Medical Imaging

In recent years, artificial intelligence has significantly advanced medical image segmentation. Nonetheless, challenges remain, including efficient 3D medical image processing across diverse modalities and handling data variability. In this work, we introduce Hierarchical Soft Mixture-of-Experts (HoME), a two-level token-routing layer for efficient long-context modeling, specifically designed for 3D medical image segmentation. Built on the Mamba Selective State Space Model (SSM) backbone, HoME enhances sequential modeling through adaptive expert routing. In the first level, a Soft Mixture-of-Experts (SMoE) layer partitions input sequences into local groups, routing tokens to specialized per-group experts for localized feature extraction. The second level aggregates these outputs through a global SMoE layer, enabling cross-group information fusion and global context refinement. This hierarchical design, combining local expert routing with global expert refinement, enhances generalizability and segmentation performance, surpassing state-of-the-art results across datasets from the three most widely used 3D medical imaging modalities and varying data qualities. The code is publicly available at https://github.com/gmum/MambaHoME.

Plug-and-play (PnP) methods with deep denoisers have shown impressive results in imaging problems. They typically require strong convexity or smoothness of the fidelity term and a (residual) non-expansive denoiser for convergence. These assumptions, however, are violated in Poisson inverse problems, and non-expansiveness can hinder denoising performance. To address these challenges, we propose a cocoercive conservative (CoCo) denoiser, which may be (residual) expansive, leading to improved denoising performance. By leveraging the generalized Helmholtz decomposition, we introduce a novel training strategy that combines Hamiltonian regularization to promote conservativeness and spectral regularization to ensure cocoerciveness. We prove that CoCo denoiser is a proximal operator of a weakly convex function, enabling a restoration model with an implicit weakly convex prior. The global convergence of PnP methods to a stationary point of this restoration model is established. Extensive experimental results demonstrate that our approach outperforms closely related methods in both visual quality and quantitative metrics.

Long-distance depth imaging holds great promise for applications such as autonomous driving and robotics. Direct time-of-flight (dToF) imaging offers high-precision, long-distance depth sensing, yet demands ultra-short pulse light sources and high-resolution time-to-digital converters. In contrast, indirect time-of-flight (iToF) imaging often suffers from phase wrapping and low signal-to-noise ratio (SNR) as the sensing distance increases. In this paper, we introduce a novel ToF imaging paradigm, termed Burst-Encodable Time-of-Flight (BE-ToF), which facilitates high-fidelity, long-distance depth imaging. Specifically, the BE-ToF system emits light pulses in burst mode and estimates the phase delay of the reflected signal over the entire burst period, thereby effectively avoiding the phase wrapping inherent to conventional iToF systems. Moreover, to address the low SNR caused by light attenuation over increasing distances, we propose an end-to-end learnable framework that jointly optimizes the coding functions and the depth reconstruction network. A specialized double well function and first-order difference term are incorporated into the framework to ensure the hardware implementability of the coding functions. The proposed approach is rigorously validated through comprehensive simulations and real-world prototype experiments, demonstrating its effectiveness and practical applicability. The code is available at: https://github.com/ComputationalPerceptionLab/BE-ToF.

In coded aperture snapshot spectral imaging (CASSI), the captured measurement entangles spatial and spectral information, posing a severely ill-posed inverse problem for hyperspectral images (HSIs) reconstruction. Moreover, the captured radiance inherently depends on scene illumination, making it difficult to recover the intrinsic spectral reflectance that remains invariant to lighting conditions. To address these challenges, we propose a chromaticity-intensity decomposition framework, which disentangles an HSI into a spatially smooth intensity map and a spectrally variant chromaticity cube. The chromaticity encodes lighting-invariant reflectance, enriched with high-frequency spatial details and local spectral sparsity. Building on this decomposition, we develop CIDNet—a Chromaticity-Intensity Decomposition unfolding network within a dual-camera CASSI system. CIDNet integrates a hybrid spatial-spectral Transformer tailored to reconstruct fine-grained and sparse spectral chromaticity and a degradation-aware, spatially-adaptive noise estimation module that captures anisotropic noise across iterative stages. Extensive experiments on both synthetic and real-world CASSI datasets demonstrate that our method achieves superior performance in both spectral and chromaticity fidelity. Code is released at: \url{https://github.com/xiaodongwo/CIDNet}.

