Risk-Routed Implicit Boundary Refinement for Robust Ultrasound Image Segmentation

Medical ultrasound (US) image segmentation faces significant challenges due to speckle noise, low-contrast boundaries, acoustic shadowing, and acquisition variation across operators and clinical centers. Although encoder-decoder and transformer-based networks have achieved strong performance, many methods recover boundary details through dense decoders or larger backbones, which may still produce over-smoothed contours or unstable predictions under external distribution shifts. In this article, we propose Risk-routed Implicit Boundary Refinement (RIBR), a compact segmentation framework that uses implicit neural representation as a risk-routed residual correction rather than an unconstrained full-mask predictor. RIBR combines boundary-refinement implicit residuals, risk-routed residual control, and geometry- and speckle-aware boundary regularization to refine uncertain contours while suppressing non-boundary oscillations. Evaluation on nine US datasets covering lymph nodes, breast lesions, thyroid nodules, and prostate shows that RIBR achieves the best overall macro-average and consistently reduces boundary error across grouped and organ-specific comparisons under a compact parameter budget. These findings suggest that controlled implicit residual learning is a practical strategy for resource-constrained and boundary-sensitive US segmentation. Source code is available at https://github.com/jinggqu/ribr.

Adapting Vision-Language Foundation Model for Next Generation Medical Ultrasound Image Analysis

Medical ultrasonography is an essential imaging technique for examining superficial organs and tissues, including lymph nodes, breast, and thyroid. It employs high-frequency ultrasound waves to generate detailed images of the internal structures of the human body. However, manually contouring regions of interest in these images is a labor-intensive task that demands expertise and often results in inconsistent interpretations among individuals. Vision-language foundation models, which have excelled in various computer vision applications, present new opportunities for enhancing ultrasound image analysis. Yet, their performance is hindered by the significant differences between natural and medical imaging domains. This research seeks to overcome these challenges by developing domain adaptation methods for vision-language foundation models. In this study, we explore the fine-tuning pipeline for vision-language foundation models by utilizing large language model as text refiner with special-designed adaptation strategies and task-driven heads. Our approach has been extensively evaluated on six ultrasound datasets and two tasks: segmentation and classification. The experimental results show that our method can effectively improve the performance of vision-language foundation models for ultrasound image analysis, and outperform the existing state-of-the-art vision-language and pure foundation models. The source code of this study is available at https://github.com/jinggqu/NextGen-UIA.