center for Advanced Studies in Computer Technology. Buenos Aires, Argentina.

Lung-Nodule Artificial Intelligence Medical Images Tumor Convolutional Neural Networks Deep Learning Data Augmentation

Sep 7, 2026cs.AI

A visual large language foundational model for medical image recognition using clinician-contributed online resources

Large language models (LLMs) have demonstrated strong capabilities across diverse domains, showing considerable potential in medicine. However, their application in medical settings remains limited by the scarcity of visual question answering (VQA) datasets that capture clinical reasoning and explicit image-text alignment. Here, we leverage de-identified medical images and expert commentaries shared through clinician-oriented online resources. By combining an advanced LLM with clinician-in-the-loop verification, we established a rigorous pipeline to construct ThoughtMed-1M, a long-form medical VQA dataset containing over one million VQA pairs and designed to capture structured clinical reasoning and medical image-text alignment. To demonstrate its utility, we developed a FOundational LLM Trained on ThoughtMed-1M (FOLTMed). FOLTMed achieved state-of-the-art performance across 42 medical VQA benchmark datasets, with a macro accuracy of 85.4 percent. It also generated more clinically coherent responses on the ThoughtMed-1M test set, outperforming state-of-the-art models by 3 to 5 percent across factuality and similarity metrics, highlighting a scalable paradigm for advancing research on clinically grounded multimodal LLMs.

Lingxuan Hou, Yuhua Xie, Yue Hu +14

College of Biomedical Engineering, Sichuan University, Chengdu, Sichuan, China · School of Engineering, Computer & Mathematical Sciences, Auckland University of Technology, Auckland, New Zealand · Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China +2

Medical Visual Question Answering Multimodal Clinical Data Medical Images Multimodal Large Language Models

Sep 1, 2026cs.CV

Pix2Rep-v2: Data-Efficient Representation Learning for Dense Medical Imaging Applications

Dense self-supervised learning (SSL) is a powerful paradigm for learning without annotations the local descriptors required to solve dense medical imaging tasks. We present Pix2Rep-v2, a framework for SSL of pixel- and voxel-level representations suitable for few-shot downstream applications. Pix2Rep-v2 addresses the main challenges of dense SSL by leveraging a redundancy reduction objective at the pixel-level with a principle of equivariance of dense representations, that scales efficiently to 3D or wide field-of-view applications. We evaluate our method on four datasets, across multiple tasks, multiple modalities and anatomical structures using multiple backbones in 2D and 3D, and under various data regimes. As an alternative to linear probing or full fine-tuning on the downstream task, we also propose an in-context variant, without downstream training, based on a dense prototype approach. Pix2Rep-v2 shows substantially higher data-efficiency in few-shot scenarios compared to fully supervised baselines, and is competitive with the state-of-the-art e.g., +9.3 Dice points in one-shot segmentation on the M&Ms-2 dataset. Our code and pre-trained models are publicly available at https://github.com/BioMedTP/pix2rep-v2.

S. Sifaoui, E. Angelini, S. Toupin +2

LTCI, Télécom Paris, Institut Polytechnique de Paris, Palaiseau, France · MIRACL.ai Laboratory, Hôpital Universitaire Lariboisière (AP-HP), Paris, France · Université Paris Cité, Inserm MASCOT, Paris, France

Self-Supervised Representations Dense Prediction Medical Images Self-Supervised Learning Representation Learning Voxel+1

Aug 10, 2026cs.CV

UniMod: Enhancing Multi-Modal Medical Diagnosis through Cross-Modality and Within-Modality Alignment

Multi-modal learning combining medical images and clinical text is promising for disease diagnosis. However, standard multi-modal training leads to shortcut learning: models exploit the easier modality (e.g., diagnostic cues in text) while neglecting harder-to-learn features (e.g., subtle visual patterns). We propose UniMod, a framework that mitigates shortcut learning by requiring each modality to predict the diagnosis on its own. It supervises image-only, text-only, and multi-modal classification simultaneously, so each modality must extract diagnostic features. We add cross-modality alignment for knowledge transfer and within-modality supervised contrastive alignment over same-diagnosis patients. On Harvard-Glaucoma, UniMod reaches 0.850 AUC, outperforming OGM-GE and Gradient Blending by 1.6-1.8%; on CheXpert Plus, it reaches 0.966 AUC, surpassing them by over 5%. UniMod also extends to 5-class multi-label diagnosis without architectural change, improving mean AUC by 0.097 over CGGM.

Zijian Gu, Weikai Lin, Shuang Zhou +2

University of Central Florida · Orlando, FL, United States · University of Rochester +5

Multimodal Clinical Data Cross-Modality Modality Alignment Medical Images Diagnosis

Aug 10, 2026cs.CV

P3CA: Encoder-Agnostic Interpretation of Vision Foundation Model Embeddings via Spatial Probing

Vision foundation models are increasingly used as reusable encoders in medical image computing, yet their high-dimensional spatial embeddings are difficult to inspect beyond downstream task performance or global dimensionality reduction. We propose position-prompted PCA (P3CA), an encoder-agnostic method for local probing of channel-rich spatial tensors. Given a user-selected spatial prompt, P3CA estimates the feature normalization and dominant covariance directions within that region, then applies the resulting projection to the full tensor to visualize where locally informative directions are expressed. This produces a region-conditioned representation lens without modifying the encoder, retraining, or requiring task-specific labels. We implement P3CA in EmbedVision, an interactive 3D Slicer-based workflow, and evaluate it across natural images, colorectal pathology foundation-model embeddings, and spatial transcriptomic tensors. Across these settings, prompted projections reveal local structure suppressed by global PCA, improve prompt-matched pathology discrimination from frozen three-dimensional projections, and support comparison between learned and measured spatial representations.

Amoon Jamzad, Dilakshan Srikanthan, Faranak Akbarifar +2

School of Computing, Queen’s University, Kingston, Ontario, K7L 2N8, Canada

Visual Embeddings Principal Component Analysis Medical Images

Aug 10, 2026cs.LG

Hallucinations and Constraints : Regulating surgical workflow recognition beyond accuracy

Hallucinations are a major concern for the integration of artificial intelligence into medicine, although less explored in the realm of medical image processing. Unlike problems in natural text understanding and reasoning therewith, determining whether or not predictions derived from biomedical images and signals is less intuitively clear. This article suggests that topological errors could constitute hallucinations in a way that can be more readily measured and thus regulated. Certain of these properties for certain types of problems, such as biomedical signal segmentation, can be rephrased as linear temporal logic predicates, a number of which can be explicitly enforced using probabilistic graphical models. Our simulations show the potential of these explicitly constrained predicates for the case of automatic surgical phase recognition in robot-assisted hysterectomy, improving accuracy by approximately 10% while removing the vast majority of topological errors, suggesting that mathematical guarantees of correctness can supplement other empirical forms of regulating machine learning in medical image computing and computer-assisted interventions.

John S. H. Baxter, Pierre Jannin

Université de Rennes, Inserm, Laboratoire Traitement du Signal et de l’Image (LTSI - UMR 1099), F-35000 Rennes, France

Medical Images Surgical Robots Real-World Clinical Workflows Topology

Aug 7, 2026eess.IV

Energy and Performance Benchmarking of Deep Learning Models for Breast Cancer Detection

Recent advances in machine learning have greatly improved breast cancer detection, enabling more accurate and timely diagnosis. Deep learning (DL) models show strong potential for medical image analysis; however, as their architectural complexity increases, their environmental impacts are becoming a growing concern. In this paper, we present a comparative analysis of seven DL models for breast cancer detection on two medical datasets: Breast Ultrasound and BreakHis 400X. The evaluated architectures range from Convolutional Neural Networks (CNNs) and transformers to hybrid models. In addition to performance metrics, we assess CO2 emissions during both training and inference. Our results show that EfficientNet and ResNet consistently deliver strong performance, although with higher CO2 emissions. The selected transformers, such as DeiT-Tiny, perform competitively on both datasets, whereas DenseNet121 achieves lower accuracy. On the Breast Ultrasound Dataset, DeiT provides the most favourable balance between accuracy and energy consumption, whereas on the BreakHis dataset, the ViT and Swin models achieve the best results. Overall, our findings indicate that no single architecture category from the evaluated ones consistently dominates across the two selected datasets. Our results highlight the importance of jointly considering performance, emissions, and dataset characteristics when selecting models for medical applications.

Samar Garrab, Ghada Achour

Royal Military College of Canada Kingston, ON, Canada · National Engineering School of Sousse Sousse, Tunisia

Mammography Deep Learning Medical Images

Aug 6, 2026cs.CV

MirrorNet: Can Medical Image Anonymization Really Protect Patient Identity?

Medical images are routinely de-identified---names, dates, and other metadata removed---and then shared for research, teaching, and public benchmarks under the assumption that this renders them anonymous. Such de-identification protects the metadata but not the pixels, and---apart from scans that directly contain facial structures---whether the image content itself identifies the patient has received little scrutiny. We investigate this question by learning a cycle-consistent correspondence between a cross-sectional medical image and a non-medical, patient-identifying image, using a pair of coupled, cycle-consistent variational autoencoders. From a held-out scan, the model recovers a recognisable likeness of the patient (identity-region MAE = 0.163); conversely, it synthesises a scan from such an image. These results indicate that a de-identified medical scan remains identifying---it is, in effect, a photograph of the patient---and that imaging data should be governed as biometric data rather than as anonymisable records. To support reproducibility, the code and trained models are shared at https://github.com/attilasimko/public-repository.