Safe deployment of machine learning (ML) models in safety-critical domains such as medical imaging requires detecting inputs with characteristics not seen during training, known as out-of-distribution (OOD) detection, to prevent unreliable predictions. Effective OOD detection after deployment could benefit from access to the training data, enabling direct comparison between test samples and the training data distribution to identify differences. State-of-the-art OOD detection methods, however, either discard the training data after deployment or assume that test samples and training data are centrally stored together, an assumption that rarely holds in real-world settings. This is because shipping the training data with the deployed model is usually impossible due to the size of training databases, as well as proprietary or privacy constraints. We introduce the Isolation Network, an OOD detection framework that quantifies the difficulty of separating a target test sample from the training data by solving a binary classification task. We then propose Decentralized Isolation Networks (DIsoN), which enables the comparison of training and test data when data-sharing is impossible, by exchanging only model parameters between the remote computational nodes of training and deployment. We further extend DIsoN with class-conditioning, comparing a target sample solely with training data of its predicted class. We evaluate DIsoN on four medical imaging datasets (dermatology, chest X-ray, breast ultrasound, histopathology) across 12 OOD detection tasks. DIsoN performs favorably against existing methods while respecting data-privacy. This decentralized OOD detection framework opens the way for a new type of service that ML developers could provide along with their models: providing remote, secure utilization of their training data for OOD detection services. Code available at: https://github.com/FelixWag/DIsoN

The scarcity of annotated medical imaging data has driven significant progress in semi-supervised learning to alleviate reliance on expensive expert labeling. While foundational vision models such as the Segment Anything Model (SAM) exhibit robust generalization in generic segmentation tasks, their direct application to medical images often results in suboptimal performance. To address this challenge, in this work, we propose a novel fully SAM-based semi-supervised medical image segmentation framework and develop the corresponding knowledge distillation-based learning strategy. Specifically, we first employ an efficient SAM variant as the backbone network of the semi‑supervised framework and update the default prompt embedding of SAM to unleash its full potential. Then, we utilize an original SAM, which is rich in prior knowledge, as the teacher to optimize our efficient student SAM backbone through hierarchical knowledge distillation and a dynamic loss weighting strategy. Extensive experiments on various medical datasets demonstrate that our method outperforms state-of-the-art semi-supervised segmentation approaches. Especially, our model requires less than 10% of the parameter size of the original SAM, enabling substantially lower deployment and storage overhead in real-world clinical settings.

Medical image reconstruction from measurement data is a vital but challenging inverse problem. Deep learning approaches have achieved promising results, but often requires paired measurement and high-quality images, which is typically simulated through a forward model, i.e., retrospective reconstruction. However, training on simulated pairs commonly leads to performance degradation on real prospective data due to the retrospective-to-prospective gap caused by incomplete imaging knowledge in simulation. To address this challenge, this paper introduces imaging Knowledge-Informed Dynamic Optimal Transport (KIDOT), a novel dynamic optimal transport framework with optimality in the sense of preserving consistency with imaging physics in transport, that conceptualizes reconstruction as finding a dynamic transport path. KIDOT learns from unpaired data by modeling reconstruction as a continuous evolution path from measurements to images, guided by an imaging knowledge-informed cost function and transport equation. This dynamic and knowledge-aware approach enhances robustness and better leverages unpaired data while respecting acquisition physics. Theoretically, we demonstrate that KIDOT naturally generalizes dynamic optimal transport, ensuring its mathematical rationale and solution existence. Extensive experiments on MRI and CT reconstruction demonstrate KIDOT's superior performance. Code is available at https://github.com/TaoranZheng717/KIDOT.

