Towards Scalable Language-Image Pre-training for 3D Medical Imaging

Language-image pre-training has demonstrated strong performance in 2D medical imaging, but its success in 3D modalities such as CT and MRI remains limited due to the high computational demands of volumetric data, which pose a significant barrier to training on large-scale, uncurated clinical studies. In this study, we introduce Hierarchical attention for Language-Image Pre-training (HLIP), a scalable pre-training framework for 3D medical imaging. HLIP adopts a lightweight hierarchical attention mechanism inspired by the natural hierarchy of radiology data: slice, scan, and study. This mechanism exhibits strong generalizability, e.g., +4.3% macro AUC on the Rad-ChestCT benchmark when pre-trained on CT-RATE. Moreover, the computational efficiency of HLIP enables direct training on uncurated datasets. Trained on 220K patients with 3.13 million scans for brain MRI and 240K patients with 1.44 million scans for head CT, HLIP achieves state-of-the-art performance, e.g., +32.4% balanced ACC on the proposed publicly available brain MRI benchmark Pub-Brain-5; +1.4% and +6.9% macro AUC on head CT benchmarks RSNA and CQ500, respectively. These results demonstrate that, with HLIP, directly pre-training on uncurated clinical datasets is a scalable and effective direction for language-image pre-training in 3D medical imaging. The code is available at https://github.com/Zch0414/hlip

Extending SEEDS to a Supervoxel Algorithm for Medical Image Analysis

In this work, we extend the SEEDS superpixel algorithm from 2D images to 3D volumes, resulting in 3D SEEDS, a faster, better, and open-source supervoxel algorithm for medical image analysis. We compare 3D SEEDS with the widely used supervoxel algorithm SLIC on 13 segmentation tasks across 10 organs. 3D SEEDS accelerates supervoxel generation by a factor of 10, improves the achievable Dice score by +6.5%, and reduces the under-segmentation error by -0.16%. The code is available at https://github.com/Zch0414/3d_seeds

Part-aware Personalized Segment Anything Model for Patient-Specific Segmentation

Precision medicine, such as patient-adaptive treatments utilizing medical images, poses new challenges for image segmentation algorithms due to (1) the large variability across different patients and (2) the limited availability of annotated data for each patient. In this work, we propose a data-efficient segmentation method to address these challenges, namely Part-aware Personalized Segment Anything Model (P^2SAM). Without any model fine-tuning, P^2SAM enables seamless adaptation to any new patients relying only on one-shot patient-specific data. We introduce a novel part-aware prompt mechanism to select multiple-point prompts based on part-level features of the one-shot data. To further promote the robustness of the selected prompt, we propose a retrieval approach to handle outlier prompts. Extensive experiments demonstrate that P^2SAM improves the performance by +8.0% and +2.0% mean Dice score within two patient-specific segmentation settings, and exhibits impressive generality across different application domains, e.g., +6.4% mIoU on the PerSeg benchmark. Code will be released upon acceptance.