arXiv subjects

Bernhard Kainz

Publications and source records attributed to Bernhard Kainz.

At least 19 recordsLinked to original sources

arXiv2026

Shadow Reduction in Ultrasound Imaging Using Differentiable Simulation and Radiance Field Decomposition

Acoustic shadows from bone and other highly attenuating tissues obscure clinically important structures in ultrasound. In fetal brain imaging, skull-induced artefacts disproportionately degrade the hemisphere closer to the transducer (proximal), limiting symmetric assessment of the two hemispheres. Existing correction methods require raw scanner data, impose restrictive assumptions on tissue properties, or rely on generative models that may hallucinate anatomy. We present RFlash, a physics-informed post-processing method that decomposes beamformed ultrasound images into explicit attenuation and scatter-intensity maps using a differentiable radiance-field formulation of image formation. Attenuation-adaptive re-rendering then removes the dependence of the signal at each depth on the intervening tissue, equivalent to virtually advancing the transducer into the tissue. Across 1,261 3D fetal brain volumes, 143 real 2D curvilinear abdominal scans, and 1,200 simulated 2D linear-probe liver scans, RFlash reduces shadow-related intensity differences more effectively than classical Hughes-Duck attenuation correction. For a gestational-age model trained on the distal hemisphere (further from the transducer) and applied to the proximal hemisphere, prediction error decreases by 5.1 days (40%) relative to the original images. The estimated attenuation maps also yield shadow-confidence maps that improve random-forest bone-shadow segmentation over the image alone and receive greater SHAP importance than an existing neural confidence-map baseline, suggesting greater physical consistency. RFlash requires neither hardware modification nor access to raw scanner data and supports 2D and 3D acquisitions with linear and curvilinear probes, making it widely applicable allowing clinicians to use our method on their already acquired scanners and images.

cs.CV↗

arXiv2026

MMAP: Multimodal Missing-Aware Pretraining for Longitudinal Alzheimer's Prediction

Clinical decision making heavily relies on predicting the disease progression trajectory by seeking to understand patient's health status which is characterised by multimodal medical data. AI holds great potential for learning useful representations from multimodal medical data to predict disease progression and aid clinical decision making. However, development of predictive AI models is constrained by missing modalities and incomplete tabular data frequently occurring in medical datasets. In addition, disease labels alone may only provide limited supervisory signals for learning representations from high-dimensional multimodal data. Here, we present MMAP, a novel Multimodal Missing-aware Alignment Pretraining method for learning image-tabular representations from incomplete data. An image encoder is pretrained with efficient sigmoid contrastive learning combined with generative reconstruction. A tabular encoder is built upon a tabular foundation model. A missing token generator enables the two encoders to take incomplete data as input, enabling the model to be robust against missing modalities, either with missing images or missing tabular data. We evaluate the clinical usefulness of the learnt multimodal representations on two challenging longitudinal clinical tasks for Alzheimer's disease: predicting disease stage conversion and predicting amyloid status. The proposed method outperforms strong multimodal and unimodal baselines.

cs.CV↗

arXiv2026

A Data-Interventional Framework for Auditing Privacy and Fairness in Generative Medical Imaging

Diffusion-based synthetic data generation offers a promising route for sharing medical imaging data without releasing sensitive patient records. However, generative models face a fundamental tension between privacy and fairness: they may memorize rare training samples, leading to privacy risks, or fail to reproduce underrepresented features, resulting in unfair synthetic distributions. While prior work has largely focused on either memorization or fairness in isolation, their interaction remains insufficiently understood. In this work, we introduce a data-interventional framework to systematically analyze privacy and fairness in diffusion models. We discuss synthetic anatomical fingerprints (SAFs), rare and manually injected image features, as controlled probes to study whether models generalize sensitive attributes across identities, memorize training samples, or suppress rare signals entirely. Across multiple conditioning modalities, we observe a consistent behavior: models either forget these fingerprints or memorize the entire image in which they appear, but do not generalize them to novel images. To support large-scale auditing where explicit sample extraction is infeasible, we further introduce the indicator metric t', which estimates a model's susceptibility to memorization by exploiting the internal structure of the diffusion process. By comparing conditioning signals of varying surprisal, we reveal a clear relationship between conditioning rarity and memorization behavior. Highly surprising conditioning signals act as retrieval keys that amplify memorization, whereas low-surprisal conditioning signals systematically suppress rare features, even when these appear repeatedly in the training data. Our findings provide actionable insights and concrete mitigation strategies for safe and fair synthetic medical data sharing. Code is available at https://github.com/MischaD/Privacy.