Physics-driven deep learning (PD-DL) approaches have become popular for improved reconstruction of fast magnetic resonance imaging (MRI) scans. Though PD-DL offers higher acceleration rates than existing clinical fast MRI techniques, their use has been limited outside specialized MRI centers. A key challenge is generalization to rare pathologies or different populations, noted in multiple studies, with fine-tuning on target populations suggested for improvement. However, current approaches for PD-DL training require access to raw k-space measurements, which is typically only available at specialized MRI centers that have research agreements for such data access. This is especially an issue for rural and under-resourced areas, where commercial MRI scanners only provide access to a final reconstructed image. To tackle these challenges, we propose Compressibility-inspired Unsupervised Learning via Parallel Imaging Fidelity (CUPID) for high-quality PD-DL training using only routine clinical reconstructed images exported from an MRI scanner. CUPID evaluates output quality with a compressibility-based approach while ensuring that the output stays consistent with the clinical parallel imaging reconstruction through well-designed perturbations. Our results show CUPID achieves similar quality to established PD-DL training that requires k-space data while outperforming compressed sensing (CS) and diffusion-based generative methods. We further demonstrate its effectiveness in a zero-shot training setup for retrospectively and prospectively sub-sampled acquisitions, attesting to its minimal training burden. As an approach that radically deviates from existing strategies, CUPID presents an opportunity to provide broader access to fast MRI for remote and rural populations in an attempt to reduce the obstacles associated with this expensive imaging modality. Code is available at https://github.com/ualcalar17/CUPID.

Recent advances in large vision-language models (LVLMs) have demonstrated strong performance on general-purpose medical tasks. However, their effectiveness in specialized domains such as dentistry remains underexplored. In particular, panoramic X-rays, a widely used imaging modality in oral radiology, pose interpretative challenges due to dense anatomical structures and subtle pathological cues, which are not captured by existing medical benchmarks or instruction datasets. To this end, we introduce MMOral, the first large-scale multimodal instruction dataset and benchmark tailored for panoramic X-ray interpretation. MMOral consists of 20,563 annotated images paired with 1.3 million instruction-following instances across diverse task types, including attribute extraction, report generation, visual question answering, and image-grounded dialogue. In addition, we present MMOral-Bench, a comprehensive evaluation suite covering five key diagnostic dimensions in dentistry. We evaluate 64 LVLMs on MMOral-Bench and find that even the best-performing model, i.e., GPT-4o, only achieves 43.31% accuracy, revealing significant limitations of current models in this domain. To promote the progress of this specific domain, we provide the supervised fine-tuning (SFT) process utilizing our meticulously curated MMOral instruction dataset. Remarkably, a single epoch of SFT yields substantial performance enhancements for LVLMs, e.g., Qwen2.5-VL-7B demonstrates a 24.73% improvement. MMOral holds significant potential as a critical foundation for intelligent dentistry and enables more clinically impactful multimodal AI systems in the dental field.

Federated learning (FL) is an effective and widely used approach to training deep learning models on decentralized datasets held by distinct clients. FL also strengthens both security and privacy protections for training data. Common challenges associated with statistical heterogeneity between distributed datasets have spurred significant interest in personalized FL (pFL) methods, where models combine aspects of global learning with local modeling specific to each client’s unique characteristics. This work investigates the efficacy of theoretically supported, adaptive MMD measures in pFL, primarily focusing on the Ditto framework, a state-of-the-art technique for distributed data heterogeneity. The use of such measures significantly improves model performance across a variety of tasks, especially those with pronounced feature heterogeneity. Additional experiments demonstrate that such measures are directly applicable to other pFL techniques and yield similar improvements across a number of datasets. Finally, the results motivate the use of constraints tailored to the various kinds of heterogeneity expected in FL systems.

