Polyp Segmentation

In real-time colonoscopy, ground-truth annotations are unavailable at inference, so polyp segmentation models can fail silently. We propose Referee-Based Quality Estimation (RBQE), a reference-free framework measuring agreement between a primary segmentation model and an independently trained referee on the same image. RBQE is evaluated on a standardized 1,223-image external benchmark drawn from four public datasets, using four referee configurations chosen to separate two design axes: referee independence and architectural diversity. Using a common Agreement Dice descriptor, a same-architecture referee differing from the primary model only in random initialization already yields a useful reliability signal (ROC-AUC = 0.923), showing that independent training alone is sufficient. Cross-architecture referees improve further: SegFormer-B0 achieves the strongest performance (ROC-AUC = 0.960), significantly outperforming the same-architecture control and UNet++, and exceeding a representative Test-Time Augmentation baseline by 0.055 ROC-AUC under an identical protocol, whereas a prompt-coupled MedSAM referee underperforms despite maximal architectural diversity. Because empty-mask agreement is trivially separable, we also report a restricted evaluation excluding such cases: ROC-AUC falls to 0.876 (SegFormer-B0, 1,046 images) and 0.783 (same-architecture control, 975 images), yet RBQE's margin over both baselines widens on this identical subset. RBQE additionally increases the mean Dice of retained predictions as low-agreement cases are progressively rejected, supporting selective prediction, and requires only one additional deterministic referee forward pass at inference. Our study therefore supports cross-model agreement as a practical, interpretable reliability framework for automated polyp segmentation.

Because dense frame-level annotation of colonoscopy videos is costly, we propose WSPolypNet, a weakly supervised framework for polyp localization using only video-level labels. WSPolypNet employs a 3D convolutional neural network trained with video-level supervision to generate class activation maps (CAMs), which identify candidate polyp regions without requiring frame-level spatial annotations. The CAM-derived localization cues are further enhanced using a multi-view strategy and provided to MedSAM2 as point prompts. MedSAM2 then propagates segmentation masks across the video, refining the coarse localization cues according to polyp boundaries. WSPolypNet achieved CorLoc scores of 47.80%, 43.68%, and 35.01% at IoU thresholds of 0.3, 0.5, and 0.7, respectively, compared with 36.87%, 33.72%, and 27.94% in the single-view setting. For small polyps, the multi-view strategy improved CorLoc@0.5 from 16.01% to 30.97%. The framework also achieved a recall of 94.51%. These results demonstrate the potential of weakly supervised spatiotemporal learning to substantially reduce spatial annotation requirements for polyp localization in colonoscopy videos.

Accurate segmentation of polyps and skin lesions is pivotal for clinical diagnosis, yet existing methods struggle with low contrast, ambiguous boundaries, and cross-domain distribution discrepancies. Discriminative networks and most diffusion-based segmentation approaches predict standalone binary masks, leaving the visual priors of large-scale pretrained generative models largely unexploited. We propose InstEditSeg, a unified generative framework that reformulates medical segmentation as an instruction-driven image editing problem. Instead of emitting a mask, the model renders a color-coded overlay on the original image, conditioned on a textual instruction, so that the edited output aligns with the natural image distribution learned by latent diffusion models and mitigates the domain gap between natural and medical imagery. To recover fine anatomical structures, we introduce DINOv3 as an auxiliary visual encoder and a DINO Feature Guidance Block that builds a multi-scale feature pyramid. The pyramid is fused into the diffusion U-Net by channel concatenation and zero-initialized convolution so that hierarchical discriminative priors can be injected without perturbing the pretrained weights. A dual-branch classifier-free guidance strategy requiring only two forward passes per denoising step reduces inference cost. On polyp and skin lesion benchmarks the framework achieves accuracy competitive with strong discriminative baselines, and it further demonstrates concrete advantages of the generative formulation: notably better cross-domain generalization on unseen data, more complete multi-lesion segmentation, instruction-conditioned task control, and sampling flexibility. We also analyze the strengths and limitations of the paradigm, including its color sensitivity and unsupported attribute-conditioned selection. Code is available at: https://github.com/wincharm001/InstEditSeg.

