Daily Papers

Previous research on retinal vessel segmentation is targeted at a specific image domain, mostly color fundus photography (CFP). In this paper we make a brave attempt to attack a more challenging task of broad-domain retinal vessel segmentation (BD-RVS), which is to develop a unified model applicable to varied domains including CFP, SLO, UWF, OCTA and FFA. To that end, we propose Dual Convoltuional Prompting (DCP) that learns to extract domain-specific features by localized prompting along both position and channel dimensions. DCP is designed as a plug-in module that can effectively turn a R2AU-Net based vessel segmentation network to a unified model, yet without the need of modifying its network structure. For evaluation we build a broad-domain set using five public domain-specific datasets including ROSSA, FIVES, IOSTAR, PRIME-FP20 and VAMPIRE. In order to benchmark BD-RVS on the broad-domain dataset, we re-purpose a number of existing methods originally developed in other contexts, producing eight baseline methods in total. Extensive experiments show the the proposed method compares favorably against the baselines for BD-RVS.

Accurate retinal vessel (RV) segmentation is a crucial step in the quantitative assessment of retinal vasculature, which is needed for the early detection of retinal diseases and other conditions. Numerous studies have been conducted to tackle the problem of segmenting vessels automatically using a pixel-wise classification approach. The common practice of creating ground truth labels is to categorize pixels as foreground and background. This approach is, however, biased, and it ignores the uncertainty of a human annotator when it comes to annotating e.g. thin vessels. In this work, we propose a simple and effective method that casts the RV segmentation task as an image-level regression. For this purpose, we first introduce a novel Segmentation Annotation Uncertainty-Aware (SAUNA) transform, which adds pixel uncertainty to the ground truth using the pixel's closeness to the annotation boundary and vessel thickness. To train our model with soft labels, we generalize the earlier proposed Jaccard metric loss to arbitrary hypercubes for soft Jaccard index (Intersection-over-Union) optimization. Additionally, we employ a stable version of the Focal-L1 loss for pixel-wise regression. We conduct thorough experiments and compare our method to a diverse set of baselines across 5 retinal image datasets. Our empirical results indicate that the integration of the SAUNA transform and these segmentation losses led to significant performance boosts for different segmentation models. Particularly, our methodology enables UNet-like architectures to substantially outperform computational-intensive baselines. Our implementation is available at https://github.com/Oulu-IMEDS/SAUNA.

Although the preservation of shape continuity and physiological anatomy is a natural assumption in the segmentation of medical images, it is often neglected by deep learning methods that mostly aim for the statistical modeling of input data as pixels rather than interconnected structures. In biological structures, however, organs are not separate entities; for example, in reality, a severed vessel is an indication of an underlying problem, but traditional segmentation models are not designed to strictly enforce the continuity of anatomy, potentially leading to inaccurate medical diagnoses. To address this issue, we propose a graph-based approach that enforces the continuity and connectivity of anatomical topology in medical images. Our method encodes the continuity of shapes as a graph constraint, ensuring that the network's predictions maintain this continuity. We evaluate our method on two public benchmarks on retinal vessel segmentation, showing significant improvements in connectivity metrics compared to traditional methods while getting better or on-par performance on segmentation metrics.

The emergence of powerful, general-purpose omnimodels capable of processing diverse data modalities has raised a critical question: can these ``jack-of-all-trades'' systems perform on par with highly specialized models in knowledge-intensive domains? This work investigates this question within the high-stakes field of medical image segmentation. We conduct a comparative study analyzing the zero-shot performance of a state-of-the-art omnimodel (Gemini 2.5 Pro, the ``Nano Banana'' model) against domain-specific deep learning models on three distinct tasks: polyp (endoscopy), retinal vessel (fundus), and breast tumor segmentation (ultrasound). Our study focuses on performance at the extremes by curating subsets of the ``easiest'' and ``hardest'' cases based on the specialist models' accuracy. Our findings reveal a nuanced and task-dependent landscape. For polyp and breast tumor segmentation, specialist models excel on easy samples, but the omnimodel demonstrates greater robustness on hard samples where specialists fail catastrophically. Conversely, for the fine-grained task of retinal vessel segmentation, the specialist model maintains superior performance across both easy and hard cases. Intriguingly, qualitative analysis suggests omnimodels may possess higher sensitivity, identifying subtle anatomical features missed by human annotators. Our results indicate that while current omnimodels are not yet a universal replacement for specialists, their unique strengths suggest a potential complementary role with specialist models, particularly in enhancing robustness on challenging edge cases.

Medical image segmentation plays a crucial role in assisting healthcare professionals with accurate diagnoses and enabling automated diagnostic processes. Traditional convolutional neural networks (CNNs) often struggle with capturing long-range dependencies, while transformer-based architectures, despite their effectiveness, come with increased computational complexity. Recent efforts have focused on combining CNNs and transformers to balance performance and efficiency, but existing approaches still face challenges in achieving high segmentation accuracy while maintaining low computational costs. Furthermore, many methods underutilize the CNN encoder's capability to capture local spatial information, concentrating primarily on mitigating long-range dependency issues. To address these limitations, we propose QTSeg, a novel architecture for medical image segmentation that effectively integrates local and global information. QTSeg features a dual-mix attention decoder designed to enhance segmentation performance through: (1) a cross-attention mechanism for improved feature alignment, (2) a spatial attention module to capture long-range dependencies, and (3) a channel attention block to learn inter-channel relationships. Additionally, we introduce a multi-level feature distribution module, which adaptively balances feature propagation between the encoder and decoder, further boosting performance. Extensive experiments on five publicly available datasets covering diverse segmentation tasks, including lesion, polyp, breast cancer, cell, and retinal vessel segmentation, demonstrate that QTSeg outperforms state-of-the-art methods across multiple evaluation metrics while maintaining lower computational costs. Our implementation can be found at: https://github.com/tpnam0901/QTSeg (v1.0.0)

Introduction: Blood vessels can be non-invasively visualized from a digital fundus image (DFI). Several studies have shown an association between cardiovascular risk and vascular features obtained from DFI. Recent advances in computer vision and image segmentation enable automatising DFI blood vessel segmentation. There is a need for a resource that can automatically compute digital vasculature biomarkers (VBM) from these segmented DFI. Methods: In this paper, we introduce a Python Vasculature BioMarker toolbox, denoted PVBM. A total of 11 VBMs were implemented. In particular, we introduce new algorithmic methods to estimate tortuosity and branching angles. Using PVBM, and as a proof of usability, we analyze geometric vascular differences between glaucomatous patients and healthy controls. Results: We built a fully automated vasculature biomarker toolbox based on DFI segmentations and provided a proof of usability to characterize the vascular changes in glaucoma. For arterioles and venules, all biomarkers were significant and lower in glaucoma patients compared to healthy controls except for tortuosity, venular singularity length and venular branching angles. Conclusion: We have automated the computation of 11 VBMs from retinal blood vessel segmentation. The PVBM toolbox is made open source under a GNU GPL 3 license and is available on physiozoo.com (following publication).

Accurate analysis and modeling of renal functions require a precise segmentation of the renal blood vessels. Micro-CT scans provide image data at higher resolutions, making more small vessels near the renal cortex visible. Although deep-learning-based methods have shown state-of-the-art performance in automatic blood vessel segmentations, they require a large amount of labeled training data. However, voxel-wise labeling in micro-CT scans is extremely time-consuming given the huge volume sizes. To mitigate the problem, we simulate synthetic renal vascular trees physiologically while generating corresponding scans of the simulated trees by training a generative model on unlabeled scans. This enables the generative model to learn the mapping implicitly without the need for explicit functions to emulate the image acquisition process. We further propose an additional segmentation branch over the generative model trained on the generated scans. We demonstrate that the model can directly segment blood vessels on real scans and validate our method on both 3D micro-CT scans of rat kidneys and a proof-of-concept experiment on 2D retinal images. Code and 3D results are available at https://github.com/miccai2023anony/RenalVesselSeg

The caliber and configuration of retinal blood vessels serve as important biomarkers for various diseases and medical conditions. A thorough analysis of the retinal vasculature requires the segmentation of the blood vessels and their classification into arteries and veins, typically performed on color fundus images obtained by retinography. However, manually performing these tasks is labor-intensive and prone to human error. While several automated methods have been proposed to address this task, the current state of art faces challenges due to manifest classification errors affecting the topological consistency of segmentation maps. In this work, we introduce RRWNet, a novel end-to-end deep learning framework that addresses this limitation. The framework consists of a fully convolutional neural network that recursively refines semantic segmentation maps, correcting manifest classification errors and thus improving topological consistency. In particular, RRWNet is composed of two specialized subnetworks: a Base subnetwork that generates base segmentation maps from the input images, and a Recursive Refinement subnetwork that iteratively and recursively improves these maps. Evaluation on three different public datasets demonstrates the state-of-the-art performance of the proposed method, yielding more topologically consistent segmentation maps with fewer manifest classification errors than existing approaches. In addition, the Recursive Refinement module within RRWNet proves effective in post-processing segmentation maps from other methods, further demonstrating its potential. The model code, weights, and predictions will be publicly available at https://github.com/j-morano/rrwnet.

We introduce VascX models, a comprehensive set of model ensembles for analyzing retinal vasculature from color fundus images (CFIs). Annotated CFIs were aggregated from public datasets for vessel, artery-vein, and disc segmentation; and fovea localization. Additional CFIs from the population-based Rotterdam Study were, with arteries and veins annotated by graders at pixel level. Our models achieved robust performance across devices from different vendors, varying levels of image quality levels, and diverse pathologies. Our models demonstrated superior segmentation performance compared to existing systems under a variety of conditions. Significant enhancements were observed in artery-vein and disc segmentation performance, particularly in segmentations of these structures on CFIs of intermediate quality, a common characteristic of large cohorts and clinical datasets. Our model outperformed human graders in segmenting vessels with greater precision. With VascX models we provide a robust, ready-to-use set of model ensembles and inference code aimed at simplifying the implementation and enhancing the quality of automated retinal vasculature analyses. The precise vessel parameters generated by the model can serve as starting points for the identification of disease patterns in and outside of the eye.

The retina is the only part of the human body in which blood vessels can be accessed non-invasively using imaging techniques such as digital fundus images (DFI). The spatial distribution of the retinal microvasculature may change with cardiovascular diseases and thus the eyes may be regarded as a window to our hearts. Computerized segmentation of the retinal arterioles and venules (A/V) is essential for automated microvasculature analysis. Using active learning, we created a new DFI dataset containing 240 crowd-sourced manual A/V segmentations performed by fifteen medical students and reviewed by an ophthalmologist, and developed LUNet, a novel deep learning architecture for high resolution A/V segmentation. LUNet architecture includes a double dilated convolutional block that aims to enhance the receptive field of the model and reduce its parameter count. Furthermore, LUNet has a long tail that operates at high resolution to refine the segmentation. The custom loss function emphasizes the continuity of the blood vessels. LUNet is shown to significantly outperform two state-of-the-art segmentation algorithms on the local test set as well as on four external test sets simulating distribution shifts across ethnicity, comorbidities, and annotators. We make the newly created dataset open access (upon publication).

Deep learning (DL) based semantic segmentation methods have been providing state-of-the-art performance in the last few years. More specifically, these techniques have been successfully applied to medical image classification, segmentation, and detection tasks. One deep learning technique, U-Net, has become one of the most popular for these applications. In this paper, we propose a Recurrent Convolutional Neural Network (RCNN) based on U-Net as well as a Recurrent Residual Convolutional Neural Network (RRCNN) based on U-Net models, which are named RU-Net and R2U-Net respectively. The proposed models utilize the power of U-Net, Residual Network, as well as RCNN. There are several advantages of these proposed architectures for segmentation tasks. First, a residual unit helps when training deep architecture. Second, feature accumulation with recurrent residual convolutional layers ensures better feature representation for segmentation tasks. Third, it allows us to design better U-Net architecture with same number of network parameters with better performance for medical image segmentation. The proposed models are tested on three benchmark datasets such as blood vessel segmentation in retina images, skin cancer segmentation, and lung lesion segmentation. The experimental results show superior performance on segmentation tasks compared to equivalent models including U-Net and residual U-Net (ResU-Net).

Coronary microvascular disease constitutes a substantial risk to human health. Employing computer-aided analysis and diagnostic systems, medical professionals can intervene early in disease progression, with 3D vessel segmentation serving as a crucial component. Nevertheless, conventional U-Net architectures tend to yield incoherent and imprecise segmentation outcomes, particularly for small vessel structures. While models with attention mechanisms, such as Transformers and large convolutional kernels, demonstrate superior performance, their extensive computational demands during training and inference lead to increased time complexity. In this study, we leverage Fourier domain learning as a substitute for multi-scale convolutional kernels in 3D hierarchical segmentation models, which can reduce computational expenses while preserving global receptive fields within the network. Furthermore, a zero-parameter frequency domain fusion method is designed to improve the skip connections in U-Net architecture. Experimental results on a public dataset and an in-house dataset indicate that our novel Fourier transformation-based network achieves remarkable dice performance (84.37\% on ASACA500 and 80.32\% on ImageCAS) in tubular vessel segmentation tasks and substantially reduces computational requirements without compromising global receptive fields.

We propose a novel framework for retinal feature point alignment, designed for learning cross-modality features to enhance matching and registration across multi-modality retinal images. Our model draws on the success of previous learning-based feature detection and description methods. To better leverage unlabeled data and constrain the model to reproduce relevant keypoints, we integrate a keypoint-based segmentation task. It is trained in a self-supervised manner by enforcing segmentation consistency between different augmentations of the same image. By incorporating a keypoint augmented self-supervised layer, we achieve robust feature extraction across modalities. Extensive evaluation on two public datasets and one in-house dataset demonstrates significant improvements in performance for modality-agnostic retinal feature alignment. Our code and model weights are publicly available at https://github.com/MedICL-VU/RetinaIPA.

Glaucoma is one of the leading causes of irreversible but preventable blindness in working age populations. Color fundus photography (CFP) is the most cost-effective imaging modality to screen for retinal disorders. However, its application to glaucoma has been limited to the computation of a few related biomarkers such as the vertical cup-to-disc ratio. Deep learning approaches, although widely applied for medical image analysis, have not been extensively used for glaucoma assessment due to the limited size of the available data sets. Furthermore, the lack of a standardize benchmark strategy makes difficult to compare existing methods in a uniform way. In order to overcome these issues we set up the Retinal Fundus Glaucoma Challenge, REFUGE (https://refuge.grand-challenge.org), held in conjunction with MICCAI 2018. The challenge consisted of two primary tasks, namely optic disc/cup segmentation and glaucoma classification. As part of REFUGE, we have publicly released a data set of 1200 fundus images with ground truth segmentations and clinical glaucoma labels, currently the largest existing one. We have also built an evaluation framework to ease and ensure fairness in the comparison of different models, encouraging the development of novel techniques in the field. 12 teams qualified and participated in the online challenge. This paper summarizes their methods and analyzes their corresponding results. In particular, we observed that two of the top-ranked teams outperformed two human experts in the glaucoma classification task. Furthermore, the segmentation results were in general consistent with the ground truth annotations, with complementary outcomes that can be further exploited by ensembling the results.

Segmentation of blood vessels in murine cerebral 3D OCTA images is foundational for in vivo quantitative analysis of the effects of neurovascular disorders, such as stroke or Alzheimer's, on the vascular network. However, to accurately segment blood vessels with state-of-the-art deep learning methods, a vast amount of voxel-level annotations is required. Since cerebral 3D OCTA images are typically plagued by artifacts and generally have a low signal-to-noise ratio, acquiring manual annotations poses an especially cumbersome and time-consuming task. To alleviate the need for manual annotations, we propose utilizing synthetic data to supervise segmentation algorithms. To this end, we extract patches from vessel graphs and transform them into synthetic cerebral 3D OCTA images paired with their matching ground truth labels by simulating the most dominant 3D OCTA artifacts. In extensive experiments, we demonstrate that our approach achieves competitive results, enabling annotation-free blood vessel segmentation in cerebral 3D OCTA images.

Identification of vessel structures of different sizes in biomedical images is crucial in the diagnosis of many neurodegenerative diseases. However, the sparsity of good-quality annotations of such images makes the task of vessel segmentation challenging. Deep learning offers an efficient way to segment vessels of different sizes by learning their high-level feature representations and the spatial continuity of such features across dimensions. Semi-supervised patch-based approaches have been effective in identifying small vessels of one to two voxels in diameter. This study focuses on improving the segmentation quality by considering the spatial correlation of the features using the Maximum Intensity Projection~(MIP) as an additional loss criterion. Two methods are proposed with the incorporation of MIPs of label segmentation on the single~(z-axis) and multiple perceivable axes of the 3D volume. The proposed MIP-based methods produce segmentations with improved vessel continuity, which is evident in visual examinations of ROIs. Patch-based training is improved by introducing an additional loss term, MIP loss, to penalise the predicted discontinuity of vessels. A training set of 14 volumes is selected from the StudyForrest dataset comprising of 18 7-Tesla 3D Time-of-Flight~(ToF) Magnetic Resonance Angiography (MRA) images. The generalisation performance of the method is evaluated using the other unseen volumes in the dataset. It is observed that the proposed method with multi-axes MIP loss produces better quality segmentations with a median Dice of 80.245 pm 0.129. Also, the method with single-axis MIP loss produces segmentations with a median Dice of 79.749 pm 0.109. Furthermore, a visual comparison of the ROIs in the predicted segmentation reveals a significant improvement in the continuity of the vessels when MIP loss is incorporated into training.