Predicting human eye movements during goal-directed visual search is critical for enhancing interactive AI systems. In medical imaging, such prediction can support radiologists in interpreting complex data, such as chest X-rays. Many existing methods rely on generic vision--language models and saliency-based features, which can limit their ability to capture fine-grained clinical semantics and integrate domain knowledge effectively. We present \textbf{LogitGaze-Med}, a state-of-the-art multimodal transformer framework that unifies (1) domain-specific visual encoders (e.g., CheXNet), (2) textual embeddings of diagnostic labels, and (3) semantic priors extracted via the logit-lens from an instruction-tuned medical vision--language model (LLaVA-Med). By directly predicting continuous fixation coordinates and dwell durations, our model generates clinically meaningful scanpaths. Experiments on the GazeSearch dataset and synthetic scanpaths generated from MIMIC-CXR and validated by experts demonstrate that LogitGaze-Med improves scanpath similarity metrics by 20--30\% over competitive baselines and yields over 5\% gains in downstream pathology classification when incorporating predicted fixations as additional training data.

Recent progress in vision-language modeling for 3D medical imaging has been fueled by large-scale computed tomography (CT) corpora with paired free-text reports, stronger architectures, and powerful pretrained models. This has enabled applications such as automated report generation and text-conditioned 3D image synthesis. Yet, current approaches struggle with high-resolution, long-sequence volumes: contrastive pretraining often yields vision encoders that are misaligned with clinical language, and slice-wise tokenization blurs fine anatomy, reducing diagnostic performance on downstream tasks. We introduce BTB3D (Better Tokens for Better 3D), a causal convolutional encoder-decoder that unifies 2D and 3D training and inference while producing compact, frequency-aware volumetric tokens. A three-stage training curriculum enables (i) local reconstruction, (ii) overlapping-window tiling, and (iii) long-context decoder refinement, during which the model learns from short slice excerpts yet generalizes to scans exceeding $300$ slices without additional memory overhead. BTB3D sets a new state-of-the-art on two key tasks: it improves BLEU scores and increases clinical F1 by 40\% over CT2Rep, CT-CHAT, and Merlin for report generation; and it reduces FID by 75\% and halves FVD compared to GenerateCT and MedSyn for text-to-CT synthesis, producing anatomically consistent $512\times512\times241$ volumes. These results confirm that precise three-dimensional tokenization, rather than larger language backbones alone, is essential for scalable vision-language modeling in 3D medical imaging. The codebase is available at: https://github.com/ibrahimethemhamamci/BTB3D

Recent advances in data-centric deep generative models have led to significant progress in solving inverse imaging problems. However, these models (e.g., diffusion models (DMs)) typically require large amounts of fully sampled (clean) training data, which is often impractical in medical and scientific settings such as dynamic imaging. On the other hand, training-data-free approaches like the Deep Image Prior (DIP) do not require clean ground-truth images but suffer from noise overfitting and can be computationally expensive as the network parameters need to be optimized for each measurement vector independently. Moreover, DIP-based methods often overlook the potential of learning a prior using a small number of sub-sampled measurements (or degraded images) available during training. In this paper, we propose **UGoDIT**—an **U**nsupervised **G**r**o**up **DI**P with **T**ransferable weights—designed for the low-data regime where only a very small number, $M$, of sub-sampled measurement vectors are available during training. Our method learns a set of transferable weights by optimizing a shared encoder and $M$ disentangled decoders. At test time, we reconstruct the unseen degraded image using a DIP network, where part of the parameters are fixed to the learned weights, while the remaining are optimized to enforce measurement consistency. We evaluate \our on both medical (multi-coil MRI) and natural (super resolution and non-linear deblurring) image recovery tasks under various settings. Compared to recent standalone DIP methods, \our provides accelerated convergence and notable improvement in reconstruction quality. Furthermore, our method achieves performance competitive with SOTA DM-based and supervised approaches, despite not requiring large amounts of clean training data. Our code is available at: https://github.com/sjames40/UGoDIT.