Attila Simkó

Department of Diagnostics and Intervention Umeå University, Umeå, Sweden

Medical Images Biometrics Patients Cone-Beam Computed Tomography Conditional Variational Autoencoder

Aug 6, 2026cs.CV

STAIL: Semantic Text-Anchored Incremental Learning for Medical Imaging via Large Language Models

Deep learning models applied to medical image analysis suffer from severe catastrophic forgetting when continually adapting to new clinical tasks in dynamic environments. Mainstream incremental learning methods typically mitigate this by rehearsing raw historical images. However, this pixel-level rehearsal incurs significant storage overhead, raises privacy concerns, and fails to adequately capture the true data distribution with sparse exemplars. Inspired by human cognitive mechanisms, we propose a novel framework termed Semantic Text-Anchored Incremental Learning (STAIL) for sequential clinical tasks. To overcome the rehearsal bottleneck, STAIL introduces an asymmetric semantic consolidation buffer (SCB). By incorporating a minimal set of image anchors and extensive textual descriptions, the SCB enables dense semantic reconstruction of old tasks at a minimal storage cost. Furthermore, we design an LLM-derived Semantic Anchoring Mechanism (LSAM) that leverages the stable semantic space of frozen large language models as developmental priors. This mechanism explicitly anchors evolving visual features to textual representations, guiding and constraining plasticity and stability at both macroscopic and microscopic levels. Extensive experiments across three heterogeneous medical datasets, covering fundus, ultrasound, and X-ray imaging, demonstrate that STAIL acts as a highly effective plug-and-play module. It comprehensively enhances the performance of various existing baselines, achieving average gains of 2.24% in AAA-AUC for sustained performance and 3.55% in BWT-AUC for reduced forgetting. Code is available.

Songpan Gao, Yajie Zhang, Guanxing Chen +9

Medical Images Class-Incremental Learning Medical Imaging Multiple Instance Learning Forgetting

Aug 4, 2026cs.CV

LocAnyMed: Vision-Language Grounding for Multimodal Medical Images

Medical visual grounding connects free-form clinical queries to spatial evidence in medical images and is an important component of interpretable medical artificial intelligence. However, general-purpose grounding models are predominantly trained on natural images, while existing medical localization resources remain fragmented across imaging modalities, datasets, and task formulations. To address this gap, we construct LocAnyMed-200K, a multimodal medical visual grounding dataset containing approximately 200K image-query-answer examples across computed tomography, optical medical imaging, ultrasound, and X-ray. We harmonize heterogeneous detection and localization resources into a unified free-form instruction format that supports one or multiple bounding boxes, point coordinates, and no-target outputs for negative queries. Full-parameter fine-tuning of LocateAnything-3B on LocAnyMed-200K improves F1@IoU 0.50 from 10.64 to 85.59 on a held-out evaluation split, demonstrating that large-scale domain-specific supervision can equip a general grounding model with effective medical localization capabilities. Beyond spatial coordinates, a clinically interpretable grounding system should also communicate the evidence supporting its prediction. We therefore derive LocAnyMed-CoT-20K, a rationale-augmented subset that connects anatomical context, visual observations, and spatial conclusions through structured reasoning and further improves cross-source generalization through fine-tuning. Together, these resources provide a unified foundation for studying both localization accuracy and rationale quality across heterogeneous medical imaging modalities. The code is publicly available at https://github.com/MiliLab/LocAnyMed.

Zihan Wang, Tong Liu, Zhiwei Wang +6

School of Computer Science, Wuhan University, Wuhan, China · College of Computing and Data Science, Nanyang Technological University, Singapore · Australian Artificial Intelligence Institute, School of Computer Science, University of Technology Sydney, Sydney, Australia +1

Medical Images Multimodal Clinical Data Multimodal Dataset

Aug 3, 2026eess.IV

An Accessible Solution for Deformable Image Registration Compared with Learning-Based Approaches

Deformable image registration (DIR) is a core problem in medical image analysis; but, unlike labeling decision problems such as classification and segmentation, registration is a problem class that involves stringent physical constraints. Although deep learning methods have made faster registration possible, the resulting models are often difficult to interpret compared to hand-crafted methods with explicit objectives and interpretable physical meaning. In this work, we show that an analytical method can still yield competitive and superior results to deep learning in a common deformable registration task. We study pTVreg as a parametric total variation based registration in that context. Observing its different implementations to perform at various degrees, we introduce here an accessible implementation of this method, together with a Bayesian optimization framework that automatically sets self-parameters for any DIR task from a set of sample examples. Experiments on Lung250M-4B show that our proposed implementation achieves state-of-the-art results in this benchmark, substantially superior to existing deep learning solutions and other pTVreg variants as baselines. The source code will be made publicly available at https://github.com/oazeybekoglu/ptvreg-python .

Onur Ali Zeybekoglu, David Tilly, Orcun Goksel

Department of Information Technology, Uppsala University, Uppsala, Sweden · Department of Medical Physics, Uppsala University Hospital, Uppsala, Sweden · Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden

Image Registration Medical Images Deep Learning

Aug 3, 2026cs.CV

SecondOpinion: Anatomy-Aware Gated Reasoning for Efficient Medical Image Analysis

Deep learning models for medical image analysis typically apply a fixed amount of computation to every input, regardless of case difficulty. Anatomy-guided dual-stream architectures have been shown to improve diagnostic performance, but they evaluate both streams unconditionally, even on cases a single stream could already resolve confidently. We propose SecondOpinion, a framework in which a fast primary stream processes every case, while a second, anatomy-guided stream is invoked only when GateKeeper, a gating mechanism trained explicitly as a binary correctness classifier, judges that the primary stream's prediction needs additional scrutiny, much as a clinician might seek a second opinion on a difficult case. When activated, the two streams are combined through a lightweight cross-attention fusion module. We evaluate SecondOpinion on a unified five-class chest X-ray dataset and a pelvic fracture dataset, the latter including a held-out, harder subset of fractures that are invisible on X-ray but confirmed via CT. SecondOpinion matches or exceeds prior state-of-the-art performance on both tasks, while activating its anatomy-guided stream on only 9.23% of chest X-ray cases, rising to 24.12% on visible fractures and 45.71% on invisible fractures, an activation rate that tracks task difficulty directly. These results suggest that supervising a gating signal toward correctness, rather than relying on unsupervised confidence, allows a model to allocate anatomical reasoning where it is actually needed.

Siam Tahsin Bhuiyan, Rashedur Rahman, Sefatul Wasi +4

Center for Computational & Data Sciences, Independent University, Bangladesh, Dhaka, Bangladesh · Department of Computer Science and Engineering, Independent University, Bangladesh, Dhaka, Bangladesh · Graduate School of Engineering, University of Hyogo, Kobe, Japan

Medical Images Anatomy Gating

Aug 3, 2026cs.CV

Generative AI and Foundation Models in Medical Image

In recent years, generative AI has attracted significant public attention, and its use has been rapidly expanding across a wide range of domains. From creative tasks such as text summarization, idea generation, and source code generation, to the streamlining of medical support tasks like diagnostic report generation and summarization, AI is now deeply involved in many areas. Today's breadth of AI applications is clearly distinct from what was seen before generative AI gained widespread recognition. Representative generative AI services include DALL-E 3 (OpenAI, California, USA) and Stable Diffusion (Stability AI, London, England, UK) for image generation, ChatGPT (OpenAI, California, USA), and Gemini (Google, California, USA) for text generation. The rise of generative AI has been influenced by advances in deep learning models and the scaling up of data, models, and computational resources based on the scaling laws. Moreover, the emergence of foundation models, which are trained on large-scale datasets and possess general-purpose knowledge applicable to various downstream tasks, is creating a new paradigm in AI development. These shifts brought about by generative AI and foundation models also profoundly impact medical image processing, fundamentally changing the framework for AI development in healthcare. This paper provides an overview of diffusion models used in image generation AI and large language models (LLMs) used in text generation AI, and introduces their applications in medical support. This paper also discusses foundation models, which are gaining attention alongside generative AI, including their construction methods and applications in the medical field. Finally, the paper explores how to develop foundation models and high-performance AI for medical support by fully utilizing national data and computational resources.

Masahiro Oda

Data Science Research Division, Information Technology Center, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan. · Graduate School of Informatics, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan.

Generative Artificial Intelligence Medical Images Artificial Intelligence Models Foundation Model

Jul 30, 2026cs.CV

DS@GT ARC at ImageCLEFmedical 2026: Architectural Diversity for Concept Detection and Foundation-Model Scaling for Caption Prediction in Medical Image Analysis

We describe the DS@GT submissions to the ImageCLEFmedical Caption 2026 challenge, which continues a long-running benchmark on the ROCOv2 dataset with two tracks: Concept Detection (Task 1), assigning UMLS Concept Unique Identifiers (CUIs) to radiology images, and Caption Prediction (Task 2), generating natural-language captions. For Task 1, our primary submission was a three-way late-fusion ensemble of ConvNeXt-V2, BiomedCLIP ViT-B/16, and DenseNet-169 with a regularized ''Honest Threshold Tuning'' procedure designed to avoid validation overfitting on rare concepts; this submission ranked first on the official submission with a primary

F_1

of

0.5790

and a secondary

F_1

of

0.9657

. In parallel, we submitted a training-free KNN retrieval pipeline over frozen BiomedCLIP embeddings, which reached a primary

F_1

of

0.5780

and a secondary

F_1

of

0.9599

-essentially matching the fine-tuned ensemble on the primary track at a fraction of the cost. For Task 2, our submissions included a fine-tuned Gemma-3 27B model (overall

0.3571

, ranking third in the official submission), a fully fine-tuned BLIP pipeline with custom Vizwins merging (

0.3564

), and a zero-shot MedGemma-4B run with a PubMed-style prompt (

0.3186

), spanning a wide range of model scales and training costs. Code: https://github.com/dsgt-arc/imageclef-caption-2026.