The scarcity of high-quality, labelled retinal imaging data, which presents a significant challenge in the development of machine learning models for ophthalmology, hinders progress in the field. Existing methods for synthesising Colour Fundus Photographs (CFPs) largely rely on predefined disease labels, which restricts their ability to generate images that reflect fine-grained anatomical variations, subtle disease stages, and diverse pathological features beyond coarse class categories. To overcome these challenges, we first introduce an innovative pipeline that creates a large-scale, captioned retinal dataset comprising 1.4 million entries, called RetinaLogos-1400k. Specifically, RetinaLogos-1400k uses the visual language model(VLM) to describe retinal conditions and key structures, such as optic disc configuration, vascular distribution, nerve fibre layers, and pathological features. Building on this dataset, we employ a novel three-step training framework, RetinaLogos, which enables fine-grained semantic control over retinal images and accurately captures different stages of disease progression, subtle anatomical variations, and specific lesion types. Through extensive experiments, our method demonstrates superior performance across multiple datasets, with 62.07% of text-driven synthetic CFPs indistinguishable from real ones by ophthalmologists. Moreover, the synthetic data improves accuracy by 5%-10% in diabetic retinopathy grading and glaucoma detection. Codes are available at https://github.com/uni-medical/retina-text2cfp.

Automated segmentation of retinal optical coherence tomography (OCT) images has become an important recent direction in machine learning for medical applications. We hypothesize that the anatomic structure of layers and their high-frequency variation in OCT images make retinal OCT a fitting choice for extracting spectral-domain features and combining them with spatial domain features. In this work, we present Upsilon-Net, an architecture that combines the frequency domain features with the image domain to improve the segmentation performance of OCT images. The results of this work demonstrate that the introduction of two branches, one for spectral and one for spatial domain features, brings a very significant improvement in fluid segmentation performance and allows outperformance as compared to the well-known U-Net model. Our improvement was 13% on the fluid segmentation dice score and 1.9% on the average dice score. Finally, removing selected frequency ranges in the spectral domain demonstrates the impact of these features on the fluid segmentation outperformance.

Optical Coherence Tomography Angiography (OCTA) and its derived en-face projections provide high-resolution visualization of the retinal and choroidal vasculature, which is critical for the rapid and accurate diagnosis of retinal diseases. However, acquiring high-quality OCTA images is challenging due to motion sensitivity and the high costs associated with software modifications for conventional OCT devices. Moreover, current deep learning methods for OCT-to-OCTA translation often overlook the vascular differences across retinal layers and struggle to reconstruct the intricate, dense vascular details necessary for reliable diagnosis. To overcome these limitations, we propose XOCT, a novel deep learning framework that integrates Cross-Dimensional Supervision (CDS) with a Multi-Scale Feature Fusion (MSFF) network for layer-aware vascular reconstruction. Our CDS module leverages 2D layer-wise en-face projections, generated via segmentation-weighted z-axis averaging, as supervisory signals to compel the network to learn distinct representations for each retinal layer through fine-grained, targeted guidance. Meanwhile, the MSFF module enhances vessel delineation through multi-scale feature extraction combined with a channel reweighting strategy, effectively capturing vascular details at multiple spatial scales. Our experiments on the OCTA-500 dataset demonstrate XOCT's improvements, especially for the en-face projections which are significant for clinical evaluation of retinal pathologies, underscoring its potential to enhance OCTA accessibility, reliability, and diagnostic value for ophthalmic disease detection and monitoring. The code is available at https://github.com/uci-cbcl/XOCT.

Scarcity of large publicly available retinal fundus image datasets for automated glaucoma detection has been the bottleneck for successful application of artificial intelligence towards practical Computer-Aided Diagnosis (CAD). A few small datasets that are available for research community usually suffer from impractical image capturing conditions and stringent inclusion criteria. These shortcomings in already limited choice of existing datasets make it challenging to mature a CAD system so that it can perform in real-world environment. In this paper we present a large publicly available retinal fundus image dataset for glaucoma classification called G1020. The dataset is curated by conforming to standard practices in routine ophthalmology and it is expected to serve as standard benchmark dataset for glaucoma detection. This database consists of 1020 high resolution colour fundus images and provides ground truth annotations for glaucoma diagnosis, optic disc and optic cup segmentation, vertical cup-to-disc ratio, size of neuroretinal rim in inferior, superior, nasal and temporal quadrants, and bounding box location for optic disc. We also report baseline results by conducting extensive experiments for automated glaucoma diagnosis and segmentation of optic disc and optic cup.

Curvilinear object segmentation plays a crucial role across various applications, yet datasets in this domain often suffer from small scale due to the high costs associated with data acquisition and annotation. To address these challenges, this paper introduces a novel approach for expanding curvilinear object segmentation datasets, focusing on enhancing the informativeness of generated data and the consistency between semantic maps and generated images. Our method enriches synthetic data informativeness by generating curvilinear objects through their multiple textual features. By combining textual features from each sample in original dataset, we obtain synthetic images that beyond the original dataset's distribution. This initiative necessitated the creation of the Curvilinear Object Segmentation based on Text Generation (COSTG) dataset. Designed to surpass the limitations of conventional datasets, COSTG incorporates not only standard semantic maps but also some textual descriptions of curvilinear object features. To ensure consistency between synthetic semantic maps and images, we introduce the Semantic Consistency Preserving ControlNet (SCP ControlNet). This involves an adaptation of ControlNet with Spatially-Adaptive Normalization (SPADE), allowing it to preserve semantic information that would typically be washed away in normalization layers. This modification facilitates more accurate semantic image synthesis. Experimental results demonstrate the efficacy of our approach across three types of curvilinear objects (angiography, crack and retina) and six public datasets (CHUAC, XCAD, DCA1, DRIVE, CHASEDB1 and Crack500). The synthetic data generated by our method not only expand the dataset, but also effectively improves the performance of other curvilinear object segmentation models. Source code and dataset are available at https://github.com/tanlei0/COSTG.

Segmenting medical images is critical to facilitating both patient diagnoses and quantitative research. A major limiting factor is the lack of labeled data, as obtaining expert annotations for each new set of imaging data and task can be labor intensive and inconsistent among annotators. We present CUTS, an unsupervised deep learning framework for medical image segmentation. CUTS operates in two stages. For each image, it produces an embedding map via intra-image contrastive learning and local patch reconstruction. Then, these embeddings are partitioned at dynamic granularity levels that correspond to the data topology. CUTS yields a series of coarse-to-fine-grained segmentations that highlight features at various granularities. We applied CUTS to retinal fundus images and two types of brain MRI images to delineate structures and patterns at different scales. When evaluated against predefined anatomical masks, CUTS improved the dice coefficient and Hausdorff distance by at least 10% compared to existing unsupervised methods. Finally, CUTS showed performance on par with Segment Anything Models (SAM, MedSAM, SAM-Med2D) pre-trained on gigantic labeled datasets.

Automatic diabetic retinopathy (DR) lesions segmentation makes great sense of assisting ophthalmologists in diagnosis. Although many researches have been conducted on this task, most prior works paid too much attention to the designs of networks instead of considering the pathological association for lesions. Through investigating the pathogenic causes of DR lesions in advance, we found that certain lesions are closed to specific vessels and present relative patterns to each other. Motivated by the observation, we propose a relation transformer block (RTB) to incorporate attention mechanisms at two main levels: a self-attention transformer exploits global dependencies among lesion features, while a cross-attention transformer allows interactions between lesion and vessel features by integrating valuable vascular information to alleviate ambiguity in lesion detection caused by complex fundus structures. In addition, to capture the small lesion patterns first, we propose a global transformer block (GTB) which preserves detailed information in deep network. By integrating the above blocks of dual-branches, our network segments the four kinds of lesions simultaneously. Comprehensive experiments on IDRiD and DDR datasets well demonstrate the superiority of our approach, which achieves competitive performance compared to state-of-the-arts.

Segmenting 3D blood vessels is a critical yet challenging task in medical image analysis. This is due to significant imaging modality-specific variations in artifacts, vascular patterns and scales, signal-to-noise ratios, and background tissues. These variations, along with domain gaps arising from varying imaging protocols, limit the generalization of existing supervised learning-based methods, requiring tedious voxel-level annotations for each dataset separately. While foundation models promise to alleviate this limitation, they typically fail to generalize to the task of blood vessel segmentation, posing a unique, complex problem. In this work, we present vesselFM, a foundation model designed specifically for the broad task of 3D blood vessel segmentation. Unlike previous models, vesselFM can effortlessly generalize to unseen domains. To achieve zero-shot generalization, we train vesselFM on three heterogeneous data sources: a large, curated annotated dataset, data generated by a domain randomization scheme, and data sampled from a flow matching-based generative model. Extensive evaluations show that vesselFM outperforms state-of-the-art medical image segmentation foundation models across four (pre-)clinically relevant imaging modalities in zero-, one-, and few-shot scenarios, therefore providing a universal solution for 3D blood vessel segmentation.

Blood vessels of the brain provide the human brain with the required nutrients and oxygen. As a vulnerable part of the cerebral blood supply, pathology of small vessels can cause serious problems such as Cerebral Small Vessel Diseases (CSVD). It has also been shown that CSVD is related to neurodegeneration, such as Alzheimer's disease. With the advancement of 7 Tesla MRI systems, higher spatial image resolution can be achieved, enabling the depiction of very small vessels in the brain. Non-Deep Learning-based approaches for vessel segmentation, e.g., Frangi's vessel enhancement with subsequent thresholding, are capable of segmenting medium to large vessels but often fail to segment small vessels. The sensitivity of these methods to small vessels can be increased by extensive parameter tuning or by manual corrections, albeit making them time-consuming, laborious, and not feasible for larger datasets. This paper proposes a deep learning architecture to automatically segment small vessels in 7 Tesla 3D Time-of-Flight (ToF) Magnetic Resonance Angiography (MRA) data. The algorithm was trained and evaluated on a small imperfect semi-automatically segmented dataset of only 11 subjects; using six for training, two for validation, and three for testing. The deep learning model based on U-Net Multi-Scale Supervision was trained using the training subset and was made equivariant to elastic deformations in a self-supervised manner using deformation-aware learning to improve the generalisation performance. The proposed technique was evaluated quantitatively and qualitatively against the test set and achieved a Dice score of 80.44 pm 0.83. Furthermore, the result of the proposed method was compared against a selected manually segmented region (62.07 resultant Dice) and has shown a considerable improvement (18.98\%) with deformation-aware learning.

The task of localizing and categorizing objects in medical images often remains formulated as a semantic segmentation problem. This approach, however, only indirectly solves the coarse localization task by predicting pixel-level scores, requiring ad-hoc heuristics when mapping back to object-level scores. State-of-the-art object detectors on the other hand, allow for individual object scoring in an end-to-end fashion, while ironically trading in the ability to exploit the full pixel-wise supervision signal. This can be particularly disadvantageous in the setting of medical image analysis, where data sets are notoriously small. In this paper, we propose Retina U-Net, a simple architecture, which naturally fuses the Retina Net one-stage detector with the U-Net architecture widely used for semantic segmentation in medical images. The proposed architecture recaptures discarded supervision signals by complementing object detection with an auxiliary task in the form of semantic segmentation without introducing the additional complexity of previously proposed two-stage detectors. We evaluate the importance of full segmentation supervision on two medical data sets, provide an in-depth analysis on a series of toy experiments and show how the corresponding performance gain grows in the limit of small data sets. Retina U-Net yields strong detection performance only reached by its more complex two-staged counterparts. Our framework including all methods implemented for operation on 2D and 3D images is available at github.com/pfjaeger/medicaldetectiontoolkit.

Retinal foundation models aim to learn generalizable representations from diverse retinal images, facilitating label-efficient model adaptation across various ophthalmic tasks. Despite their success, current retinal foundation models are generally restricted to a single imaging modality, such as Color Fundus Photography (CFP) or Optical Coherence Tomography (OCT), limiting their versatility. Moreover, these models may struggle to fully leverage expert annotations and overlook the valuable domain knowledge essential for domain-specific representation learning. To overcome these limitations, we introduce UrFound, a retinal foundation model designed to learn universal representations from both multimodal retinal images and domain knowledge. UrFound is equipped with a modality-agnostic image encoder and accepts either CFP or OCT images as inputs. To integrate domain knowledge into representation learning, we encode expert annotation in text supervision and propose a knowledge-guided masked modeling strategy for model pre-training. It involves reconstructing randomly masked patches of retinal images while predicting masked text tokens conditioned on the corresponding retinal image. This approach aligns multimodal images and textual expert annotations within a unified latent space, facilitating generalizable and domain-specific representation learning. Experimental results demonstrate that UrFound exhibits strong generalization ability and data efficiency when adapting to various tasks in retinal image analysis. By training on ~180k retinal images, UrFound significantly outperforms the state-of-the-art retinal foundation model trained on up to 1.6 million unlabelled images across 8 public retinal datasets. Our code and data are available at https://github.com/yukkai/UrFound.

In the domain of medical imaging, many supervised learning based methods for segmentation face several challenges such as high variability in annotations from multiple experts, paucity of labelled data and class imbalanced datasets. These issues may result in segmentations that lack the requisite precision for clinical analysis and can be misleadingly overconfident without associated uncertainty quantification. We propose the PULASki for biomedical image segmentation that accurately captures variability in expert annotations, even in small datasets. Our approach makes use of an improved loss function based on statistical distances in a conditional variational autoencoder structure (Probabilistic UNet), which improves learning of the conditional decoder compared to the standard cross-entropy particularly in class imbalanced problems. We analyse our method for two structurally different segmentation tasks (intracranial vessel and multiple sclerosis (MS) lesion) and compare our results to four well-established baselines in terms of quantitative metrics and qualitative output. Empirical results demonstrate the PULASKi method outperforms all baselines at the 5\% significance level. The generated segmentations are shown to be much more anatomically plausible than in the 2D case, particularly for the vessel task. Our method can also be applied to a wide range of multi-label segmentation tasks and and is useful for downstream tasks such as hemodynamic modelling (computational fluid dynamics and data assimilation), clinical decision making, and treatment planning.

With the rapid development of artificial intelligence (AI) in medical image processing, deep learning in color fundus photography (CFP) analysis is also evolving. Although there are some open-source, labeled datasets of CFPs in the ophthalmology community, large-scale datasets for screening only have labels of disease categories, and datasets with annotations of fundus structures are usually small in size. In addition, labeling standards are not uniform across datasets, and there is no clear information on the acquisition device. Here we release a multi-annotation, multi-quality, and multi-device color fundus image dataset for glaucoma analysis on an original challenge -- Retinal Fundus Glaucoma Challenge 2nd Edition (REFUGE2). The REFUGE2 dataset contains 2000 color fundus images with annotations of glaucoma classification, optic disc/cup segmentation, as well as fovea localization. Meanwhile, the REFUGE2 challenge sets three sub-tasks of automatic glaucoma diagnosis and fundus structure analysis and provides an online evaluation framework. Based on the characteristics of multi-device and multi-quality data, some methods with strong generalizations are provided in the challenge to make the predictions more robust. This shows that REFUGE2 brings attention to the characteristics of real-world multi-domain data, bridging the gap between scientific research and clinical application.

Diabetic retinopathy (DR) is a growing health problem worldwide and is a leading cause of visual impairment and blindness, especially among working people aged 20-65. Its incidence is increasing along with the number of diabetes cases, and it is more common in developed countries than in developing countries. Recent research in the field of diabetic retinopathy diagnosis is using advanced technologies, such as analysis of images obtained by ophthalmoscopy. Automatic methods for analyzing eye images based on neural networks, deep learning and image analysis algorithms can improve the efficiency of diagnosis. This paper describes an automatic DR diagnosis method that includes processing and analysis of ophthalmoscopic images of the eye. It uses morphological algorithms to identify the optic disc and lesions characteristic of DR, such as microaneurysms, hemorrhages and exudates. Automated DR diagnosis has the potential to improve the efficiency of early detection of this disease and contribute to reducing the number of cases of diabetes-related visual impairment. The final step was to create an application with a graphical user interface that allowed retinal images taken at cooperating ophthalmology offices to be uploaded to the server. These images were then analyzed using a developed algorithm to make a diagnosis.