Variations in Magnetic resonance imaging (MRI) scanners and acquisition protocols cause distribution shifts that degrade reconstruction performance on unseen data. Test-time adaptation (TTA) offers a promising solution to address this discrepancies. However, previous single-shot TTA approaches are inefficient due to repeated training and suboptimal distributional models. Self-supervised learning methods may risk over-smoothing in scarce data scenarios. To address these challenges, we propose a novel Dual-Stage Distribution and Slice Adaptation (D2SA) via MRI implicit neural representation (MR-INR) to improve MRI reconstruction performance and efficiency, which features two stages. In the first stage, an MR-INR branch performs patient-wise distribution adaptation by learning shared representations across slices and modelling patient-specific shifts with mean and variance adjustments. In the second stage, single-slice adaptation refines the output from frozen convolutional layers with a learnable anisotropic diffusion module, preventing over-smoothing and reducing computation. Experiments across five MRI distribution shifts demonstrate that our method can integrate well with various self-supervised learning (SSL) framework, improving performance and accelerating convergence under diverse conditions.

Multimodal large language models (MLLMs) have begun to demonstrate robust reasoning capabilities on general tasks, yet their application in the medical domain remains in its early stages. Constructing chain-of-thought (CoT) training data is essential for bolstering the reasoning abilities of medical MLLMs. However, existing approaches exhibit a deficiency in offering a comprehensive framework for searching and evaluating effective reasoning paths towards critical diagnosis. To address this challenge, we propose Mentor-Intern Collaborative Search (MICS), a novel reasoning-path searching scheme to generate rigorous and effective medical CoT data. MICS first leverages mentor models to initialize the reasoning, one step at a time, then prompts each intern model to continue the thinking along those initiated paths, and finally selects the optimal reasoning path according to the overall reasoning performance of multiple intern models. The reasoning performance is determined by an MICS-Score, which assesses the quality of generated reasoning paths. Eventually, we construct MMRP, a multi-task medical reasoning dataset with ranked difficulty, and Chiron-o1, a new medical MLLM devised via a curriculum learning strategy, with robust visual question-answering and generalizable reasoning capabilities. Extensive experiments demonstrate that Chiron-o1, trained on our CoT dataset constructed using MICS, achieves state-of-the-art performance across a list of medical visual question answering and reasoning benchmarks. Codes are available at https://github.com/Yankai96/Chiron-o1

Vision–language models (VLMs) exhibit strong zero-shot generalization on natural images and show early promise in interpretable medical image analysis. However, existing benchmarks do not systematically evaluate whether these models truly reason like human clinicians or merely imitate superficial patterns. To address this gap, we propose DrVD-Bench, the first multimodal benchmark for clinical visual reasoning. DrVD-Bench consists of three modules: Visual Evidence Comprehension, Reasoning Trajectory Assessment, and Report Generation Evaluation, comprising a total of 7,789 image–question pairs. Our benchmark covers 20 task types, 17 diagnostic categories, and five imaging modalities—CT, MRI, ultrasound, radiography, and pathology. DrVD-Bench is explicitly structured to reflect the clinical reasoning workflow from modality recognition to lesion identification and diagnosis. We benchmark 19 VLMs, including general-purpose and medical-specific, open-source and proprietary models, and observe that performance drops sharply as reasoning complexity increases. While some models begin to exhibit traces of human-like reasoning, they often still rely on shortcut correlations rather than grounded visual understanding. DrVD-Bench offers a rigorous and structured evaluation framework to guide the development of clinically trustworthy VLMs.