Medical image segmentation remains difficult to scale because high-performing methods typically rely on dense expert annotations and task-specific training. We introduce GazeRefine, a training-free framework that uses gaze as an inference-time prompt for zero-shot medical image segmentation. Sparse, duration-weighted fixations are converted into foreground and background priors that initialize semantic prototypes in frozen DINOv3 feature space. These prototypes are iteratively refined through foreground-background discrimination, feature-space affinity propagation, and anchoring to the initial gaze guidance, allowing segmentation to extend beyond directly fixated regions while limiting semantic drift. GazeRefine requires no segmentation masks, fine-tuning, adapters, prompt encoders, or gradient updates. We evaluate the method on gaze-annotated polyp segmentation and prostate MRI segmentation. The results show strong performance on colonoscopy images and competitive performance on prostate MRI, supporting gaze-guided prototype refinement as a promising approach for segmentation-label-efficient, human-in-the-loop medical image segmentation. Our tools and code can be found in the following repository: https://github.com/MohammedOussamaBEN/GazeRefine.git

Colorectal cancer (CRC) remains one of the leading causes of cancer-related mortality worldwide, predominantly arising from precancerous polyps. Accurate detection, segmentation, and endoscopic and histological classification of colorectal polyps are crucial for timely clinical intervention. In this study, we present PolypVision, a three-stage hierarchical deep learning framework that sequentially performs: (Stage 1) binary classification of polyps as adenomatous or hyperplastic, with simultaneous Paris and JNet classification, using EfficientNetV2-M with Focal Loss; (Stage 2) polyp segmentation with recommended resection method using a UNet++ decoder with the Stage 1 backbone as encoder, optimized with Dice and BCE losses; and (Stage 3) adenoma subtype classification (tubular, tubulovillous, villous) using EfficientNetV2-M with transfer learning from Stage 2. Evaluated on three public datasets -- PolypGen, Kvasir-SEG, and CVC-ClinicDB -- PolypVision achieves an AUC of approximately 0.99 for frame classification and a detection mAP@50 of 94.4% on Kvasir-SEG, outperforming or matching state-of-the-art methods. Gradient-weighted Class Activation Maps (Grad-CAM) confirm that the model attends to clinically relevant lesion features. The framework is device-independent, operating across diverse endoscopic imaging systems without hardware-specific adaptation. These results demonstrate that a hierarchical, transfer-learning-driven pipeline with task-specific loss functions offers a robust, device-independent, and clinically meaningful approach to automated colorectal polyp analysis. PolypVision is freely available as a web application at https://polypvision.com, a DataBioX initiative, with a free usage tier open to all users.

Myopia-induced posterior-pole remodeling is frequently accompanied by Optic Disc (OD) deformation and Peripapillary Atrophy (PPA), both of which provide clinically relevant structural biomarkers. In Cartesian fundus images, however, PPA often appears as an irregular and partially visible crescent adjacent to the OD, leading to fragmented segmentation and post-processing-dependent quantification. We propose UPolarSQ, a unified polar-domain framework for OD/PPA segmentation and biomarker quantification in myopic fundus images. UPolarSQ first maps an OD-centered region of interest into polar coordinates, where OD and PPA boundaries can be represented as radial profiles. It then employs UPolarSeg, a U-Net-based segmentation network enhanced with a Radial-Angular-Decoupled Module and boundary-aware auxiliary supervision to model anisotropic polar features and radial boundary transitions. Clinical biomarkers, including disc shape and PPA-width-related measurements, are deterministically extracted from the predicted polar masks, aligning segmentation and quantification within a shared geometric representation. Experiments on internal and external cohorts demonstrate that UPolarSQ improves OD/PPA segmentation and supports reliable polar-native biomarker estimation for myopic analysis.

