CSWinUNETR: Segmentation of Thin Anatomical Structures in Medical Images

Accurate segmentation of thin, tortuous anatomical structures, such as retinal vessels, cerebral vasculature, and facial wrinkles, remains challenging due to low contrast, frequent discontinuities, and severe class imbalance. Although recent convolutional and Transformer-based models have improved performance, they often yield fragmented predictions and fail to recover fine branches. We propose CSWinUNETR, a general-purpose backbone for 2D and 3D thin-structure segmentation. It employs cross-shaped stripe self-attention to model long-range principal-axis context and incorporates cyclic shifts to enhance information exchange across stripes. To better preserve fine-grained details, we further introduce a detail-enhanced multi-scale self-attention module that aggregates contextual features from multi-resolution representations. In addition, we propose sparse-control dynamic snake convolution, which reconstructs reliable dense curvilinear kernels from sparsely predicted control points to better follow tortuous geometry. Extensive experiments on four benchmarks across ophthalmology, neurovascular imaging, and dermatology demonstrate that CSWinUNETR consistently outperforms state-of-the-art methods without task-specific post-processing or topology-aware losses. The code is available at https://github.com/labhai/CSWinUNETR.

OTCHA: Optimal Transport-driven Confidence-aware Latent Hub Alignment for Multi-View Medical Image Classification

Multi-view imaging, such as mammography and chest radiography, is a standard component of clinical practice. However, medical images are often unregistered and contain view-specific artifacts or irrelevant background cues that can obscure diagnostically relevant findings. Many existing methods directly fuse per-view representations, allowing such irrelevant content to contaminate the fused embedding and reducing robustness under varying view configurations. We propose OTCHA, a confidence-aware latent hub token alignment module based on optimal transport (OT) that refines patch tokens before fusion for multi-view classification. OTCHA introduces a set of learnable latent hub tokens shared across views. For each view, we compute an OT plan between patch tokens and hub tokens that jointly considers feature similarity and geometry, and augment the OT formulation with token-conditional dustbins to enable partial matching and discard irrelevant tokens. The resulting transport plan provides token-wise matching confidence, which gates hub-mediated message passing and weights a novel optimal-transport-based representation alignment loss to stabilize refinement. Experiments on three multi-view medical image datasets demonstrate consistent improvements over competing baselines across diverse anatomies and view configurations. Our code is available at https://github.com/labhai/OTCHA.

When, Where, and How: Adaptive Binning for Tabular Self-Supervised Learning

Medical tabular data are ubiquitous in clinical research, but deep learning for tables remains underexplored because reliable labels often require costly expert adjudication, even though structured clinical variables are routinely available in tabular form. Self-supervised learning can leverage these unlabeled tables, and recent binning-based pretexts offer a promising inductive bias, but existing objectives fix a single global quantile discretization and apply feature-agnostic supervision. We propose Adaptive Binning, a training-adaptive discretization pretext for tabular SSL that couples discretization to learning through a feature-wise coarse-to-fine curriculum. Motivated by the spectral bias of neural networks and the principles of curriculum learning, our method progressively refines discretization per feature upon plateau detection and selects representation-aware splits to jointly improve value-space concentration and representation-space coherence. A heterogeneity-aware objective unifies categorical reconstruction with ordinal supervision for numerical features, and experiments on public medical tabular datasets under unified evaluation protocols show consistent gains for linear probing and fine-tuning without dataset-specific discretization tuning. We further introduce a medical tabular SSL benchmark with standardized protocols to support reproducible progress in this underexplored domain. Our code is available at https://github.com/labhai/Adaptive-Binning.

Surprise-Guided MergeSort: Budget-Efficient Human-in-the-Loop Ranking via Adaptive Comparison Scheduling

Pairwise comparison is the gold standard for subjective ranking tasks; however, exhaustive annotation requires a massive number of human comparisons ($O(n^2)$). While sorting-based methods have reduced this burden to $O(n\log n)$, they still require expensive human judgment for every single comparison. To further improve annotation efficiency, we propose leveraging a Vision-Language Model (VLM) not as an annotator replacement, but as a \emph{question prioritizer} to identify which comparisons genuinely require human judgment. The proposed \textbf{Surprise-Guided MergeSort (SGS)} framework achieves this through three integrated components: (1) a bottom-up MergeSort scheduler that structures comparisons and exploits transitivity, (2) a composite Surprise Scorer -- combining position-bias-cancelled VLM confidence, Elo gap, and vote entropy -- to quantify comparison ambiguity, and (3) an adaptive budget allocator that routes high-surprise pairs to humans while automating low-surprise pairs via transitivity inference. Validation was conducted on six diverse benchmarks spanning text similarity (STS-B, BIOSSES, SICKR-STS) and image quality assessment (KonIQ-10k, TID2013, LIVE Challenge). SGS effectively identified and skipped up to 535 non-informative comparisons per session. Consequently, it achieved Kendall's $τ{\times}100$ improvements of $+6$ to $+12$ over Active Elo under the same total budget. These results demonstrate that combining VLM-guided surprise metrics with algorithmic sorting provides a generally consistent accuracy-efficiency trade-off across diverse domains.

