Describe Anything in Medical Images

Localized image captioning has made significant progress with models like the Describe Anything Model (DAM), which can generate detailed region-specific descriptions without explicit region-text supervision. However, such capabilities have yet to be widely applied to specialized domains like medical imaging, where diagnostic interpretation relies on subtle regional findings rather than global understanding. To mitigate this gap, we propose MedDAM, the first comprehensive framework leveraging large vision-language models for region-specific captioning in medical images. MedDAM employs medical expert-designed prompts tailored to specific imaging modalities and establishes a robust evaluation benchmark comprising a customized assessment protocol, data pre-processing pipeline, and specialized QA template library. This benchmark evaluates both MedDAM and other adaptable large vision-language models, focusing on clinical factuality through attribute-level verification tasks, thereby circumventing the absence of ground-truth region-caption pairs in medical datasets. Extensive experiments on the VinDr-CXR, LIDC-IDRI, and SkinCon datasets demonstrate MedDAM's superiority over leading peers (including GPT-4o, Claude 3.7 Sonnet, LLaMA-3.2 Vision, Qwen2.5-VL, GPT-4Rol, and OMG-LLaVA) in the task, revealing the importance of region-level semantic alignment in medical image understanding and establishing MedDAM as a promising foundation for clinical vision-language integration.

Enhancing Skin Disease Diagnosis: Interpretable Visual Concept Discovery with SAM Empowerment

Current AI-assisted skin image diagnosis has achieved dermatologist-level performance in classifying skin cancer, driven by rapid advancements in deep learning architectures. However, unlike traditional vision tasks, skin images in general present unique challenges due to the limited availability of well-annotated datasets, complex variations in conditions, and the necessity for detailed interpretations to ensure patient safety. Previous segmentation methods have sought to reduce image noise and enhance diagnostic performance, but these techniques require fine-grained, pixel-level ground truth masks for training. In contrast, with the rise of foundation models, the Segment Anything Model (SAM) has been introduced to facilitate promptable segmentation, enabling the automation of the segmentation process with simple yet effective prompts. Efforts applying SAM predominantly focus on dermatoscopy images, which present more easily identifiable lesion boundaries than clinical photos taken with smartphones. This limitation constrains the practicality of these approaches to real-world applications. To overcome the challenges posed by noisy clinical photos acquired via non-standardized protocols and to improve diagnostic accessibility, we propose a novel Cross-Attentive Fusion framework for interpretable skin lesion diagnosis. Our method leverages SAM to generate visual concepts for skin diseases using prompts, integrating local visual concepts with global image features to enhance model performance. Extensive evaluation on two skin disease datasets demonstrates our proposed method's effectiveness on lesion diagnosis and interpretability.

From Majority to Minority: A Diffusion-based Augmentation for Underrepresented Groups in Skin Lesion Analysis

AI-based diagnoses have demonstrated dermatologist-level performance in classifying skin cancer. However, such systems are prone to under-performing when tested on data from minority groups that lack sufficient representation in the training sets. Although data collection and annotation offer the best means for promoting minority groups, these processes are costly and time-consuming. Prior works have suggested that data from majority groups may serve as a valuable information source to supplement the training of diagnosis tools for minority groups. In this work, we propose an effective diffusion-based augmentation framework that maximizes the use of rich information from majority groups to benefit minority groups. Using groups with different skin types as a case study, our results show that the proposed framework can generate synthetic images that improve diagnostic results for the minority groups, even when there is little or no reference data from these target groups. The practical value of our work is evident in medical imaging analysis, where under-diagnosis persists as a problem for certain groups due to insufficient representation.