The rise of imaging techniques such as optical coherence tomography (OCT) and advances in deep learning (DL) have enabled clinicians and researchers to streamline retinal disease staging. A popular DL approach is self-supervised learning (SSL), where models learn from vast amounts of unlabeled data, avoiding costly annotation. SSL has allowed the development of foundation models (FMs), large models that can be used for a variety of downstream tasks. However, existing FMs for OCT, trained solely on image data, lack a comprehensive and robust semantic understanding of images, as evidenced by their downstream performance (especially for complex tasks), and thus require supervised fine-tuning (which may be unfeasible) to better adapt to specific applications and populations. To address this, we propose RetFiner, an SSL vision-language refinement scheme that improves the representations of existing FMs and enables their efficient and direct adaptation to specific populations for improved downstream performance. Our method uses a diverse set of training objectives which take advantage of the rich supervisory signal found in textual data. We tested RetFiner on the retinal FMs RETFound, UrFound, and VisionFM, showing significant improvements in linear probing performance on seven highly diverse OCT classification tasks, with an average increase of 5.8, 3.9, and 2.1 percentage points over their baselines, respectively. Our code and model weights are publicly available at https://github.com/ronnief1/RetFiner.

Clinicians are often very sceptical about applying automatic image processing approaches, especially deep learning based methods, in practice. One main reason for this is the black-box nature of these approaches and the inherent problem of missing insights of the automatically derived decisions. In order to increase trust in these methods, this paper presents approaches that help to interpret and explain the results of deep learning algorithms by depicting the anatomical areas which influence the decision of the algorithm most. Moreover, this research presents a unified framework, TorchEsegeta, for applying various interpretability and explainability techniques for deep learning models and generate visual interpretations and explanations for clinicians to corroborate their clinical findings. In addition, this will aid in gaining confidence in such methods. The framework builds on existing interpretability and explainability techniques that are currently focusing on classification models, extending them to segmentation tasks. In addition, these methods have been adapted to 3D models for volumetric analysis. The proposed framework provides methods to quantitatively compare visual explanations using infidelity and sensitivity metrics. This framework can be used by data scientists to perform post-hoc interpretations and explanations of their models, develop more explainable tools and present the findings to clinicians to increase their faith in such models. The proposed framework was evaluated based on a use case scenario of vessel segmentation models trained on Time-of-fight (TOF) Magnetic Resonance Angiogram (MRA) images of the human brain. Quantitative and qualitative results of a comparative study of different models and interpretability methods are presented. Furthermore, this paper provides an extensive overview of several existing interpretability and explainability methods.

Diabetic retinopathy (DR) is a leading cause of vision loss in working-age adults. While screening reduces the risk of blindness, traditional imaging is often costly and inaccessible. Artificial intelligence (AI) algorithms present a scalable diagnostic solution, but concerns regarding fairness and generalization persist. This work evaluates the fairness and performance of image-trained models in DR prediction, as well as the impact of disentanglement as a bias mitigation technique, using the diverse mBRSET fundus dataset. Three models, ConvNeXt V2, DINOv2, and Swin V2, were trained on macula images to predict DR and sensitive attributes (SAs) (e.g., age and gender/sex). Fairness was assessed between subgroups of SAs, and disentanglement was applied to reduce bias. All models achieved high DR prediction performance in diagnosing (up to 94% AUROC) and could reasonably predict age and gender/sex (91% and 77% AUROC, respectively). Fairness assessment suggests disparities, such as a 10% AUROC gap between age groups in DINOv2. Disentangling SAs from DR prediction had varying results, depending on the model selected. Disentanglement improved DINOv2 performance (2% AUROC gain), but led to performance drops in ConvNeXt V2 and Swin V2 (7% and 3%, respectively). These findings highlight the complexity of disentangling fine-grained features in fundus imaging and emphasize the importance of fairness in medical imaging AI to ensure equitable and reliable healthcare solutions.

Foundation vision-language models are currently transforming computer vision, and are on the rise in medical imaging fueled by their very promising generalization capabilities. However, the initial attempts to transfer this new paradigm to medical imaging have shown less impressive performances than those observed in other domains, due to the significant domain shift and the complex, expert domain knowledge inherent to medical-imaging tasks. Motivated by the need for domain-expert foundation models, we present FLAIR, a pre-trained vision-language model for universal retinal fundus image understanding. To this end, we compiled 37 open-access, mostly categorical fundus imaging datasets from various sources, with up to 97 different target conditions and 284,660 images. We integrate the expert's domain knowledge in the form of descriptive textual prompts, during both pre-training and zero-shot inference, enhancing the less-informative categorical supervision of the data. Such a textual expert's knowledge, which we compiled from the relevant clinical literature and community standards, describes the fine-grained features of the pathologies as well as the hierarchies and dependencies between them. We report comprehensive evaluations, which illustrate the benefit of integrating expert knowledge and the strong generalization capabilities of FLAIR under difficult scenarios with domain shifts or unseen categories. When adapted with a lightweight linear probe, FLAIR outperforms fully-trained, dataset-focused models, more so in the few-shot regimes. Interestingly, FLAIR outperforms by a large margin more generalist, larger-scale image-language models, which emphasizes the potential of embedding experts' domain knowledge and the limitations of generalist models in medical imaging.

Deep learning is currently the state-of-the-art for automated detection of referable diabetic retinopathy (DR) from color fundus photographs (CFP). While the general interest is put on improving results through methodological innovations, it is not clear how good these approaches perform compared to standard deep classification models trained with the appropriate settings. In this paper we propose to model a strong baseline for this task based on a simple and standard ResNet-18 architecture. To this end, we built on top of prior art by training the model with a standard preprocessing strategy but using images from several public sources and an empirically calibrated data augmentation setting. To evaluate its performance, we covered multiple clinically relevant perspectives, including image and patient level DR screening, discriminating responses by input quality and DR grade, assessing model uncertainties and analyzing its results in a qualitative manner. With no other methodological innovation than a carefully designed training, our ResNet model achieved an AUC = 0.955 (0.953 - 0.956) on a combined test set of 61007 test images from different public datasets, which is in line or even better than what other more complex deep learning models reported in the literature. Similar AUC values were obtained in 480 images from two separate in-house databases specially prepared for this study, which emphasize its generalization ability. This confirms that standard networks can still be strong baselines for this task if properly trained.

Fundus images are widely used for diagnosing various eye diseases, such as diabetic retinopathy, glaucoma, and age-related macular degeneration. However, manual analysis of fundus images is time-consuming and prone to errors. In this report, we propose a novel method for fundus detection using object detection and machine learning classification techniques. We use a YOLO_V8 to perform object detection on fundus images and locate the regions of interest (ROIs) such as optic disc, optic cup and lesions. We then use machine learning SVM classification algorithms to classify the ROIs into different DR stages based on the presence or absence of pathological signs such as exudates, microaneurysms, and haemorrhages etc. Our method achieves 84% accuracy and efficiency for fundus detection and can be applied for retinal fundus disease triage, especially in remote areas around the world.

Vision Transformers (ViTs) have recently achieved strong results in semantic segmentation, yet their deployment on resource-constrained devices remains limited due to their high memory footprint and computational cost. Quantization offers an effective strategy to improve efficiency, but ViT-based segmentation models are notoriously fragile under low precision, as quantization errors accumulate across deep encoder-decoder pipelines. We introduce I-Segmenter, the first fully integer-only ViT segmentation framework. Building on the Segmenter architecture, I-Segmenter systematically replaces floating-point operations with integer-only counterparts. To further stabilize both training and inference, we propose lambda-ShiftGELU, a novel activation function that mitigates the limitations of uniform quantization in handling long-tailed activation distributions. In addition, we remove the L2 normalization layer and replace bilinear interpolation in the decoder with nearest neighbor upsampling, ensuring integer-only execution throughout the computational graph. Extensive experiments show that I-Segmenter achieves accuracy within a reasonable margin of its FP32 baseline (5.1 % on average), while reducing model size by up to 3.8x and enabling up to 1.2x faster inference with optimized runtimes. Notably, even in one-shot PTQ with a single calibration image, I-Segmenter delivers competitive accuracy, underscoring its practicality for real-world deployment.

Blood vessel networks in the brain play a crucial role in stroke research, where understanding their topology is essential for analyzing blood flow dynamics. However, extracting detailed topological vessel network information from microscopy data remains a significant challenge, mainly due to the scarcity of labeled training data and the need for high topological accuracy. This work combines synthetic data generation with deep learning to automatically extract vessel networks as graphs from volumetric microscopy data. To combat data scarcity, we introduce a comprehensive pipeline for generating large-scale synthetic datasets that mirror the characteristics of real vessel networks. Our three-stage approach progresses from abstract graph generation through vessel mask creation to realistic medical image synthesis, incorporating biological constraints and imaging artifacts at each stage. Using this synthetic data, we develop a two-stage deep learning pipeline of 3D U-Net-based models for node detection and edge prediction. Fine-tuning on real microscopy data shows promising adaptation, improving edge prediction F1 scores from 0.496 to 0.626 by training on merely 5 manually labeled samples. These results suggest that automated vessel network extraction is becoming practically feasible, opening new possibilities for large-scale vascular analysis in stroke research.

Retinal detachment (RD) is a vision-threatening condition that requires timely intervention to preserve vision. Macular involvement -- whether the macula is still intact (macula-intact) or detached (macula-detached) -- is the key determinant of visual outcomes and treatment urgency. Point-of-care ultrasound (POCUS) offers a fast, non-invasive, cost-effective, and accessible imaging modality widely used in diverse clinical settings to detect RD. However, ultrasound image interpretation is limited by a lack of expertise among healthcare providers, especially in resource-limited settings. Deep learning offers the potential to automate ultrasound-based assessment of RD. However, there are no ML ultrasound algorithms currently available for clinical use to detect RD and no prior research has been done on assessing macular status using ultrasound in RD cases -- an essential distinction for surgical prioritization. Moreover, no public dataset currently supports macular-based RD classification using ultrasound video clips. We introduce Eye Retinal DEtachment ultraSound, ERDES, the first open-access dataset of ocular ultrasound clips labeled for (i) presence of retinal detachment and (ii) macula-intact versus macula-detached status. The dataset is intended to facilitate the development and evaluation of machine learning models for detecting retinal detachment. We also provide baseline benchmarks using multiple spatiotemporal convolutional neural network (CNN) architectures. All clips, labels, and training code are publicly available at https://osupcvlab.github.io/ERDES/.

We explore the capability of plain Vision Transformers (ViTs) for semantic segmentation and propose the SegVit. Previous ViT-based segmentation networks usually learn a pixel-level representation from the output of the ViT. Differently, we make use of the fundamental component -- attention mechanism, to generate masks for semantic segmentation. Specifically, we propose the Attention-to-Mask (ATM) module, in which the similarity maps between a set of learnable class tokens and the spatial feature maps are transferred to the segmentation masks. Experiments show that our proposed SegVit using the ATM module outperforms its counterparts using the plain ViT backbone on the ADE20K dataset and achieves new state-of-the-art performance on COCO-Stuff-10K and PASCAL-Context datasets. Furthermore, to reduce the computational cost of the ViT backbone, we propose query-based down-sampling (QD) and query-based up-sampling (QU) to build a Shrunk structure. With the proposed Shrunk structure, the model can save up to 40% computations while maintaining competitive performance.

Accurate segmentation of topological tubular structures, such as blood vessels and roads, is crucial in various fields, ensuring accuracy and efficiency in downstream tasks. However, many factors complicate the task, including thin local structures and variable global morphologies. In this work, we note the specificity of tubular structures and use this knowledge to guide our DSCNet to simultaneously enhance perception in three stages: feature extraction, feature fusion, and loss constraint. First, we propose a dynamic snake convolution to accurately capture the features of tubular structures by adaptively focusing on slender and tortuous local structures. Subsequently, we propose a multi-view feature fusion strategy to complement the attention to features from multiple perspectives during feature fusion, ensuring the retention of important information from different global morphologies. Finally, a continuity constraint loss function, based on persistent homology, is proposed to constrain the topological continuity of the segmentation better. Experiments on 2D and 3D datasets show that our DSCNet provides better accuracy and continuity on the tubular structure segmentation task compared with several methods. Our codes will be publicly available.

Effectively representing medical images, especially retinal images, presents a considerable challenge due to variations in appearance, size, and contextual information of pathological signs called lesions. Precise discrimination of these lesions is crucial for diagnosing vision-threatening issues such as diabetic retinopathy. While visual attention-based neural networks have been introduced to learn spatial context and channel correlations from retinal images, they often fall short in capturing localized lesion context. Addressing this limitation, we propose a novel attention mechanism called Guided Context Gating, an unique approach that integrates Context Formulation, Channel Correlation, and Guided Gating to learn global context, spatial correlations, and localized lesion context. Our qualitative evaluation against existing attention mechanisms emphasize the superiority of Guided Context Gating in terms of explainability. Notably, experiments on the Zenodo-DR-7 dataset reveal a substantial 2.63% accuracy boost over advanced attention mechanisms & an impressive 6.53% improvement over the state-of-the-art Vision Transformer for assessing the severity grade of retinopathy, even with imbalanced and limited training samples for each class.

Coronary artery disease (CAD) is a leading cause of cardiovascular-related mortality, and accurate stenosis detection is crucial for effective clinical decision-making. Coronary angiography remains the gold standard for diagnosing CAD, but manual analysis of angiograms is prone to errors and subjectivity. This study aims to develop a deep learning-based approach for the automatic segmentation of coronary arteries from angiographic images and the quantitative detection of stenosis, thereby improving the accuracy and efficiency of CAD diagnosis. We propose a novel deep learning-based method for the automatic segmentation of coronary arteries in angiographic images, coupled with a dynamic cohort method for stenosis detection. The segmentation model combines the MedSAM and VM-UNet architectures to achieve high-performance results. After segmentation, the vascular centerline is extracted, vessel diameter is computed, and the degree of stenosis is measured with high precision, enabling accurate identification of arterial stenosis. On the mixed dataset (including the ARCADE, DCA1, and GH datasets), the model achieved an average IoU of 0.6308, with sensitivity and specificity of 0.9772 and 0.9903, respectively. On the ARCADE dataset, the average IoU was 0.6303, with sensitivity of 0.9832 and specificity of 0.9933. Additionally, the stenosis detection algorithm achieved a true positive rate (TPR) of 0.5867 and a positive predictive value (PPV) of 0.5911, demonstrating the effectiveness of our model in analyzing coronary angiography images. SAM-VMNet offers a promising tool for the automated segmentation and detection of coronary artery stenosis. The model's high accuracy and robustness provide significant clinical value for the early diagnosis and treatment planning of CAD. The code and examples are available at https://github.com/qimingfan10/SAM-VMNet.

Medical image segmentation allows quantifying target structure size and shape, aiding in disease diagnosis, prognosis, surgery planning, and comprehension.Building upon recent advancements in foundation Vision-Language Models (VLMs) from natural image-text pairs, several studies have proposed adapting them to Vision-Language Segmentation Models (VLSMs) that allow using language text as an additional input to segmentation models. Introducing auxiliary information via text with human-in-the-loop prompting during inference opens up unique opportunities, such as open vocabulary segmentation and potentially more robust segmentation models against out-of-distribution data. Although transfer learning from natural to medical images has been explored for image-only segmentation models, the joint representation of vision-language in segmentation problems remains underexplored. This study introduces the first systematic study on transferring VLSMs to 2D medical images, using carefully curated 11 datasets encompassing diverse modalities and insightful language prompts and experiments. Our findings demonstrate that although VLSMs show competitive performance compared to image-only models for segmentation after finetuning in limited medical image datasets, not all VLSMs utilize the additional information from language prompts, with image features playing a dominant role. While VLSMs exhibit enhanced performance in handling pooled datasets with diverse modalities and show potential robustness to domain shifts compared to conventional segmentation models, our results suggest that novel approaches are required to enable VLSMs to leverage the various auxiliary information available through language prompts. The code and datasets are available at https://github.com/naamiinepal/medvlsm.

The convolutional neural network-based methods have become more and more popular for medical image segmentation due to their outstanding performance. However, they struggle with capturing long-range dependencies, which are essential for accurately modeling global contextual correlations. Thanks to the ability to model long-range dependencies by expanding the receptive field, the transformer-based methods have gained prominence. Inspired by this, we propose an advanced 2D feature extraction method by combining the convolutional neural network and Transformer architectures. More specifically, we introduce a parallelized encoder structure, where one branch uses ResNet to extract local information from images, while the other branch uses Transformer to extract global information. Furthermore, we integrate pyramid structures into the Transformer to extract global information at varying resolutions, especially in intensive prediction tasks. To efficiently utilize the different information in the parallelized encoder at the decoder stage, we use a channel attention module to merge the features of the encoder and propagate them through skip connections and bottlenecks. Intensive numerical experiments are performed on both aortic vessel tree, cardiac, and multi-organ datasets. By comparing with state-of-the-art medical image segmentation methods, our method is shown with better segmentation accuracy, especially on small organs. The code is publicly available on https://github.com/HongkunSun/ParaTransCNN.

