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When Fusion Fails: Corruption-Aware Rebalanced Fusion for Multi-Modal Medical Image Segmentation

Multi-modal medical image segmentation leverages complementary diagnostic information, yet fusion can underperform single-modality baselines when spatially aligned inputs differ in quality. Here, "corruption" primarily denotes resolution-induced degradation rather than misalignment or complete modality absence, while synthetic noise is evaluated only as an auxiliary setting. We identify a critical optimization-inference inconsistency: degraded modalities can receive weak training updates yet substantially affect predictions, indicating active interference with fusion. We attribute this failure to resampling-induced feature corruption and optimization bias, where noisy features propagate through skip connections and encourage unreliable modality selection. We therefore propose CoReFuse-Med, a Corruption-aware Rebalanced Fusion framework that suppresses corruption during feature transmission and rebalances modality contributions during high-level fusion. Experiments on EPVS, BraTS, and WMH, including multiple Z-axis slice-retention ratios and an auxiliary noise test, demonstrate improved accuracy and robustness under modality-quality discrepancies. Our code is available at https://github.com/lrever/CoReFuse.

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A Latent Source Model for Patch-Based Image Segmentation

Despite the popularity and empirical success of patch-based nearest-neighbor and weighted majority voting approaches to medical image segmentation, there has been no theoretical development on when, why, and how well these nonparametric methods work. We bridge this gap by providing a theoretical performance guarantee for nearest-neighbor and weighted majority voting segmentation under a new probabilistic model for patch-based image segmentation. Our analysis relies on a new local property for how similar nearby patches are, and fuses existing lines of work on modeling natural imagery patches and theory for nonparametric classification. We use the model to derive a new patch-based segmentation algorithm that iterates between inferring local label patches and merging these local segmentations to produce a globally consistent image segmentation. Many existing patch-based algorithms arise as special cases of the new algorithm.

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Towards Collective Intelligence: Uncertainty-aware SAM Adaptation for Ambiguous Medical Image Segmentation

Collective intelligence from multiple medical experts consistently surpasses individual expertise in clinical diagnosis, particularly for ambiguous medical image segmentation tasks involving unclear tissue boundaries or pathological variations. The Segment Anything Model (SAM), a powerful vision foundation model originally designed for natural image segmentation, has shown remarkable potential when adapted to medical image segmentation tasks. However, existing SAM adaptation methods follow a single-expert paradigm, developing models based on individual expert annotations to predict deterministic masks. These methods systematically ignore the inherent uncertainty and variability in expert annotations, which fundamentally contradicts clinical practice, where multiple specialists provide different yet equally valid interpretations that collectively enhance diagnostic confidence. We propose an Uncertainty-aware Adapter, the first SAM adaptation framework designed to transition from single expert mindset to collective intelligence representation. Our approach integrates stochastic uncertainty sampling from a Conditional Variational Autoencoder into the adapters, enabling diverse prediction generation that captures expert knowledge distributions rather than individual expert annotations. We employ a novel position-conditioned control mechanism to integrate multi-expert knowledge, ensuring that the output distribution closely aligns with the multi-annotation distribution. Comprehensive evaluations across seven medical segmentation benchmarks have demonstrated that our collective intelligence-based adaptation achieves superior performance while maintaining computational efficiency, establishing a new adaptation framework for reliable clinical implementation.

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Uncertainty Modeling in Ultrasound Image Segmentation for Precise Fetal Biometric Measurements

Medical image segmentation, particularly in the context of ultrasound data, is a crucial aspect of computer vision and medical imaging. This paper delves into the complexities of uncertainty in the segmentation process, focusing on fetal head and femur ultrasound images. The proposed methodology involves extracting target contours and exploring techniques for precise parameter measurement. Uncertainty modeling methods are employed to enhance the training and testing processes of the segmentation network. The study reveals that the average absolute error in fetal head circumference measurement is 8.0833mm, with a relative error of 4.7347%. Similarly, the average absolute error in fetal femur measurement is 2.6163mm, with a relative error of 6.3336%. Uncertainty modeling experiments employing Test-Time Augmentation (TTA) demonstrate effective interpretability of data uncertainty on both datasets. This suggests that incorporating data uncertainty based on the TTA method can support clinical practitioners in making informed decisions and obtaining more reliable measurement results in practical clinical applications. The paper contributes to the advancement of ultrasound image segmentation, addressing critical challenges and improving the reliability of biometric measurements.