Background and Study Aims: Accurate optical diagnosis of colorectal polyps guides resection strategy and surveillance, with multimodal large language models (MLLMs) showing potential for image-based diagnosis. We aimed to evaluate the diagnostic accuracy of MLLMs in classifying colorectal polyps and predicting histology. Methods: We conducted a retrospective diagnostic performance study using the PRIME dataset, a curated set of white light and narrow-band imaging (NBI) images. We evaluated Claude Opus 4, Google Gemini 2.5 Pro, GPT-o3, GPT-4o, and GPT-5. For Paris, Narrow-band Imaging Colorectal Endoscopic (NICE), and predicted histology, we calculated F1 scores, percent correct scores, and accuracy of each MLLM compared to expert responses for 132 cases. Cochran's Q and McNemar's Test were used to determine differences between predicted values of each MLLM. Results: The F1 scores among MLLMs were >0.9 for all models for neoplastic vs. non-neoplastic polyps. Gemini 2.5 Pro demonstrated the highest F1 scores for invasive vs. non-invasive polyps and low- vs. high-grade adenoma, at 0.560 and 0.492 respectively. Claude Opus 4 and GPT-5 had statistically significantly higher percent correct scores than other MLLMs at 41.7%, using Paris classification. Conclusions: Claude Opus 4 and Gemini 2.5 Pro showed the highest accuracy in differentiating polyp subtypes, performing closest to expert consensus. Sensitivity and specificity, however, did not meet ESGE standards, highlighting the need for prospective multicenter trials and the design of human-in-the-loop workflows before clinical deployment.

Gastrointestinal (GI) endoscopic image analysis has shifted from single-label classification toward visual question answering (VQA), where a model must answer free-form clinical questions about an image. While recent vision-language models (VLMs) achieve promising answer accuracy on this task, clinical adoption also requires the model's internal representations to reflect the visual evidence behind its answers. We propose a simple multi-task fine-tuning recipe that constructs auxiliary grounding and description tasks from an existing VQA dataset with minimal additional annotation: expert-annotated polyp masks are reused directly, while a GI-domain pretrained classifier with Grad-CAM localization provides weak supervision for finding categories that lack ground-truth masks. Three small VLM backbones are fine-tuned with low-rank adaptation under matched VQA-only and multi-task recipes on Kvasir-VQA-x1, and we show consistent accuracy gains together with improved implicit alignment between answer tokens and the relevant image region, evaluated on both in-distribution and out-of-distribution data.

Background and Objective: Automatic polyp segmentation supports computer-aided diagnosis and early colorectal cancer detec- tion. Centralized deep learning requires hospitals to share sensitive medical data, while federated learning preserves privacy but introduces high communication costs through repeated transmission of full-precision model parameters. We propose QFedPolyp, a communication- and inference-efficient federated learning framework for collaborative polyp segmentation. Methods: QFedPolyp combines quantization-aware training with low-precision model communication. Each hospital locally trains a lightweight U-Net on private data while simulating quantization during training. Clients transmit quantized model parameters to a central server, where they are reconstructed and aggregated using Federated Averaging. Evaluation is performed on Kvasir-SEG, CVC-ClinicVideoDB, PolypGen, and BKAI-IGH NeoPolyp. Results: Full-precision federated training achieves Dice scores of 0.910 on Kvasir-SEG and 0.930 on CVC-ClinicVideoDB. Uni- form 8-bit communication reduces transmission cost by approximately 4 times while preserving competitive segmentation accuracy. Quantized models also achieve up to 1.5 times faster inference than full-precision models. Conclusions: QFedPolyp enables privacy-preserving collaborative polyp segmentation with reduced communication overhead and faster inference. The resulting lightweight models are suitable for real-time clinical deployment.