As a bio-inspired vision sensor, spike camera records light intensity by accumulating photons and firing a spike once a preset threshold is reached. For high-light regions, the accumulated photons may reach the threshold multiple times within a readout interval, while only one spike can be stored and read out, resulting in incorrect intensity representation and a limited dynamic range. Multi-level (ML) spike camera enhances the dynamic range by introducing a spike-firing counter (SFC) to count spikes within each readout interval for each pixel, and uses different spike symbols to represent the arrival of different amounts of photons. However, when the light intensity becomes even higher, each pixel requires an SFC with a higher bit depth, causing great cost to the manufacturing process. To address these issues, we propose time-encoding (TE) spike camera, which transforms the counting of spikes to recording of the time at which a specific number of spikes (i.e., an overflow) is reached. To encode time information with as few bits as possible, instead of directly utilising a timer, we leverage a periodic timing signal with a higher frequency than the readout signal. Then the recording of overflow moment can be transformed into recording the number of accumulated timing signal cycles until the overflow occurs. Additionally, we propose an image reconstruction scheme for TE spike camera, which leverages the multi-scale gradient features of spike data. This scheme includes a similarity-based pyramid alignment module to align spike streams across the temporal domain and a light intensity-based refinement module, which utilises the guidance of light intensity to fuse spatial features of the spike data. Experimental results demonstrate that TE spike camera effectively improves the dynamic range of spike camera.

Seeing hidden structures and objects around corners is critical for robots operating in complex, cluttered environments. Existing methods, however, are limited to detecting and tracking hidden objects rather than reconstructing the occluded full scene. We present HoloRadar, a practical system that reconstructs both line-of-sight (LOS) and non-line-of-sight (NLOS) 3D scenes using a single mmWave radar. HoloRadar uses a two-stage pipeline: the first stage generates high-resolution multi-return range images that capture both LOS and NLOS reflections, and the second stage reconstructs the physical scene by mapping mirrored observations to their true locations using a physics-guided architecture that models ray interactions. We deploy HoloRadar on a mobile robot and evaluate it across diverse real-world environments. Our evaluation results demonstrate accurate and robust reconstruction in both LOS and NLOS regions. Code, dataset and demo videos are available on the project website: https://waves.seas.upenn.edu/projects/holoradar.

Developing effective multimodal fusion approaches has become increasingly essential in many real-world scenarios, such as health care and finance. The key challenge is how to preserve the feature expressiveness in each modality while learning cross-modal interactions. Previous approaches primarily focus on the cross-modal alignment, while over-emphasis on the alignment of marginal distributions of modalities may impose excess regularization and obstruct meaningful representations within each modality. The Dirichlet process (DP) mixture model is a powerful Bayesian non-parametric method that can amplify the most prominent features by its richer-gets-richer property, which allocates increasing weights to them. Inspired by this unique characteristic of DP, we propose a new DP-driven multimodal learning framework that automatically achieves an optimal balance between prominent intra-modal representation learning and cross-modal alignment. Specifically, we assume that each modality follows a mixture of multivariate Gaussian distributions and further adopt DP to calculate the mixture weights for all the components. This paradigm allows DP to dynamically allocate the contributions of features and select the most prominent ones, leveraging its richer-gets-richer property, thus facilitating multimodal feature fusion. Extensive experiments on several multimodal datasets demonstrate the superior performance of our model over other competitors. Ablation analysis further validates the effectiveness of DP in aligning modality distributions and its robustness to changes in key hyperparameters. Code is anonymously available at https://github.com/HKU-MedAI/DPMM.git

In semi-supervised segmentation, capturing meaningful semantic structures from unlabeled data is essential. This is particularly challenging in histopathology image analysis, where objects are densely distributed. To address this issue, we propose a semi-supervised segmentation framework designed to robustly identify and preserve relevant topological features. Our method leverages multiple perturbed predictions obtained through stochastic dropouts and temporal training snapshots, enforcing topological consistency across these varied outputs. This consistency mechanism helps distinguish biologically meaningful structures from transient and noisy artifacts. A key challenge in this process is to accurately match the corresponding topological features across the predictions in the absence of ground truth. To overcome this, we introduce a novel matching strategy that integrates spatial overlap with global structural alignment, minimizing discrepancies among predictions. Extensive experiments demonstrate that our approach effectively reduces topological errors, resulting in more robust and accurate segmentations essential for reliable downstream analysis. Code is available at https://github.com/Melon-Xu/MATCH.