Rapid advancements in medical image segmentation performance have been significantly driven by the development of Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs). These models follow the discriminative pixel-wise classification learning paradigm and often have limited ability to generalize across diverse medical imaging datasets. In this manuscript, we introduce Generative Medical Segmentation (GMS), a novel approach leveraging a generative model to perform image segmentation. Concretely, GMS employs a robust pre-trained vision foundation model to extract latent representations for images and corresponding ground truth masks, followed by a model that learns a mapping function from the image to the mask in the latent space. Once trained, the model generates an estimated segmentation mask using the pre-trained vision foundation model to decode the predicted latent representation back into the image space. The design of GMS leads to fewer trainable parameters in the model which reduces the risk of overfitting and enhances its generalization capability. Our experimental analysis across five public datasets in different medical imaging domains demonstrates GMS outperforms existing discriminative and generative segmentation models. Furthermore, GMS is able to generalize well across datasets from different centers within the same imaging modality. Our experiments suggest GMS offers a scalable and effective solution for medical image segmentation. GMS implementation and trained model weights are available at https://github.com/King-HAW/GMS.

Training convolutional neural networks (CNNs) for segmentation of pulmonary airway, artery, and vein is challenging due to sparse supervisory signals caused by the severe class imbalance between tubular targets and background. We present a CNNs-based method for accurate airway and artery-vein segmentation in non-contrast computed tomography. It enjoys superior sensitivity to tenuous peripheral bronchioles, arterioles, and venules. The method first uses a feature recalibration module to make the best use of features learned from the neural networks. Spatial information of features is properly integrated to retain relative priority of activated regions, which benefits the subsequent channel-wise recalibration. Then, attention distillation module is introduced to reinforce representation learning of tubular objects. Fine-grained details in high-resolution attention maps are passing down from one layer to its previous layer recursively to enrich context. Anatomy prior of lung context map and distance transform map is designed and incorporated for better artery-vein differentiation capacity. Extensive experiments demonstrated considerable performance gains brought by these components. Compared with state-of-the-art methods, our method extracted much more branches while maintaining competitive overall segmentation performance. Codes and models are available at http://www.pami.sjtu.edu.cn/News/56

Retinal imaging has emerged as a powerful, non-invasive modality for detecting and quantifying biomarkers of systemic diseases-ranging from diabetes and hypertension to Alzheimer's disease and cardiovascular disorders but current insights remain dispersed across platforms and specialties. Recent technological advances in optical coherence tomography (OCT/OCTA) and adaptive optics (AO) now deliver ultra-high-resolution scans (down to 5 {\mu}m ) with superior contrast and spatial integration, allowing early identification of microvascular abnormalities and neurodegenerative changes. At the same time, AI-driven and machine learning (ML) algorithms have revolutionized the analysis of large-scale retinal datasets, increasing sensitivity and specificity; for example, deep learning models achieve > 90 \% sensitivity for diabetic retinopathy and AUC = 0.89 for the prediction of cardiovascular risk from fundus photographs. The proliferation of mobile health technologies and telemedicine platforms further extends access, reduces costs, and facilitates community-based screening and longitudinal monitoring. Despite these breakthroughs, translation into routine practice is hindered by heterogeneous imaging protocols, limited external validation of AI models, and integration challenges within clinical workflows. In this review, we systematically synthesize the latest OCT/OCT and AO developments, AI/ML approaches, and mHealth/Tele-ophthalmology initiatives and quantify their diagnostic performance across disease domains. Finally, we propose a roadmap for multicenter protocol standardization, prospective validation trials, and seamless incorporation of retinal screening into primary and specialty care pathways-paving the way for precision prevention, early intervention, and ongoing treatment of life-threatening systemic diseases.

The oxygen saturation level in the blood (SaO2) is crucial for health, particularly in relation to sleep-related breathing disorders. However, continuous monitoring of SaO2 is time-consuming and highly variable depending on patients' conditions. Recently, optical coherence tomography angiography (OCTA) has shown promising development in rapidly and effectively screening eye-related lesions, offering the potential for diagnosing sleep-related disorders. To bridge this gap, our paper presents three key contributions. Firstly, we propose JointViT, a novel model based on the Vision Transformer architecture, incorporating a joint loss function for supervision. Secondly, we introduce a balancing augmentation technique during data preprocessing to improve the model's performance, particularly on the long-tail distribution within the OCTA dataset. Lastly, through comprehensive experiments on the OCTA dataset, our proposed method significantly outperforms other state-of-the-art methods, achieving improvements of up to 12.28% in overall accuracy. This advancement lays the groundwork for the future utilization of OCTA in diagnosing sleep-related disorders. See project website https://steve-zeyu-zhang.github.io/JointViT

Active contour models have achieved prominent success in the area of image segmentation, allowing complex objects to be segmented from the background for further analysis. Existing models can be divided into region-based active contour models and edge-based active contour models. However, both models use direct image data to achieve segmentation and face many challenging problems in terms of the initial contour position, noise sensitivity, local minima and inefficiency owing to the in-homogeneity of image intensities. The saliency map of an image changes the image representation, making it more visual and meaningful. In this study, we propose a novel model that uses the advantages of a saliency map with local image information (LIF) and overcomes the drawbacks of previous models. The proposed model is driven by a saliency map of an image and the local image information to enhance the progress of the active contour models. In this model, the saliency map of an image is first computed to find the saliency driven local fitting energy. Then, the saliency-driven local fitting energy is combined with the LIF model, resulting in a final novel energy functional. This final energy functional is formulated through a level set formulation, and regulation terms are added to evolve the contour more precisely across the object boundaries. The quality of the proposed method was verified on different synthetic images, real images and publicly available datasets, including medical images. The image segmentation results, and quantitative comparisons confirmed the contour initialization independence, noise insensitivity, and superior segmentation accuracy of the proposed model in comparison to the other segmentation models.

Accurate segmentation is essential for echocardiography-based assessment of cardiovascular diseases (CVDs). However, the variability among sonographers and the inherent challenges of ultrasound images hinder precise segmentation. By leveraging the joint representation of image and text modalities, Vision-Language Segmentation Models (VLSMs) can incorporate rich contextual information, potentially aiding in accurate and explainable segmentation. However, the lack of readily available data in echocardiography hampers the training of VLSMs. In this study, we explore using synthetic datasets from Semantic Diffusion Models (SDMs) to enhance VLSMs for echocardiography segmentation. We evaluate results for two popular VLSMs (CLIPSeg and CRIS) using seven different kinds of language prompts derived from several attributes, automatically extracted from echocardiography images, segmentation masks, and their metadata. Our results show improved metrics and faster convergence when pretraining VLSMs on SDM-generated synthetic images before finetuning on real images. The code, configs, and prompts are available at https://github.com/naamiinepal/synthetic-boost.

Optical coherence tomography (OCT) is a non-invasive imaging technique with extensive clinical applications in ophthalmology. OCT enables the visualization of the retinal layers, playing a vital role in the early detection and monitoring of retinal diseases. OCT uses the principle of light wave interference to create detailed images of the retinal microstructures, making it a valuable tool for diagnosing ocular conditions. This work presents an open-access OCT dataset (OCTDL) comprising over 1600 high-resolution OCT images labeled according to disease group and retinal pathology. The dataset consists of OCT records of patients with Age-related Macular Degeneration (AMD), Diabetic Macular Edema (DME), Epiretinal Membrane (ERM), Retinal Artery Occlusion (RAO), Retinal Vein Occlusion (RVO), and Vitreomacular Interface Disease (VID). The images were acquired with an Optovue Avanti RTVue XR using raster scanning protocols with dynamic scan length and image resolution. Each retinal b-scan was acquired by centering on the fovea and interpreted and cataloged by an experienced retinal specialist. In this work, we applied Deep Learning classification techniques to this new open-access dataset.

Cell instance segmentation is a fundamental task in digital pathology with broad clinical applications. Recently, vision foundation models, which are predominantly based on Vision Transformers (ViTs), have achieved remarkable success in pathology image analysis. However, their improvements in cell instance segmentation remain limited. A key challenge arises from the tokenization process in ViTs, which substantially reduces the spatial resolution of input images, leading to suboptimal segmentation quality, especially for small and densely packed cells. To address this problem, we propose CellVTA (Cell Vision Transformer with Adapter), a novel method that improves the performance of vision foundation models for cell instance segmentation by incorporating a CNN-based adapter module. This adapter extracts high-resolution spatial information from input images and injects it into the ViT through a cross-attention mechanism. Our method preserves the core architecture of ViT, ensuring seamless integration with pretrained foundation models. Extensive experiments show that CellVTA achieves 0.538 mPQ on the CoNIC dataset and 0.506 mPQ on the PanNuke dataset, which significantly outperforms the state-of-the-art cell segmentation methods. Ablation studies confirm the superiority of our approach over other fine-tuning strategies, including decoder-only fine-tuning and full fine-tuning. Our code and models are publicly available at https://github.com/JieZheng-ShanghaiTech/CellVTA.

Segmentation of the coronary artery is an important task for the quantitative analysis of coronary computed tomography angiography (CCTA) images and is being stimulated by the field of deep learning. However, the complex structures with tiny and narrow branches of the coronary artery bring it a great challenge. Coupled with the medical image limitations of low resolution and poor contrast, fragmentations of segmented vessels frequently occur in the prediction. Therefore, a geometry-based cascaded segmentation method is proposed for the coronary artery, which has the following innovations: 1) Integrating geometric deformation networks, we design a cascaded network for segmenting the coronary artery and vectorizing results. The generated meshes of the coronary artery are continuous and accurate for twisted and sophisticated coronary artery structures, without fragmentations. 2) Different from mesh annotations generated by the traditional marching cube method from voxel-based labels, a finer vectorized mesh of the coronary artery is reconstructed with the regularized morphology. The novel mesh annotation benefits the geometry-based segmentation network, avoiding bifurcation adhesion and point cloud dispersion in intricate branches. 3) A dataset named CCA-200 is collected, consisting of 200 CCTA images with coronary artery disease. The ground truths of 200 cases are coronary internal diameter annotations by professional radiologists. Extensive experiments verify our method on our collected dataset CCA-200 and public ASOCA dataset, with a Dice of 0.778 on CCA-200 and 0.895 on ASOCA, showing superior results. Especially, our geometry-based model generates an accurate, intact and smooth coronary artery, devoid of any fragmentations of segmented vessels.

Purpose: Foundation models, trained on multitudes of public datasets, often require additional fine-tuning or re-prompting mechanisms to be applied to visually distinct target domains such as surgical videos. Further, without domain knowledge, they cannot model the specific semantics of the target domain. Hence, when applied to surgical video segmentation, they fail to generalise to sections where previously tracked objects leave the scene or new objects enter. Methods: We propose SASVi, a novel re-prompting mechanism based on a frame-wise Mask R-CNN Overseer model, which is trained on a minimal amount of scarcely available annotations for the target domain. This model automatically re-prompts the foundation model SAM2 when the scene constellation changes, allowing for temporally smooth and complete segmentation of full surgical videos. Results: Re-prompting based on our Overseer model significantly improves the temporal consistency of surgical video segmentation compared to similar prompting techniques and especially frame-wise segmentation, which neglects temporal information, by at least 1.5%. Our proposed approach allows us to successfully deploy SAM2 to surgical videos, which we quantitatively and qualitatively demonstrate for three different cholecystectomy and cataract surgery datasets. Conclusion: SASVi can serve as a new baseline for smooth and temporally consistent segmentation of surgical videos with scarcely available annotation data. Our method allows us to leverage scarce annotations and obtain complete annotations for full videos of the large-scale counterpart datasets. We make those annotations publicly available, providing extensive annotation data for the future development of surgical data science models.

In the realm of computer vision, the integration of advanced techniques into the processing of RGB-D camera inputs poses a significant challenge, given the inherent complexities arising from diverse environmental conditions and varying object appearances. Therefore, this paper introduces FusionVision, an exhaustive pipeline adapted for the robust 3D segmentation of objects in RGB-D imagery. Traditional computer vision systems face limitations in simultaneously capturing precise object boundaries and achieving high-precision object detection on depth map as they are mainly proposed for RGB cameras. To address this challenge, FusionVision adopts an integrated approach by merging state-of-the-art object detection techniques, with advanced instance segmentation methods. The integration of these components enables a holistic (unified analysis of information obtained from both color RGB and depth D channels) interpretation of RGB-D data, facilitating the extraction of comprehensive and accurate object information. The proposed FusionVision pipeline employs YOLO for identifying objects within the RGB image domain. Subsequently, FastSAM, an innovative semantic segmentation model, is applied to delineate object boundaries, yielding refined segmentation masks. The synergy between these components and their integration into 3D scene understanding ensures a cohesive fusion of object detection and segmentation, enhancing overall precision in 3D object segmentation. The code and pre-trained models are publicly available at https://github.com/safouaneelg/FusionVision/.

Medical image segmentation is an important analysis task in clinical practice and research. Deep learning has massively advanced the field, but current approaches are mostly based on models trained for a specific task. Training such models or adapting them to a new condition is costly due to the need for (manually) labeled data. The emergence of vision foundation models, especially Segment Anything, offers a path to universal segmentation for medical images, overcoming these issues. Here, we study how to improve Segment Anything for medical images by comparing different finetuning strategies on a large and diverse dataset. We evaluate the finetuned models on a wide range of interactive and (automatic) semantic segmentation tasks. We find that the performance can be clearly improved for interactive segmentation. However, semantic segmentation does not benefit from pretraining on medical images. Our best model, MedicoSAM, is publicly available at https://github.com/computational-cell-analytics/medico-sam. We show that it is compatible with existing tools for data annotation and believe that it will be of great practical value.

Building on the success of deep learning models in cardiovascular structure segmentation, increasing attention has been focused on improving generalization and robustness, particularly in small, annotated datasets. Despite recent advancements, current approaches often face challenges such as overfitting and accuracy limitations, largely due to their reliance on large datasets and narrow optimization techniques. This paper introduces the UU-Mamba model, an extension of the U-Mamba architecture, designed to address these challenges in both cardiac and vascular segmentation. By incorporating Sharpness-Aware Minimization (SAM), the model enhances generalization by targeting flatter minima in the loss landscape. Additionally, we propose an uncertainty-aware loss function that combines region-based, distribution-based, and pixel-based components to improve segmentation accuracy by capturing both local and global features. While the UU-Mamba model has already demonstrated great performance, further testing is required to fully assess its generalization and robustness. We expand our evaluation by conducting new trials on the ImageCAS (coronary artery) and Aorta (aortic branches and zones) datasets, which present more complex segmentation challenges than the ACDC dataset (left and right ventricles) used in our previous work, showcasing the model's adaptability and resilience. We confirm UU-Mamba's superior performance over leading models such as TransUNet, Swin-Unet, nnUNet, and nnFormer. Moreover, we provide a more comprehensive evaluation of the model's robustness and segmentation accuracy, as demonstrated by extensive experiments.

Glaucoma is the leading cause of irreversible blindness worldwide and poses significant diagnostic challenges due to its reliance on subjective evaluation. However, recent advances in computer vision and deep learning have demonstrated the potential for automated assessment. In this paper, we survey recent studies on AI-based glaucoma diagnosis using fundus, optical coherence tomography, and visual field images, with a particular emphasis on deep learning-based methods. We provide an updated taxonomy that organizes methods into architectural paradigms and includes links to available source code to enhance the reproducibility of the methods. Through rigorous benchmarking on widely-used public datasets, we reveal performance gaps in generalizability, uncertainty estimation, and multimodal integration. Additionally, our survey curates key datasets while highlighting limitations such as scale, labeling inconsistencies, and bias. We outline open research challenges and detail promising directions for future studies. This survey is expected to be useful for both AI researchers seeking to translate advances into practice and ophthalmologists aiming to improve clinical workflows and diagnosis using the latest AI outcomes.

We propose a minimal path method to simultaneously compute segmentation masks and extract centerlines of tubular structures with line-topology. Minimal path methods are commonly used for the segmentation of tubular structures in a wide variety of applications. Recent methods use features extracted by CNNs, and often outperform methods using hand-tuned features. However, for CNN-based methods, the samples used for training may be generated inappropriately, so that they can be very different from samples encountered during inference. We approach this discrepancy by introducing a novel iterative training scheme, which enables generating better training samples specifically tailored for the minimal path methods without changing existing annotations. In our method, segmentation masks and centerlines are not determined after one another by post-processing, but obtained using the same steps. Our method requires only very few annotated training images. Comparison with seven previous approaches on three public datasets, including satellite images and medical images, shows that our method achieves state-of-the-art results both for segmentation masks and centerlines.