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An image segmentation algorithm based on multi-scale feature pyramid network

Medical image segmentation is particularly critical as a prerequisite for relevant quantitative analysis in the treatment of clinical diseases. For example, in clinical cervical cancer radiotherapy, after acquiring subabdominal MRI images, a fast and accurate image segmentation of organs and tumors in MRI images can optimize the clinical radiotherapy process, whereas traditional approaches use manual annotation by specialist doctors, which is time-consuming and laborious, therefore, automatic organ segmentation of subabdominal MRI images is a valuable research topic.

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HST-MRF: Heterogeneous Swin Transformer with Multi-Receptive Field for Medical Image Segmentation

The Transformer has been successfully used in medical image segmentation due to its excellent long-range modeling capabilities. However, patch segmentation is necessary when building a Transformer class model. This process may disrupt the tissue structure in medical images, resulting in the loss of relevant information. In this study, we proposed a Heterogeneous Swin Transformer with Multi-Receptive Field (HST-MRF) model based on U-shaped networks for medical image segmentation. The main purpose is to solve the problem of loss of structural information caused by patch segmentation using transformer by fusing patch information under different receptive fields. The heterogeneous Swin Transformer (HST) is the core module, which achieves the interaction of multi-receptive field patch information through heterogeneous attention and passes it to the next stage for progressive learning. We also designed a two-stage fusion module, multimodal bilinear pooling (MBP), to assist HST in further fusing multi-receptive field information and combining low-level and high-level semantic information for accurate localization of lesion regions. In addition, we developed adaptive patch embedding (APE) and soft channel attention (SCA) modules to retain more valuable information when acquiring patch embedding and filtering channel features, respectively, thereby improving model segmentation quality. We evaluated HST-MRF on multiple datasets for polyp and skin lesion segmentation tasks. Experimental results show that our proposed method outperforms state-of-the-art models and can achieve superior performance. Furthermore, we verified the effectiveness of each module and the benefits of multi-receptive field segmentation in reducing the loss of structural information through ablation experiments.

cs.CV↗

Cycle Context Verification for In-Context Medical Image Segmentation

In-context learning (ICL) is emerging as a promising technique for achieving universal medical image segmentation, where a variety of objects of interest across imaging modalities can be segmented using a single model. Nevertheless, its performance is highly sensitive to the alignment between the query image and in-context image-mask pairs. In a clinical scenario, the scarcity of annotated medical images makes it challenging to select optimal in-context pairs, and fine-tuning foundation ICL models on contextual data is infeasible due to computational costs and the risk of catastrophic forgetting. To address this challenge, we propose Cycle Context Verification (CCV), a novel framework that enhances ICL-based medical image segmentation by enabling self-verification of predictions and accordingly enhancing contextual alignment. Specifically, CCV employs a cyclic pipeline in which the model initially generates a segmentation mask for the query image. Subsequently, the roles of the query and an in-context pair are swapped, allowing the model to validate its prediction by predicting the mask of the original in-context image. The accuracy of this secondary prediction serves as an implicit measure of the initial query segmentation. A query-specific prompt is introduced to alter the query image and updated to improve the measure, thereby enhancing the alignment between the query and in-context pairs. We evaluated CCV on seven medical image segmentation datasets using two ICL foundation models, demonstrating its superiority over existing methods. Our results highlight CCV's ability to enhance ICL-based segmentation, making it a robust solution for universal medical image segmentation. The code will be available at https://github.com/ShishuaiHu/CCV.

