Img2ST-Net: Efficient High-Resolution Spatial Omics Prediction from Whole Slide Histology Images via Fully Convolutional Image-to-Image Learning

Recent advances in multi-modal AI have demonstrated promising potential for generating the currently expensive spatial transcriptomics (ST) data directly from routine histology images, offering a means to reduce the high cost and time-intensive nature of ST data acquisition. However, the increasing resolution of ST, particularly with platforms such as Visium HD achieving 8um or finer, introduces significant computational and modeling challenges. Conventional spot-by-spot sequential regression frameworks become inefficient and unstable at this scale, while the inherent extreme sparsity and low expression levels of high-resolution ST further complicate both prediction and evaluation. To address these limitations, we propose Img2ST-Net, a novel histology-to-ST generation framework for efficient and parallel high-resolution ST prediction. Unlike conventional spot-by-spot inference methods, Img2ST-Net employs a fully convolutional architecture to generate dense, HD gene expression maps in a parallelized manner. By modeling HD ST data as super-pixel representations, the task is reformulated from image-to-omics inference into a super-content image generation problem with hundreds or thousands of output channels. This design not only improves computational efficiency but also better preserves the spatial organization intrinsic to spatial omics data. To enhance robustness under sparse expression patterns, we further introduce SSIM-ST, a structural-similarity-based evaluation metric tailored for high-resolution ST analysis. We present a scalable, biologically coherent framework for high-resolution ST prediction. Img2ST-Net offers a principled solution for efficient and accurate ST inference at scale. Our contributions lay the groundwork for next-generation ST modeling that is robust and resolution-aware. The source code has been made publicly available at https://github.com/hrlblab/Img2ST-Net.

PanTS: The Pancreatic Tumor Segmentation Dataset

PanTS is a large-scale, multi-institutional dataset curated to advance research in pancreatic CT analysis. It contains 36,390 CT scans from 145 medical centers, with expert-validated, voxel-wise annotations of over 993,000 anatomical structures, covering pancreatic tumors, pancreas head, body, and tail, and 24 surrounding anatomical structures such as vascular/skeletal structures and abdominal/thoracic organs. Each scan includes metadata such as patient age, sex, diagnosis, contrast phase, in-plane spacing, slice thickness, etc. AI models trained on PanTS achieve significantly better performance in pancreatic tumor detection, localization, and segmentation compared to those trained on existing public datasets. Our analysis indicates that these gains are directly attributable to the 16x larger-scale tumor annotations and indirectly supported by the 24 additional surrounding anatomical structures. As the largest and most comprehensive resource of its kind, PanTS offers a new benchmark for developing and evaluating AI models in pancreatic CT analysis.

BEAST: Efficient Tokenization of B-Splines Encoded Action Sequences for Imitation Learning

We present the B-spline Encoded Action Sequence Tokenizer (BEAST), a novel action tokenizer that encodes action sequences into compact discrete or continuous tokens using B-splines. In contrast to existing action tokenizers based on vector quantization or byte pair encoding, BEAST requires no separate tokenizer training and consistently produces tokens of uniform length, enabling fast action sequence generation via parallel decoding. Leveraging our B-spline formulation, BEAST inherently ensures generating smooth trajectories without discontinuities between adjacent segments. We extensively evaluate BEAST by integrating it with three distinct model architectures: a Variational Autoencoder (VAE) with continuous tokens, a decoder-only Transformer with discrete tokens, and Florence-2, a pretrained Vision-Language Model with an encoder-decoder architecture, demonstrating BEAST's compatibility and scalability with large pretrained models. We evaluate BEAST across three established benchmarks consisting of 166 simulated tasks and on three distinct robot settings with a total of 8 real-world tasks. Experimental results demonstrate that BEAST (i) significantly reduces both training and inference computational costs, and (ii) consistently generates smooth, high-frequency control signals suitable for continuous control tasks while (iii) reliably achieves competitive task success rates compared to state-of-the-art methods.