Despite that deep learning has achieved state-of-the-art performance for medical image segmentation, its success relies on a large set of manually annotated images for training that are expensive to acquire. In this paper, we propose an annotation-efficient learning framework for segmentation tasks that avoids annotations of training images, where we use an improved Cycle-Consistent Generative Adversarial Network (GAN) to learn from a set of unpaired medical images and auxiliary masks obtained either from a shape model or public datasets. We first use the GAN to generate pseudo labels for our training images under the implicit high-level shape constraint represented by a Variational Auto-encoder (VAE)-based discriminator with the help of the auxiliary masks, and build a Discriminator-guided Generator Channel Calibration (DGCC) module which employs our discriminator's feedback to calibrate the generator for better pseudo labels. To learn from the pseudo labels that are noisy, we further introduce a noise-robust iterative learning method using noise-weighted Dice loss. We validated our framework with two situations: objects with a simple shape model like optic disc in fundus images and fetal head in ultrasound images, and complex structures like lung in X-Ray images and liver in CT images. Experimental results demonstrated that 1) Our VAE-based discriminator and DGCC module help to obtain high-quality pseudo labels. 2) Our proposed noise-robust learning method can effectively overcome the effect of noisy pseudo labels. 3) The segmentation performance of our method without using annotations of training images is close or even comparable to that of learning from human annotations.

Visualization of large-scale time-dependent simulation data is crucial for domain scientists to analyze complex phenomena, but it demands significant I/O bandwidth, storage, and computational resources. To enable effective visualization on local, low-end machines, recent advances in view synthesis techniques, such as neural radiance fields, utilize neural networks to generate novel visualizations for volumetric scenes. However, these methods focus on reconstruction quality rather than facilitating interactive visualization exploration, such as feature extraction and tracking. We introduce VolSegGS, a novel Gaussian splatting framework that supports interactive segmentation and tracking in dynamic volumetric scenes for exploratory visualization and analysis. Our approach utilizes deformable 3D Gaussians to represent a dynamic volumetric scene, allowing for real-time novel view synthesis. For accurate segmentation, we leverage the view-independent colors of Gaussians for coarse-level segmentation and refine the results with an affinity field network for fine-level segmentation. Additionally, by embedding segmentation results within the Gaussians, we ensure that their deformation enables continuous tracking of segmented regions over time. We demonstrate the effectiveness of VolSegGS with several time-varying datasets and compare our solutions against state-of-the-art methods. With the ability to interact with a dynamic scene in real time and provide flexible segmentation and tracking capabilities, VolSegGS offers a powerful solution under low computational demands. This framework unlocks exciting new possibilities for time-varying volumetric data analysis and visualization.

Many keypoint detection and description methods have been proposed for image matching or registration. While these methods demonstrate promising performance for single-modality image matching, they often struggle with multimodal data because the descriptors trained on single-modality data tend to lack robustness against the non-linear variations present in multimodal data. Extending such methods to multimodal image matching often requires well-aligned multimodal data to learn modality-invariant descriptors. However, acquiring such data is often costly and impractical in many real-world scenarios. To address this challenge, we propose a modality-invariant feature learning network (MIFNet) to compute modality-invariant features for keypoint descriptions in multimodal image matching using only single-modality training data. Specifically, we propose a novel latent feature aggregation module and a cumulative hybrid aggregation module to enhance the base keypoint descriptors trained on single-modality data by leveraging pre-trained features from Stable Diffusion models. We validate our method with recent keypoint detection and description methods in three multimodal retinal image datasets (CF-FA, CF-OCT, EMA-OCTA) and two remote sensing datasets (Optical-SAR and Optical-NIR). Extensive experiments demonstrate that the proposed MIFNet is able to learn modality-invariant feature for multimodal image matching without accessing the targeted modality and has good zero-shot generalization ability. The source code will be made publicly available.

WHO has declared that more than 2.2 billion people worldwide are suffering from visual disorders, such as media haze, glaucoma, and drusen. At least 1 billion of these cases could have been either prevented or successfully treated, yet they remain unaddressed due to poverty, a lack of specialists, inaccurate ocular fundus diagnoses by ophthalmologists, or the presence of a rare disease. To address this, the research has developed the Hybrid Trio-Network Model Algorithm for accurately diagnosing 12 distinct common and rare eye diseases. This algorithm utilized the RFMiD dataset of 3,200 fundus images and the Binary Relevance Method to detect diseases separately, ensuring expandability and avoiding incorrect correlations. Each detector, incorporating finely tuned hyperparameters to optimize performance, consisted of three feature components: A classical transfer learning CNN model, a two-stage CNN model, and a Siamese Network. The diagnosis was made using features extracted through this Trio-Model with Ensembled Machine Learning algorithms. The proposed model achieved an average accuracy of 97% and an AUC score of 0.96. Compared to past benchmark studies, an increase of over 10% in the F1-score was observed for most diseases. Furthermore, using the Siamese Network, the model successfully made predictions in diseases like optic disc pallor, which past studies failed to predict due to low confidence. This diagnostic tool presents a stable, adaptive, cost-effective, efficient, accessible, and fast solution for globalizing early detection of both common and rare diseases.

Diffusion probabilistic model (DPM) recently becomes one of the hottest topic in computer vision. Its image generation application such as Imagen, Latent Diffusion Models and Stable Diffusion have shown impressive generation capabilities, which aroused extensive discussion in the community. Many recent studies also found it is useful in many other vision tasks, like image deblurring, super-resolution and anomaly detection. Inspired by the success of DPM, we propose the first DPM based model toward general medical image segmentation tasks, which we named MedSegDiff. In order to enhance the step-wise regional attention in DPM for the medical image segmentation, we propose dynamic conditional encoding, which establishes the state-adaptive conditions for each sampling step. We further propose Feature Frequency Parser (FF-Parser), to eliminate the negative effect of high-frequency noise component in this process. We verify MedSegDiff on three medical segmentation tasks with different image modalities, which are optic cup segmentation over fundus images, brain tumor segmentation over MRI images and thyroid nodule segmentation over ultrasound images. The experimental results show that MedSegDiff outperforms state-of-the-art (SOTA) methods with considerable performance gap, indicating the generalization and effectiveness of the proposed model. Our code is released at https://github.com/WuJunde/MedSegDiff.

Multimodal large language models (MLLMs) demonstrate significant potential in the field of medical diagnosis. However, they face critical challenges in specialized domains such as ophthalmology, particularly the fragmentation of annotation granularity and inconsistencies in clinical reasoning logic, which hinder precise cross-modal understanding. This paper introduces FundusExpert, an ophthalmology-specific MLLM with integrated positioning-diagnosis reasoning capabilities, along with FundusGen, a dataset constructed through the intelligent Fundus-Engine system. Fundus-Engine automates localization and leverages MLLM-based semantic expansion to integrate global disease classification, local object detection, and fine-grained feature analysis within a single fundus image. Additionally, by constructing a clinically aligned cognitive chain, it guides the model to generate interpretable reasoning paths. FundusExpert, fine-tuned with instruction data from FundusGen, achieves the best performance in ophthalmic question-answering tasks, surpassing the average accuracy of the 40B MedRegA by 26.6%. It also excels in zero-shot report generation tasks, achieving a clinical consistency of 77.0%, significantly outperforming GPT-4o's 47.6%. Furthermore, we reveal a scaling law between data quality and model capability (L propto N^{0.068}), demonstrating that the cognitive alignment annotations in FundusGen enhance data utilization efficiency. By integrating region-level localization with diagnostic reasoning chains, our work develops a scalable, clinically-aligned MLLM and explores a pathway toward bridging the visual-language gap in specific MLLMs. Our project can be found at https://github.com/MeteorElf/FundusExpert.

Glaucoma is the number one cause of irreversible blindness globally. A major challenge for accurate glaucoma detection and progression forecasting is the bottleneck of limited labeled patients with the state-of-the-art (SOTA) 3D retinal imaging data of optical coherence tomography (OCT). To address the data scarcity issue, this paper proposes two solutions. First, we develop a novel generalization-reinforced semi-supervised learning (SSL) model called pseudo supervisor to optimally utilize unlabeled data. Compared with SOTA models, the proposed pseudo supervisor optimizes the policy of predicting pseudo labels with unlabeled samples to improve empirical generalization. Our pseudo supervisor model is evaluated with two clinical tasks consisting of glaucoma detection and progression forecasting. The progression forecasting task is evaluated both unimodally and multimodally. Our pseudo supervisor model demonstrates superior performance than SOTA SSL comparison models. Moreover, our model also achieves the best results on the publicly available LAG fundus dataset. Second, we introduce the Harvard Glaucoma Detection and Progression (Harvard-GDP) Dataset, a multimodal multitask dataset that includes data from 1,000 patients with OCT imaging data, as well as labels for glaucoma detection and progression. This is the largest glaucoma detection dataset with 3D OCT imaging data and the first glaucoma progression forecasting dataset that is publicly available. Detailed sex and racial analysis are provided, which can be used by interested researchers for fairness learning studies. Our released dataset is benchmarked with several SOTA supervised CNN and transformer deep learning models. The dataset and code are made publicly available via https://ophai.hms.harvard.edu/datasets/harvard-gdp1000.

Foundation Vision-Language Models (VLMs) trained using large-scale open-domain images and text pairs have recently been adapted to develop Vision-Language Segmentation Models (VLSMs) that allow providing text prompts during inference to guide image segmentation. If robust and powerful VLSMs can be built for medical images, it could aid medical professionals in many clinical tasks where they must spend substantial time delineating the target structure of interest. VLSMs for medical images resort to fine-tuning base VLM or VLSM pretrained on open-domain natural image datasets due to fewer annotated medical image datasets; this fine-tuning is resource-consuming and expensive as it usually requires updating all or a significant fraction of the pretrained parameters. Recently, lightweight blocks called adapters have been proposed in VLMs that keep the pretrained model frozen and only train adapters during fine-tuning, substantially reducing the computing resources required. We introduce a novel adapter, VLSM-Adapter, that can fine-tune pretrained vision-language segmentation models using transformer encoders. Our experiments in widely used CLIP-based segmentation models show that with only 3 million trainable parameters, the VLSM-Adapter outperforms state-of-the-art and is comparable to the upper bound end-to-end fine-tuning. The source code is available at: https://github.com/naamiinepal/vlsm-adapter.

Image segmentation is a vital task for providing human assistance and enhancing autonomy in our daily lives. In particular, RGB-D segmentation-leveraging both visual and depth cues-has attracted increasing attention as it promises richer scene understanding than RGB-only methods. However, most existing efforts have primarily focused on semantic segmentation and thus leave a critical gap. There is a relative scarcity of instance-level RGB-D segmentation datasets, which restricts current methods to broad category distinctions rather than fully capturing the fine-grained details required for recognizing individual objects. To bridge this gap, we introduce three RGB-D instance segmentation benchmarks, distinguished at the instance level. These datasets are versatile, supporting a wide range of applications from indoor navigation to robotic manipulation. In addition, we present an extensive evaluation of various baseline models on these benchmarks. This comprehensive analysis identifies both their strengths and shortcomings, guiding future work toward more robust, generalizable solutions. Finally, we propose a simple yet effective method for RGB-D data integration. Extensive evaluations affirm the effectiveness of our approach, offering a robust framework for advancing toward more nuanced scene understanding.

Accurate segmentation of coronary arteries remains a significant challenge in clinical practice, hindering the ability to effectively diagnose and manage coronary artery disease. The lack of large, annotated datasets for model training exacerbates this issue, limiting the development of automated tools that could assist radiologists. To address this, we introduce CM-UNet, which leverages self-supervised pre-training on unannotated datasets and transfer learning on limited annotated data, enabling accurate disease detection while minimizing the need for extensive manual annotations. Fine-tuning CM-UNet with only 18 annotated images instead of 500 resulted in a 15.2% decrease in Dice score, compared to a 46.5% drop in baseline models without pre-training. This demonstrates that self-supervised learning can enhance segmentation performance and reduce dependence on large datasets. This is one of the first studies to highlight the importance of self-supervised learning in improving coronary artery segmentation from X-ray angiography, with potential implications for advancing diagnostic accuracy in clinical practice. By enhancing segmentation accuracy in X-ray angiography images, the proposed approach aims to improve clinical workflows, reduce radiologists' workload, and accelerate disease detection, ultimately contributing to better patient outcomes. The source code is publicly available at https://github.com/CamilleChallier/Contrastive-Masked-UNet.

The application of methods based on Neural Radiance Fields (NeRF) and 3D Gaussian Splatting (3D GS) have steadily gained popularity in the field of 3D object segmentation in static scenes. These approaches demonstrate efficacy in a range of 3D scene understanding and editing tasks. Nevertheless, the 4D object segmentation of dynamic scenes remains an underexplored field due to the absence of a sufficiently extensive and accurately labelled multi-view video dataset. In this paper, we present MUVOD, a new multi-view video dataset for training and evaluating object segmentation in reconstructed real-world scenarios. The 17 selected scenes, describing various indoor or outdoor activities, are collected from different sources of datasets originating from various types of camera rigs. Each scene contains a minimum of 9 views and a maximum of 46 views. We provide 7830 RGB images (30 frames per video) with their corresponding segmentation mask in 4D motion, meaning that any object of interest in the scene could be tracked across temporal frames of a given view or across different views belonging to the same camera rig. This dataset, which contains 459 instances of 73 categories, is intended as a basic benchmark for the evaluation of multi-view video segmentation methods. We also present an evaluation metric and a baseline segmentation approach to encourage and evaluate progress in this evolving field. Additionally, we propose a new benchmark for 3D object segmentation task with a subset of annotated multi-view images selected from our MUVOD dataset. This subset contains 50 objects of different conditions in different scenarios, providing a more comprehensive analysis of state-of-the-art 3D object segmentation methods. Our proposed MUVOD dataset is available at https://volumetric-repository.labs.b-com.com/#/muvod.

The widespread use of vector graphics creates a significant demand for vectorization methods. While recent learning-based techniques have shown their capability to create vector images of clear topology, filling these primitives with gradients remains a challenge. In this paper, we propose a segmentation-guided vectorization framework to convert raster images into concise vector graphics with radial gradient fills. With the guidance of an embedded gradient-aware segmentation subroutine, our approach progressively appends gradient-filled B\'ezier paths to the output, where primitive parameters are initiated with our newly designed initialization technique and are optimized to minimize our novel loss function. We build our method on a differentiable renderer with traditional segmentation algorithms to develop it as a model-free tool for raster-to-vector conversion. It is tested on various inputs to demonstrate its feasibility, independent of datasets, to synthesize vector graphics with improved visual quality and layer-wise topology compared to prior work.

Amodal object segmentation is a challenging task that involves segmenting both visible and occluded parts of an object. In this paper, we propose a novel approach, called Coarse-to-Fine Segmentation (C2F-Seg), that addresses this problem by progressively modeling the amodal segmentation. C2F-Seg initially reduces the learning space from the pixel-level image space to the vector-quantized latent space. This enables us to better handle long-range dependencies and learn a coarse-grained amodal segment from visual features and visible segments. However, this latent space lacks detailed information about the object, which makes it difficult to provide a precise segmentation directly. To address this issue, we propose a convolution refine module to inject fine-grained information and provide a more precise amodal object segmentation based on visual features and coarse-predicted segmentation. To help the studies of amodal object segmentation, we create a synthetic amodal dataset, named as MOViD-Amodal (MOViD-A), which can be used for both image and video amodal object segmentation. We extensively evaluate our model on two benchmark datasets: KINS and COCO-A. Our empirical results demonstrate the superiority of C2F-Seg. Moreover, we exhibit the potential of our approach for video amodal object segmentation tasks on FISHBOWL and our proposed MOViD-A. Project page at: http://jianxgao.github.io/C2F-Seg.

Medical image and video segmentation is a critical task for precision medicine, which has witnessed considerable progress in developing task or modality-specific and generalist models for 2D images. However, there have been limited studies on building general-purpose models for 3D images and videos with comprehensive user studies. Here, we present MedSAM2, a promptable segmentation foundation model for 3D image and video segmentation. The model is developed by fine-tuning the Segment Anything Model 2 on a large medical dataset with over 455,000 3D image-mask pairs and 76,000 frames, outperforming previous models across a wide range of organs, lesions, and imaging modalities. Furthermore, we implement a human-in-the-loop pipeline to facilitate the creation of large-scale datasets resulting in, to the best of our knowledge, the most extensive user study to date, involving the annotation of 5,000 CT lesions, 3,984 liver MRI lesions, and 251,550 echocardiogram video frames, demonstrating that MedSAM2 can reduce manual costs by more than 85%. MedSAM2 is also integrated into widely used platforms with user-friendly interfaces for local and cloud deployment, making it a practical tool for supporting efficient, scalable, and high-quality segmentation in both research and healthcare environments.