SafeECGMatch: Calibration-Aware Joint Frequency and Time Space Semi-Supervised Learning for Open-Set ECG Classification

Electrocardiogram (ECG) classification models often suffer from severe label scarcity, making semi-supervised learning (SSL) an attractive strategy for reducing annotation costs. In clinical settings, however, unlabeled pools frequently contain out-of-distribution (OOD) anomalies or diagnostic groups absent from the labeled set. Standard SSL forces incorrect pseudo-labels onto these unseen classes, producing overconfident predictions. To address this, we propose SafeECGMatch, a calibration-aware safe SSL framework for single-label ECG classification under label distribution mismatch. Methodologically, SafeECGMatch employs a dual-branch architecture extracting time-frequency latent representations via ECG-specific augmentations. Crucially, it dynamically aligns confidence with empirical accuracy through adaptive label smoothing and temperature scaling, calibrating both the multiclass classifier and the OOD detector across temporal and spectral domains. This joint optimization allows trustworthy OOD rejection and reliable pseudo-labeling. Evaluated on the PTB-XL and PhysioNet/CinC Challenge benchmarks, SafeECGMatch achieves state-of-the-art accuracy and calibration, advancing reliable knowledge discovery in physiological time-series. Code is available at https://github.com/labhai/SafeECGMatch.

RAPID: Layer-Wise Redundancy-Aware Pruning and Importance-Driven Token Merging for Efficient ViT

Vision Transformers (ViTs) achieve strong performance but suffer from high computational costs due to quadratic self-attention complexity. Although token reduction techniques such as pruning and merging mitigate this, they typically overlook how representations evolve across network depth. We propose RAPID, a depth-aware token reduction framework that adapts reduction strategies to the layer-wise characteristics of token representations. The primary methodological contribution is a bifurcated strategy: in shallow-to-middle layers, RAPID employs a redundancy-similarity aware pruning metric to eliminate over-represented local patterns. As features transition to global semantic concepts in deeper layers, the framework shifts to an importance-similarity aware merging mechanism. This stage leverages classification (CLS) token attention weights to protect semantically critical tokens while fusing less important but similar neighbors. Empirical validation on ImageNet-1K using ViT and DeiT architectures demonstrates that RAPID establishes a superior accuracy-compression Pareto frontier compared to plug-and-play baselines such as ToMe and ToFu. RAPID is particularly robust in aggressive compression regimes, achieving up to 4.29% higher accuracy than ToMe at extreme reduction rates. Our framework provides a training-free template for optimizing vision models by aligning reduction strategies with hierarchical feature evolution.

MetaRanker: Human-in-the-loop Active Ranking for Metalens Image Quality

Image quality in modern imaging systems emerges from the coupled effects of the sensor, optics, and computational reconstruction. Ultra-thin metalenses offer a path toward substantial miniaturization of optical modules, but practical designs often exhibit pronounced chromatic and field-dependent aberrations that necessitate computational reconstruction. In current metalens pipelines, reconstruction models are commonly trained and selected using distortion-based fidelity objectives, such as PSNR, yet these proxies can be weakly correlated with human preference and downstream utility, reflecting the well-known perception--distortion trade-off. We introduce MetaRanker, a human-in-the-loop active ranking framework that formalizes metalens image quality in terms of semantic interpretability, defined as the degree to which humans can reliably recognize objects and structures in the presence of optical artifacts. MetaRanker combines a probabilistic preference model with uncertainty-aware query selection, and leverages vision--language models to provide lightweight semantic priors. Importantly, these priors are used only to guide the sampling of informative comparisons; human judgments remain the primary supervision signal throughout. Across real-world and synthetic metalens datasets with distinct degradation profiles, MetaRanker produces rankings that align most closely with human assessments, while reducing the number of pairwise annotations required by approximately 80% relative to exhaustive pairwise evaluation. Finally, we show that standard image quality assessment metrics exhibit limited alignment with human interpretability in the metalens domain, positioning MetaRanker as a practical step toward perceptually grounded metalens evaluation and co-design.