Dynamic Domains, Dynamic Solutions: DPCore for Continual Test-Time Adaptation

Continual Test-Time Adaptation (TTA) seeks to adapt a source pre-trained model to continually changing, unlabeled target domains. Existing TTA methods are typically designed for environments where domain changes occur gradually and can struggle in more dynamic scenarios. Inspired by the principles of online K-Means, this paper introduces a novel approach to continual TTA through visual prompting. We propose a Dynamic Prompt Coreset that not only preserves knowledge from previously visited domains but also accommodates learning from new potential domains. This is complemented by a distance-based weight updating mechanism that ensures the coreset remains current and relevant. Our approach employs a fixed model architecture alongside the coreset and an innovative updating system to effectively mitigate challenges such as catastrophic forgetting and error accumulation. Extensive testing across various benchmarks-including ImageNet-C, CIFAR100-C, and CIFAR10-C-demonstrates that our method consistently outperforms state-of-the-art (SOTA) alternatives, particularly excelling in dynamically changing environments.

Test-time Assessment of a Model's Performance on Unseen Domains via Optimal Transport

Gauging the performance of ML models on data from unseen domains at test-time is essential yet a challenging problem due to the lack of labels in this setting. Moreover, the performance of these models on in-distribution data is a poor indicator of their performance on data from unseen domains. Thus, it is essential to develop metrics that can provide insights into the model's performance at test time and can be computed only with the information available at test time (such as their model parameters, the training data or its statistics, and the unlabeled test data). To this end, we propose a metric based on Optimal Transport that is highly correlated with the model's performance on unseen domains and is efficiently computable only using information available at test time. Concretely, our metric characterizes the model's performance on unseen domains using only a small amount of unlabeled data from these domains and data or statistics from the training (source) domain(s). Through extensive empirical evaluation using standard benchmark datasets, and their corruptions, we demonstrate the utility of our metric in estimating the model's performance in various practical applications. These include the problems of selecting the source data and architecture that leads to the best performance on data from an unseen domain and the problem of predicting a deployed model's performance at test time on unseen domains. Our empirical results show that our metric, which uses information from both the source and the unseen domain, is highly correlated with the model's performance, achieving a significantly better correlation than that obtained via the popular prediction entropy-based metric, which is computed solely using the data from the unseen domain.

On the Fly Neural Style Smoothing for Risk-Averse Domain Generalization

Achieving high accuracy on data from domains unseen during training is a fundamental challenge in domain generalization (DG). While state-of-the-art DG classifiers have demonstrated impressive performance across various tasks, they have shown a bias towards domain-dependent information, such as image styles, rather than domain-invariant information, such as image content. This bias renders them unreliable for deployment in risk-sensitive scenarios such as autonomous driving where a misclassification could lead to catastrophic consequences. To enable risk-averse predictions from a DG classifier, we propose a novel inference procedure, Test-Time Neural Style Smoothing (TT-NSS), that uses a "style-smoothed" version of the DG classifier for prediction at test time. Specifically, the style-smoothed classifier classifies a test image as the most probable class predicted by the DG classifier on random re-stylizations of the test image. TT-NSS uses a neural style transfer module to stylize a test image on the fly, requires only black-box access to the DG classifier, and crucially, abstains when predictions of the DG classifier on the stylized test images lack consensus. Additionally, we propose a neural style smoothing (NSS) based training procedure that can be seamlessly integrated with existing DG methods. This procedure enhances prediction consistency, improving the performance of TT-NSS on non-abstained samples. Our empirical results demonstrate the effectiveness of TT-NSS and NSS at producing and improving risk-averse predictions on unseen domains from DG classifiers trained with SOTA training methods on various benchmark datasets and their variations.

Can Domain Adaptation Improve Accuracy and Fairness of Skin Lesion Classification?

Deep learning-based diagnostic system has demonstrated potential in classifying skin cancer conditions when labeled training example are abundant. However, skin lesion analysis often suffers from a scarcity of labeled data, hindering the development of an accurate and reliable diagnostic system. In this work, we leverage multiple skin lesion datasets and investigate the feasibility of various unsupervised domain adaptation (UDA) methods in binary and multi-class skin lesion classification. In particular, we assess three UDA training schemes: single-, combined-, and multi-source. Our experiment results show that UDA is effective in binary classification, with further improvement being observed when imbalance is mitigated. In multi-class task, its performance is less prominent, and imbalance problem again needs to be addressed to achieve above-baseline accuracy. Through our quantitative analysis, we find that the test error of multi-class tasks is strongly correlated with label shift, and feature-level UDA methods have limitations when handling imbalanced datasets. Finally, our study reveals that UDA can effectively reduce bias against minority groups and promote fairness, even without the explicit use of fairness-focused techniques.