Automated polyp segmentation in colonoscopy continues to pose challenges due to substantial appearance variations and indistinct polyp boundaries. Although emerging foundation models (FMs) such as DINOv2, SAM, and OneFormer, demonstrate remarkable generalization capabilities, their direct transfer to the polyp segmentation task and deployment in real-time clinical settings are difficult due to lack of large-scale labeled data and high computational demands. In addition, adopting multiple FMs together raises concerns, even though they encode complementary semantic and structural information. While lightweight models, including U-Net, PraNet and U-Net++, are computationally efficient, they often struggle to generalize across datasets due to limited representational capacity. To address this gap, we propose Lite-Polyp Inductor (Lite-Pi), a novel foundation model induction framework that significantly enhances lightweight polyp segmentation baselines. Our proposed framework generates FM-specific prototype representations and aligns them semantically with the corresponding foundation model priors through reconstruction-based supervision. Subsequently, transformer-based fusion is introduced to highlight the polyp relevant representations, including salient boundary information, while preserving complementary semantic cues. Extensive experiments across five polyp segmentation benchmark datasets demonstrate that Lite-π significantly improves lightweight baselines, achieving superior generalization performance with minimal computational overhead and thereby, offering a practical solution for generalized polyp segmentation. Our code is available at GitHub. https://github.com/lostinrepo/Lite-Pi

Progress in colonoscopy polyp segmentation is routinely reported through leaderboard comparisons on a small set of public benchmarks. We argue that this apparent progress is difficult to verify: a systematic audit of \textbf{27 papers} published between 2015 and 2026 reveals three structural problems in how the community evaluates models. \textbf{First}, 25 of 27 papers \textit{omit the Hausdorff distance}. Hausdorff distance is a boundary-accuracy metric with direct clinical relevance for detecting flat or small polyps, and is a standard in radiotherapy segmentation. \textbf{Second}, at least five \textit{incompatible train/test split protocols} co-exist across papers reporting results on the same two datasets (Kvasir-SEG and CVC-ClinicDB), making published Dice scores non-comparable even when they appear in the same leaderboard column. \textbf{Third}, 26 of 27 papers make \textit{performance claims without any statistical significance test}. Strikingly, four papers published \emph{after} the Metrics Reloaded framework~\cite{metricsreloaded2024} (Maier-Hein et al., \textit{Nature Methods} 2024) perpetuate these same problems, suggesting that general-purpose metric guidance has not yet reached the colonoscopy sub-community. To show these problems are not merely cosmetic, we re-evaluate five representative models under three controlled protocols with a single uniform scorer, and find that the reported metric conceals large boundary and recall failures, that the ``best'' model changes with the metric, and that near-tied rankings reverse across random splits. We propose a five-point \textbf{Polyp Segmentation Reporting Checklist}~(PSRC) as a lightweight, domain-adapted corrective.

While lightweight polyp segmentation is highly desirable for low-cost deployment, reported performance gains often stem from upgraded backbone encoders, complex decoders, or heavy refinement branches. Consequently, it remains difficult to isolate whether a lightweight correction mechanism is inherently effective on its own. We address this limitation by formulating refinement as a prediction-space recursive correction task, introducing a recursive controller that operates directly on backbone logits. Under a fixed recursion budget, this controller aggregates discrepancy and uncertainty evidence, updates a compact state tracking recent correction utility, and applies additive residual logit corrections. By design, this correction path remains small, host-portable, and deployment-explicit. Utilizing a unified Kvasir-trained protocol, we evaluate our approach across seven lightweight backbones on Kvasir-SEG and three transfer datasets, measuring segmentation accuracy (Dice/IoU) alongside deployment efficiency (parameters, GMACs, and peak memory). The controller yields consistent improvements in the source domain, achieves competitive performance against both training-side baselines and heavier structural refiners on representative hosts, and delivers selective transfer gains with minimal static overhead. Code is available at https://github.com/tyui99/Gain-Aware-Prediction-Space-Recursive-Controller.