The lack of labeled datasets in 3D vision for surgical scenes inhibits the development of robust 3D reconstruction algorithms in the medical domain. Despite the popularity of Neural Radiance Fields and 3D Gaussian Splatting in the general computer vision community, these systems have yet to find consistent success in surgical scenes due to challenges such as non-stationary lighting and non-Lambertian surfaces. As a result, the need for labeled surgical datasets continues to grow. In this work, we introduce a differentiable rendering framework for material and lighting estimation from endoscopic images and known geometry. Compared to previous approaches that model lighting and material jointly as radiance, we explicitly disentangle these scene properties for robust and photorealistic novel view synthesis. To disambiguate the training process, we formulate domain-specific properties inherent in surgical scenes. Specifically, we model the scene lighting as a simple spotlight and material properties as a bidirectional reflectance distribution function, parameterized by a neural network. By grounding color predictions in the rendering equation, we can generate photorealistic images at arbitrary camera poses. We evaluate our method with various sequences from the Colonoscopy 3D Video Dataset and show that our method produces competitive novel view synthesis results compared with other approaches. Furthermore, we demonstrate that synthetic data can be used to develop 3D vision algorithms by finetuning a depth estimation model with our rendered outputs. Overall, we see that the depth estimation performance is on par with fine-tuning with the original real images.

From a falcon detecting prey to humans recognizing faces, many species exhibit extraordinary abilities in rapid visual localization and classification. These are made possible by a specialized retinal region called the fovea, which provides high acuity at the center of vision while maintaining lower resolution in the periphery. This distinctive spatial organization, preserved along the early visual pathway through retinotopic mapping, is fundamental to biological vision, yet remains largely unexplored in machine learning. Our study investigates how incorporating foveated retinotopy may benefit deep convolutional neural networks (CNNs) in image classification tasks. By implementing a foveated retinotopic transformation in the input layer of standard ResNet models and re-training them, we maintain comparable classification accuracy while enhancing the network's robustness to scale and rotational perturbations. Although this architectural modification introduces increased sensitivity to fixation point shifts, we demonstrate how this apparent limitation becomes advantageous: variations in classification probabilities across different gaze positions serve as effective indicators for object localization. Our findings suggest that foveated retinotopic mapping encodes implicit knowledge about visual object geometry, offering an efficient solution to the visual search problem - a capability crucial for many living species.

In the realm of medical image segmentation, both CNN-based and Transformer-based models have been extensively explored. However, CNNs exhibit limitations in long-range modeling capabilities, whereas Transformers are hampered by their quadratic computational complexity. Recently, State Space Models (SSMs), exemplified by Mamba, have emerged as a promising approach. They not only excel in modeling long-range interactions but also maintain a linear computational complexity. In this paper, leveraging state space models, we propose a U-shape architecture model for medical image segmentation, named Vision Mamba UNet (VM-UNet). Specifically, the Visual State Space (VSS) block is introduced as the foundation block to capture extensive contextual information, and an asymmetrical encoder-decoder structure is constructed with fewer convolution layers to save calculation cost. We conduct comprehensive experiments on the ISIC17, ISIC18, and Synapse datasets, and the results indicate that VM-UNet performs competitively in medical image segmentation tasks. To our best knowledge, this is the first medical image segmentation model constructed based on the pure SSM-based model. We aim to establish a baseline and provide valuable insights for the future development of more efficient and effective SSM-based segmentation systems. Our code is available at https://github.com/JCruan519/VM-UNet.

Neural Radiance Fields (NeRFs) have emerged as a popular approach for novel view synthesis. While NeRFs are quickly being adapted for a wider set of applications, intuitively editing NeRF scenes is still an open challenge. One important editing task is the removal of unwanted objects from a 3D scene, such that the replaced region is visually plausible and consistent with its context. We refer to this task as 3D inpainting. In 3D, solutions must be both consistent across multiple views and geometrically valid. In this paper, we propose a novel 3D inpainting method that addresses these challenges. Given a small set of posed images and sparse annotations in a single input image, our framework first rapidly obtains a 3D segmentation mask for a target object. Using the mask, a perceptual optimizationbased approach is then introduced that leverages learned 2D image inpainters, distilling their information into 3D space, while ensuring view consistency. We also address the lack of a diverse benchmark for evaluating 3D scene inpainting methods by introducing a dataset comprised of challenging real-world scenes. In particular, our dataset contains views of the same scene with and without a target object, enabling more principled benchmarking of the 3D inpainting task. We first demonstrate the superiority of our approach on multiview segmentation, comparing to NeRFbased methods and 2D segmentation approaches. We then evaluate on the task of 3D inpainting, establishing state-ofthe-art performance against other NeRF manipulation algorithms, as well as a strong 2D image inpainter baseline. Project Page: https://spinnerf3d.github.io

Recently two-stage detectors have surged ahead of single-shot detectors in the accuracy-vs-speed trade-off. Nevertheless single-shot detectors are immensely popular in embedded vision applications. This paper brings single-shot detectors up to the same level as current two-stage techniques. We do this by improving training for the state-of-the-art single-shot detector, RetinaNet, in three ways: integrating instance mask prediction for the first time, making the loss function adaptive and more stable, and including additional hard examples in training. We call the resulting augmented network RetinaMask. The detection component of RetinaMask has the same computational cost as the original RetinaNet, but is more accurate. COCO test-dev results are up to 41.4 mAP for RetinaMask-101 vs 39.1mAP for RetinaNet-101, while the runtime is the same during evaluation. Adding Group Normalization increases the performance of RetinaMask-101 to 41.7 mAP. Code is at:https://github.com/chengyangfu/retinamask

Clinical diagnosis of the eye is performed over multifarious data modalities including scalar clinical labels, vectorized biomarkers, two-dimensional fundus images, and three-dimensional Optical Coherence Tomography (OCT) scans. Clinical practitioners use all available data modalities for diagnosing and treating eye diseases like Diabetic Retinopathy (DR) or Diabetic Macular Edema (DME). Enabling usage of machine learning algorithms within the ophthalmic medical domain requires research into the relationships and interactions between all relevant data over a treatment period. Existing datasets are limited in that they neither provide data nor consider the explicit relationship modeling between the data modalities. In this paper, we introduce the Ophthalmic Labels for Investigating Visual Eye Semantics (OLIVES) dataset that addresses the above limitation. This is the first OCT and near-IR fundus dataset that includes clinical labels, biomarker labels, disease labels, and time-series patient treatment information from associated clinical trials. The dataset consists of 1268 near-IR fundus images each with at least 49 OCT scans, and 16 biomarkers, along with 4 clinical labels and a disease diagnosis of DR or DME. In total, there are 96 eyes' data averaged over a period of at least two years with each eye treated for an average of 66 weeks and 7 injections. We benchmark the utility of OLIVES dataset for ophthalmic data as well as provide benchmarks and concrete research directions for core and emerging machine learning paradigms within medical image analysis.

A single unexpected object on the road can cause an accident or may lead to injuries. To prevent this, we need a reliable mechanism for finding anomalous objects on the road. This task, called anomaly segmentation, can be a stepping stone to safe and reliable autonomous driving. Current approaches tackle anomaly segmentation by assigning an anomaly score to each pixel and by grouping anomalous regions using simple heuristics. However, pixel grouping is a limiting factor when it comes to evaluating the segmentation performance of individual anomalous objects. To address the issue of grouping multiple anomaly instances into one, we propose an approach that produces accurate anomaly instance masks. Our approach centers on an out-of-distribution segmentation model for identifying uncertain regions and a strong generalist segmentation model for anomaly instances segmentation. We investigate ways to use uncertain regions to guide such a segmentation model to perform segmentation of anomalous instances. By incorporating strong object priors from a generalist model we additionally improve the per-pixel anomaly segmentation performance. Our approach outperforms current pixel-level anomaly segmentation methods, achieving an AP of 80.08% and 88.98% on the Fishyscapes Lost and Found and the RoadAnomaly validation sets respectively. Project page: https://vision.rwth-aachen.de/ugains

Identifying cell types and understanding their functional properties is crucial for unraveling the mechanisms underlying perception and cognition. In the retina, functional types can be identified by carefully selected stimuli, but this requires expert domain knowledge and biases the procedure towards previously known cell types. In the visual cortex, it is still unknown what functional types exist and how to identify them. Thus, for unbiased identification of the functional cell types in retina and visual cortex, new approaches are needed. Here we propose an optimization-based clustering approach using deep predictive models to obtain functional clusters of neurons using Most Discriminative Stimuli (MDS). Our approach alternates between stimulus optimization with cluster reassignment akin to an expectation-maximization algorithm. The algorithm recovers functional clusters in mouse retina, marmoset retina and macaque visual area V4. This demonstrates that our approach can successfully find discriminative stimuli across species, stages of the visual system and recording techniques. The resulting most discriminative stimuli can be used to assign functional cell types fast and on the fly, without the need to train complex predictive models or show a large natural scene dataset, paving the way for experiments that were previously limited by experimental time. Crucially, MDS are interpretable: they visualize the distinctive stimulus patterns that most unambiguously identify a specific type of neuron.

Interactive Medical Image Segmentation (IMIS) has long been constrained by the limited availability of large-scale, diverse, and densely annotated datasets, which hinders model generalization and consistent evaluation across different models. In this paper, we introduce the IMed-361M benchmark dataset, a significant advancement in general IMIS research. First, we collect and standardize over 6.4 million medical images and their corresponding ground truth masks from multiple data sources. Then, leveraging the strong object recognition capabilities of a vision foundational model, we automatically generated dense interactive masks for each image and ensured their quality through rigorous quality control and granularity management. Unlike previous datasets, which are limited by specific modalities or sparse annotations, IMed-361M spans 14 modalities and 204 segmentation targets, totaling 361 million masks-an average of 56 masks per image. Finally, we developed an IMIS baseline network on this dataset that supports high-quality mask generation through interactive inputs, including clicks, bounding boxes, text prompts, and their combinations. We evaluate its performance on medical image segmentation tasks from multiple perspectives, demonstrating superior accuracy and scalability compared to existing interactive segmentation models. To facilitate research on foundational models in medical computer vision, we release the IMed-361M and model at https://github.com/uni-medical/IMIS-Bench.

Color fundus photography and Optical Coherence Tomography (OCT) are the two most cost-effective tools for glaucoma screening. Both two modalities of images have prominent biomarkers to indicate glaucoma suspected. Clinically, it is often recommended to take both of the screenings for a more accurate and reliable diagnosis. However, although numerous algorithms are proposed based on fundus images or OCT volumes in computer-aided diagnosis, there are still few methods leveraging both of the modalities for the glaucoma assessment. Inspired by the success of Retinal Fundus Glaucoma Challenge (REFUGE) we held previously, we set up the Glaucoma grAding from Multi-Modality imAges (GAMMA) Challenge to encourage the development of fundus \& OCT-based glaucoma grading. The primary task of the challenge is to grade glaucoma from both the 2D fundus images and 3D OCT scanning volumes. As part of GAMMA, we have publicly released a glaucoma annotated dataset with both 2D fundus color photography and 3D OCT volumes, which is the first multi-modality dataset for glaucoma grading. In addition, an evaluation framework is also established to evaluate the performance of the submitted methods. During the challenge, 1272 results were submitted, and finally, top-10 teams were selected to the final stage. We analysis their results and summarize their methods in the paper. Since all these teams submitted their source code in the challenge, a detailed ablation study is also conducted to verify the effectiveness of the particular modules proposed. We find many of the proposed techniques are practical for the clinical diagnosis of glaucoma. As the first in-depth study of fundus \& OCT multi-modality glaucoma grading, we believe the GAMMA Challenge will be an essential starting point for future research.

In the field of medical imaging, the scarcity of large-scale datasets due to privacy restrictions stands as a significant barrier to develop large models for medical. To address this issue, we introduce SynFundus-1M, a high-quality synthetic dataset with over 1 million retinal fundus images and extensive disease and pathologies annotations, which is generated by a Denoising Diffusion Probabilistic Model. The SynFundus-Generator and SynFundus-1M achieve superior Frechet Inception Distance (FID) scores compared to existing methods on main-stream public real datasets. Furthermore, the ophthalmologists evaluation validate the difficulty in discerning these synthetic images from real ones, confirming the SynFundus-1M's authenticity. Through extensive experiments, we demonstrate that both CNN and ViT can benifit from SynFundus-1M by pretraining or training directly. Compared to datasets like ImageNet or EyePACS, models train on SynFundus-1M not only achieve better performance but also faster convergence on various downstream tasks.

Automatic organ segmentation is an important yet challenging problem for medical image analysis. The pancreas is an abdominal organ with very high anatomical variability. This inhibits previous segmentation methods from achieving high accuracies, especially compared to other organs such as the liver, heart or kidneys. In this paper, we present a probabilistic bottom-up approach for pancreas segmentation in abdominal computed tomography (CT) scans, using multi-level deep convolutional networks (ConvNets). We propose and evaluate several variations of deep ConvNets in the context of hierarchical, coarse-to-fine classification on image patches and regions, i.e. superpixels. We first present a dense labeling of local image patches via P{-}ConvNet and nearest neighbor fusion. Then we describe a regional ConvNet (R_1{-}ConvNet) that samples a set of bounding boxes around each image superpixel at different scales of contexts in a "zoom-out" fashion. Our ConvNets learn to assign class probabilities for each superpixel region of being pancreas. Last, we study a stacked R_2{-}ConvNet leveraging the joint space of CT intensities and the P{-}ConvNet dense probability maps. Both 3D Gaussian smoothing and 2D conditional random fields are exploited as structured predictions for post-processing. We evaluate on CT images of 82 patients in 4-fold cross-validation. We achieve a Dice Similarity Coefficient of 83.6pm6.3% in training and 71.8pm10.7% in testing.

Automatic identification of brain lesions from magnetic resonance imaging (MRI) scans of stroke survivors would be a useful aid in patient diagnosis and treatment planning. We propose a multi-modal multi-path convolutional neural network system for automating stroke lesion segmentation. Our system has nine end-to-end UNets that take as input 2-dimensional (2D) slices and examines all three planes with three different normalizations. Outputs from these nine total paths are concatenated into a 3D volume that is then passed to a 3D convolutional neural network to output a final lesion mask. We trained and tested our method on datasets from three sources: Medical College of Wisconsin (MCW), Kessler Foundation (KF), and the publicly available Anatomical Tracings of Lesions After Stroke (ATLAS) dataset. Cross-study validation results (with independent training and validation datasets) were obtained to compare with previous methods based on naive Bayes, random forests, and three recently published convolutional neural networks. Model performance was quantified in terms of the Dice coefficient. Training on the KF and MCW images and testing on the ATLAS images yielded a mean Dice coefficient of 0.54. This was reliably better than the next best previous model, UNet, at 0.47. Reversing the train and test datasets yields a mean Dice of 0.47 on KF and MCW images, whereas the next best UNet reaches 0.45. With all three datasets combined, the current system compared to previous methods also attained a reliably higher cross-validation accuracy. It also achieved high Dice values for many smaller lesions that existing methods have difficulty identifying. Overall, our system is a clear improvement over previous methods for automating stroke lesion segmentation, bringing us an important step closer to the inter-rater accuracy level of human experts.

Vision Transformers (ViTs) have shown remarkable performance and scalability across various computer vision tasks. To apply single-scale ViTs to image segmentation, existing methods adopt a convolutional adapter to generate multi-scale features, a pixel decoder to fuse these features, and a Transformer decoder that uses the fused features to make predictions. In this paper, we show that the inductive biases introduced by these task-specific components can instead be learned by the ViT itself, given sufficiently large models and extensive pre-training. Based on these findings, we introduce the Encoder-only Mask Transformer (EoMT), which repurposes the plain ViT architecture to conduct image segmentation. With large-scale models and pre-training, EoMT obtains a segmentation accuracy similar to state-of-the-art models that use task-specific components. At the same time, EoMT is significantly faster than these methods due to its architectural simplicity, e.g., up to 4x faster with ViT-L. Across a range of model sizes, EoMT demonstrates an optimal balance between segmentation accuracy and prediction speed, suggesting that compute resources are better spent on scaling the ViT itself rather than adding architectural complexity. Code: https://www.tue-mps.org/eomt/.