cs.CV↗

arXiv2026

A Principled Approach to Unsupervised Anomaly Detection

Traditional unsupervised anomaly detection (UAD) methods are designed to flag or localise deviations from a normative distribution, ignoring the underlying generative mechanisms of the anomalies. Yet the nature of an anomaly is often as important as its presence. We reformulate UAD as a Bayesian inverse problem, in which the objective is to infer the most probable corruption responsible for each observation. Our framework yields a probabilistic anomaly score as the energy of the inferred corruption parameters, and serves as a principled recipe for developing new UAD algorithms. We derive several existing methods as instances of the general framework, each corresponding to the same energy score under different modelling choices. Experimentally, we study the framework's components in a controlled setting, and improve object-class AUROC on the MVTec AD dataset by 2.3% by adapting the underlying corruption model. Finally, we validate the framework on a brain MRI benchmark, achieving strong detection performance while producing estimates of pathology intensity, bias, and geometry. Code is available at https://github.com/jgmyles/inverse-uad.

cs.CV↗

arXiv2026

Self-Supervised Cardiac Phase Detection via Single-Parameter Latent Orbits

Accurate identification of end-diastole (ED) and end-systole (ES) in echocardiography underpins the quantification of ventricular function, yet manual selection of these key frames is subjective and introduces clinically significant inter-operator variability. Recent self-supervised methods either prescribe strict periodic trajectories or learn an unconstrained low-dimensional motion subspace from reconstruction or registration objectives. The former offers interpretability but imposes restrictive assumptions on temporal progression, whereas the latter leaves cardiac phase implicit and ED/ES must be recovered through post-hoc geometric processing of the learned trajectory. We translate the physiological observation that cardiac phase is a one-dimensional signal into a prior by constraining the latent motion component to a single-parameter latent orbit, i.e., a global linear trajectory in latent space indexed by a bounded scalar phase variable. Mapping this variable through a sinusoidal nonlinearity yields an oscillatory motion signal with consistent temporal ordering, enabling direct identification of ED and ES from the learned phase signal. This inductive bias allows the model to capture an interpretable representation of the cardiac cycle, while maintaining flexibility to capture irregular heartbeats. Trained on EchoNet-Dynamic without annotations, our minimal single-parameter cardiac phase model learns an effective latent orbit, significantly improves upon the previous state of the art in ED localisation and matches it in ES localisation while using a more constrained representation and fewer training epochs. This demonstrates that a principled physiological inductive bias can match or exceed the performance of more complex representations. Code is available at: https://github.com/BonniciJ/OrbitalEcho/

cs.CV↗

arXiv2026

Stain-Aware Wavelet Regularization for Instant Adversarial Purification in Histopathology

Deep learning has become prevalent in computational pathology pipelines that support tasks such as cancer screening and digital pathology analysis. However, the susceptibility of neural networks to adversarial perturbations raises safety concerns for reliable deployment in clinical practice. In histopathological images, this challenge is exacerbated by the difficulty of distinguishing high-frequency adversarial noise from subtle and diagnostically relevant tissue structures. To address this issue, we propose Stain-Aware Wavelet Regularization (SAWR), an adversarial purification framework that leverages multi-level wavelet-domain regularization based on Haar transform to hierarchically disentangle adversarial perturbations from diagnostic structural information. This spectral constraint is further extended to individual histological channels, enabling stain-specific frequency regulation consistent with the biological properties of Hematoxylin and Eosin. Extensive experiments demonstrate that SAWR improves adversarial robustness by up to 10.69\% over the baseline approach, while maintaining texture and spectral fidelity under adversarial perturbations.