Post-refinement can improve colonoscopy segmentation after host inference, but many designs still rely on extra correction heads or multi-stage pipelines with non-negligible parameter or computational cost. For polyp segmentation, host predictions are often already reasonable globally, with remaining errors clustered around ambiguous boundaries and difficult local structures. These residual errors matter in colonoscopy images because useful masks need correct lesion coverage and clean contour delineation across subtle mucosal transitions. This setting favors selective local repair in prediction space over reprocessing the entire mask. We therefore propose RIGS-Refiner, a lightweight post-refinement plugin for risk-guided recursive refinement in prediction space. Starting from a frozen host anchor prediction, RIGS-Refiner extracts lightweight image priors and prediction cues, applies risk-guided update, and writes back residual corrections through a shared recursive cell. The module adds only +519 parameters and +0.631 GFLOPs, keeping the refinement path compact for deployment. Experiments use Kvasir-SEG for training and Kvasir, ClinicDB, ColonDB, and ETIS for evaluation under two frozen hosts, namely PraNet and SegFormer-B0. Results show consistent gains on both hosts and a favorable efficiency-accuracy trade-off against representative post-refinement methods. Code is available at https://github.com/tyui99/RIGS-Refiner.

Risk stratification for advanced colorectal polyps typically relies on colonoscopy and/or pathology findings. However, there is growing interest in whether non-invasive features available prior to colonoscopy can help identify patients at higher risk. Such approaches may enhance clinical decision-making by prioritizing surveillance for individuals most likely to harbor high-risk polyps, when colonoscopy resources are limited while potentially reducing unnecessary procedures in lower-risk patients. Importantly, the use of non-invasive, pre-procedural information may also help promote more equitable access to risk stratification, particularly in settings where colonoscopy resources are limited or unevenly distributed. We aimed to develop and externally validate machine learning models to predict high-risk colorectal polyps using only non-invasive, pre-colonoscopy demographic, clinical, and behavioral features in a diverse, predominantly African American, urban cohort. We conducted a retrospective cohort study using demographic, lifestyle, and comorbidity data from patients who underwent colonoscopy at Howard University Hospital to develop and validate several machine learning models, including neural networks, random forest, support vector machines (SVM), Naive Bayes, logistic regression, decision trees, k-nearest neighbors (KNN), and XGBoost, for predicting high-risk colorectal polyps. High-risk polyps (HRP) were defined as villous or tubullovillous adenomas, high-grade dysplasia, polyps >= 10 mm in size, and/or the presence of >= 3 polyps per procedure; all other cases were classified as low-risk polyps (LRP). The dataset included 4,681 patients from 2015-2022 used for internal validation and 1,562 patients from 2023-2024 used for external validation.

Imperfectly supervised video polyp segmentation (VPS) aims to learn dense, temporally consistent masks from inexpensive supervision, including weak annotations (points, scribbles) and semi-supervision with few densely labeled frames. This setting is clinically valuable but challenging due to weak contrast, ambiguous boundaries, motion blur, and specular highlights, compounded by sparse pixel-level guidance. While SAM2 can generate dense masks from sparse inputs, direct pseudo-labeling often yields geometry-degraded masks with boundary leakage, underutilizes temporal consistency, and ignores reliability. To address these issues, we propose ARTEMIS, a unified framework for imperfectly supervised VPS driven by agent-guided reliability-aware temporal mask evolution. ARTEMIS initializes coarse masks from available supervision: SAM2 converts points/scribbles, while dense labels serve as reliable anchors. A debate-and-judge vision-language agent selects reliable temporal anchors under weak supervision, which are propagated bidirectionally with SAM2 to refine unreliable or unlabeled frames. Finally, ARTEMIS trains the segmenter using temporal reliability-aware robust learning, incorporating reliability-guided reference selection, a Reference Prototype Transport Module, and reliability-aware robust loss. These components assess mask reliability, evolve anchors over time, transport target identity across frames, and down-weight noisy supervision instead of discarding difficult samples. Experiments on SUN-SEG and CVC-ClinicDB-612 under scribble, point, and limited-label settings demonstrate that ARTEMIS achieves state-of-the-art performance. Code will be released at https://github.com/wangtong627/ARTEMIS.