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Text Augmented Spatial-aware Zero-shot Referring Image Segmentation

In this paper, we study a challenging task of zero-shot referring image segmentation. This task aims to identify the instance mask that is most related to a referring expression without training on pixel-level annotations. Previous research takes advantage of pre-trained cross-modal models, e.g., CLIP, to align instance-level masks with referring expressions. %Yet, CLIP only considers image-text pair level alignment, which neglects fine-grained image region and complex sentence matching. Yet, CLIP only considers the global-level alignment of image-text pairs, neglecting fine-grained matching between the referring sentence and local image regions. To address this challenge, we introduce a Text Augmented Spatial-aware (TAS) zero-shot referring image segmentation framework that is training-free and robust to various visual encoders. TAS incorporates a mask proposal network for instance-level mask extraction, a text-augmented visual-text matching score for mining the image-text correlation, and a spatial rectifier for mask post-processing. Notably, the text-augmented visual-text matching score leverages a $P$ score and an $N$-score in addition to the typical visual-text matching score. The $P$-score is utilized to close the visual-text domain gap through a surrogate captioning model, where the score is computed between the surrogate model-generated texts and the referring expression. The $N$-score considers the fine-grained alignment of region-text pairs via negative phrase mining, encouraging the masked image to be repelled from the mined distracting phrases. Extensive experiments are conducted on various datasets, including RefCOCO, RefCOCO+, and RefCOCOg. The proposed method clearly outperforms state-of-the-art zero-shot referring image segmentation methods.

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Delving Aleatoric Uncertainty in Medical Image Segmentation via Vision Foundation Models

Medical image segmentation supports clinical workflows by precisely delineating anatomical structures and lesions. However, medical image datasets medical image datasets suffer from acquisition noise and annotation ambiguity, causing pervasive data uncertainty that substantially undermines model robustness. Existing research focuses primarily on model architectural improvements and predictive reliability estimation, while systematic exploration of the intrinsic data uncertainty remains insufficient. To address this gap, this work proposes leveraging the universal representation capabilities of visual foundation models to estimate inherent data uncertainty. Specifically, we analyze the feature diversity of the model's decoded representations and quantify their singular value energy to define the semantic perception scale for each class, thereby measuring sample difficulty and aleatoric uncertainty. Based on this foundation, we design two uncertainty-driven application strategies: (1) the aleatoric uncertainty-aware data filtering mechanism to eliminate potentially noisy samples and enhance model learning quality; (2) the dynamic uncertainty-aware optimization strategy that adaptively adjusts class-specific loss weights during training based on the semantic perception scale, combined with a label denoising mechanism to improve training stability. Experimental results on five public datasets encompassing CT and MRI modalities and involving multi-organ and tumor segmentation tasks demonstrate that our method achieves significant and robust performance improvements across various mainstream network architectures, revealing the broad application potential of aleatoric uncertainty in medical image understanding and segmentation tasks.

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Efficient Smoothing of Dilated Convolutions for Image Segmentation

Dilated Convolutions have been shown to be highly useful for the task of image segmentation. By introducing gaps into convolutional filters, they enable the use of larger receptive fields without increasing the original kernel size. Even though this allows for the inexpensive capturing of features at different scales, the structure of the dilated convolutional filter leads to a loss of information. We hypothesise that inexpensive modifications to Dilated Convolutional Neural Networks, such as additional averaging layers, could overcome this limitation. In this project we test this hypothesis by evaluating the effect of these modifications for a state-of-the art image segmentation system and compare them to existing approaches with the same objective. Our experiments show that our proposed methods improve the performance of dilated convolutions for image segmentation. Crucially, our modifications achieve these results at a much lower computational cost than previous smoothing approaches.