Bowen Wang, Youwen Zhang, Ritesh Mehta

Georgia Institute of Technology, North Ave NW, Atlanta, GA 30332

Medical Images Convnext Multimodal Clinical Data Multi-Image Editing Benchmarks Text Corpora

Jul 29, 2026cs.CV

Hearsay: Vision-Language Medical Diagnoses Without an Image

When asked to describe a medical image that was never attached, frontier vision-language models do not abstain: they confabulate a diagnosis. We show that this confabulation is not random. It is structured by who the patient is said to be. Across chest X-ray, brain MRI, and dermatology, Claude Opus-4.7, GPT-5.4, and Gemini-3.1-Pro are each queried with only a demographic descriptor and no image, and changing the descriptor systematically shifts the diagnosis returned. Claude concentrates sharply: a 65-year-old white man asking about a skin mole receives Melanoma in nearly every response, and a 32-year-old Black woman asking about her chest X-ray receives a Sarcoidosis diagnosis whose reasoning reads "suspected, based on demographics and classic pattern.'' GPT-5.4's effect is broader, fabricating across every demographic cell we test, most conspicuously naming Sarcoidosis for young Black patients on chest X-ray. Two structural findings sharpen the problem. A hedged regime appears in which the prose acknowledges the missing image while the structured diagnosis field nevertheless names a disease, a dissociation invisible to prose-only audits. And Claude's dermatology effect collapses entirely when 'skin mole' is swapped for 'skin lesion' while GPT-5.4's is preserved, indicating that mirage is a family of distinct failure modes rather than a single phenomenon. Trustworthy VLM deployment in clinical pipelines requires auditing the structured output channel directly, and probe-word sensitivity should be treated as a first-class evaluation dimension

Siddharth Vohra

Carnegie Mellon University Pittsburgh, PA, USA · Amazon Web Services AI Native Pittsburgh, PA, USA

Medical Vision-Language Models Diagnosis Medical Images Recent Vision-Language Models Confabulation Hear

Jul 28, 2026cs.CV

Gaussian Volumetric Representation for Efficient Shear-Warp Visualization

Medical image visualization requires volumetric rendering algorithms that preserve anatomical fidelity while maintaining high rendering speeds. To address the high computational cost of large volumetric datasets, we propose a Gaussian-based volumetric representation for efficient visualization of dense medical volumes without compromising structural and radiometric details. We optimize the proposed representation using Monte Carlo volumetric estimation, which enables training on a highly sparse subset of voxels while maintaining consistency with the dense volumetric objective. In addition, we introduce a curriculum learning strategy that progressively incorporates structured slice-based sampling during training. Sparse voxel samples provide an early global coverage of the volume, while slice samples capture spatially correlated regions that aid geometric structure and texture continuity. This combination enables the Gaussian representation to learn anatomical details of various structures and corresponding textures from sparse supervision while significantly reducing the computational cost associated with dense voxel processing. The learned representation supports slice-based rendering methods such as shear-warp volume rendering, enabling efficient visualization of multimodal medical datasets including MRI and Cryosection volumes while preserving anatomical structures. Using sparse supervision, our method achieves up to 43.86 FPS rendering with a compression ratio of 11.31:1.

Mayuri Mathur, Ojaswa Sharma

Indraprastha Institute of Information Technology Delhi · Indraprastha Institute of Information Technology Delhi, New Delhi, India

Volume Voxel Rasterization Medical Images Anatomy

Jul 24, 2026cs.CV

RadSight: Towards Perceptually Reliable Multimodal Radiology Image Understanding

Medical multimodal large language models (MLLMs) are increasingly expected to perform complex image understanding tasks, yet their reliability is often compromised by frequent errors in visual interpretation. To systematically trace these failures, we traverse the hierarchy from high-level clinical tasks down to fundamental visual perception. We therefore introduce Perception-Bench, a large-scale benchmark comprising 1.13 million samples that assesses medical MLLMs across six dimensions: attribute judgment, spatial grounding, spatial understanding, disease prediction, anomaly detection, and report generation, spanning both 2D and 3D radiology images. Our analysis on Perception-Bench reveals that existing MLLMs lack the ability to capture even the most basic lesion attributes, such as location, size, and density. This inability to ground clinical outputs in primary visual evidence reveals that the models' diagnostic unreliability is rooted in a critical but overlooked bottleneck in low-level visual perception. Motivated by this, we propose RadSight, a perception-driven MLLM built upon a dual 2D/3D encoder architecture that preserves native imaging spatial structures. RadSight formulates medical image understanding as a four-stage progressive process: visual-language alignment, fine-grained visual perception, clinical diagnosis, and diagnostic interpretation. The model is trained on an 8.37 million perception-oriented corpus using progressive curriculum learning. On Perception-Bench, RadSight consistently outperforms existing MLLMs across all six evaluation dimensions, with particularly strong gains in spatial grounding and clinical diagnosis. It also achieves consistent improvements on public 2D and 3D medical benchmarks, further demonstrating that robust low-level visual perception is a critical foundation for reliable clinical understanding. Code and model will be publicly available.

Jianqin Liu, Weiwei Cao, Wanxing Chang +7

1DAMO Academy, Alibaba Group · University of Electronic Science and Technology of China

Medical Images Multimodal Clinical Data Multimodal Benchmarks Multimodal Large Language Models

Jul 24, 2026cs.CV

Medical-Checklist: Assessing the Comprehension of Medical Images by Multimodal Models

This paper introduces a new benchmark test, Medical-Checklist, for assessing medical multimodal models. The recent advancements in multimodal models have demonstrated significant potential in the field of medical vision-language tasks. However, it is becoming increasingly clear that evaluating these models' performance, whether they are applied to natural or medical images, is challenging. The critical question is whether the models can accurately understand an input image while associating it with relevant input text. To address this, Medical-Checklist imposes a binary test on the models: they are given an image and two captions, where one is correct and the other incorrect, and the model must select the correct one. The incorrect caption contains a single medical concept (word or phrase) that is inaccurately substituted from the correct caption. Although the task is simple, this simplicity enables the unified assessment of diverse multimodal models designed and learned on different principles. It also enables us to verify whether models correctly understand a wide range of medical concepts across various medical sub-domains. Medical-Checklist is designed to reduce potential biases in data and to enable evaluation of the models' ability to handle out-of-distribution inputs, which were difficult in existing datasets. When evaluating four state-of-the-art medical multimodal models with Medical-Checklist, it was revealed that despite their excellent performance in specific tasks such as Med-VQA, they may not correctly understand images, suggesting a long journey ahead for clinical application. The dataset and code will be made public upon acceptance.

Bannapol Limanond, Masanori Suganuma, Takayuki Okatani

Multimodal Clinical Data Medical Vision-Language Models Multimodal Benchmarks Medical Images Multimodal Model Textvqa+1

Jul 24, 2026cs.CV

Diffusion Models in Medical Image Inpainting: Challenges, Solution Taxonomy, and Future Directions

Image inpainting aims to reconstruct missing or corrupted regions of an image while preserving as much as possible, visual and semantic consistency. In medical imaging, this task is particularly important because artifacts, missing information, and pathological alterations can compromise diagnostic reliability and downstream clinical applications. Recently, diffusion models have emerged as state-of-the-art generative approaches for medical image inpainting due to their ability to generate anatomically consistent reconstructions. This survey presents a systematic review of diffusion-based methods for medical image inpainting, covering the main architectures, applications, datasets, and evaluation strategies reported across 60 studies. In addition, we propose a taxonomy for diffusion-based approaches. The analysis reveals a rapid growth of research interest in diffusion-based medical image inpainting, with denoising diffusion probabilistic models and latent diffusion models emerging as the dominant architectures. The reviewed studies mainly focus on artifact removal, data augmentation, pseudo-healthy tissue reconstruction, and anomaly detection, particularly in magnetic resonance imaging and computed tomography imaging. Overall, diffusion models demonstrate strong performance in producing anatomically plausible reconstructions and aiding downstream clinical tasks. However, the review also highlights important challenges, including the lack of standardized benchmarks, limited dataset diversity, and restricted validation procedures across diverse clinical applications and imaging scenarios.

Arthur Dantas Mangussi, Joana Cristo Santos, Ricardo Cardoso Pereira +3

Computer Science Division, Aeronautics Institute of Technology and Science and Technology Institute, Federal University of São Paulo, Brazil · LASIGE, Faculdade de Ciências, Universidade de Lisboa, Portugal · University of Coimbra, CISUC/LASI – Centre for Informatics and Systems of the University of Coimbra, Department of Informatics Engineering, Portugal +1

Inpainting Medical Images Diffusion Models Latent Diffusion Model Challenges

Jul 21, 2026cs.CV

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

Positron Emission Tomography Medical Images Multiple Instance Learning

Jul 17, 2026cs.CV

Model Merging for Medical LVLMs: A Benchmark and a Winner-Take-All Approach

Large vision-language models (LVLMs) can be adapted to specialized medical imaging tasks via parameter-efficient fine-tuning approaches such as low-rank adaptation (LoRA), leading to a growing ecosystem of expert models tailored to specific imaging modalities and clinical scenarios. However, deploying multiple expert LVLMs in practice incurs substantial computational and operational overhead. Model merging provides a promising solution by consolidating multiple experts into a single model without retraining, yet it remains largely unexplored in the medical domain. In this work, we present the first systematic study of model merging for medical LVLMs. We introduce MergeMedBench, a comprehensive benchmark spanning eight imaging modalities and diverse clinical task types, comprising 16 LoRA fine-tuned models built upon two mainstream architectures. We conduct an extensive evaluation of existing merging methods and further propose winner-take-all, a simple and hyperparameter-free approach that retains only the most dominant parameters across expert models. By preserving the critical parameters that govern model behavior and discarding weaker ones, our method avoids the information dilution inherent in averaging- or alignment-based strategies. Despite its simplicity, winner-take-all consistently outperforms existing approaches, offering both a new perspective on LoRA merging and a strong practical baseline for future research.

