CMCNet: Aligning Ultrasound Image Embeddings with Textual TI-RADS Representations for Fine-Grained Thyroid Classification

Ultrasound is the primary imaging modality for assessing thyroid nodules, and the ACR TI-RADS framework standardizes diagnosis through five ultrasound feature categories that are aggregated into five risk levels (TR1-TR5). Although widely adopted in clinical practice, most deep learning approaches focus on binary malignancy classification, while multi-class prediction and explicit utilization of feature-level supervision remain underexplored, largely due to limited annotated data. In this study, we introduce the STN dataset of 600 thyroid nodules with paired transverse and longitudinal ultrasound images, bounding box annotations, and complete labels for all five TI-RADS feature categories. Following the clinical decision process, we investigate how structured feature information can guide representation learning during training while requiring only images at inference. We demonstrate that text embeddings derived from standardized feature descriptions form a stable surrogate representation for TI-RADS risk levels. Based on this observation, we propose CMCNet, which aligns image embeddings to fixed textual embeddings via a Center-Margin Contrastive Loss that simultaneously promotes intra-class compactness and inter-class separation. Experimental results show that this embedding alignment strategy is more data-efficient and robust than direct multitask learning, and consistently outperforms InfoNCE, center loss, a strong multitask baseline, and a VQA-style multimodal model, particularly in imbalanced settings. The dataset is freely available at doi: 10.5281/zenodo.19125693 and the source code is available at: https://www.healthinformaticslab.org/supp/.

Frequency-Domain Latent Attention Gating for Cross-Domain Token Aggregation

Token aggregation is a common bottleneck in models that map token representations to sample-level predictions, yet most pooling methods operate only in the original token domain. We propose FLaG, a plug-in aggregation module that transforms token representations with the real FFT, summarizes spectral components with learnable latent queries, applies a channel-wise gate, and reconstructs enhanced time-domain tokens for final pooling. We evaluate FLaG on antimicrobial peptide (AMP) activity prediction with ESM2, image classification with ResNet18 on CIFAR-10 and CIFAR-100, and text classification with RoBERTa on IMDB and GLUE. FLaG achieves its clearest gains on the ESM2-8M antimicrobial peptide tasks and on CIFAR-100, while remaining competitive with strong text baselines on IMDB and GLUE. Then we probe its behavior on the AMP setting with band knockouts, gate summaries, residue perturbations, latent-query readouts, and structure-proxy stratification. We find that low-frequency bands contribute the most overall, and the remaining higher-band pattern is more sample-specific. The gate acts as a broadly shared spectral reweighting stage and the cross-attention patterns are sample-specific with mild query-wise differentiation, and higher-helix peptides exhibit stronger average spectral sensitivity in both bacteria. The supplementary materials, source code and data are released at https://www.healthinformaticslab.org/supp/ and https://github.com/Kewei2023/AMPCliff/tree/FLaG.