Self-supervised Learning of Echocardiographic Video Representations via Online Cluster Distillation

Self-supervised learning (SSL) has achieved major advances in natural images and video understanding, but challenges remain in domains like echocardiography (heart ultrasound) due to subtle anatomical structures, complex temporal dynamics, and the current lack of domain-specific pre-trained models. Existing SSL approaches such as contrastive, masked modeling, and clustering-based methods struggle with high intersample similarity, sensitivity to low PSNR inputs common in ultrasound, or aggressive augmentations that distort clinically relevant features. We present DISCOVR (Distilled Image Supervision for Cross Modal Video Representation), a self-supervised dual branch framework for cardiac ultrasound video representation learning. DISCOVR combines a clustering-based video encoder that models temporal dynamics with an online image encoder that extracts fine-grained spatial semantics. These branches are connected through a semantic cluster distillation loss that transfers anatomical knowledge from the evolving image encoder to the video encoder, enabling temporally coherent representations enriched with fine-grained semantic understanding. Evaluated on six echocardiography datasets spanning fetal, pediatric, and adult populations, DISCOVR outperforms both specialized video anomaly detection methods and state-of-the-art video-SSL baselines in zero-shot and linear probing setups, and achieves superior segmentation transfer.

MCAT: Visual Query-Based Localization of Standard Anatomical Clips in Fetal Ultrasound Videos Using Multi-Tier Class-Aware Token Transformer

Accurate standard plane acquisition in fetal ultrasound (US) videos is crucial for fetal growth assessment, anomaly detection, and adherence to clinical guidelines. However, manually selecting standard frames is time-consuming and prone to intra- and inter-sonographer variability. Existing methods primarily rely on image-based approaches that capture standard frames and then classify the input frames across different anatomies. This ignores the dynamic nature of video acquisition and its interpretation. To address these challenges, we introduce Multi-Tier Class-Aware Token Transformer (MCAT), a visual query-based video clip localization (VQ-VCL) method, to assist sonographers by enabling them to capture a quick US sweep. By then providing a visual query of the anatomy they wish to analyze, MCAT returns the video clip containing the standard frames for that anatomy, facilitating thorough screening for potential anomalies. We evaluate MCAT on two ultrasound video datasets and a natural image VQ-VCL dataset based on Ego4D. Our model outperforms state-of-the-art methods by 10% and 13% mIoU on the ultrasound datasets and by 5.35% mIoU on the Ego4D dataset, using 96% fewer tokens. MCAT's efficiency and accuracy have significant potential implications for public health, especially in low- and middle-income countries (LMICs), where it may enhance prenatal care by streamlining standard plane acquisition, simplifying US-based screening, diagnosis and allowing sonographers to examine more patients.

Self-supervised Normality Learning and Divergence Vector-guided Model Merging for Zero-shot Congenital Heart Disease Detection in Fetal Ultrasound Videos

Congenital Heart Disease (CHD) is one of the leading causes of fetal mortality, yet the scarcity of labeled CHD data and strict privacy regulations surrounding fetal ultrasound (US) imaging present significant challenges for the development of deep learning-based models for CHD detection. Centralised collection of large real-world datasets for rare conditions, such as CHD, from large populations requires significant co-ordination and resource. In addition, data governance rules increasingly prevent data sharing between sites. To address these challenges, we introduce, for the first time, a novel privacy-preserving, zero-shot CHD detection framework that formulates CHD detection as a normality modeling problem integrated with model merging. In our framework dubbed Sparse Tube Ultrasound Distillation (STUD), each hospital site first trains a sparse video tube-based self-supervised video anomaly detection (VAD) model on normal fetal heart US clips with self-distillation loss. This enables site-specific models to independently learn the distribution of healthy cases. To aggregate knowledge across the decentralized models while maintaining privacy, we propose a Divergence Vector-Guided Model Merging approach, DivMerge, that combines site-specific models into a single VAD model without data exchange. Our approach preserves domain-agnostic rich spatio-temporal representations, ensuring generalization to unseen CHD cases. We evaluated our approach on real-world fetal US data collected from 5 hospital sites. Our merged model outperformed site-specific models by 23.77% and 30.13% in accuracy and F1-score respectively on external test sets.