Abstract:Dental diagnosis from Orthopantomograms (OPGs) requires coordination of tooth detection, caries segmentation (CarSeg), anomaly detection (AD), and dental developmental staging (DDS). We propose Mamba-based Architectural Tooth Hierarchical Estimator and Holistic Evaluation Network for Anatomy (MATHENA), a unified framework leveraging Mamba's linear-complexity State Space Models (SSM) to address all four tasks. MATHENA integrates MATHE, a multi-resolution SSM-driven detector with four-directional Vision State Space (VSS) blocks for O(N) global context modeling, generating per-tooth crops. These crops are processed by HENA, a lightweight Mamba-UNet with a triple-head architecture and Global Context State Token (GCST). In the triple-head architecture, CarSeg is first trained as an upstream task to establish shared representations, which are then frozen and reused for downstream AD fine-tuning and DDS classification via linear probing, enabling stable, efficient learning. We also curate PARTHENON, a benchmark comprising 15,062 annotated instances from ten datasets. MATHENA achieves 93.78% mAP@50 in tooth detection, 90.11% Dice for CarSeg, 88.35% for AD, and 72.40% ACC for DDS.
Abstract:Minimizing invasive diagnostic procedures to reduce the risk of patient injury and infection is a central goal in medical imaging. And yet, noninvasive diagnosis of perineural invasion (PNI), a critical prognostic factor involving infiltration of tumor cells along the surrounding nerve, still remains challenging, due to the lack of clear and consistent imaging criteria criteria for identifying PNI. To address this challenge, we present NeoNet, an integrated end-to-end 3D deep learning framework for PNI prediction in cholangiocarcinoma that does not rely on predefined image features. NeoNet integrates three modules: (1) NeoSeg, utilizing a Tumor-Localized ROI Crop (TLCR) algorithm; (2) NeoGen, a 3D Latent Diffusion Model (LDM) with ControlNet, conditioned on anatomical masks to generate synthetic image patches, specifically balancing the dataset to a 1:1 ratio; and (3) NeoCls, the final prediction module. For NeoCls, we developed the PNI-Attention Network (PattenNet), which uses the frozen LDM encoder and specialized 3D Dual Attention Blocks (DAB) designed to detect subtle intensity variations and spatial patterns indicative of PNI. In 5-fold cross-validation, NeoNet outperformed baseline 3D models and achieved the highest performance with a maximum AUC of 0.7903.
Abstract:Lesion detection, symptom tracking, and visual explainability are central to real-world medical image analysis, yet current medical Vision-Language Models (VLMs) still lack mechanisms that translate their broad knowledge into clinically actionable outputs. To bridge this gap, we present MEDIC-AD, a clinically oriented VLM that strengthens these three capabilities through a stage-wise framework. First, learnable anomaly-aware tokens (<Ano>) encourage the model to focus on abnormal regions and build more discriminative lesion centered representations. Second, inter image difference tokens (<Diff>) explicitly encode temporal changes between studies, allowing the model to distinguish worsening, improvement, and stability in disease burden. Finally, a dedicated explainability stage trains the model to generate heatmaps that highlight lesion-related regions, offering clear visual evidence that is consistent with the model's reasoning. Through our staged design, MEDIC-AD steadily boosts performance across anomaly detection, symptom tracking, and anomaly segmentation, achieving state-of-the-art results compared with both closed source and medical-specialized baselines. Evaluations on real longitudinal clinical data collected from real hospital workflows further show that MEDIC-AD delivers stable predictions and clinically faithful explanations in practical patient-monitoring and decision-support workflows
Abstract:Deep learning and generative models are advancing rapidly, with synthetic data increasingly being integrated into training pipelines for downstream analysis tasks. However, in medical imaging, their adoption remains constrained by the scarcity of reliable annotated datasets. To address this limitation, we propose 3D-LLDM, a label-guided 3D latent diffusion model that generates high-quality synthetic magnetic resonance (MR) volumes with corresponding anatomical segmentation masks. Our approach uses hepatobiliary phase MR images enhanced with the Gd-EOB-DTPA contrast agent to derive structural masks for the liver, portal vein, hepatic vein, and hepatocellular carcinoma, which then guide volumetric synthesis through a ControlNet-based architecture. Trained on 720 real clinical hepatobiliary phase MR scans from Samsung Medical Center, 3D-LLDM achieves a Fréchet Inception Distance (FID) of 28.31, improving over GANs by 70.9% and over state-of-the-art diffusion baselines by 26.7%. When used for data augmentation, the synthetic volumes improve hepatocellular carcinoma segmentation by up to 11.153% Dice score across five CNN architectures.