Analysis of Task Transferability in Large Pre-trained Classifiers

Transfer learning transfers the knowledge acquired by a model from a source task to multiple downstream target tasks with minimal fine-tuning. The success of transfer learning at improving performance, especially with the use of large pre-trained models has made transfer learning an essential tool in the machine learning toolbox. However, the conditions under which the performance is transferable to downstream tasks are not understood very well. In this work, we analyze the transfer of performance for classification tasks, when only the last linear layer of the source model is fine-tuned on the target task. We propose a novel Task Transfer Analysis approach that transforms the source distribution (and classifier) by changing the class prior distribution, label, and feature spaces to produce a new source distribution (and classifier) and allows us to relate the loss of the downstream task (i.e., transferability) to that of the source task. Concretely, our bound explains transferability in terms of the Wasserstein distance between the transformed source and downstream task's distribution, conditional entropy between the label distributions of the two tasks, and weighted loss of the source classifier on the source task. Moreover, we propose an optimization problem for learning the transforms of the source task to minimize the upper bound on transferability. We perform a large-scale empirical study by using state-of-the-art pre-trained models and demonstrate the effectiveness of our bound and optimization at predicting transferability. The results of our experiments demonstrate how factors such as task relatedness, pretraining method, and model architecture affect transferability.

FBA-Net: Foreground and Background Aware Contrastive Learning for Semi-Supervised Atrium Segmentation

Medical image segmentation of gadolinium enhancement magnetic resonance imaging (GE MRI) is an important task in clinical applications. However, manual annotation is time-consuming and requires specialized expertise. Semi-supervised segmentation methods that leverage both labeled and unlabeled data have shown promise, with contrastive learning emerging as a particularly effective approach. In this paper, we propose a contrastive learning strategy of foreground and background representations for semi-supervised 3D medical image segmentation (FBA-Net). Specifically, we leverage the contrastive loss to learn representations of both the foreground and background regions in the images. By training the network to distinguish between foreground-background pairs, we aim to learn a representation that can effectively capture the anatomical structures of interest. Experiments on three medical segmentation datasets demonstrate state-of-the-art performance. Notably, our method achieves a Dice score of 91.31% with only 20% labeled data, which is remarkably close to the 91.62% score of the fully supervised method that uses 100% labeled data on the left atrium dataset. Our framework has the potential to advance the field of semi-supervised 3D medical image segmentation and enable more efficient and accurate analysis of medical images with a limited amount of annotated labels.

On Certifying and Improving Generalization to Unseen Domains

Domain Generalization (DG) aims to learn models whose performance remains high on unseen domains encountered at test-time by using data from multiple related source domains. Many existing DG algorithms reduce the divergence between source distributions in a representation space to potentially align the unseen domain close to the sources. This is motivated by the analysis that explains generalization to unseen domains using distributional distance (such as the Wasserstein distance) to the sources. However, due to the openness of the DG objective, it is challenging to evaluate DG algorithms comprehensively using a few benchmark datasets. In particular, we demonstrate that the accuracy of the models trained with DG methods varies significantly across unseen domains, generated from popular benchmark datasets. This highlights that the performance of DG methods on a few benchmark datasets may not be representative of their performance on unseen domains in the wild. To overcome this roadblock, we propose a universal certification framework based on distributionally robust optimization (DRO) that can efficiently certify the worst-case performance of any DG method. This enables a data-independent evaluation of a DG method complementary to the empirical evaluations on benchmark datasets. Furthermore, we propose a training algorithm that can be used with any DG method to provably improve their certified performance. Our empirical evaluation demonstrates the effectiveness of our method at significantly improving the worst-case loss (i.e., reducing the risk of failure of these models in the wild) without incurring a significant performance drop on benchmark datasets.