Conventional medical image segmentation methods have been found inadequate in facilitating physicians with the identification of specific lesions for diagnosis and treatment. Given the utility of text as an instructional format, we introduce a novel task termed Medical Image Referring Segmentation (MIRS), which requires segmenting specified lesions in images based on the given language expressions. Due to the varying object scales in medical images, MIRS demands robust vision-language modeling and comprehensive multi-scale interaction for precise localization and segmentation under linguistic guidance. However, existing medical image segmentation methods fall short in meeting these demands, resulting in insufficient segmentation accuracy. In response, we propose an approach named Language-guided Scale-aware MedSegmentor (LSMS), incorporating two appealing designs: (1)~a Scale-aware Vision-Language Attention module that leverages diverse convolutional kernels to acquire rich visual knowledge and interact closely with linguistic features, thereby enhancing lesion localization capability; (2)~a Full-Scale Decoder that globally models multi-modal features across various scales, capturing complementary information between scales to accurately outline lesion boundaries. Addressing the lack of suitable datasets for MIRS, we constructed a vision-language medical dataset called Reference Hepatic Lesion Segmentation (RefHL-Seg). This dataset comprises 2,283 abdominal CT slices from 231 cases, with corresponding textual annotations and segmentation masks for various liver lesions in images. We validated the performance of LSMS for MIRS and conventional medical image segmentation tasks across various datasets. Our LSMS consistently outperforms on all datasets with lower computational costs. The code and datasets will be released.

Accurate segmentation of organs and tumors in CT and MRI scans is essential for diagnosis, treatment planning, and disease monitoring. While deep learning has advanced automated segmentation, most models remain task-specific, lacking generalizability across modalities and institutions. Vision foundation models (FMs) pretrained on billion-scale natural images offer powerful and transferable representations. However, adapting them to medical imaging faces two key challenges: (1) the ViT backbone of most foundation models still underperform specialized CNNs on medical image segmentation, and (2) the large domain gap between natural and medical images limits transferability. We introduce MedDINOv3, a simple and effective framework for adapting DINOv3 to medical segmentation. We first revisit plain ViTs and design a simple and effective architecture with multi-scale token aggregation. Then, we perform domain-adaptive pretraining on CT-3M, a curated collection of 3.87M axial CT slices, using a multi-stage DINOv3 recipe to learn robust dense features. MedDINOv3 matches or exceeds state-of-the-art performance across four segmentation benchmarks, demonstrating the potential of vision foundation models as unified backbones for medical image segmentation. The code is available at https://github.com/ricklisz/MedDINOv3.

Autonomous vehicles (AV) require that neural networks used for perception be robust to different viewpoints if they are to be deployed across many types of vehicles without the repeated cost of data collection and labeling for each. AV companies typically focus on collecting data from diverse scenarios and locations, but not camera rig configurations, due to cost. As a result, only a small number of rig variations exist across most fleets. In this paper, we study how AV perception models are affected by changes in camera viewpoint and propose a way to scale them across vehicle types without repeated data collection and labeling. Using bird's eye view (BEV) segmentation as a motivating task, we find through extensive experiments that existing perception models are surprisingly sensitive to changes in camera viewpoint. When trained with data from one camera rig, small changes to pitch, yaw, depth, or height of the camera at inference time lead to large drops in performance. We introduce a technique for novel view synthesis and use it to transform collected data to the viewpoint of target rigs, allowing us to train BEV segmentation models for diverse target rigs without any additional data collection or labeling cost. To analyze the impact of viewpoint changes, we leverage synthetic data to mitigate other gaps (content, ISP, etc). Our approach is then trained on real data and evaluated on synthetic data, enabling evaluation on diverse target rigs. We release all data for use in future work. Our method is able to recover an average of 14.7% of the IoU that is otherwise lost when deploying to new rigs.

Background. Fully automatic analysis of myocardial perfusion MRI datasets enables rapid and objective reporting of stress/rest studies in patients with suspected ischemic heart disease. Developing deep learning techniques that can analyze multi-center datasets despite limited training data and variations in software and hardware is an ongoing challenge. Methods. Datasets from 3 medical centers acquired at 3T (n = 150 subjects) were included: an internal dataset (inD; n = 95) and two external datasets (exDs; n = 55) used for evaluating the robustness of the trained deep neural network (DNN) models against differences in pulse sequence (exD-1) and scanner vendor (exD-2). A subset of inD (n = 85) was used for training/validation of a pool of DNNs for segmentation, all using the same spatiotemporal U-Net architecture and hyperparameters but with different parameter initializations. We employed a space-time sliding-patch analysis approach that automatically yields a pixel-wise "uncertainty map" as a byproduct of the segmentation process. In our approach, a given test case is segmented by all members of the DNN pool and the resulting uncertainty maps are leveraged to automatically select the "best" one among the pool of solutions. Results. The proposed DAUGS analysis approach performed similarly to the established approach on the internal dataset (p = n.s.) whereas it significantly outperformed on the external datasets (p < 0.005 for exD-1 and exD-2). Moreover, the number of image series with "failed" segmentation was significantly lower for the proposed vs. the established approach (4.3% vs. 17.1%, p < 0.0005). Conclusions. The proposed DAUGS analysis approach has the potential to improve the robustness of deep learning methods for segmentation of multi-center stress perfusion datasets with variations in the choice of pulse sequence, site location or scanner vendor.

The highest accuracy object detectors to date are based on a two-stage approach popularized by R-CNN, where a classifier is applied to a sparse set of candidate object locations. In contrast, one-stage detectors that are applied over a regular, dense sampling of possible object locations have the potential to be faster and simpler, but have trailed the accuracy of two-stage detectors thus far. In this paper, we investigate why this is the case. We discover that the extreme foreground-background class imbalance encountered during training of dense detectors is the central cause. We propose to address this class imbalance by reshaping the standard cross entropy loss such that it down-weights the loss assigned to well-classified examples. Our novel Focal Loss focuses training on a sparse set of hard examples and prevents the vast number of easy negatives from overwhelming the detector during training. To evaluate the effectiveness of our loss, we design and train a simple dense detector we call RetinaNet. Our results show that when trained with the focal loss, RetinaNet is able to match the speed of previous one-stage detectors while surpassing the accuracy of all existing state-of-the-art two-stage detectors. Code is at: https://github.com/facebookresearch/Detectron.

This paper investigates the capability of plain Vision Transformers (ViTs) for semantic segmentation using the encoder-decoder framework and introduces SegViTv2. In this study, we introduce a novel Attention-to-Mask (\atm) module to design a lightweight decoder effective for plain ViT. The proposed ATM converts the global attention map into semantic masks for high-quality segmentation results. Our decoder outperforms the popular decoder UPerNet using various ViT backbones while consuming only about 5% of the computational cost. For the encoder, we address the concern of the relatively high computational cost in the ViT-based encoders and propose a Shrunk++ structure that incorporates edge-aware query-based down-sampling (EQD) and query-based upsampling (QU) modules. The Shrunk++ structure reduces the computational cost of the encoder by up to 50% while maintaining competitive performance. Furthermore, we propose to adapt SegViT for continual semantic segmentation, demonstrating nearly zero forgetting of previously learned knowledge. Experiments show that our proposed SegViTv2 surpasses recent segmentation methods on three popular benchmarks including ADE20k, COCO-Stuff-10k and PASCAL-Context datasets. The code is available through the following link: https://github.com/zbwxp/SegVit.

A large-scale labeled dataset is a key factor for the success of supervised deep learning in computer vision. However, a limited number of annotated data is very common, especially in ophthalmic image analysis, since manual annotation is time-consuming and labor-intensive. Self-supervised learning (SSL) methods bring huge opportunities for better utilizing unlabeled data, as they do not need massive annotations. With an attempt to use as many as possible unlabeled ophthalmic images, it is necessary to break the dimension barrier, simultaneously making use of both 2D and 3D images. In this paper, we propose a universal self-supervised Transformer framework, named Uni4Eye, to discover the inherent image property and capture domain-specific feature embedding in ophthalmic images. Uni4Eye can serve as a global feature extractor, which builds its basis on a Masked Image Modeling task with a Vision Transformer (ViT) architecture. We employ a Unified Patch Embedding module to replace the origin patch embedding module in ViT for jointly processing both 2D and 3D input images. Besides, we design a dual-branch multitask decoder module to simultaneously perform two reconstruction tasks on the input image and its gradient map, delivering discriminative representations for better convergence. We evaluate the performance of our pre-trained Uni4Eye encoder by fine-tuning it on six downstream ophthalmic image classification tasks. The superiority of Uni4Eye is successfully established through comparisons to other state-of-the-art SSL pre-training methods.

This work introduces a new framework, ProtoSAM, for one-shot medical image segmentation. It combines the use of prototypical networks, known for few-shot segmentation, with SAM - a natural image foundation model. The method proposed creates an initial coarse segmentation mask using the ALPnet prototypical network, augmented with a DINOv2 encoder. Following the extraction of an initial mask, prompts are extracted, such as points and bounding boxes, which are then input into the Segment Anything Model (SAM). State-of-the-art results are shown on several medical image datasets and demonstrate automated segmentation capabilities using a single image example (one shot) with no need for fine-tuning of the foundation model. Our code is available at: https://github.com/levayz/ProtoSAM

Automatic radiology report generation is booming due to its huge application potential for the healthcare industry. However, existing computer vision and natural language processing approaches to tackle this problem are limited in two aspects. First, when extracting image features, most of them neglect multi-view reasoning in vision and model single-view structure of medical images, such as space-view or channel-view. However, clinicians rely on multi-view imaging information for comprehensive judgment in daily clinical diagnosis. Second, when generating reports, they overlook context reasoning with multi-modal information and focus on pure textual optimization utilizing retrieval-based methods. We aim to address these two issues by proposing a model that better simulates clinicians' perspectives and generates more accurate reports. Given the above limitation in feature extraction, we propose a Globally-intensive Attention (GIA) module in the medical image encoder to simulate and integrate multi-view vision perception. GIA aims to learn three types of vision perception: depth view, space view, and pixel view. On the other hand, to address the above problem in report generation, we explore how to involve multi-modal signals to generate precisely matched reports, i.e., how to integrate previously predicted words with region-aware visual content in next word prediction. Specifically, we design a Visual Knowledge-guided Decoder (VKGD), which can adaptively consider how much the model needs to rely on visual information and previously predicted text to assist next word prediction. Hence, our final Intensive Vision-guided Network (IVGN) framework includes a GIA-guided Visual Encoder and the VKGD. Experiments on two commonly-used datasets IU X-Ray and MIMIC-CXR demonstrate the superior ability of our method compared with other state-of-the-art approaches.

Accurate segmentation of thin structures is critical for microsurgical scene understanding but remains challenging due to resolution loss, low contrast, and class imbalance. We propose Microsurgery Instrument Segmentation for Robotic Assistance(MISRA), a segmentation framework that augments RGB input with luminance channels, integrates skip attention to preserve elongated features, and employs an Iterative Feedback Module(IFM) for continuity restoration across multiple passes. In addition, we introduce a dedicated microsurgical dataset with fine-grained annotations of surgical instruments including thin objects, providing a benchmark for robust evaluation Dataset available at https://huggingface.co/datasets/KIST-HARILAB/MISAW-Seg. Experiments demonstrate that MISRA achieves competitive performance, improving the mean class IoU by 5.37% over competing methods, while delivering more stable predictions at instrument contacts and overlaps. These results position MISRA as a promising step toward reliable scene parsing for computer-assisted and robotic microsurgery.

Accurate medical image segmentation demands the integration of multi-scale information, spanning from local features to global dependencies. However, it is challenging for existing methods to model long-range global information, where convolutional neural networks (CNNs) are constrained by their local receptive fields, and vision transformers (ViTs) suffer from high quadratic complexity of their attention mechanism. Recently, Mamba-based models have gained great attention for their impressive ability in long sequence modeling. Several studies have demonstrated that these models can outperform popular vision models in various tasks, offering higher accuracy, lower memory consumption, and less computational burden. However, existing Mamba-based models are mostly trained from scratch and do not explore the power of pretraining, which has been proven to be quite effective for data-efficient medical image analysis. This paper introduces a novel Mamba-based model, Swin-UMamba, designed specifically for medical image segmentation tasks, leveraging the advantages of ImageNet-based pretraining. Our experimental results reveal the vital role of ImageNet-based training in enhancing the performance of Mamba-based models. Swin-UMamba demonstrates superior performance with a large margin compared to CNNs, ViTs, and latest Mamba-based models. Notably, on AbdomenMRI, Encoscopy, and Microscopy datasets, Swin-UMamba outperforms its closest counterpart U-Mamba_Enc by an average score of 2.72%.

Traditional convolutional neural networks have a limited receptive field while transformer-based networks are mediocre in constructing long-term dependency from the perspective of computational complexity. Such the bottleneck poses a significant challenge when processing long video sequences in video analysis tasks. Very recently, the state space models (SSMs) with efficient hardware-aware designs, famous by Mamba, have exhibited impressive achievements in long sequence modeling, which facilitates the development of deep neural networks on many vision tasks. To better capture available cues in video frames, this paper presents a generic Video Vision Mamba-based framework for medical video object segmentation tasks, named Vivim. Our Vivim can effectively compress the long-term spatiotemporal representation into sequences at varying scales by our designed Temporal Mamba Block. Compared to existing video-level Transformer-based methods, our model maintains excellent segmentation results with better speed performance. Extensive experiments on the breast US dataset demonstrate the effectiveness and efficiency of our Vivim. The code for Vivim is available at: https://github.com/scott-yjyang/Vivim.

Optical coherence tomography (OCT) imaging from different camera devices causes challenging domain shifts and can cause a severe drop in accuracy for machine learning models. In this work, we introduce a minimal noise adaptation method based on a singular value decomposition (SVDNA) to overcome the domain gap between target domains from three different device manufacturers in retinal OCT imaging. Our method utilizes the difference in noise structure to successfully bridge the domain gap between different OCT devices and transfer the style from unlabeled target domain images to source images for which manual annotations are available. We demonstrate how this method, despite its simplicity, compares or even outperforms state-of-the-art unsupervised domain adaptation methods for semantic segmentation on a public OCT dataset. SVDNA can be integrated with just a few lines of code into the augmentation pipeline of any network which is in contrast to many state-of-the-art domain adaptation methods which often need to change the underlying model architecture or train a separate style transfer model. The full code implementation for SVDNA is available at https://github.com/ValentinKoch/SVDNA.

Medical vision-language models enable co-learning and integrating features from medical imaging and clinical text. However, these models are not easy to train and the latent representation space can be complex. Here we propose a novel way for pre-training and regularising medical vision-language models. The proposed method, named Medical vision-language pre-training with Frozen language models and Latent spAce Geometry optimization (M-FLAG), leverages a frozen language model for training stability and efficiency and introduces a novel orthogonality loss to harmonize the latent space geometry. We demonstrate the potential of the pre-trained model on three downstream tasks: medical image classification, segmentation, and object detection. Extensive experiments across five public datasets demonstrate that M-FLAG significantly outperforms existing medical vision-language pre-training approaches and reduces the number of parameters by 78\%. Notably, M-FLAG achieves outstanding performance on the segmentation task while using only 1\% of the RSNA dataset, even outperforming ImageNet pre-trained models that have been fine-tuned using 100\% of the data.

Image segmentation remains a challenging task in computer vision, demanding robust mask generation and precise classification. Recent mask-based approaches yield high-quality masks by capturing global context. However, accurately classifying these masks, especially in the presence of ambiguous boundaries and imbalanced class distributions, remains an open challenge. In this work, we introduce ViT-P, a novel two-stage segmentation framework that decouples mask generation from classification. The first stage employs a proposal generator to produce class-agnostic mask proposals, while the second stage utilizes a point-based classification model built on the Vision Transformer (ViT) to refine predictions by focusing on mask central points. ViT-P serves as a pre-training-free adapter, allowing the integration of various pre-trained vision transformers without modifying their architecture, ensuring adaptability to dense prediction tasks. Furthermore, we demonstrate that coarse and bounding box annotations can effectively enhance classification without requiring additional training on fine annotation datasets, reducing annotation costs while maintaining strong performance. Extensive experiments across COCO, ADE20K, and Cityscapes datasets validate the effectiveness of ViT-P, achieving state-of-the-art results with 54.0 PQ on ADE20K panoptic segmentation, 87.4 mIoU on Cityscapes semantic segmentation, and 63.6 mIoU on ADE20K semantic segmentation. The code and pretrained models are available at: https://github.com/sajjad-sh33/ViT-P}{https://github.com/sajjad-sh33/ViT-P.