cs.CV↗

arXiv2026

Frozen DINO Localizes Image Edits Without a Localizer

Localized image edits can change a photograph's meaning while leaving most of it authentic, so forensic analysis must identify where an edit occurred. We show that patch-level perturbation responses from frozen DINO encoders are themselves localization maps. Training-free Localization of AI-image Edits from patch-token Drift (TRAIL) applies one global Haar perturbation and maps cosine drift between corresponding patch tokens. On 80 source-disjoint CocoGlide test images, TRAIL reaches .903 patch AUROC versus .912 for the mask-supervised Detective SAM; fixed-threshold Dice is .619 versus .709, while an oracle threshold raises TRAIL to .790. Transferred unchanged to Poisson image interpolation, TRAIL reaches .855 AUROC versus .864, showing that the cue persists without a generator. Across sixteen DINO encoders, the best block lies at normalized depth .80-.94. Global context matters: AUROC falls from .903 globally to .857 for local-in-canvas perturbations and .735 for independently encoded crops. Frozen DINO patch tokens therefore contain a strong late-layer localization signal whose visibility depends on the perturbation and preserved context. Code: https://github.com/VishalJ99/trail-image-edit-localization.

cs.CV↗

arXiv2026

Entangled by Design: Spurious Intra-Variable Signal Routing in Tabular In-Context Learners

Consider a model trained at a single hospital to predict patient recovery, where the measured feature $X$ bundles the patient's true health signal ($C$) with a systematic artefact from that hospital's equipment ($S$). Within that hospital, the artefact correlates with outcomes through unmeasured confounders such as patient demographics; an in-context learner rationally routes predictions through $S$, not $C$, and fails silently when deployed at a new hospital with different equipment. We formalise this as \emph{spurious routing in composite representations}: when a feature $X = [C;\,αS;\,η]$ encodes a causal signal $C$ and a spurious signal $S$ in distinct subspaces, the ICL cannot determine which drives predictions. We prove that under ridge ICL, a linear in-context learner, this routing is unavoidable regardless of context size; TabPFN, a state-of-the-art pretrained tabular ICL model, shows qualitatively consistent behaviour empirically. We derive a closed-form characterisation, $\mathrm{CSR} \propto ρ_S/ρ_C$, confirmed at $r = 0.997$ for linear ICL and $r = 0.979$ for TabPFN. Contrary to intuition, larger context sharpens commitment to the dominant in-context signal, amplifying spurious routing by up to $1.74\times$; in the high-spurious corner, more expressive models show greater vulnerability empirically ($+2.22$ CSR gap at high entanglement). We introduce two lightweight mitigations: environment-stratified context construction and S-swap augmentation, that require only weak environment labels and no knowledge of the causal partition. S-swap reduces spurious routing by $74\%$ for linear ICL and $98.8\%$ for TabPFN, with TabPFN's causal sensitivity increasing $8.4\times$ simultaneously: the model does not become agnostic, it reroutes through the causal signal.

cs.AI↗

arXiv2026

From Training to Deployment: Post-Hoc Causal Feature Identification via Sensitivity Ratios

Given a model that is already trained, which features does it rely on causally versus spuriously? Existing methods require access to the training procedure and cannot answer this post-hoc. We introduce the \textbf{Normalised Sensitivity Ratio~(NSR)}, a post-hoc, model-agnostic diagnostic for this question under a structured-shift regime: environments differ primarily in the mean of spurious features while the causal mechanism and causal marginals remain stable, as in multi-site clinical data or multi-batch genomics. Within this regime, causal features induce constant model sensitivity across environments while spurious features track shift. NSR formalises this as the squared coefficient of variation of per-environment sensitivity. Under a linear structural causal model (SCM) with $K\ge3$ non-degenerate environments, NSR achieves exact identification (Theorem~1). We fully characterise failure: weak shifts ($O(\varepsilon^4)$ collapse), degenerate geometry, and proxy attenuation ($O((1-α)^4)$), giving practitioners quantitative criteria for assessing whether the regime holds. Finite-sample rates are $O_p(n^{-1})$ under the null and $O_p(n^{-1/2})$ under the alternative. Experiments confirm all theoretical predictions on synthetic data (area under the ROC curve [AUROC] $= 1.000$ under conditions satisfying the regime), show consistent rankings across five model families (Kendall $τ\ge0.529$), and recover six of eight causal features on bike-sharing data (Precision@7 $= 0.75$) without modifying any trained model.

cs.AI↗

arXiv2026

Latent Interpolation Learning Using Diffusion Models for Cardiac Volume Reconstruction

