SARFA: Segment Anything with Radiomic Feature Alignment

The Segment Anything Model (SAM) has demonstrated strong generalizability across a variety of segmentation tasks. However, SAM often struggles in situations where the target to be segmented is ambiguous. This poses a problem in medical imaging, where accurate delineation of targets such as tumors is vital, but even expert radiologists can disagree on the appropriate boundary for a target. Addressing this, we propose SARFA (Segment Anything with Radiomic Feature Alignment), a novel framework for improved medical image segmentation. Via probabilistic prompting, SARFA generates a diverse set of plausible masks for each input image and optimizes them with a radiomics-driven training objective based on Fréchet Radiomic Distance (FRD) and Direct Preference Optimization (DPO). By minimizing the FRD between masked predicted and ground truth regions within each image, SARFA encourages segmentation outputs whose anatomical and textural characteristics align with clinically meaningful ground truth representations, without relying solely on pixel-level overlap. Evaluated on computed tomography (CT) and magnetic resonance imaging (MRI) benchmarks, SARFA outperforms existing ambiguous segmentation methods, demonstrating the effectiveness of radiomic feature alignment and DPO-style candidate mask ranking as a training objective. Our code is available at https://github.com/tbwa233/SARFA.

CAP-IQA: Context-Aware Prompt-Guided CT Image Quality Assessment

Prompt-based methods, which encode medical priors through descriptive text, have been only minimally explored for CT Image Quality Assessment (IQA). While such prompts can embed prior knowledge about diagnostic quality, they often introduce bias by reflecting idealized definitions that may not hold under real-world degradations such as noise, motion artifacts, or scanner variability. To address this, we propose the Context-Aware Prompt-guided Image Quality Assessment (CAP-IQA) framework, which integrates text-level priors with instance-level context prompts and applies causal debiasing to separate idealized knowledge from factual, image-specific degradations. Our framework combines a CNN-based visual encoder with a domain-specific text encoder to assess diagnostic visibility, anatomical clarity, and noise perception in abdominal CT images. The model leverages radiology-style prompts and context-aware fusion to align semantic and perceptual representations. On the 2023 LDCTIQA challenge benchmark, CAP-IQA achieves an overall correlation score of 2.8590 (sum of PLCC, SROCC, and KROCC), surpassing the top-ranked leaderboard team (2.7427) by 4.24%. Moreover, our comprehensive ablation experiments confirm that prompt-guided fusion and the simplified encoder-only design jointly enhance feature alignment and interpretability. Furthermore, evaluation on an in-house dataset of 91,514 pediatric CT images demonstrates the true generalizability of CAP-IQA in assessing perceptual fidelity in a different patient population.

ABFR-KAN: Kolmogorov-Arnold Networks for Functional Brain Analysis

Functional connectivity (FC) analysis, a valuable tool for computer-aided brain disorder diagnosis, traditionally relies on atlas-based parcellation. However, issues relating to selection bias and a lack of regard for subject specificity can arise as a result of such parcellations. Addressing this, we propose ABFR-KAN, a transformer-based classification network that incorporates novel advanced brain function representation components with the power of Kolmogorov-Arnold Networks (KANs) to mitigate structural bias, improve anatomical conformity, and enhance the reliability of FC estimation. Extensive experiments on the ABIDE I dataset, including cross-site evaluation and ablation studies across varying model backbones and KAN configurations, demonstrate that ABFR-KAN consistently outperforms state-of-the-art baselines for autism spectrum distorder (ASD) classification. Our code is available at https://github.com/tbwa233/ABFR-KAN.

Detection of Breast Cancer Lumpectomy Margin with SAM-incorporated Forward-Forward Contrastive Learning

Complete removal of cancer tumors with a negative specimen margin during lumpectomy is essential in reducing breast cancer recurrence. However, 2D specimen radiography (SR), the current method used to assess intraoperative specimen margin status, has limited accuracy, resulting in nearly a quarter of patients requiring additional surgery. To address this, we propose a novel deep learning framework combining the Segment Anything Model (SAM) with Forward-Forward Contrastive Learning (FFCL), a pre-training strategy leveraging both local and global contrastive learning for patch-level classification of SR images. After annotating SR images with regions of known maligancy, non-malignant tissue, and pathology-confirmed margins, we pre-train a ResNet-18 backbone with FFCL to classify margin status, then reconstruct coarse binary masks to prompt SAM for refined tumor margin segmentation. Our approach achieved an AUC of 0.8455 for margin classification and segmented margins with a 27.4% improvement in Dice similarity over baseline models, while reducing inference time to 47 milliseconds per image. These results demonstrate that FFCL-SAM significantly enhances both the speed and accuracy of intraoperative margin assessment, with strong potential to reduce re-excision rates and improve surgical outcomes in breast cancer treatment. Our code is available at https://github.com/tbwa233/FFCL-SAM/.