CSV-ViT: A Vision Transformer with the Variable-sized Cortical Supervertices for Detection of Alzheimer's Disease Pathologies

Confirming Alzheimer's disease (AD) typically relies on positron emission tomography (PET), which remains costly and invasive, motivating the use of structural MRI-based prescreening. Deep learning on non-Euclidean manifolds, particularly brain cortical surfaces, faces significant challenges due to the data's spherical topology. Recent surface models have enabled learning from cortical surface data; however, imposing face-based uniform patches often causes duplicate vertices at patch boundaries. In general, many surface-based models are limited in their awareness of the region of interest (ROI), which can result in non-cortical regions, such as the medial wall, being included. We propose a cortical surface tokenization that performs ROI-preserving, vertex-based, variable-sized patch partitioning. We refer to these cortical surface patches as cortical supervertices (CSVs). Building on this representation, we design the CSV Vision Transformer (CSV-ViT), a variable-size patch-tolerant Vision Transformer that uses padding and a mask-aware patch embedding. We used T1-weighted MRI and evaluated our framework by classifying AD-related status into three categories: AD diagnosis, amyloid positivity, and tau positivity. Across the experiments, CSV-ViT achieved higher classification performance than recent surface-based models. The results suggest that the proposed CSV-ViT may support MRI-based prediction of AD-related status prior to PET or CSF confirmation.

Improved Multiscale Structural Mapping with Supervertex Vision Transformer for the Detection of Alzheimer's Disease Neurodegeneration

Alzheimer's disease (AD) confirmation often relies on positron emission tomography (PET) or cerebrospinal fluid (CSF) analysis, which are costly and invasive. Consequently, structural MRI biomarkers such as cortical thickness (CT) are widely used for non-invasive AD screening. Multiscale structural mapping (MSSM) was recently proposed to integrate gray-white matter contrasts (GWCs) with CT from a single T1-weighted MRI (T1w) scan. Building on this framework, we propose MSSM+, together with surface supervertex mapping (SSVM) and a Supervertex Vision Transformer (SV-ViT). 3D T1w images from individuals with AD and cognitively normal (CN) controls were analyzed. MSSM+ extends MSSM by incorporating sulcal depth and cortical curvature at the vertex level. SSVM partitions the cortical surface into supervertices (surface patches) that effectively represent inter- and intra-regional spatial relationships. SV-ViT is a Vision Transformer architecture operating on these supervertices, enabling anatomically informed learning from surface mesh representations. Compared with MSSM, MSSM+ identified more spatially extensive and statistically significant group differences between AD and CN. In AD vs. CN classification, MSSM+ achieved a 3%p higher area under the precision-recall curve than MSSM. Vendor-specific analyses further demonstrated reduced signal variability and consistently improved classification performance across MR manufacturers relative to CT, GWCs, and MSSM. These findings suggest that MSSM+ combined with SV-ViT is a promising MRI-based imaging marker for AD detection prior to CSF/PET confirmation.

ADP-DiT: Text-Guided Diffusion Transformer for Brain Image Generation in Alzheimer's Disease Progression

Alzheimer's disease (AD) progresses heterogeneously across individuals, motivating subject-specific synthesis of follow-up magnetic resonance imaging (MRI) to support progression assessment. While Diffusion Transformers (DiT), an emerging transformer-based diffusion model, offer a scalable backbone for image synthesis, longitudinal AD MRI generation with clinically interpretable control over follow-up time and participant metadata remains underexplored. We present ADP-DiT, an interval-aware, clinically text-conditioned diffusion transformer for longitudinal AD MRI synthesis. ADP-DiT encodes follow-up interval together with multi-domain demographic, diagnostic (CN/MCI/AD), and neuropsychological information as a natural-language prompt, enabling time-specific control beyond coarse diagnostic stages. To inject this conditioning effectively, we use dual text encoders-OpenCLIP for vision-language alignment and T5 for richer clinical-language understanding. Their embeddings are fused into DiT through cross-attention for fine-grained guidance and adaptive layer normalization for global modulation. We further enhance anatomical fidelity by applying rotary positional embeddings to image tokens and performing diffusion in a pre-trained SDXL-VAE latent space to enable efficient high-resolution reconstruction. On 3,321 longitudinal 3T T1-weighted scans from 712 participants (259,038 image slices), ADP-DiT achieves SSIM 0.8739 and PSNR 29.32 dB, improving over a DiT baseline by +0.1087 SSIM and +6.08 dB PSNR while capturing progression-related changes such as ventricular enlargement and shrinking hippocampus. These results suggest that integrating comprehensive, subject-specific clinical conditions with architectures can improve longitudinal AD MRI synthesis.