Cardiac Magnetic Resonance (CMR) imaging is a critical tool for diagnosing and managing cardiovascular disease, yet its utility is often limited by the sparse acquisition of 2D short-axis slices, resulting in incomplete volumetric information. Accurate 3D reconstruction from these sparse slices is essential for comprehensive cardiac assessment, but existing methods face challenges, including reliance on predefined interpolation schemes (e.g., linear or spherical), computational inefficiency, and dependence on additional semantic inputs such as segmentation labels or motion data. To address these limitations, we propose a novel Cardiac Latent Interpolation Diffusion (CaLID) framework that introduces three key innovations. First, we present a data-driven interpolation scheme based on diffusion models, which can capture complex, non-linear relationships between sparse slices and improves reconstruction accuracy. Second, we design a computationally efficient method that operates in the latent space and speeds up 3D whole-heart upsampling time by a factor of 24, reducing computational overhead compared to previous methods. Third, with only sparse 2D CMR images as input, our method achieves SOTA performance against baseline methods, eliminating the need for auxiliary input such as morphological guidance, thus simplifying workflows. We further extend our method to 2D+T data, enabling the effective modeling of spatiotemporal dynamics and ensuring temporal coherence. Extensive volumetric evaluations and downstream segmentation tasks demonstrate that CaLID achieves superior reconstruction quality and efficiency. By addressing the fundamental limitations of existing approaches, our framework advances the state of the art for spatio and spatiotemporal whole-heart reconstruction, offering a robust and clinically practical solution for cardiovascular imaging.

eess.IV↗

arXiv2026

STARCaster: Spatio-Temporal AutoRegressive Video Diffusion for Identity- and View-Aware Talking Portraits

This paper presents STARCaster, an identity-aware spatio-temporal video diffusion model that addresses both speech-driven portrait animation and dynamic viewpoint control, given an identity embedding or reference image, within a unified framework. Existing 2D speech-to-video diffusion models depend heavily on reference guidance, leading to limited motion diversity. At the same time, 3D-aware animation typically relies on inversion through pretrained tri-plane generators, which often leads to imperfect reconstructions and identity drift. We rethink reference- and geometry-based paradigms in two ways. First, we deviate from strict reference conditioning at pretraining by introducing softer identity constraints. Second, we address 3D awareness implicitly within the 2D video domain by leveraging the inherent multi-view nature of video data. STARCaster adopts a compositional approach progressing from ID-aware motion modeling, to audio-visual synchronization via lip reading-based supervision, and finally to novel view animation through temporal-to-spatial adaptation. To overcome the scarcity of 4D audio-visual data, we propose a decoupled learning approach in which view consistency and temporal coherence are trained independently. Comprehensive evaluations demonstrate that STARCaster generalizes effectively across tasks and identities, consistently surpassing prior approaches in different benchmarks.

cs.CV↗

arXiv2026

Geometry-Aware Uncertainty Coresets for Robust Visual In-Context Learning in Histopathology

Vision-language models (VLMs) can couple visual perception with open-ended clinical reasoning, making them attractive for computational histopathology. However, fine-tuning billions of parameters on scarce, expert-annotated pathology data is prohibitive, while in-context learning (ICL), which conditions the VLM on demonstrative image-text pairs without parameter updates, suffers from high sensitivity to which examples are selected and how the query is phrased, producing unreliable diagnostics. Existing selection strategies rely on query-dependent nearest-neighbour retrieval that ignores global data structure, require costly parameter updates, or disregard the joint vision-text embedding geometry of VLMs. We propose GAUC, a training-free coreset selection method operating directly in the pre-trained multimodal embedding space. GAUC jointly optimises three objectives: (1) a Maximum Mean Discrepancy term enforcing distributional fidelity between coreset and full dataset, (2) an Effective Mutual Information Difference regulariser bounding performance degradation under prompt paraphrases by exploiting the VLM's joint vision-text alignment, and (3) a predictive-uncertainty (entropy) penalty suppressing ambivalent, hallucination-prone outputs. On CRC-100K and MHIST across multiple open-source VLM architectures, GAUC \emph{matches} the accuracy of the strongest ICL selection and dataset-distillation baselines while substantially improving calibration, prompt robustness, and hallucination rates, all without a single gradient update.