Large, fine-grained image segmentation datasets, annotated at pixel-level, are difficult to obtain, particularly in medical imaging, where annotations also require expert knowledge. Weakly-supervised learning can train models by relying on weaker forms of annotation, such as scribbles. Here, we learn to segment using scribble annotations in an adversarial game. With unpaired segmentation masks, we train a multi-scale GAN to generate realistic segmentation masks at multiple resolutions, while we use scribbles to learn their correct position in the image. Central to the model's success is a novel attention gating mechanism, which we condition with adversarial signals to act as a shape prior, resulting in better object localization at multiple scales. Subject to adversarial conditioning, the segmentor learns attention maps that are semantic, suppress the noisy activations outside the objects, and reduce the vanishing gradient problem in the deeper layers of the segmentor. We evaluated our model on several medical (ACDC, LVSC, CHAOS) and non-medical (PPSS) datasets, and we report performance levels matching those achieved by models trained with fully annotated segmentation masks. We also demonstrate extensions in a variety of settings: semi-supervised learning; combining multiple scribble sources (a crowdsourcing scenario) and multi-task learning (combining scribble and mask supervision). We release expert-made scribble annotations for the ACDC dataset, and the code used for the experiments, at https://vios-s.github.io/multiscale-adversarial-attention-gates

Real-world medical image segmentation has tremendous long-tailed complexity of objects, among which tail conditions correlate with relatively rare diseases and are clinically significant. A trustworthy medical AI algorithm should demonstrate its effectiveness on tail conditions to avoid clinically dangerous damage in these out-of-distribution (OOD) cases. In this paper, we adopt the concept of object queries in Mask Transformers to formulate semantic segmentation as a soft cluster assignment. The queries fit the feature-level cluster centers of inliers during training. Therefore, when performing inference on a medical image in real-world scenarios, the similarity between pixels and the queries detects and localizes OOD regions. We term this OOD localization as MaxQuery. Furthermore, the foregrounds of real-world medical images, whether OOD objects or inliers, are lesions. The difference between them is less than that between the foreground and background, possibly misleading the object queries to focus redundantly on the background. Thus, we propose a query-distribution (QD) loss to enforce clear boundaries between segmentation targets and other regions at the query level, improving the inlier segmentation and OOD indication. Our proposed framework is tested on two real-world segmentation tasks, i.e., segmentation of pancreatic and liver tumors, outperforming previous state-of-the-art algorithms by an average of 7.39% on AUROC, 14.69% on AUPR, and 13.79% on FPR95 for OOD localization. On the other hand, our framework improves the performance of inlier segmentation by an average of 5.27% DSC when compared with the leading baseline nnUNet.

Recent efforts at scaling computer vision models have established Vision Transformers (ViTs) as the leading architecture. ViTs incorporate weight sharing over image patches as an important inductive bias. In this work, we show that ViTs benefit from incorporating equivariance under the octic group, i.e., reflections and 90-degree rotations, as a further inductive bias. We develop new architectures, octic ViTs, that use octic-equivariant layers and put them to the test on both supervised and self-supervised learning. Through extensive experiments on DeiT-III and DINOv2 training on ImageNet-1K, we show that octic ViTs yield more computationally efficient networks while also improving performance. In particular, we achieve approximately 40% reduction in FLOPs for ViT-H while simultaneously improving both classification and segmentation results.

Recent advancements in prompt-based medical image segmentation have enabled clinicians to identify tumors using simple input like bounding boxes or text prompts. However, existing methods face challenges when doctors need to interact through natural language or when position reasoning is required - understanding spatial relationships between anatomical structures and pathologies. We present PRS-Med, a framework that integrates vision-language models with segmentation capabilities to generate both accurate segmentation masks and corresponding spatial reasoning outputs. Additionally, we introduce the MMRS dataset (Multimodal Medical in Positional Reasoning Segmentation), which provides diverse, spatially-grounded question-answer pairs to address the lack of position reasoning data in medical imaging. PRS-Med demonstrates superior performance across six imaging modalities (CT, MRI, X-ray, ultrasound, endoscopy, RGB), significantly outperforming state-of-the-art methods in both segmentation accuracy and position reasoning. Our approach enables intuitive doctor-system interaction through natural language, facilitating more efficient diagnoses. Our dataset pipeline, model, and codebase will be released to foster further research in spatially-aware multimodal reasoning for medical applications.

This paper proposes a new framework to detect, segment, and estimate the localization of the eyes from a periocular Near-Infra-Red iris image under alcohol consumption. The purpose of the system is to measure the fitness for duty. Fitness systems allow us to determine whether a person is physically or psychologically able to perform their tasks. Our framework is based on an object detector trained from scratch to detect both eyes from a single image. Then, two efficient networks were used for semantic segmentation; a Criss-Cross attention network and DenseNet10, with only 122,514 and 210,732 parameters, respectively. These networks can find the pupil, iris, and sclera. In the end, the binary output eye mask is used for pupil and iris diameter estimation with high precision. Five state-of-the-art algorithms were used for this purpose. A mixed proposal reached the best results. A second contribution is establishing an alcohol behavior curve to detect the alcohol presence utilizing a stream of images captured from an iris instance. Also, a manually labeled database with more than 20k images was created. Our best method obtains a mean Intersection-over-Union of 94.54% with DenseNet10 with only 210,732 parameters and an error of only 1-pixel on average.

We present VPNeXt, a new and simple model for the Plain Vision Transformer (ViT). Unlike the many related studies that share the same homogeneous paradigms, VPNeXt offers a fresh perspective on dense representation based on ViT. In more detail, the proposed VPNeXt addressed two concerns about the existing paradigm: (1) Is it necessary to use a complex Transformer Mask Decoder architecture to obtain good representations? (2) Does the Plain ViT really need to depend on the mock pyramid feature for upsampling? For (1), we investigated the potential underlying reasons that contributed to the effectiveness of the Transformer Decoder and introduced the Visual Context Replay (VCR) to achieve similar effects efficiently. For (2), we introduced the ViTUp module. This module fully utilizes the previously overlooked ViT real pyramid feature to achieve better upsampling results compared to the earlier mock pyramid feature. This represents the first instance of such functionality in the field of semantic segmentation for Plain ViT. We performed ablation studies on related modules to verify their effectiveness gradually. We conducted relevant comparative experiments and visualizations to show that VPNeXt achieved state-of-the-art performance with a simple and effective design. Moreover, the proposed VPNeXt significantly exceeded the long-established mIoU wall/barrier of the VOC2012 dataset, setting a new state-of-the-art by a large margin, which also stands as the largest improvement since 2015.

Medical image segmentation poses challenges due to domain gaps, data modality variations, and dependency on domain knowledge or experts, especially for low- and middle-income countries (LMICs). Whereas for humans, given a few exemplars (with corresponding labels), we are able to segment different medical images even without exten-sive domain-specific clinical training. In addition, current SAM-based medical segmentation models use fine-grained visual prompts, such as the bounding rectangle generated from manually annotated target segmentation mask, as the bounding box (bbox) prompt during the testing phase. However, in actual clinical scenarios, no such precise prior knowledge is available. Our experimental results also reveal that previous models nearly fail to predict when given coarser bbox prompts. Considering these issues, in this paper, we introduce a domain-aware selective adaptation approach to adapt the general knowledge learned from a large model trained with natural images to the corresponding medical domains/modalities, with access to only a few (e.g. less than 5) exemplars. Our method mitigates the aforementioned limitations, providing an efficient and LMICs-friendly solution. Extensive experimental analysis showcases the effectiveness of our approach, offering potential advancements in healthcare diagnostics and clinical applications in LMICs.

Medical image segmentation methods downsample images for feature extraction and then upsample them to restore resolution for pixel-level predictions. In such a schema, upsample technique is vital in restoring information for better performance. However, existing upsample techniques leverage little information from downsampling paths. The local and detailed feature from the shallower layer such as boundary and tissue texture is particularly more important in medical segmentation compared with natural image segmentation. To this end, we propose a novel upsample approach for medical image segmentation, Window Attention Upsample (WAU), which upsamples features conditioned on local and detailed features from downsampling path in local windows by introducing attention decoders of Transformer. WAU could serve as a general upsample method and be incorporated into any segmentation model that possesses lateral connections. We first propose the Attention Upsample which consists of Attention Decoder (AD) and bilinear upsample. AD leverages pixel-level attention to model long-range dependency and global information for a better upsample. Bilinear upsample is introduced as the residual connection to complement the upsampled features. Moreover, considering the extensive memory and computation cost of pixel-level attention, we further design a window attention scheme to restrict attention computation in local windows instead of the global range. We evaluate our method (WAU) on classic U-Net structure with lateral connections and achieve state-of-the-art performance on Synapse multi-organ segmentation, Medical Segmentation Decathlon (MSD) Brain, and Automatic Cardiac Diagnosis Challenge (ACDC) datasets. We also validate the effectiveness of our method on multiple classic architectures and achieve consistent improvement.

The need for improved diagnostic methods in ophthalmology is acute, especially in the underdeveloped regions with limited access to specialists and advanced equipment. Therefore, we introduce VisionUnite, a novel vision-language foundation model for ophthalmology enhanced with clinical knowledge. VisionUnite has been pretrained on an extensive dataset comprising 1.24 million image-text pairs, and further refined using our proposed MMFundus dataset, which includes 296,379 high-quality fundus image-text pairs and 889,137 simulated doctor-patient dialogue instances. Our experiments indicate that VisionUnite outperforms existing generative foundation models such as GPT-4V and Gemini Pro. It also demonstrates diagnostic capabilities comparable to junior ophthalmologists. VisionUnite performs well in various clinical scenarios including open-ended multi-disease diagnosis, clinical explanation, and patient interaction, making it a highly versatile tool for initial ophthalmic disease screening. VisionUnite can also serve as an educational aid for junior ophthalmologists, accelerating their acquisition of knowledge regarding both common and underrepresented ophthalmic conditions. VisionUnite represents a significant advancement in ophthalmology, with broad implications for diagnostics, medical education, and understanding of disease mechanisms. The source code is at https://github.com/HUANGLIZI/VisionUnite.

This paper presents one of the first learning-based NeRF 3D instance segmentation pipelines, dubbed as {\bf \inerflong}, or \inerf. Taking a NeRF pretrained from multi-view RGB images as input, \inerf can learn 3D instance segmentation of a given scene, represented as an instance field component of the NeRF model. To this end, we adopt a 3D proposal-based mask prediction network on the sampled volumetric features from NeRF, which generates discrete 3D instance masks. The coarse 3D mask prediction is then projected to image space to match 2D segmentation masks from different views generated by existing panoptic segmentation models, which are used to supervise the training of the instance field. Notably, beyond generating consistent 2D segmentation maps from novel views, \inerf can query instance information at any 3D point, which greatly enhances NeRF object segmentation and manipulation. Our method is also one of the first to achieve such results in pure inference. Experimented on synthetic and real-world NeRF datasets with complex indoor scenes, \inerf surpasses previous NeRF segmentation works and competitive 2D segmentation methods in segmentation performance on unseen views. Watch the demo video at https://youtu.be/wW9Bme73coI. Code and data are available at https://github.com/lyclyc52/Instance_NeRF.

Camouflaged object segmentation presents unique challenges compared to traditional segmentation tasks, primarily due to the high similarity in patterns and colors between camouflaged objects and their backgrounds. Effective solutions to this problem have significant implications in critical areas such as pest control, defect detection, and lesion segmentation in medical imaging. Prior research has predominantly emphasized supervised or unsupervised pre-training methods, leaving zero-shot approaches significantly underdeveloped. Existing zero-shot techniques commonly utilize the Segment Anything Model (SAM) in automatic mode or rely on vision-language models to generate cues for segmentation; however, their performances remain unsatisfactory, due to the similarity of the camouflaged object and the background. This work studies how to avoid training by integrating large pre-trained models like SAM-2 and Owl-v2 with temporal information into a modular pipeline. Evaluated on the MoCA-Mask dataset, our approach achieves outstanding performance improvements, significantly outperforming existing zero-shot methods by raising the F-measure (F_beta^w) from 0.296 to 0.628. Our approach also surpasses supervised methods, increasing the F-measure from 0.476 to 0.628. Additionally, evaluation on the MoCA-Filter dataset demonstrates an increase in the success rate from 0.628 to 0.697 when compared with FlowSAM, a supervised transfer method. A thorough ablation study further validates the individual contributions of each component. Besides our main contributions, we also highlight inconsistencies in previous work regarding metrics and settings. Code can be found in https://github.com/weathon/vcos.

As convolution has empowered many smart applications, dynamic convolution further equips it with the ability to adapt to diverse inputs. However, the static and dynamic convolutions are either layout-agnostic or computation-heavy, making it inappropriate for layout-specific applications, e.g., face recognition and medical image segmentation. We observe that these applications naturally exhibit the characteristics of large intra-image (spatial) variance and small cross-image variance. This observation motivates our efficient translation variant convolution (TVConv) for layout-aware visual processing. Technically, TVConv is composed of affinity maps and a weight-generating block. While affinity maps depict pixel-paired relationships gracefully, the weight-generating block can be explicitly overparameterized for better training while maintaining efficient inference. Although conceptually simple, TVConv significantly improves the efficiency of the convolution and can be readily plugged into various network architectures. Extensive experiments on face recognition show that TVConv reduces the computational cost by up to 3.1x and improves the corresponding throughput by 2.3x while maintaining a high accuracy compared to the depthwise convolution. Moreover, for the same computation cost, we boost the mean accuracy by up to 4.21%. We also conduct experiments on the optic disc/cup segmentation task and obtain better generalization performance, which helps mitigate the critical data scarcity issue. Code is available at https://github.com/JierunChen/TVConv.

Image segmentation plays an essential role in medicine for both diagnostic and interventional tasks. Segmentation approaches are either manual, semi-automated or fully-automated. Manual segmentation offers full control over the quality of the results, but is tedious, time consuming and prone to operator bias. Fully automated methods require no human effort, but often deliver sub-optimal results without providing users with the means to make corrections. Semi-automated approaches keep users in control of the results by providing means for interaction, but the main challenge is to offer a good trade-off between precision and required interaction. In this paper we present a deep learning (DL) based semi-automated segmentation approach that aims to be a "smart" interactive tool for region of interest delineation in medical images. We demonstrate its use for segmenting multiple organs on computed tomography (CT) of the abdomen. Our approach solves some of the most pressing clinical challenges: (i) it requires only one to a few user clicks to deliver excellent 2D segmentations in a fast and reliable fashion; (ii) it can generalize to previously unseen structures and "corner cases"; (iii) it delivers results that can be corrected quickly in a smart and intuitive way up to an arbitrary degree of precision chosen by the user and (iv) ensures high accuracy. We present our approach and compare it to other techniques and previous work to show the advantages brought by our method.

Interactive image segmentation enables annotators to efficiently perform pixel-level annotation for segmentation tasks. However, the existing interactive segmentation pipeline suffers from inefficient computations of interactive models because of the following two issues. First, annotators' later click is based on models' feedback of annotators' former click. This serial interaction is unable to utilize model's parallelism capabilities. Second, in each interaction step, the model handles the invariant image along with the sparse variable clicks, resulting in a process that's highly repetitive and redundant. For efficient computations, we propose a method named InterFormer that follows a new pipeline to address these issues. InterFormer extracts and preprocesses the computationally time-consuming part i.e. image processing from the existing process. Specifically, InterFormer employs a large vision transformer (ViT) on high-performance devices to preprocess images in parallel, and then uses a lightweight module called interactive multi-head self attention (I-MSA) for interactive segmentation. Furthermore, the I-MSA module's deployment on low-power devices extends the practical application of interactive segmentation. The I-MSA module utilizes the preprocessed features to efficiently response to the annotator inputs in real-time. The experiments on several datasets demonstrate the effectiveness of InterFormer, which outperforms previous interactive segmentation models in terms of computational efficiency and segmentation quality, achieve real-time high-quality interactive segmentation on CPU-only devices. The code is available at https://github.com/YouHuang67/InterFormer.

Efficient, reliable and reproducible target volume delineation is a key step in the effective planning of breast radiotherapy. However, post-operative breast target delineation is challenging as the contrast between the tumor bed volume (TBV) and normal breast tissue is relatively low in CT images. In this study, we propose to mimic the marker-guidance procedure in manual target delineation. We developed a saliency-based deep learning segmentation (SDL-Seg) algorithm for accurate TBV segmentation in post-operative breast irradiation. The SDL-Seg algorithm incorporates saliency information in the form of markers' location cues into a U-Net model. The design forces the model to encode the location-related features, which underscores regions with high saliency levels and suppresses low saliency regions. The saliency maps were generated by identifying markers on CT images. Markers' locations were then converted to probability maps using a distance-transformation coupled with a Gaussian filter. Subsequently, the CT images and the corresponding saliency maps formed a multi-channel input for the SDL-Seg network. Our in-house dataset was comprised of 145 prone CT images from 29 post-operative breast cancer patients, who received 5-fraction partial breast irradiation (PBI) regimen on GammaPod. The performance of the proposed method was compared against basic U-Net. Our model achieved mean (standard deviation) of 76.4 %, 6.76 mm, and 1.9 mm for DSC, HD95, and ASD respectively on the test set with computation time of below 11 seconds per one CT volume. SDL-Seg showed superior performance relative to basic U-Net for all the evaluation metrics while preserving low computation cost. The findings demonstrate that SDL-Seg is a promising approach for improving the efficiency and accuracy of the on-line treatment planning procedure of PBI, such as GammaPod based PBI.