Search arXiv⌕ Search
Home/Archive/arXiv

arXiv · 2610.02269

Confidence-Gated Cloud-Edge Cascade Triage via Variational Risk Minimization for Medical Imaging

Xinye Yang·Zhusi Zhong·Scott Collins·Michael Bernstein·Grayson Baird·Terrence Healey·Michael Atalay·Mahesh Jayaraman·Xuyu Wang·Zhicheng Jiao
View original source ↗Read source document ↗Export metadata ↓

Abstract

Emergency chest X-ray (CXR) triage has a structural modality gap: reports arrive after triage decisions, yet multimodal foundation models require image-text inputs. We present Variational Risk Minimization (VRM), a distillation framework that treats LVLM-generated report variants as Monte Carlo samples of latent clinical interpretations. Rather than distilling from a single teacher target, VRM learns from a variationally marginalized teacher distribution, enabling uncertainty-aware supervision under missing-modality constraints. Under matched encoder families, VRM outperforms direct fine-tuning baselines and improves calibration with strong recovery from hallucinated supervision. Marginalized supervision reduces report-selection instability. In our compact edge-student instantiation, a confidence-gated cascade reaches AUC 0.941 at 103ms average latency with 20.3% cloud escalation, yielding an explicit reliability-latency operating point for cloud-edge clinical workflows.

Explore related subjects

eess.IVcs.CVcs.LG

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Xinye Yang, Zhusi Zhong, Scott Collins, Michael Bernstein, Grayson Baird, Terrence Healey, Michael Atalay, Mahesh Jayaraman, Xuyu Wang, Zhicheng Jiao. 2026-10-01. Confidence-Gated Cloud-Edge Cascade Triage via Variational Risk Minimization for Medical Imaging. https://doi.org/10.1016/j.smhl.2026.100689

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

arXiv2026

One Photon, Many Worlds: Posteriors and Predictions with Single-Photon Cameras

Single-photon avalanche diode (SPAD) cameras operate fundamentally differently from conventional cameras due to their photon-counting nature. Each frame produces a binary image: pixels report zero if no photons arrived during exposure, and one if one or more photons arrived. Reconstructing a scene or inferring its properties from a single binary frame is difficult because many different images could produce the same measurement; thus, the inverse problem is fundamentally one-to-many. As we gather more binary measurements, the inherent uncertainty associated with the inverse problem and any associated inference diminishes. With sufficient photon counts, photon noise becomes negligible relative to the signal mean, enabling near-deterministic scene recovery and inference. This work characterizes the transition from stochastic to near-deterministic scene understanding as photon budget increases, analyzing how the stochasticity in photon arrival affects downstream inference tasks. Technically, we develop a conditional generative framework based on a Hypergeometric frame-thinning process for accumulated binary SPAD measurements. Generative models capture the one-to-many nature of photon-starved inverse problems, enabling empirical characterization of how this ambiguity diminishes with increasing measurements and its impact on downstream tasks like character recognition, QR code decoding, and facial analysis.

eess.IV↗
arXiv2026

Wrong Organ, Right Physics: Transferring Echocardiography Pretraining to Lung Ultrasound for Tuberculosis Screening

Lung ultrasound (LUS) is attractive for tuberculosis (TB) screening at primary-care level, but labelled cohorts are small. Echocardiography carries no such constraint, while sharing the same underlying ultrasound imaging physics, signal processing and B-mode appearance as LUS. We ask whether an encoder pretrained on that high-resource ultrasound domain carries representations that remain usable in the low-resource one. Only the encoder varies, across seventeen encoders spanning three architecture families. Among them, a latent-predictive video encoder pretrained on generic video (V-JEPA2-L) and its echocardiography counterpart (EchoJEPA-L) differ in pretraining corpus alone. The choice among these encoders does not resolve the classification, the whole family spanning 2.50 percentage points against a measurement resolution of 2.71. What moves the task instead is feature conditioning. Standardising the features between the encoder and the classifier improves all seventeen encoders by a mean of +1.23 percentage points at $p=1.5\times10^{-5}$. On the held-out test set every encoder selected on the development folds stands above the baseline system by up to +2.57 percentage points of area under the receiver operating characteristic curve (AUROC), and specificity at 90% sensitivity reaches 79.3% against 60.3%. The contrast specified in advance, EchoJEPA-L against V-JEPA2-L, measures -0.16 percentage points at $p=0.926$. We therefore find no evidence that shared ultrasonic physics alone makes echocardiography a more productive pretraining corpus than generic video, and any advantage, if present, is smaller than this cohort can resolve. The video encoders receive replicated still images, however, so whether this absence of an effect reflects the pretraining domain or a video encoder applied to static frames cannot be separated. The limiting factor is the labelled cohort rather than the encoder.

eess.IV↗
arXiv2026

Trajectory Stitching for Solving Inverse Problems with Flow-Based Models

Flow-based generative models have emerged as powerful priors for solving inverse problems. One option is to directly optimize the initial latent code (noise), such that the flow output solves the inverse problem. However, this requires backpropagating through the entire generative trajectory, incurring high memory costs and numerical instability. We propose MS-Flow, which represents the trajectory as a sequence of intermediate latent states rather than a single initial code. By enforcing the flow dynamics locally and coupling segments through trajectory-matching penalties, MS-Flow alternates between updating intermediate latent states and enforcing consistency with observed data. This reduces memory consumption while improving reconstruction quality. We demonstrate the effectiveness of MS-Flow over existing methods on image recovery and inverse problems, including inpainting, super-resolution, and computed tomography.

eess.IV↗