cs.CV↗

arXiv2026

CPAgents: Agentic Composite Phenotype Generation for Cardiac Disease Association

Identifying robust associations between cardiac imaging phenotypes and clinical diseases is fundamental to population-scale cardiovascular research and reliable risk stratification. However, current phenome-wide association studies rely on pre-defined, single-variable phenotypes or expert-crafted features, which limits their ability to capture clinically meaningful non-linear effects and cross-phenotype interactions. To address this, we propose CPAgents, an iterative phenotype-Composition framework for cardiovascular Phenome-wide association study (PheWAS) that automatically constructs and validates interpretable composite phenotypes (e.g., polynomial, ratio, and interaction forms) from base imaging features. Specifically, our system coordinates three agents: (i) an Analyst that identifies statistical pathologies and nominates candidate transformations; (ii) a Proposer that generates constrained, medically and statistically motivated expressions under numerical safety rules; and (iii) a Verifier that evaluates candidates using multi-stage criteria and produces transparent evidence trails for accepted phenotypes. Evaluated on a population-scale cardiac imaging cohort, the discovered composite phenotypes markedly improve disease discrimination: across 72 classifier-disease-metric combinations, our variants achieve the top rank in 56 cases versus 18 for baselines, with gains observed across all nine clinical disease categories. Our framework yields compact, clinically interpretable phenotype formulas with transparent evidence trails, enabling scalable discovery of stronger phenotype-disease associations beyond expert-driven feature selection.

cs.LG↗

arXiv2026

Distribution-Aware Diffusion-LLM for Robust Ultra-Long-Term Time Series Forecasting

Time series forecasting is a fundamental machine learning task. Recent work has explored Large Language Models (LLMs) for this purpose due to their strong generalization, pattern recognition, and zero-shot or few-shot capabilities. Despite their suitability for long-context learning, LLMs face challenges in multimodal settings: they lack calibrated probabilistic modeling for non-text data and struggle to align heterogeneous representations. To address these issues, we propose a new framework Diffusion-LLM that integrates a conditional diffusion model into an LLM-based forecasting pipeline. This joint design enables learning the conditional distribution of future data while improving semantic alignment in a shared latent space. We evaluate Diffusion-LLM on six long-term forecasting benchmarks, including ETT, Weather, and ECL. Our method consistently outperforms existing LLM-based baseline, achieving notable gains in ultra-long-term and few-shot forecasting and demonstrating the value of distribution-aware regularization for enhancing robustness and generalization in time series LLMs.

cs.LG↗

arXiv2026

Wasserstein-Aligned Localisation for VLM-Based Distributional OOD Detection in Medical Imaging

Zero-shot anomaly localisation via vision-language models (VLMs) offers a compelling approach for rare pathology detection, yet its performance is fundamentally limited by the absence of healthy anatomical context. We reformulate zero-shot localisation as a comparative inference problem in which anomalies are identified through structured comparison against reference distributions of normal anatomy. We introduce WALDO, a training-free framework grounded in optimal transport theory that enables comparative reasoning through: (i) entropy-weighted Sliced Wasserstein distances for anatomically-aware reference selection from DINOv2 patch distributions, (ii) Goldilocks zone sampling exploiting the non-monotonic relationship between reference similarity and localisation accuracy, and (iii) self-consistency aggregation via weighted non-maximum suppression. We theoretically analyse the Goldilocks effect through distributional divergence, and show that references with moderate similarity minimize a bias-variance trade-off in comparative visual reasoning. On the NOVA brain MRI benchmark, WALDO with Qwen2.5-VL-72B achieves $43.5_{\pm1.6}\%$ mAP@30 (95\% CI: [40.4, 46.7]), representing a 19\% relative improvement over zero-shot baselines. Cross-model evaluation shows consistent gains: GPT-4o achieves $32.0_{\pm6.5}\%$ and Qwen3-VL-32B achieves $32.0_{\pm6.6}\%$ mAP@30. Paired McNemar tests confirm statistical significance ($p<0.01$). Source code is available at https://github.com/bkainz/WALDO_MICCAI26_demo .