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Self-Ensembling Contrastive Learning for Semi-Supervised Medical Image Segmentation

Deep learning has demonstrated significant improvements in medical image segmentation using a sufficiently large amount of training data with manual labels. Acquiring well-representative labels requires expert knowledge and exhaustive labors. In this paper, we aim to boost the performance of semi-supervised learning for medical image segmentation with limited labels using a self-ensembling contrastive learning technique. To this end, we propose to train an encoder-decoder network at image-level with small amounts of labeled images, and more importantly, we learn latent representations directly at feature-level by imposing contrastive loss on unlabeled images. This method strengthens intra-class compactness and inter-class separability, so as to get a better pixel classifier. Moreover, we devise a student encoder for online learning and an exponential moving average version of it, called teacher encoder, to improve the performance iteratively in a self-ensembling manner. To construct contrastive samples with unlabeled images, two sampling strategies that exploit structure similarity across medical images and utilize pseudo-labels for construction, termed region-aware and anatomical-aware contrastive sampling, are investigated. We conduct extensive experiments on an MRI and a CT segmentation dataset and demonstrate that in a limited label setting, the proposed method achieves state-of-the-art performance. Moreover, the anatomical-aware strategy that prepares contrastive samples on-the-fly using pseudo-labels realizes better contrastive regularization on feature representations.

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An Intuitionistic Fuzzy Logic Driven UNet architecture: Application to Brain Image segmentation

Accurate segmentation of MRI brain images is essential for image analysis, diagnosis of neuro-logical disorders and medical image computing. In the deep learning approach, the convolutional neural networks (CNNs), especially UNet, are widely applied in medical image segmentation. However, it is difficult to deal with uncertainty due to the partial volume effect in brain images. To overcome this limitation, we propose an enhanced framework, named UNet with intuitionistic fuzzy logic (IF-UNet), which incorporates intuitionistic fuzzy logic into UNet. The model processes input data in terms of membership, nonmembership, and hesitation degrees, allowing it to better address tissue ambiguity resulting from partial volume effects and boundary uncertainties. The proposed architecture is evaluated on the Internet Brain Segmentation Repository (IBSR) dataset, and its performance is computed using accuracy, Dice coefficient, and intersection over union (IoU). Experimental results confirm that IF-UNet improves segmentation quality with handling uncertainty in brain images.

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Piecewise Flat Embedding for Image Segmentation

We introduce a new multi-dimensional nonlinear embedding -- Piecewise Flat Embedding (PFE) -- for image segmentation. Based on the theory of sparse signal recovery, piecewise flat embedding with diverse channels attempts to recover a piecewise constant image representation with sparse region boundaries and sparse cluster value scattering. The resultant piecewise flat embedding exhibits interesting properties such as suppressing slowly varying signals, and offers an image representation with higher region identifiability which is desirable for image segmentation or high-level semantic analysis tasks. We formulate our embedding as a variant of the Laplacian Eigenmap embedding with an $L_{1,p} (0<p\leq1)$ regularization term to promote sparse solutions. First, we devise a two-stage numerical algorithm based on Bregman iterations to compute $L_{1,1}$-regularized piecewise flat embeddings. We further generalize this algorithm through iterative reweighting to solve the general $L_{1,p}$-regularized problem. To demonstrate its efficacy, we integrate PFE into two existing image segmentation frameworks, segmentation based on clustering and hierarchical segmentation based on contour detection. Experiments on four major benchmark datasets, BSDS500, MSRC, Stanford Background Dataset, and PASCAL Context, show that segmentation algorithms incorporating our embedding achieve significantly improved results.

