Extending 2D foundational DINOv3 representations to 3D segmentation of neonatal brain MR images

Precise volumetric delineation of hippocampal structures is essential for quantifying neurodevelopmental trajectories in pre-term and term infants, where subtle morphological variations may carry prognostic significance. While foundation encoders trained on large-scale visual data offer discriminative representations, their 2D formulation is a limitation with respect to the $3$D organization of brain anatomy. We propose a volumetric segmentation strategy that reconciles this tension through a structured window-based disassembly-reassembly mechanism: the global MRI volume is decomposed into non-overlapping 3D windows or sub-cubes, each processed via a separate decoding arm built upon frozen high-fidelity features, and subsequently reassembled prior to a ground-truth correspendence using a dense-prediction head. This architecture preserves constant a decoder memory footprint while forcing predictions to lie within an anatomically consistent geometry. Evaluated on the ALBERT dataset for hippocampal segmentation, the proposed approach achieves a Dice score of 0.65 for a single 3D window. The method demonstrates that volumetric anatomical structure could be recovered from frozen 2D foundation representations through structured compositional decoding, and offers a principled and generalizable extension for foundation models for 3D medical applications.

Clinically-aligned ischemic stroke segmentation and ASPECTS scoring on NCCT imaging using a slice-gated loss on foundation representations

Rapid infarct assessment on non-contrast CT (NCCT) is essential for acute ischemic stroke management. Most deep learning methods perform pixel-wise segmentation without modeling the structured anatomical reasoning underlying ASPECTS scoring, where basal ganglia (BG) and supraganglionic (SG) levels are clinically interpreted in a coupled manner. We propose a clinically aligned framework that combines a frozen DINOv3 backbone with a lightweight decoder and introduce a Territory-Aware Gated Loss (TAGL) to enforce BG-SG consistency during training. This anatomically informed supervision adds no inference-time complexity. Our method achieves a Dice score of 0.6385 on AISD, outperforming prior CNN and foundation-model baselines. On a proprietary ASPECTS dataset, TAGL improves mean Dice from 0.698 to 0.767. These results demonstrate that integrating foundation representations with structured clinical priors improves NCCT stroke segmentation and ASPECTS delineation.

Rethinking Test-Time Training: Tilting The Latent Distribution For Few-Shot Source-Free Adaptation

Often, constraints arise in deployment settings where even lightweight parameter updates e.g. parameter-efficient fine-tuning could induce model shift or tuning instability. We study test-time adaptation of foundation models for few-shot classification under a completely frozen-model regime, where additionally, no upstream data are accessible. We propose arguably the first training-free inference method that adapts predictions to the new task by performing a change of measure over the latent embedding distribution induced by the encoder. Using task-similarity scores derived from a small labeled support set, exponential tilting reweights latent distributions in a KL-optimal manner without modifying model parameters. Empirically, the method consistently competes with parameter-update-based methods across multiple benchmarks and shot regimes, while operating under strictly and universally stronger constraints. These results demonstrate the viability of inference-level distributional correction for test-time adaptation even with a fully-frozen model pipeline.