Early and highly accurate prediction of colorectal polyps, as an important sign of one of the most dangerous types of cancer, will result in saving more lives. Despite the advancements in colorectal polyp classification, many challenges remain in obtaining an automated polyp prediction system that is able to diagnose the difficult-to-predict polyps accompanied by different features in real scenarios, where the model can handle imbalanced data, label distribution shift, and cross-modality generalization successfully. In this study, we propose Polyp-D2ATL, a novel framework accompanied by a specific training strategy, which mitigates these limitations and effectively predicts the different classes of polyps belonging to the NICE classification. Our extensive experiments on the PICCOLO validation and test sets demonstrate that the proposed Polyp-D2ATL significantly outperforms existing state-of-the-art models across various reliable metrics, achieving an accuracy of 82.38%, a Macro-F1 of 77.49%, and a specificity of 87.47% on the validation set, alongside consistent improvements on the held-out test set which demonstrates the generalization capacity and clinical applicability of the proposed approach.

Accurate polyp size stratification guides surveillance decisions, with lesions larger than 5 mm typically requiring closer follow-up. However, monocular colonoscopy lacks a reliable metric reference. We present a diagnostic audit of binary polyp size classification (<=5 mm vs. >5 mm) across multiple public multi-center datasets, model families, and patient-stratified cross-validation. Across architectures and input modalities, including RGB appearance, relative depth, and photometry, model performance is moderately consistent, suggesting reliance on cues correlated with examination behavior rather than true metric scales. By providing ground-truth scale at varying granularities, we quantify the potential improvement from perfect scale information and show that current depth estimation and global calibration offer limited gains. We further demonstrate that segmentation errors under distribution shift eliminate most of this potential, with oracle scale under predicted masks recovering only baseline performance. These results highlight metric scale and mask robustness as two independent bottlenecks and provide reusable evaluation tools such as oracle scale ladders, shortcut partitions, and mask substitution for auditing future polyp sizing pipelines. Our code is publicly accessible at https://github.com/anaxqx/polyp-sizing-audit.

Accurate polyp segmentation in colonoscopy is essential for early colorectal cancer detection, yet real-world clinical environments pose persistent challenges such as motion blur, specular reflections, and illumination instability. Most existing methods are optimized on clean benchmark images and suffer noticeable performance degradation when deployed in authentic surgical scenarios. We propose DepthPolyp, a lightweight and robust segmentation framework based on pseudo-depth-guided multi-task learning and efficient feature modulation. The architecture combines hierarchical Ghost factorization for compact feature generation, Interleaved Shuffle Fusion for low-cost cross-scale interaction, and Dynamic Group Gating for adaptive group-wise feature weighting. Extensive experiments demonstrate that DepthPolyp achieves strong cross-dataset generalization when trained on degraded data and evaluated on both clean and noisy target domains, consistently outperforming lightweight baselines and remaining competitive with substantially larger models. In real surgical video evaluation on PolypGen, DepthPolyp achieves better segmentation performance than models up to $20\times$ larger while preserving real-time inference speed. With only 3.57M parameters and 0.86 GMACs, the proposed method runs at over 180 FPS on mobile devices, making it well suited for real-time deployment in resource-constrained clinical environments. Code and pretrained weights are available at: https://github.com/ReaganWu/DepthPolyp/