cs.CV↗

arXiv2026

Vision-Language Models as Zero-Annotation Oracles in Histopathology

Foreground segmentation is the critical first step of every computational pathology pipeline, yet existing methods rely on hand-tuned heuristics or supervised models that overfit to narrow stain and scanner distributions, failing silently on specialised stains such as Jones silver or Elastica van Gieson. We propose a coarse-to-fine approach that recasts foreground segmentation as a visual perception task and leverages general-purpose vision-language models (VLMs) as zero-annotation oracles. Our key insight is that tissue-versus-background discrimination is a natural-image recognition problem, not a histopathological one, so VLMs trained on internet-scale corpora generalise where domain-specific models cannot. We introduce Leica-75, a benchmark of 75 renal transplant whole-slide images spanning three stain families. On Leica-75, our method achieves the highest segmentation quality on out-of-distribution stains (Dice 0.858 +/- 0.027 on Jones, 0.853 +/- 0.041 on EVG) with 7x lower cross-stain variance than the best supervised baseline, while remaining competitive on in-distribution H&E. Few-shot prompting with automatically curated exemplars (Auto-context) rescues hard cases on Stress-32 (n=32), a curated stress-test subset (Dice 0.470 to 0.819 for the 2B model). VLM-based annotation review matches human expert consensus (kappa=0.989 for blur detection; mean precision/recall grading accuracy 0.708 vs. human 0.646 for segmentation mask review). The resulting pseudo-labels are used to distil lightweight student models that are as performant as the teacher model while running for a fraction of the cost. Our framework provides a principled, scalable solution to a persistent infrastructure bottleneck in digital pathology.

cs.CV↗

arXiv2026

Wasserstein Equilibrium Decoding for Reliable Medical Visual Question Answering

Small vision-language models (2-8B) are well-suited for clinical deployment due to privacy constraints, limited connectivity, and low-latency requirements favouring on-device or on-premise inference. However, their limited capacity exacerbates the generation of plausible but incorrect outputs. We extend game-theoretic decoding, previously restricted to text-only, closed-ended NLP tasks, to vision-language models for open-ended Medical VQA. We introduce a semantically aware Wasserstein stopping criterion that replaces lexical order matching, enabling convergence based on semantic consensus among near-synonymous candidate answers and avoiding unnecessary iterations caused by clinically equivalent ranking swaps. On VQA-RAD and PathVQA, we obtain consistent, statistically significant improvements over greedy and discriminative baselines. On VQA-RAD, we improve Qwen3-VL-2B by +3.5 percentage points (p < 0.01), surpassing the greedy 4B model, with similar trends at larger scales. On PathVQA, Gemma-3-4B with BDG matches MedGemma-4B under greedy decoding despite no domain-specific fine-tuning. At accuracy parity with classic BDG, the Wasserstein criterion reduces average convergence iterations by approximately 20%, improving inference efficiency while preserving the game-theoretic equilibrium behaviour. Code is available at https://github.com/luca-hagen/ Wasserstein-BDG-medical-VQA.

cs.CV↗

arXiv2026

Enhancing Adversarial Robustness with Signed Distance Fields for Harmonizing Geometric Invariance and Texture

Deep neural networks demonstrate impressive performance in visual recognition but remain highly vulnerable to imperceptible adversarial attacks. Existing defense strategies such as adversarial training and diffusion-based purification have achieved significant progress but are frequently constrained by high computational cost, information loss, and inference latency. To address these challenges, we propose a Geometric and Texture balancing Purification (GeoTexPuri) framework that enhances adversarial robustness by harmonizing invariant geometric structures with textural features. Specifically, the framework integrates dense geometric guidance into the training phase by transforming discrete image masks into continuous spatial fields via Signed Distance Fields (SDF). This process establishes stable structural anchors that shield the model from local pixel noise. Through a multi-stream training objective, the model learns to internalize purified representations that effectively align semantic textural cues with these underlying geometric invariants. Extensive experiments on ImageNet demonstrate the efficacy of our approach. GeoTexPuri achieves 84.79\% clean accuracy and 83.52\% robust accuracy under the AutoAttack. Crucially, GeoTexPuri functions as a deterministic classifier during inference, requiring only the input image without any auxiliary geometric modules or additional computational costs, thereby ensuring a scalable and efficient solution for real-time applications.

cs.CV↗