Learning from Noisy Prompts: Saliency-Guided Prompt Distillation for Robust Segmentation with SAM

Segmentation is central to clinical diagnosis and monitoring, yet the reliability of modern foundation models in medical imaging still depends on the availability of precise prompts. The Segment Anything Model (SAM) offers powerful zero-shot capabilities, although it collapses under the weak, generic, and noisy prompts that dominate real clinical workflows. In practice, annotations such as centerline points are coarse and ambiguous, often drifting across neighboring anatomy and misguiding SAM toward inconsistent or incomplete masks. We introduce SPD, a Saliency-Guided Prompt Distillation framework that converts these unreliable cues into robust guidance. SPD first learns data-driven anatomical priors through a lightweight saliency head to obtain confident localization maps. These priors then drive Contextual Prompt Distillation, which validates and enriches noisy prompts using cues from anatomically adjacent slices, producing a consensus prompt set that matches the behavior of expert reasoning. A Pairwise Slice Consistency objective further enforces local anatomical coherence during segmentation. Experiments on four challenging MRI and CT benchmarks demonstrate that SPD consistently outperforms existing SAM adaptations and supervised baselines, delivering large gains in both region-based and boundary-based metrics. SPD provides a practical and principled path toward reliable foundation model deployment in clinical environments where only imperfect prompts are available.

Automatic Detection of Bowel Disease with Residual Networks

Crohn's disease, one of two inflammatory bowel diseases (IBD), affects 200,000 people in the UK alone, or roughly one in every 500. We explore the feasibility of deep learning algorithms for identification of terminal ileal Crohn's disease in Magnetic Resonance Enterography images on a small dataset. We show that they provide comparable performance to the current clinical standard, the MaRIA score, while requiring only a fraction of the preparation and inference time. Moreover, bowels are subject to high variation between individuals due to the complex and free-moving anatomy. Thus we also explore the effect of difficulty of the classification at hand on performance. Finally, we employ soft attention mechanisms to amplify salient local features and add interpretability.