The life history of an individual coral is archived within the accreting skeleton of the colony. While reef-forming coral colonies (e.g. massive $\textit{Porites}$ sp.) may live for hundreds of years and deposit calcareous structures many metres in height and width, their living tissue is a thin outer surface layer comprised of asexually-dividing polyps that only survive a few years. To understand the rate and timing of polyp division and the consequences for colony skeletal growth, scientists need to track the skeletal corallite deposited around each polyp. Here we propose CoralLite, an annotated $μ$CT scan dataset of entire calcareous skeletons and an associated, first corallite deep learning reconstruction baseline. CoralLite combines fully quantified volumetric segmentations with cross-slice linking for visualisations of 3D models for each corallite up to colony scale. For segmentation, we propose and evaluate in detail a hybrid V-Trans-UNet architecture applicable to segmenting tiled $μ$CT virtual slabs of $\textit{Porites}$ sp. colonies. The model is pre-trained on weakly annotated data and topology-aware fine-tuned using fully annotated slice sections with 8k+ manual corallite region annotations. On unseen slices of the same colony, the resulting model reaches 0.94 topological accuracy at mean Dice scores of 0.77 on the same colony and projection axis, and 0.63 mean Dice scores on a different, biologically unrelated specimen. Whilst our experiments are limited in scale and context, our results show for the first time that visual machine learning can effectively support full 3D individual corallite modelling from $μ$CT scans of coral skeletons alone. For reproducibility and as a baseline for future research we publish our full dataset of 697 $μ$CT slices, 37 partial or full slice annotations, and all network weights and source code with this paper.

Learning robust representations of polyp tracklets is key to enabling multiple AI-assisted colonoscopy applications, from polyp characterization to automated reporting and retrieval. Supervised contrastive learning is an effective approach for learning such representations, but it typically relies on correct positive and negative definitions. Collecting these labels requires linking tracklets that depict the same underlying polyp entity throughout the video, which is costly and demands specialized clinical expertise. In this work, we leverage the sequential workflow of colonoscopy procedures to derive self-supervised associations from temporal structure. Since temporally derived associations are not guaranteed to be correct, we introduce a noise-aware contrastive loss to account for noisy associations. We demonstrate the effectiveness of the learned representations across multiple downstream tasks, including polyp retrieval and re-identification, size estimation, and histology classification. Our method outperforms prior self-supervised and supervised baselines, and matches or exceeds recent foundation models across all tasks, using a lightweight encoder trained on only 27 videos. Code is available at https://github.com/lparolari/ntssl.

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.

Automated polyp segmentation is critical for early colorectal cancer detection and its prevention, yet remains challenging due to weak boundaries, large appearance variations, and limited annotated data. Lightweight segmentation models such as U-Net, U-Net++, and PraNet offer practical efficiency for clinical deployment but struggle to capture the rich semantic and structural cues required for accurate delineation of complex polyp regions. In contrast, large Vision Foundation Models (VFMs), including SAM, OneFormer, Mask2Former, and DINOv2, exhibit strong generalization but transfer poorly to polyp segmentation due to domain mismatch, insufficient boundary sensitivity, and high computational cost. To bridge this gap, we propose \textit{\textbf{LiteBounD}, a \underline{Li}gh\underline{t}w\underline{e}ight \underline{Boun}dary-guided \underline{D}istillation} framework that transfers complementary semantic and structural priors from multiple VFMs into compact segmentation backbones. LiteBounD introduces (i) a dual-path distillation mechanism that disentangles semantic and boundary-aware representations, (ii) a frequency-aware alignment strategy that supervises low-frequency global semantics and high-frequency boundary details separately, and (iii) a boundary-aware decoder that fuses multi-scale encoder features with distilled semantically rich boundary information for precise segmentation. Extensive experiments on both seen (Kvasir-SEG, CVC-ClinicDB) and unseen (ColonDB, CVC-300, ETIS) datasets demonstrate that LiteBounD consistently outperforms its lightweight baselines by a significant margin and achieves performance competitive with state-of-the-art methods, while maintaining the efficiency required for real-time clinical use. Our code is available at https://github.com/lostinrepo/LiteBounD.