Lichao Mou, Shilan Zhang, Chunlei Li +7

MedAI Technology (Wuxi) Co. Ltd. · Wuhan University of Technology · Technical University of Munich +1

Medical Vision-Language Models Medical Images

Jul 14, 2026cs.CV

Improving Medical Image Generative Models with Fréchet Distance Loss

Diffusion generative models have demonstrated immense potential for synthetic medical image generation. However, these models often struggle to capture complex morphological characteristics of heterogeneous tumors with irregular boundaries, limiting their utility for downstream clinical tasks such as segmentation. This limitation stems from the standard denoising objective: minimizing a per-pixel error, which smooths high-variance irregular structures characteristic of tumors. To address this, we propose finetuning these generative models with Fréchet Distance loss (FD-loss). FD-loss aligns the first and second order feature statistics of real and generated images in a pretrained encoder space, encouraging the generator to capture complex structural variations characteristic of heterogeneous tumors. We integrate FD-loss across diverse architectural settings, using both natural- and medical-image encoders on multiple liver and brain cancer datasets spanning CT and MRI modalities. Downstream segmentation networks trained on our FD-regularized synthetic data consistently achieve superior performance, improving tumor DSC by

>$$5\%

over unregularized synthetic augmentation alone. Qualitative analysis suggests these gains are associated with more faithful tumor synthesis and fewer segmentation hallucinations. Our results show FD-loss as an effective regularizer for medical image generative models to improve clinical workflows.

Andrew Marshall, Xuanang Xu, Xiaoran Zhang +3

Department of Biomedical Engineering, Yale University · Department of Radiology & Biomedical Imaging, Yale University · Department of Electrical Engineering, Yale University

Medical Image Generation Semi-Supervised Medical Image Segmentation Fréchet Inception Distance Medical Images Generative Models

Jul 12, 2026cs.CV

Towards Autonomous and Auditable Medical Imaging Model Development

Large language model (LLM) agents are beginning to automate machine learning engineering (MLE) by coupling planning, code execution, debugging, and empirical feedback. Translating this capability to medical imaging remains difficult because each task imposes modality-specific experimentation and strict requirements for validation protocols and prediction artifacts. Here we introduce AMID, an autonomous multi-agent framework for medical imaging model development. AMID first proposes Data-Conditioned Method Planning, which refines coarse task-level search spaces into executable, parallelizable method lanes grounded in task-specific data analysis and runnable medical-imaging resources. It then develops Verification-Guided Two-Stage Optimization, moving from broad early exploration of diverse method lanes to selective exploitation of promising candidates while enforcing strict verification of validation protocols, metric computation, and prediction artifacts throughout the optimization. Across 20 medical imaging challenge tasks spanning diverse modalities and prediction types, AMID outperformed evaluated general-purpose MLE systems and, on several tasks, approached or matched strong human-designed challenge solutions. These results suggest that AMID can turn task-specific medical imaging model development from bespoke manual engineering into an agentic workflow for producing high-performing and auditable model artifacts across heterogeneous tasks.

Shengyuan Liu, Jia-Xuan Jiang, Boyun Zheng +8

The Chinese University of Hong Kong · Institute of Automation, Chinese Academy of Sciences · Independent Researcher +2

Medical Images Medical Imaging Multimodal Clinical Data

Jul 10, 2026eess.IV

Performance Benchmarking and Optimisation of Clustering Algorithms for Local and Non-Local Similarity Measure in Medical Image Analysis

Medical imaging generates high-resolution images posing significant storage, transmission, and computational challenges. While low-rank matrix approximation (LoRMA) techniques offer efficient compression by exploiting structural redundancy, global approaches often fail to preserve local details critical for diagnosis. This paper focuses on clustering techniques that exploit non-local self-similarity to identify structurally similar regions in medical images. These clusters can be used for post-processing tasks such as adaptive image compression. We evaluate five clustering techniques: k-means, mini-batch k-means, agglomerative hierarchical clustering, balanced iterative reducing and clustering using hierarchies (BIRCH), and bisecting k-means across MRI, ultrasound, and chest X-ray modalities. All clustering techniques were optimised using random search, and cluster quality was assessed using the Silhouette score, the Davies-Bouldin (DB) index, and the Calinski-Harabasz (CH) index. Results demonstrate that standard k-means and bisecting k-means generally achieve strong cluster cohesion and separation across modalities. However, they tend to form a small number of clusters with high intra-cluster variability, limiting their effectiveness for post-processing tasks such as adaptive compression. Agglomerative clustering outperformed other techniques for MRI and ultrasound in terms of intra-cluster homogeneity, making it more suitable for preserving fine diagnostic details. For chest X-rays, mini-batch k-means achieved the best balance between clustering quality and intra-cluster compactness. BIRCH consistently underperformed across all modalities.

Sisipho Hamlomo, Marcellin Atemkeng

Department of Mathematics, Rhodes University, PO Box 94, Makhanda, 6140, South Africa · Department of Statistics, Rhodes University, PO Box 94, Makhanda, 6140, South Africa · National Institute for Theoretical and Computational Sciences (NITheCS), Stellenbosch 7600, South Africa

Clustering Medical Imaging Medical Images Learned Image Compression Low-Rank Structure Similarity and Metrics+1

Jul 10, 2026cs.CV

Super-Generalist: Towards Comprehensive and Accurate Medical Image Understanding via Generalist-Specialist Synergy

Medical images require comprehensive and accurate interpretation to support the diagnosis of diverse clincial conditions. Recent vision-language generalist models offer broad task coverage and promising zero-shot capabilities, yet often lack fine-grained anatomical and lesion awareness for reliable diagnosis and spatial interpretability. In contrast, supervised specialist models achieve strong performance on specific tasks but typically lack generalization across diseases and anatomies. In this work, we present SuG, a Super-Generalist framework that unifies generalist vision-language learning with specialist objectives, enabling both broad generalization and specialist-level diagnostic capability. We perform specialist-enhanced vision-language alignment in SuG by incorporating spatial priors from multiple segmentation experts, including anatomy, class-specific lesion and class-agnostic lesion segmentors that captures lesions beyond anatomies annotated during training. To improve lesion grounding capability, we leverage lesion masks as spatial priors to calibrate text-conditioned visual attention, encouraging disease-related semantics to focus on clinically relevant regions. We evaluate SuG on extensive chest and abdominal CT benchmarks, including CT-RATE, Merlin, MedVL-CT69K, and several in-house tumor datasets. SuG achieves state-of-the-art performance across a wide range of disease diagnosis tasks and surpasses specialist models on several critical tumor diagnosis benchmarks. Furthermore, SuG demonstrates strong lesion grounding capability, including robust generalization to lesion types lacking class-specific supervision.

Shaoteng Zhang, Weiwei Cao, Wanxing Chang +9

DAMO Academy, Alibaba Group · Department of Radiology, Ningbo No. 2 Hospital, Ningbo, Zhejiang, China · Hupan Lab +5

Medical Images Lesion Segmentation Recent Vision-Language Models Synergy

Jul 9, 2026cs.CV

Secure-by-Disguise: A Systematic Evaluation of Image Disguising for Confidential Medical Image Modeling

Cloud-based deep learning enables large-scale medical image analysis but raises significant privacy concerns when sensitive patient images are outsourced for model development. Image disguising has recently emerged as a promising privacy-enhancing technology (PET) that transforms images into visually unintelligible representations while preserving information for downstream learning. We established a unified framework to evaluate representative methods, DisguisedNets and NeuraCrypt, across four datasets involving classification and semantic segmentation tasks. Our analysis assessed predictive utility, efficiency, and robustness against reconstruction attacks. Results showed that image disguising performance varies significantly between tasks; while methods preserved utility for medical image classification, they caused substantial degradation in dense semantic segmentation. Specifically, Randomized Multidimensional Transformation (RMT) offered the optimal balance of performance and security, whereas AES-based disguising severely impacted utility. Furthermore, regression-based reconstruction attacks effective on natural images proved considerably less successful on realistic medical images. These findings provide a systematic assessment of PET suitability for confidential medical AI applications.

Jason Rojas, Jiajie He, Yash Patel +3

University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, 21250, MD, USA · Lawrence Technological University, 21000 West Ten Mile Road, Southfield, 48075, MI, USA · University of Wisconsin, Milwaukee, 3203 N. Downer Avenue, Milwaukee, 53211, WI, USA

Medical Images Deep Learning

Jul 2, 2026cs.CV

HistoSeg++: Delving deeper with attention and multiscale feature fusion for biomarker segmentation

Segmentation of biomarkers in medical images is frequently viewed as a first step towards medical image analysis in any bioinformatics or biomedical application. Despite progress, existing methods still struggle to capture information at multiple scales and to perform upsampling effectively across different datasets. These shortcomings often result in suboptimal generalization capabilities. Recently, architectures belonging to the Nested-UNet family excel in capturing multiscale contextual information and upsample them effectively. In this work, We propose a novel Nested-UNet architecture that effectively captures multi-scale contextual information. It includes inner and outer attention units to enhance focus during upsampling, along with channel-wise feature recalibration using squeeze-and-excitation modules, leading to improved segmentation performance. Additionally, the architecture integrates an edge-aware loss to emphasize boundary accuracy by assigning greater importance to edge regions. Tested extensively on three publicly available benchmark datasets. Our method demonstrates a generalization performance superior to existing Nested-UNet methods. Code: https://github.com/saadwazir/histosegplusplus

Saad Wazir, Rao Faizan, Daeyoung Kim

School of Computing, KAIST Daejeon, Republic of Korea · Kyung Hee University (Global Campus) Yongin-si, Republic of Korea

Semi-Supervised Medical Image Segmentation U-Net Medical Images Multiscale Upsampling

Jul 1, 2026cs.CV

An automated method of identifying incorrectly labelled images based on the sequences of loss functions of deep learning networks

Deep learning is widely applied in medical image analysis, but up to 10% of manually labelled images may be incorrect, degrading model performance. This paper proposes an automated method to identify incorrectly labelled medical images by analyzing sequences of loss functions from deep learning classification networks over multiple training epochs. Identified images can be reviewed and relabelled by experts, improving dataset quality and model performance. Two experiments validate the method on a fundus image dataset for referable diabetic retinopathy screening. In the first, 6% (648) of 10,788 gold-standard labels were intentionally flipped. The method identified 75.31% (488) of the flipped samples, with only 4.85% (492) false positives among correctly labelled samples. In the second, reviewing and correcting the 980 identified samples (9.1% of the dataset) and retraining the model improved best accuracy on an independent test set from 95.93% (with 6% label noise) to 96.50% (with 1.5% noise), approaching the ideal 96.57% (with 0% noise). The results demonstrate the method's effectiveness in improving model performance through automated label quality control.