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High-Resolution Swin Transformer for Automatic Medical Image Segmentation

The Resolution of feature maps is critical for medical image segmentation. Most of the existing Transformer-based networks for medical image segmentation are U-Net-like architecture that contains an encoder that utilizes a sequence of Transformer blocks to convert the input medical image from high-resolution representation into low-resolution feature maps and a decoder that gradually recovers the high-resolution representation from low-resolution feature maps. Unlike previous studies, in this paper, we utilize the network design style from the High-Resolution Network (HRNet), replace the convolutional layers with Transformer blocks, and continuously exchange information from the different resolution feature maps that are generated by Transformer blocks. The newly Transformer-based network presented in this paper is denoted as High-Resolution Swin Transformer Network (HRSTNet). Extensive experiments illustrate that HRSTNet can achieve comparable performance with the state-of-the-art Transformer-based U-Net-like architecture on Brain Tumor Segmentation(BraTS) 2021 and the liver dataset from Medical Segmentation Decathlon. The code of HRSTNet will be publicly available at https://github.com/auroua/HRSTNet.

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Semi-Supervised Multi-Modal Medical Image Segmentation for Complex Situations

Semi-supervised learning addresses the issue of limited annotations in medical images effectively, but its performance is often inadequate for complex backgrounds and challenging tasks. Multi-modal fusion methods can significantly improve the accuracy of medical image segmentation by providing complementary information. However, they face challenges in achieving significant improvements under semi-supervised conditions due to the challenge of effectively leveraging unlabeled data. There is a significant need to create an effective and reliable multi-modal learning strategy for leveraging unlabeled data in semi-supervised segmentation. To address these issues, we propose a novel semi-supervised multi-modal medical image segmentation approach, which leverages complementary multi-modal information to enhance performance with limited labeled data. Our approach employs a multi-stage multi-modal fusion and enhancement strategy to fully utilize complementary multi-modal information, while reducing feature discrepancies and enhancing feature sharing and alignment. Furthermore, we effectively introduce contrastive mutual learning to constrain prediction consistency across modalities, thereby facilitating the robustness of segmentation results in semi-supervised tasks. Experimental results on two multi-modal datasets demonstrate the superior performance and robustness of the proposed framework, establishing its valuable potential for solving medical image segmentation tasks in complex scenarios.

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Incorporating Near-Infrared Information into Semantic Image Segmentation

Recent progress in computational photography has shown that we can acquire near-infrared (NIR) information in addition to the normal visible (RGB) band, with only slight modifications to standard digital cameras. Due to the proximity of the NIR band to visible radiation, NIR images share many properties with visible images. However, as a result of the material dependent reflection in the NIR part of the spectrum, such images reveal different characteristics of the scene. We investigate how to effectively exploit these differences to improve performance on the semantic image segmentation task. Based on a state-of-the-art segmentation framework and a novel manually segmented image database (both indoor and outdoor scenes) that contain 4-channel images (RGB+NIR), we study how to best incorporate the specific characteristics of the NIR response. We show that adding NIR leads to improved performance for classes that correspond to a specific type of material in both outdoor and indoor scenes. We also discuss the results with respect to the physical properties of the NIR response.

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Semi-supervised Contrastive Learning for Label-efficient Medical Image Segmentation

The success of deep learning methods in medical image segmentation tasks heavily depends on a large amount of labeled data to supervise the training. On the other hand, the annotation of biomedical images requires domain knowledge and can be laborious. Recently, contrastive learning has demonstrated great potential in learning latent representation of images even without any label. Existing works have explored its application to biomedical image segmentation where only a small portion of data is labeled, through a pre-training phase based on self-supervised contrastive learning without using any labels followed by a supervised fine-tuning phase on the labeled portion of data only. In this paper, we establish that by including the limited label in formation in the pre-training phase, it is possible to boost the performance of contrastive learning. We propose a supervised local contrastive loss that leverages limited pixel-wise annotation to force pixels with the same label to gather around in the embedding space. Such loss needs pixel-wise computation which can be expensive for large images, and we further propose two strategies, downsampling and block division, to address the issue. We evaluate our methods on two public biomedical image datasets of different modalities. With different amounts of labeled data, our methods consistently outperform the state-of-the-art contrast-based methods and other semi-supervised learning techniques.

cs.CV↗

Exploring Transfer Learning in Medical Image Segmentation using Vision-Language Models

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.

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