Early identification and removal of polyps can reduce the risk of developing colorectal cancer. However, the diverse morphologies, complex backgrounds and often concealed nature of polyps make polyp segmentation in colonoscopy images highly challenging. Despite the promising performance of existing deep learning-based polyp segmentation methods, their perceptual capabilities remain biased toward local regions, mainly because of the strong spatial correlations between neighboring pixels in the spatial domain. This limitation makes it difficult to capture the complete polyp structures, ultimately leading to sub-optimal segmentation results. In this paper, we propose a novel adaptive spectrum guidance network, called ASGNet, which addresses the limitations of spatial perception by integrating spectral features with global attributes. Specifically, we first design a spectrum-guided non-local perception module that jointly aggregates local and global information, therefore enhancing the discriminability of polyp structures, and refining their boundaries. Moreover, we introduce a multi-source semantic extractor that integrates rich high-level semantic information to assist in the preliminary localization of polyps. Furthermore, we construct a dense cross-layer interaction decoder that effectively integrates diverse information from different layers and strengthens it to generate high-quality representations for accurate polyp segmentation. Extensive quantitative and qualitative results demonstrate the superiority of our ASGNet approach over 21 state-of-the-art methods across five widely-used polyp segmentation benchmarks. The code will be publicly available at: https://github.com/CSYSI/ASGNet.

Early screening via colonoscopy is critical for colon cancer prevention, yet developing robust AI systems for this domain is hindered by the lack of densely annotated, long-sequence video datasets. Existing datasets predominantly focus on single-class polyp detection and lack the rich spatial, temporal, and linguistic annotations required to evaluate modern Multimodal Large Language Models (MLLMs). To address this critical gap, we introduce Colon-Bench, generated via a novel multi-stage agentic workflow. Our pipeline seamlessly integrates temporal proposals, bounding-box tracking, AI-driven visual confirmation, and human-in-the-loop review to scalably annotate full-procedure videos. The resulting verified benchmark is unprecedented in scope, encompassing 528 videos, 14 distinct lesion categories (including polyps, ulcers, and bleeding), over 300,000 bounding boxes, 213,000 segmentation masks, and 133,000 words of clinical descriptions. We utilize Colon-Bench to rigorously evaluate state-of-the-art MLLMs across lesion classification, Open-Vocabulary Video Object Segmentation (OV-VOS), and video Visual Question Answering (VQA). The MLLM results demonstrate surprisingly high localization performance in medical domains compared to SAM-3. Finally, we analyze common VQA errors from MLLMs to introduce a novel "colon-skill" prompting strategy, improving zero-shot MLLM performance by up to 9.7% across most MLLMs. The dataset and the code are available at https://abdullahamdi.com/colon-bench .

Medical image analysis depends on accurate segmentation and controllable synthesis, but both tasks face severe spatial imbalance: lesions occupy small regions against large backgrounds. We study adaptive spatial weighting as a task-level design principle and instantiate it in two adapters. LAW learns per-pixel loss weights for mask-conditioned diffusion by modulating a ratio prior with a feature-dependent delta map, with normalization, clamping, and Dice regularization for stability. ORDER improves lightweight segmentation by adding selective bidirectional skip attention with stage-wise confidence gating. On held-out diffusion test sets, LAW lowers FID from 158.13$\pm$0.15 to 108.43$\pm$0.71 on Polyps, from 144.13$\pm$0.31 to 89.51$\pm$0.96 on KiTS19, and from 139.22$\pm$0.38 to 112.58$\pm$0.68 on BRISC, while improving held-out mask-recovery Dice from 0.681$\pm$0.013 to 0.825$\pm$0.003 on Polyps. When the resulting images are added to nnUNet training, downstream Polyps mDice rises from 71.7$\pm$0.4 to 74.1$\pm$0.8. On the cleaned Polyps segmentation protocol, the reported ORDER configuration reaches 76.3$\pm$1.9 mDice and 67.2$\pm$2.0 mIoU at 42K parameters and 0.11 GFLOPs, versus 70.3$\pm$1.5 mDice and 59.9$\pm$1.7 mIoU for matched MK-UNet. On BRISC under the same training recipe, ORDER reaches 77.4$\pm$0.8 mDice and 68.1$\pm$0.7 mIoU. These results position adaptive spatial weighting as a practical design idea for both medical diffusion and efficient segmentation.