Zhipeng Zhang, Wenhui Shou, Wengting Ma +5

China Mobile Research Institute, Beijing 100032, China · Shenyang He Eye Hospital, Shenyang 110034, China

Medical Image Classification Fundus Images Medical Images Deep Learning Loss Function

Jun 24, 2026cs.CV

MRI2Rep: Autoregressive Structured Report Generation for 3D Liver MRI

Manual reporting of 3D MRI studies is time-consuming, yet end-to-end structured report generation for 3D liver MRI remains underexplored due to volumetric complexity and scarce paired data. We propose MRI2Rep, an autoregressive framework for liver MRI report generation. From 3,929 real-world MRI-report pairs acquired over a 10-year single-institution cohort, a Report-to-Label Canonicalization (RLC) module converts free-text reports into structured, closed-vocabulary diagnostic sequences without lesion-level annotations. On a held-out test set, MRI2Rep achieves 76.0% case-level sensitivity, 29.4% lesion-level F1, compared with no more than 8.3% for adapted medical vision-language baselines, and 82.4% liver-level accuracy. In a blinded reader study, two radiologists rated 75% and 70% of AI-generated reports as clinically acceptable, compared with 95% and 100% for original reports. Our automated LLM-based judge, LLM-Eval, rated 61.8% of AI-generated reports as acceptable, applying a stricter standard and supporting its use as a conservative proxy. To our knowledge, this is the first end-to-end LI-RADS-structured reporting system for 3D liver MRI.

Xinran Li, Junlin Yang, Annabella Shewarega +4

Yale University, New Haven, CT 06520, USA · Department of Biomedical Engineering · Department of Radiology & Biomedical Imaging +3

Radiology Report Generation Report Medical Images Autoregressive Generation Autoregressive Model

Jun 23, 2026cs.CV

Jolia: Concept-Level Vision-Language Alignment for 3D CT Contrastive Learning

Vision-language contrastive pretraining has become the dominant recipe for 3D medical foundation models, leveraging the large volumes of paired scans and reports produced in clinical practice. However, medical images usually span dozens of organs, and radiological reports are much longer than typical natural image captions and are composed of multiple structured sections. CLIP-style pretraining compresses this structure by encoding each modality into a single global token, at the risk of losing important details. We introduce ConQuer (Concept Queries), an image-text pretraining method that augments CLIP's global alignment with a set of localized alignments, one per concept. ConQuer splits the report into concept-specific sections and learns cross-attention queries that pool the matching image features without using any segmentation mask or spatial supervision. Contrastive learning is then applied independently for each concept. Concepts can be any unit of semantic localization; here, they are anatomical regions, one query per organ or gross body region. As a byproduct, each query learns attention maps focused on its concept, providing built-in spatial interpretability. We use ConQuer to train Jolia, a 3D CT foundation model on chest and abdominal CT. Jolia consistently outperforms a CLIP baseline on findings classification, report generation, and cross-center transfer, and sets a new state of the art across multiple public benchmarks. Jolia's weights are available at https://huggingface.co/raidium/Jolia

Julien Khlaut, Charles Corbière, Baptiste Callard +9

Raidium, Paris, 75014, France · Department of Vascular and Oncological Interventional Radiology,2026 Hôpital Européen Georges Pompidou, AP-HP, Paris, France · Faculté de Santé, Université Paris-Cité, Paris, France +3

Vision-Language Alignment Medical Images 3D Foundation Models Contrastive Learning Cone-Beam Computed Tomography

Jun 21, 2026cs.CV

MaRS: Robust Out-of-Distribution Detection via Mahalanobis Residual Scoring

Foundation models provide highly descriptive representations for medical images, yet their reliability degrades under distribution shifts arising from changes in patients, devices, or acquisition conditions. Reliable out-of-distribution (OOD) detection is therefore essential for safe deployment. Recent post-hoc detectors efficiently exploit frozen embeddings (e.g., kNN), whereas reconstruction-based OOD detection in latent feature space has seen limited adoption due to inconsistent performance. In this work, we show that the limitation of reconstruction-based methods in latent space does not stem from poor reconstruction quality, but from how reconstruction errors are scored. Standard L2 residual norms collapse the anisotropic residual structure, thereby suppressing informative deviations. To address this limitation, we introduce MaRS (Mahalanobis Residual Scoring), a label-free OOD detector that learns an in-distribution manifold using a lightweight autoencoder and measures deviation via a Mahalanobis distance on reconstruction residuals, yielding variance-aware OOD scores. Across three imaging modalities, multiple types of distribution shift, and different model families and scales, MaRS outperforms established confidence-, distance-, and reconstruction-based baselines, while remaining fully post-hoc and lightweight. The code is available at https://github.com/francescodisalvo05/mars.

Francesco Di Salvo, Sebastian Doerrich, Christian Ledig

XAI Lab Bamberg, University of Bamberg, Germany

Out-Of-Distribution Detection Out-Of-Distribution Medical Images Anisotropic

Jun 18, 2026cs.CV

CSWinUNETR: Segmentation of Thin Anatomical Structures in Medical Images

Accurate segmentation of thin, tortuous anatomical structures, such as retinal vessels, cerebral vasculature, and facial wrinkles, remains challenging due to low contrast, frequent discontinuities, and severe class imbalance. Although recent convolutional and Transformer-based models have improved performance, they often yield fragmented predictions and fail to recover fine branches. We propose CSWinUNETR, a general-purpose backbone for 2D and 3D thin-structure segmentation. It employs cross-shaped stripe self-attention to model long-range principal-axis context and incorporates cyclic shifts to enhance information exchange across stripes. To better preserve fine-grained details, we further introduce a detail-enhanced multi-scale self-attention module that aggregates contextual features from multi-resolution representations. In addition, we propose sparse-control dynamic snake convolution, which reconstructs reliable dense curvilinear kernels from sparsely predicted control points to better follow tortuous geometry. Extensive experiments on four benchmarks across ophthalmology, neurovascular imaging, and dermatology demonstrate that CSWinUNETR consistently outperforms state-of-the-art methods without task-specific post-processing or topology-aware losses. The code is available at https://github.com/labhai/CSWinUNETR.

Junho Moon, Haejun Chung, Ikbeom Jang

Hanyang University, Seoul, Republic of Korea · Hankuk University of Foreign Studies, Yongin, Republic of Korea

Vessel Segmentation U-Net Semi-Supervised Medical Image Segmentation Swin Medical Images Anatomy+2

Jun 17, 2026eess.IV

Beyond Algorithms: Conceptual Innovation in Medical Imaging AI

Artificial intelligence has driven rapid progress in medical imaging research, producing increasingly sophisticated algorithms and steady improvements on benchmark tasks. However, this algorithm-centric trajectory has also revealed a growing imbalance: while computational methods advance rapidly, the conceptual foundations that define imaging tasks, evaluation metrics, and clinical meaning sometimes remain underexamined. In this Perspective, we distinguish algorithmic innovation, which focuses on improving computational implementations and performance within a fixed problem definition, from conceptual innovation, which reframes what problems are posed, how success is measured, and why an approach is clinically relevant. We argue that prevailing incentive structures, training pathways, and publication norms disproportionately reward algorithmic novelty, particularly for early-career researchers, while at times undervaluing conceptual contributions that are essential for scientific maturation and clinical translation. Through representative examples from medical imaging AI, we show how insufficient conceptual grounding can lead to misaligned objectives, fragile generalization, and limited real-world impact. We conclude with actionable recommendations for researchers, mentors, reviewers, and journals to better recognize, support, and integrate conceptual innovation alongside algorithmic advances.

Mark A. Anastasio

Mallinckrodt Institute of Radiology and Department of Electrical & Systems Engineering, Washington University in St. Louis, St. Louis, MO 63110 USA

Medical Images Innovation Algorithmic Cores

Jun 17, 2026cs.HC

A Clinician-Centered Pipeline for Annotation and Evaluation in Ultrasound AI Studies

Clinician-centered evaluation is critical for validating medical AI systems, especially in ultrasound imaging where quantitative metrics do not always capture clinical usability. Existing medical image platforms primarily focus on dataset labeling. They lack integrated support for blinded model comparison and reproducible evaluation workflows. We present a clinician-centered pipeline for remote annotation and evaluation in ultrasound AI studies. The proposed pipeline uses a centralized server and lightweight browser interfaces to enable clinicians to perform annotation, blinded ranking, and review without local dataset downloads. The pipeline also supports multi-rater participation, centralized result aggregation, and automated statistical analysis. We validate the pipeline in a fetal ultrasound segmentation study with six raters spanning expert, generalist, and non-expert experience levels. The system automatically generated Spearman correlation, Kendall's

τ

, and top-1 selection statistics. Results indicated moderate to strong agreement across experts and other groups. The blinded evaluation results showed a tendency for later active learning models to be preferred. These outcomes suggest that the pipeline can support clinician-centered annotation and reproducible human-\ac{AI} evaluation studies in ultrasound imaging. The proposed pipeline is available on \href{https://github.com/13204942/SonoRate}{GitHub}.

