PF-DAformer: Proximal Femur Segmentation via Domain Adaptive Transformer for Dual-Center QCT

Quantitative computed tomography (QCT) plays a crucial role in assessing bone strength and fracture risk by enabling volumetric analysis of bone density distribution in the proximal femur. However, deploying automated segmentation models in practice remains difficult because deep networks trained on one dataset often fail when applied to another. This failure stems from domain shift, where scanners, reconstruction settings, and patient demographics vary across institutions, leading to unstable predictions and unreliable quantitative metrics. Overcoming this barrier is essential for multi-center osteoporosis research and for ensuring that radiomics and structural finite element analysis results remain reproducible across sites. In this work, we developed a domain-adaptive transformer segmentation framework tailored for multi-institutional QCT. Our model is trained and validated on one of the largest hip fracture related research cohorts to date, comprising 1,024 QCT images scans from Tulane University and 384 scans from Rochester, Minnesota for proximal femur segmentation. To address domain shift, we integrate two complementary strategies within a 3D TransUNet backbone: adversarial alignment via Gradient Reversal Layer (GRL), which discourages the network from encoding site-specific cues, and statistical alignment via Maximum Mean Discrepancy (MMD), which explicitly reduces distributional mismatches between institutions. This dual mechanism balances invariance and fine-grained alignment, enabling scanner-agnostic feature learning while preserving anatomical detail.

FedDA-TSformer: Federated Domain Adaptation with Vision TimeSformer for Left Ventricle Segmentation on Gated Myocardial Perfusion SPECT Image

Background and Purpose: Functional assessment of the left ventricle using gated myocardial perfusion (MPS) single-photon emission computed tomography relies on the precise extraction of the left ventricular contours while simultaneously ensuring the security of patient data. Methods: In this paper, we introduce the integration of Federated Domain Adaptation with TimeSformer, named 'FedDA-TSformer' for left ventricle segmentation using MPS. FedDA-TSformer captures spatial and temporal features in gated MPS images, leveraging spatial attention, temporal attention, and federated learning for improved domain adaptation while ensuring patient data security. In detail, we employed Divide-Space-Time-Attention mechanism to extract spatio-temporal correlations from the multi-centered MPS datasets, ensuring that predictions are spatio-temporally consistent. To achieve domain adaptation, we align the model output on MPS from three different centers using local maximum mean discrepancy (LMMD) loss. This approach effectively addresses the dual requirements of federated learning and domain adaptation, enhancing the model's performance during training with multi-site datasets while ensuring the protection of data from different hospitals. Results: Our FedDA-TSformer was trained and evaluated using MPS datasets collected from three hospitals, comprising a total of 150 subjects. Each subject's cardiac cycle was divided into eight gates. The model achieved Dice Similarity Coefficients (DSC) of 0.842 and 0.907 for left ventricular (LV) endocardium and epicardium segmentation, respectively. Conclusion: Our proposed FedDA-TSformer model addresses the challenge of multi-center generalization, ensures patient data privacy protection, and demonstrates effectiveness in left ventricular (LV) segmentation.