Fangyijie Wang, Jianjun Yu, Wentao Shi +4

Research Ireland Centre for Research Training in Machine Learning · School of Medicine, University College Dublin, Dublin, Ireland · The Third People’s Hospital of Zhenjiang City, Zhenjiang, China +3

Ultrasound Medical Images Reproducibility Annotations

Jun 15, 2026cs.CV

An Open-Source Monitoring Framework for Data Exploration and Progress Tracking in Multi-Center Radiology Studies

Multi-center studies are crucial for advancing medical and radiological research. Data exploration, collaboration discovery, and study progress monitoring are essential for maximizing their potential. However, in practice these processes often rely on manual communication and shared tables, which quickly become outdated and hinder efficient coordination in large distributed studies. This highlights the need for dedicated monitoring solutions that provide transparent and up-to-date insights into study progress. We propose a lightweight, open-source monitoring architecture for multi-center studies based on the widely used Grafana-Prometheus stack. The framework collects aggregated monitoring metrics from distributed study sites and visualizes them through configurable dashboards. As a real-world deployment example, the framework is integrated into the medical imaging platform Kaapana and evaluated within a large multi-center research network. By deploying our solution within the Germany-wide RACOON consortium, we demonstrate its ability to enable privacy-preserving data exploration and study progress monitoring across all 38 German university clinics. The monitoring framework supports transparent coordination of distributed research activities and can facilitate more efficient management of large-scale multi-center studies. The source code and Kaapana integration are publicly available at https://github.com/MIC-DKFZ/study-monitoring-kaapana.

Markus Bujotzek, Jonas Scherer, Stefan Denner +7

Division of Medical Image Computing, Germany Cancer Research Center, Heidelberg, 69120, Germany. · Medical Faculty, University of Heidelberg, Heidelberg, 69120, Germany. · Faculty for Computer Science, University of Heidelberg, Heidelberg, 69120, Germany. +3

Multicenter Evaluation Medical Images Global Coordination

Jun 14, 2026cs.CL

Calibrated Triage, Not Autonomy: Confidence Estimation for Medical Vision-Language Models

A vision-language model can answer a question about a medical image fluently and confidently while barely using the image, leaning instead on language priors. In medicine this is the failure that matters most, because the answer looks trustworthy and is not, and the only protection is a confidence score reliable enough to tell the system when to abstain. We ask a deployment question rather than an accuracy one: how much imaging work a model can safely handle alone, and which confidence signal makes that possible. We evaluate seven confidence estimators across five open-weight LVLMs and three medical visual-question-answering datasets spanning broad clinical imaging, radiology, and pathology, with every probe trained only on natural images and applied without adaptation. Recast as bounded selective prediction (automate a case only when confidence clears a threshold, defer the rest), the comparison is cautionary. The standard metrics are poor guides: discrimination barely separates the methods, and the weak calibration of a cheap self-report is cheaply removed by off-domain temperature scaling without changing deployable yield. What distinguishes a usable estimator is the high-confidence region a clinician acts on: the weakest baselines are confidently wrong on 41 to 45 percent of their errors against 1 to 4 percent for the best probe, and no estimator is reliably best across domains or models. Safe handoff is governed at two levels: base-model competence sets a ceiling, so a well-calibrated score recovers roughly a third of radiology cases at a 20 percent error tolerance but almost none of pathology; the confidence layer then decides how much of that ceiling is reachable. The usable role today is calibrated triage, not autonomy: automate the cases a calibrated score marks safe, route the rest to a clinician. We release all outputs, correctness judgments, and confidence scores, with code.

Reza Khanmohammadi, Kundan Thind, Mohammad M. Ghassemi

Michigan State University East Lansing, MI, USA · Henry Ford Health Detroit, MI, USA

Medical Vision-Language Models Medical Visual Question Answering Confidence Estimation Triage Medical Images

Jun 10, 2026cs.CV

Analyzing and Improving Fine-grained Preference Optimization in Medical LVLMs

Large Vision-Language Models (LVLMs) have achieved strong performance across medical imaging tasks, yet they remain prone to factual inconsistencies, poor visual grounding, and misalignment with clinically meaningful feedback. Existing post-training alignment approaches, including Direct Preference Optimization (DPO) and its variants, face three critical limitations in the medical domain: (1) sequence-level reward signals treat clinically critical tokens identically to generic filler text; (2) reliance on static supervised fine-tuning references as preferred responses introduces an off-policy distribution shift, steering optimization toward stylistic artifacts over clinical correctness; and (3) alignment objectives lack explicit visual grounding constraints, leaving models insensitive to subtle yet diagnostically decisive pathological features. Our method leverages a bidirectional token-wise KL regularizer alongside a visual-contrastive grounding objective that pairs clean and lesion-corrupted images to penalize responses generated without adequate visual evidence. Together, these components form a fine-grained, on-policy alignment framework that constructs preference pairs by minimally editing model-generated outputs, correcting only clinically erroneous spans while preserving the original linguistic style. Extensive experiments across medical imaging tasks and clinical text generation benchmarks validate the effectiveness of our approach.

Shayan Mohammadizadehsamakosh, Pritam Sarkar, Leonid Sigal +2

York University · Vector Institute · University of British Columbia +1

Medical Vision-Language Models Vision-Language Alignment Sequential Preference Optimization Medical Images Post-Training

Jun 4, 2026cs.CV

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

Radiology Report Generation Medical Images Comparison Vision-Language Foundation Models

Jun 3, 2026cs.CV

Enhancing MedSAM with a Lightweight Box Predictor for Medical Image Segmentation

Semantic segmentation in medical imaging is a critical yet challenging task due to data scarcity and high variability across modalities. While foundation models like the Segment Anything Model (SAM) show promise, they often struggle with medical images without specific adaptation. Moreover, point prompts, despite being the most natural form of user interaction, provide insufficient spatial context for reliable segmentation, particularly when target structures are irregular or poorly contrasted. In this paper, we propose an enhanced segmentation framework that integrates a lightweight Box Predictor module into the MedSAM architecture. The Box Predictor estimates an approximate bounding box from a single user click using localized image embedding features, providing spatial guidance that reduces the ambiguity of point prompts, while introducing only 1.6M additional parameters and negligible inference overhead. We introduce a two-stage training pipeline where the Box Predictor is trained independently before being integrated into MedSAM. To validate the generalization capability of our method, we conduct extensive evaluations on four diverse datasets (FLARE22, BRISC, BUSI, LungSegDB) spanning distinct imaging modalities, including CT, MRI, and Ultrasound. Our method improves segmentation accuracy and robustness across varied anatomical structures and imaging domains, achieving Dice scores of 0.89 (BUSI), 0.93 (FLARE22), 0.88 (BRISC), and 0.98 (LungSegDB). Code is available at https://github.com/Amirhosseinmovahedi/MedSAM-BoxPredictor

Amirhossein Movahedisefat, Amirreza Fateh, Mohammad Reza Mohammadi

School of Computer Engineering, Iran University of Science and Technology (IUST), Tehran, Iran

Semi-Supervised Medical Image Segmentation Medical Images Semantic Segmentation Lightweight

Jun 3, 2026cs.CV

A New Angle on Bones: Robust Pose Estimation in X-Ray and Ultrasound

Measuring the angle between bone structures is a routine task in medical image analysis and provides a key quantitative parameter for diagnosis and treatment planning. Automated methods can reduce time and cost while improving reproducibility. In this work, we address automatic bone pose estimation using a learning-based point candidate proposal followed by a line model to extract axis parameters. Since conventional line models such as least squares are sensitive to outliers, we incorporate false-positive reduction strategies and robust fitting techniques, such as RANSAC and Hough transforms, to improve robustness. We evaluate our method on three clinically relevant paediatric angle estimation tasks: fracture fragment assessment in radiographs and ultrasound and developmental dysplasia of the hip evaluation in ultrasound using the Graf method. Our approach achieves mean errors of

4.1^\circ

,

5.4^\circ

, and

5.51^\circ

, respectively, not only remaining within the expected clinical observer variability, but also significantly outperforming landmark-based methods. Our code and annotations for fracture angle assessment in radiographs are publicly available on GitHub.

Ron Keuth, Christoph Großbröhmer, Franziska Halm +5

Medical Informatics, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany. · EchoScout GmbH, Maria-Goeppert-Str. 3, 23562 Lübeck, Germany · Institut of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein +1

Category-Level Object Pose Estimation Skeleton X-Ray Ultrasound Medical Images

May 30, 2026cs.CV

Bridging Topology and Deep Representation Learning: A TDA-ViT Fusion Model for Four-Class Brain Tumor Classification

Accurate brain tumor classification from magnetic resonance imaging (MRI) is a key requirement for early diagnosis and clinical decision-making. Vision Transformers (ViTs) have shown strong performance in medical image analysis by learning global contextual representations, but they often fail to capture intrinsic structural and topological patterns present in tumor regions. To address this limitation, we propose a fusion framework that combines Topological Data Analysis (TDA) features with pretrained Vision Transformer representations for four-class brain tumor classification. In the proposed method, TDA is used to extract complementary topological descriptors that capture geometric structure, connectivity, and shape information from MRI images. In parallel, a pretrained ViT model learns high-level semantic representations from the same images. These two feature spaces are then fused to form a unified and more discriminative representation for classification. The model is evaluated on the BRISC2025 dataset, which contains four brain tumor classes: glioma, meningioma, pituitary tumor, and non-tumor cases. Experimental results show that combining topological and transformer-based features significantly improves performance compared to using either approach alone. The proposed TDA-ViT fusion model achieves an accuracy of 99.10%, precision of 99.27%, recall of 99.15%, F1-score of 99.21%, and an AUC of 99.98%. It also outperforms several state-of-the-art models, including ResNet50, ResNet101, EfficientNetB2, and standalone Vision Transformers. These results demonstrate that topological features provide valuable complementary information that enhances deep representation learning, leading to a robust and highly accurate framework for automated brain tumor classification.

Faisal Ahmed

Department of Data Science and Mathematics, Embry-Riddle Aeronautical University, 3700 Willow Creek Rd, Prescott, 86301, Arizona, USA.

Brain Tumor Classification Medical Images Vision Transformer Topology Bridging Language

May 29, 2026cs.LG

A Context-Aware Middleware for Medical Image Based Reports: An approach based on image feature extraction and association rules

This work proposes a context-aware middleware for medical workflow organization and efficiency improvement. In hospitals, laboratories and teleradiology companies, each physician or technician is specialized in a specific kind of diagnosis or analysis. Therefore, certain types of medical images are often forwarded to a certain physician or a certain group. This forwarding is time consuming. That is, repeatedly deciding who would be the best physician, whether he is available at a certain moment given a certain context is exhaustive and may be very inefficient. Thus, the proposed middleware has the ability to process and collect data from images analyzed by each medical staff. Based on the collected data and current clinical context, the middleware is able to infer who would be the best fit staff to receive a certain incoming medical image.

Erick O. Rodrigues, Jose Viterbo, Aura Conci +1

Department of Computer Science Universidade Federal Fluminense Niter6i, Rio de Janeiro · Departament of Mathematics & Statistics, York University Keele St 4700, Toronto, ON M3J IP3, Canada

Real-World Clinical Workflows Medical Images Context-Awareness Medical Imaging Datasets Radiology Report Generation Efficiency

May 25, 2026cs.CV

A multifractal-based masked auto-encoder: an application to medical images

Masked autoencoders (MAE) have shown great promise in medical image classification. However, the random masking strategy employed by traditional MAEs may overlook critical areas in medical images, where even subtle changes can indicate disease. To address this limitation, we propose a novel approach that utilizes a multifractal measure (Renyi entropy) to optimize the masking strategy. Our method, termed Multifractal-Optimized Masked Autoencoder (MO-MAE), employs a multifractal analysis to identify regions of high complexity and information content. By focusing the masking process on these areas, MO-MAE ensures that the model learns to reconstruct the most diagnostically relevant features. This approach is particularly beneficial for medical imaging, where fine-grained inspection of tissue structures is crucial for accurate diagnosis. We evaluate MO-MAE on several medical datasets covering various diseases, including MedMNIST and COVID-CT. Our results demonstrate that MO-MAE achieves promising performance, surpassing other basiline and state-of-the-art models. The proposed method also adds minimum computational overhead as the computation of the proposed measure is straightforward. Our findings suggest that the multifractal-optimized masking strategy enhances the model's ability to capture and reconstruct complex tissue structures, leading to more accurate and efficient medical image representation. The proposed MO-MAE framework offers a promising direction for improving the accuracy and efficiency of deep learning models in medical image analysis, potentially advancing the field of computer-aided diagnosis.

Joao Batista Florindo, Viviane de Moura

Institute of Mathematics, Statistics and Scientific Computing - University of Campinas, Rua Sérgio Buarque de Holanda, 651, Cidade Universitária ”Zeferino Vaz” - Distr. Barão Geraldo, CEP 13083-859, Campinas, SP, Brasil

3D Masked Autoencoders Medical Images Autoencoder Architectures Fractal Dimension

May 24, 2026cs.CV

Self-Supervised Contrastive Learning for Cardiac MR Sequence Classification

Vision Transformer (ViT) models, utilizing self-attention mechanisms, have demonstrated robust generalization capabilities across various vision tasks, including image classification. However, these models, typically pretrained on general public datasets, often lack the specialized domain knowledge necessary for medical imaging applications. In this study, we investigate the adaptation of ViT models, specifically for cardiac magnetic resonance (MR) images, using an in-house dataset. We found that pretrained ViT features do not effectively transfer to the cardiac MR domain. To overcome this limitation, we introduce an adaptation strategy that utilizes image-based self-supervised contrastive learning, demonstrating superior performance compared to traditional supervised training approaches. Moreover, our adapted ViT model exhibits strong generalization to external MR datasets such as BraTS and ADNI. Through ablation studies, we further investigate the impact of batch size and dataset scale on performance. Ultimately, our adapted model achieves classification AUC exceeding 0.75 across the four most common cardiac MR sequences.

Yuli Wang, Hyewon Jung, Dongshen Peng +10

Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA · Department of Electrical and Computer Engineering, Johns Hopkins University,2026 Baltimore, MD, 21218, USA · Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 +4

Cardiac Magnetic Resonance Imaging Medical Images Vision Transformer Magnetic Resonance Imaging Contrastive Learning

May 22, 2026cs.CV

Radiuma: A Unified Zero-Code Executable Graphical Workflow Generator for Reproducible and Shareable Medical Image Analysis and Machine Learning

Medical image computing software is essential for identifying imaging biomarkers that can support diagnosis, prognosis, treatment planning, and clinical research. However, the lack of standardized, user-friendly, and reproducible software environments has limited the broader adoption of advanced medical image analysis workflows. We present Radiuma, a freely available modular platform designed to support reliable and reproducible medical image analysis across multiple modalities and file formats. Radiuma integrates image reading, visualization, registration, fusion, processing, segmentation, radiomics feature extraction, and machine learning modules for classification, regression, and clustering. Its modular design allows users to execute each component independently or connect modules through a visual workflow system, where the output of one step can be graphically passed to the next. This enables the creation of custom, executable, and reproducible multi-step pipelines without requiring extensive programming expertise. Results from each module can be inspected directly in the visualization window, providing immediate feedback on processing quality and workflow accuracy. Radiuma also supports saving and sharing customized workflows, promoting transparency, reusability, and consistency across collaborative studies. By combining flexibility, usability, and standardized analysis tools, Radiuma provides a practical environment for radiomics and machine learning research in clinical and translational settings. The platform is designed to be accessible to users with diverse expertise, including radiologists, physicists, clinicians, and data scientists.

Mohammad Salmanpour, Mehrdad Oveisi, Isaac Shiri +1

Department of Basic and Translational Research, BC Cancer Research Institute, Vancouver, BC, Canada · Department of Radiology, University of British Columbia, Vancouver, BC, Canada · Technological Virtual Collaboration (TECVICO Corp.), Vancouver, BC, Canada +4

Radiomics Medical Images Biomarker Agentic Workflow Design

May 18, 2026cs.CV

Task-Aligned Self-Supervised Learning for Medical Image Analysis: A Task-Oriented Review with Practical Design Guidelines

Self-supervised learning (SSL) is increasingly used in medical image analysis to reduce dependence on costly expert annotations by learning transferable representations from unlabeled data. However, SSL performance depends not only on model architecture, but also on whether the pretext task preserves information required by the downstream clinical objective. This review presents a task-oriented synthesis of SSL methods for medical imaging, focusing on how pretext-task design interacts with imaging modality, label availability, and downstream performance. We analyze 75 studies published from 2017 to 2025 and organize them into four paradigms: contrastive learning, non-contrastive and predictive learning, generative and reconstruction-based learning, and hybrid learning. Rather than cataloging methods chronologically, we examine how these paradigms support classification, segmentation, detection, reconstruction, and regression. The evidence suggests that no SSL strategy is universally optimal. Contrastive objectives generally encourage global discriminative representations and are well aligned with classification, but may underrepresent subtle or localized pathology. Spatial prediction, masked modeling, and reconstruction-based objectives better preserve anatomical structure and are often more suitable for segmentation and dense prediction. Hybrid methods can provide balanced representations, although they increase training complexity. Across modalities, SSL is most beneficial in low-label and few-shot regimes, but its effectiveness depends on modality-aware augmentation, pathology-preserving corruption, and clinically meaningful evaluation. We conclude with practical design guidelines and identify open challenges, including pathology-aware pretext tasks, resource-efficient training for high-dimensional data, and standardized evaluation protocols.

Chathura Wimalasiri, Kishor Nandakishor, Marimuthu Palaniswami

Department of Electrical and Electronic Engineering, University of Melbourne, Parkville, VIC 3052, Australia

Medical Images Self-Supervised Learning Medical Imaging Review

May 17, 2026cs.CV

A World Model of Radiologist Reading for Medical Image Representation Learning

Radiologist eye-tracking data provide a rich record of how experts search, compare, and accumulate evidence during image reading; yet, existing methods exploit this signal only partially, either as a static spatial prior or as an auxiliary prediction target decoupled from diagnosis. We propose GazeWorld, a medical imaging world model that treats the image as the world and the radiologist's fixation sequence as a trajectory through it. GazeWorld autoregressively predicts the latent representation of the next fixated patch from all previously visited ones, while a spatial-completion branch covers unvisited regions. At inference, GazeWorld generates a sequence of patch representations from the image alone without requiring real gaze data. Frozen GazeWorld features achieve state-of-the-art diagnostic accuracy across all nine supervised settings on CheXpert, RSNA Pneumonia, and SIIM-ACR Pneumothorax, as well as the highest zero-shot accuracy on all three benchmarks. On the GazeSearch benchmark, a generic decoder trained on the same frozen features outperforms the purpose-built LogitGaze-Med by over 16% in ScanMatch and 22% in SED, despite not being explicitly trained to predict gaze. GazeWorld demonstrates that modeling how experts read, not just what they conclude, offers a promising pretraining paradigm for medical imaging AI.

Yiwei Li, Zihao Wu, Huaqin Zhao +5

University of Georgia · University of Texas at Arlington · New Jersey Institute of Technology

Medical Images Radiology Report Generation Eye Tracking World Models Aeroact

May 15, 2026stat.ML

A Scalable Nonparametric Continuous-Time Survival Model through Numerical Quadrature

Flexible continuous-time survival modeling is critical for capturing complex time-varying hazard dynamics in high-dimensional data; however, training such models remains challenging due to the intractable integral required for likelihood estimation. We introduce QSurv, a scalable deep learning framework that enables nonparametric continuous-time modeling without relying on time discretization or restrictive distributional assumptions. We propose a training objective based on Gauss-Legendre numerical quadrature, which approximates the cumulative hazard with high-order accuracy while facilitating efficient end-to-end training via standard backpropagation. Furthermore, to effectively capture non-stationary hazard dynamics in complex architectures, we introduce time-conditioned low-rank adaptation, a mechanism that conditions general neural backbones on time by dynamically modulating weights via low-rank updates. We provide theoretical analysis establishing approximation error bounds for cumulative-hazard evaluation. Comprehensive experiments across synthetic benchmarks, large-scale real-world tabular datasets, and high-dimensional medical imaging tasks demonstrate that QSurv achieves competitive predictive performance with advantages in instantaneous hazard function estimation, enabling more interpretable characterization of time-varying risk patterns.

Chaeyeon Lee, Sehwan Kim, Hyungrok Do

Department of Statistics · Ewha Womans University · Seoul, Korea +3

Survival Analysis Time-To-Event Data Surrogate Models Exponential Family Bayesian Quadrature Neural Ordinary Differential Equations+1

May 13, 2026eess.IV

Keyed Nonlinear Transform: Lightweight Privacy-Enhancing Feature Sharing for Medical Image Analysis

Feature sharing via split inference offers a lightweight alternative to federated learning for resource-constrained hospitals, but transmitted features still leak patient identity information and lack practical mechanisms for controlled feature sharing. We propose Keyed Nonlinear Transform (KNT), a drop-in feature transformation that applies key-conditioned obfuscation to intermediate representations. KNT reduces re-identification AUC from 0.635 to 0.586, corresponding to a 36% reduction in above-chance identity signal, while introducing only 0.15 ms CPU overhead, without backbone retraining, and preserving classification performance within 1.0 pp. Our analysis shows that KNT's nonlinear transform prevents closed-form inversion and shifts recovery to iterative gradient-based optimization under full key compromise, substantially increasing inversion difficulty. The same transform generalizes to dense prediction tasks, incurring only a 4.4 pp Dice reduction on skin-lesion segmentation without retraining. These results position KNT as a practical and efficient privacy layer for split inference deployments.

Haebom Lee, Gyeongjung Kim

OOLU Soft Co., Ltd.

Privacy-Preserving Machine Learning Medical Images

May 12, 2026cs.CV

Beyond Masks: The Case for Medical Image Parsing

Medical imaging research has spent a decade getting very good at one thing: producing per-voxel masks. Masks tell us size, volume, and location, and a decade of clinical infrastructure rests on those outputs. Yet the report a radiologist writes contains almost nothing a mask can express. We argue that medical imaging research should adopt medical image parsing as its central output: a structured representation in which entities, attributes, and relationships are emitted together and mutually consistent. Entities are the named structures and findings, present or absent. Attributes describe those entities, capturing things like margin regularity, enhancement pattern, or severity grade. Relationships connect them, naming where one structure sits relative to another, what abuts what, and what has changed since the prior scan. A good parse satisfies three properties, in order: (1) decision (the parse names the right things in the current image), (2) reconstruction (its content is rich enough to regenerate that image), and (3) prediction (its content is rich enough to forecast how the patient state will evolve). Quantitative measurements are derived from this content; they are not predicted alongside it. To test how close the field is to producing such an output, we audit eleven representative systems against the three parsing primitives plus closure. None emits a well-formed parse. Entities are largely solved. Attributes, relationships, and closure remain near-empty. The path forward is not a new architecture. It is a commitment to a richer output, and to training signals that reward it. Segmentation taught models to measure. Parsing asks them to explain.

Siddharth Gupta, Alan L. Yuille, Zongwei Zhou

Johns Hopkins University · Northwestern University · Johns Hopkins Medicine

Medical Images Beyond Retrieval Enhancement

May 11, 2026cs.CV

ABRA: Agent Benchmark for Radiology Applications

Existing medical-agent benchmarks deliver imaging as pre-selected samples, never as an environment the agent must navigate. We introduce ABRA, a radiology-agent benchmark in which the agent operates an OHIF viewer and an Orthanc DICOM server through twenty-one function-calling tools that span slice navigation, windowing, series selection, pixel-coordinate annotation, and structured reporting. ABRA contains 655 programmatically generated tasks across three difficulty tiers and eight types (viewer control, metadata QA, vision probe, annotation, longitudinal comparison, BI-RADS reporting, and oracle variants of annotation and BI-RADS reporting), drawn from LIDC-IDRI, Duke Breast Cancer MRI, and NLST New-Lesion LongCT. Each episode is scored along Planning, Execution, and Outcome (Bluethgen et al., 2025) by task-type-specific automatic scorers. Ten current models, five closed-weight and five open-weight, reach at least 89% Execution on real annotation but only 0-25% Outcome; on the paired oracle variant where a simulated detector supplies the finding, Outcome on the same task reaches 69-100% across the models evaluated, localising the bottleneck to perception rather than tool orchestration. Code, task generators, and scorers are released at https://github.com/Luab/ABRA

Bulat Maksudov, Vladislav Kurenkov, Kathleen M. Curran +1

School of Computing Dublin City University Dublin, Ireland · AXXX · School of Medicine University College Dublin Dublin, Ireland

Radiology Report Generation Medical Images Agentic Benchmarks Pixel-Level Annotation

May 11, 2026cs.CV

Med-StepBench: A Hierarchical Reasoning Framework for Evaluating Hallucinations in Medical Vision-Language Models

Large vision-language models (VLMs) demonstrate strong performance in medical image understanding, but frequently generate clinically plausible yet incorrect statements, raising significant safety concerns. Existing medical hallucination benchmarks primarily focus on 2D imaging with one-shot diagnostic questions, offering limited insight into whether predictions are grounded in correct localization and abnormality identification, allowing critical reasoning errors to remain hidden behind seemingly correct diagnoses. We introduce Med-StepBench, the first large-scale benchmark for step-wise hallucination detection in 3D oncological PET/CT, comprising over 12,000 images and more than 1,000,000 image-statement pairs across volumetric and multi-view 2D data, which decomposes clinical reasoning into four expert-designed diagnostic stages. Using clinician-verified annotations, we perform the first step-level evaluation of general-purpose and medical VLMs, revealing systematic failure modes obscured by aggregate accuracy metrics. Furthermore, we show that current VLMs are highly susceptible to adversarial yet clinically plausible intermediate explanations, which significantly amplify hallucinations despite contradictory visual evidence. Together, our findings highlight fundamental limitations in grounding multi-step clinical reasoning and establish Med-StepBench as a rigorous benchmark for developing safer and more reliable medical VLMs.

Minh Khoi Nguyen, Dai Lam Le, Amir Reza Jafari +8

1AI4LIFE, Hanoi University of Science and Technology, Vietnam · 2SAMOVAR, Télécom SudParis, Institut Polytechnique de Paris, France · Military Central Hospital, Vietnam +1

Medical Vision-Language Models Citation Hallucination Detection Hallucination Detection Medical Images Clinical Reasoning Training Diagnostic Benchmark

May 7, 2026cs.LG

Medical Imaging Classification with Cold-Atom Reservoir Computing using Auto-Encoders and Surrogate-Driven Training

We introduce a hybrid quantum-classical pipeline, based on neutral-atom reservoir computing, for medical image classification, focusing on the binary classification task of polyp detection. To deal effectively with the high dimensionality, we integrate a guided auto-encoder. This pipeline learns compact and discriminative representations of image data that are also well-suited for quantum reservoir computing. A key challenge in such systems is the non-differentiable nature of quantum measurements, which creates a 'gradient barrier' for standard training. We overcome this barrier by incorporating a differentiable surrogate model that emulates the quantum layer, enabling end-to-end backpropagation through the entire system. This guided training process is jointly optimized for classification accuracy and for faithful image recovery from the auto-encoder. The learned latent representations are encoded as pulse detuning parameters within a Rydberg Hamiltonian, and quantum embeddings are subsequently obtained through expectation values. These embeddings are then passed to a linear classifier. Our simulations show that this method outperforms some traditional approaches that use PCA or unguided autoencoders. We also conduct ablation studies to assess the impact of various quantum and training parameters, demonstrating the robustness and flexibility of our proposed pipeline for real-world medical imaging applications, even in the current NISQ era.

Nuno Batista, Ana Morgado, Oscar Ferraz +3

Instituto de Telecomunicac¸˜oes, Dept. of Electrical and Computer Engineering, University of Coimbra, Portugal · CFisUC, Department of Physics, University of Coimbra, Portugal · ISR - Institute of Systems and Robotics, Dept. of Electrical and Computer Engineering, University of Coimbra, Portugal

Hybrid Quantum-Classical Pipeline Reservoir Computing Medical Images Autoencoder Architectures Polyp Segmentation Machine Learning Surrogates+1

May 7, 2026cs.CV

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

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

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

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

Medical Images Multi--Task Learning Mixture-Of-Experts

May 3, 2026cs.CV

Cross-Domain Adversarial Augmentation: Stabilizing GANs for Medical and Handwriting Data Scarcity

Generative Adversarial Networks (GANs) can help overcome data scarcity in computer vision tasks by generating additional training samples. In this work, we explore generative data augmentation in two low-resource domains: Bangla handwritten character recognition and chest X-ray image analysis. We use DCGAN-based models trained on 64x64 images to generate synthetic samples and evaluate their quality using Inception Score (IS), Fréchet Inception Distance (FID), and visualization methods such as t-SNE and UMAP. To measure practical usefulness, we train image classifiers using real data and a combination of real and synthetic data. Experimental results show that synthetic augmentation improves data diversity and consistently increases classification performance in limited-data settings. We also investigate training stability techniques, including gradient penalty and spectral normalization, and perform ablation studies on synthetic-to-real data ratios and sample filtering strategies. In addition, we discuss challenges related to medical image evaluation, dataset licensing, and privacy concerns of synthetic data. Our approach is simple, reproducible, and provides a strong baseline for generative augmentation in resource-constrained imaging applications.

Md. Sohanuzzaman Soad, Mahady Al Hady, S M Rafiuddin Rifat +1

Department of Computer Science and Engineering University of Asia Pacific Dhaka, Bangladesh

Data Augmentation Generative Adversarial Network Medical Image Generation Medical Images Handwriting