IRS: Incremental Relationship-guided Segmentation for Digital Pathology

Continual learning is rapidly emerging as a key focus in computer vision, aiming to develop AI systems capable of continuous improvement, thereby enhancing their value and practicality in diverse real-world applications. In healthcare, continual learning holds great promise for continuously acquired digital pathology data, which is collected in hospitals on a daily basis. However, panoramic segmentation on digital whole slide images (WSIs) presents significant challenges, as it is often infeasible to obtain comprehensive annotations for all potential objects, spanning from coarse structures (e.g., regions and unit objects) to fine structures (e.g., cells). This results in temporally and partially annotated data, posing a major challenge in developing a holistic segmentation framework. Moreover, an ideal segmentation model should incorporate new phenotypes, unseen diseases, and diverse populations, making this task even more complex. In this paper, we introduce a novel and unified Incremental Relationship-guided Segmentation (IRS) learning scheme to address temporally acquired, partially annotated data while maintaining out-of-distribution (OOD) continual learning capacity in digital pathology. The key innovation of IRS lies in its ability to realize a new spatial-temporal OOD continual learning paradigm by mathematically modeling anatomical relationships between existing and newly introduced classes through a simple incremental universal proposition matrix. Experimental results demonstrate that the IRS method effectively handles the multi-scale nature of pathological segmentation, enabling precise kidney segmentation across various structures (regions, units, and cells) as well as OOD disease lesions at multiple magnifications. This capability significantly enhances domain generalization, making IRS a robust approach for real-world digital pathology applications.

MedSegFactory: Text-Guided Generation of Medical Image-Mask Pairs

This paper presents MedSegFactory, a versatile medical synthesis framework that generates high-quality paired medical images and segmentation masks across modalities and tasks. It aims to serve as an unlimited data repository, supplying image-mask pairs to enhance existing segmentation tools. The core of MedSegFactory is a dual-stream diffusion model, where one stream synthesizes medical images and the other generates corresponding segmentation masks. To ensure precise alignment between image-mask pairs, we introduce Joint Cross-Attention (JCA), enabling a collaborative denoising paradigm by dynamic cross-conditioning between streams. This bidirectional interaction allows both representations to guide each other's generation, enhancing consistency between generated pairs. MedSegFactory unlocks on-demand generation of paired medical images and segmentation masks through user-defined prompts that specify the target labels, imaging modalities, anatomical regions, and pathological conditions, facilitating scalable and high-quality data generation. This new paradigm of medical image synthesis enables seamless integration into diverse medical imaging workflows, enhancing both efficiency and accuracy. Extensive experiments show that MedSegFactory generates data of superior quality and usability, achieving competitive or state-of-the-art performance in 2D and 3D segmentation tasks while addressing data scarcity and regulatory constraints.

Interactive Tumor Progression Modeling via Sketch-Based Image Editing

Accurately visualizing and editing tumor progression in medical imaging is crucial for diagnosis, treatment planning, and clinical communication. To address the challenges of subjectivity and limited precision in existing methods, we propose SkEditTumor, a sketch-based diffusion model for controllable tumor progression editing. By leveraging sketches as structural priors, our method enables precise modifications of tumor regions while maintaining structural integrity and visual realism. We evaluate SkEditTumor on four public datasets - BraTS, LiTS, KiTS, and MSD-Pancreas - covering diverse organs and imaging modalities. Experimental results demonstrate that our method outperforms state-of-the-art baselines, achieving superior image fidelity and segmentation accuracy. Our contributions include a novel integration of sketches with diffusion models for medical image editing, fine-grained control over tumor progression visualization, and extensive validation across multiple datasets, setting a new benchmark in the field.

MagNet: Multi-Level Attention Graph Network for Predicting High-Resolution Spatial Transcriptomics

The rapid development of spatial transcriptomics (ST) offers new opportunities to explore the gene expression patterns within the spatial microenvironment. Current research integrates pathological images to infer gene expression, addressing the high costs and time-consuming processes to generate spatial transcriptomics data. However, as spatial transcriptomics resolution continues to improve, existing methods remain primarily focused on gene expression prediction at low-resolution spot levels. These methods face significant challenges, especially the information bottleneck, when they are applied to high-resolution HD data. To bridge this gap, this paper introduces MagNet, a multi-level attention graph network designed for accurate prediction of high-resolution HD data. MagNet employs cross-attention layers to integrate features from multi-resolution image patches hierarchically and utilizes a GAT-Transformer module to aggregate neighborhood information. By integrating multilevel features, MagNet overcomes the limitations posed by low-resolution inputs in predicting high-resolution gene expression. We systematically evaluated MagNet and existing ST prediction models on both a private spatial transcriptomics dataset and a public dataset at three different resolution levels. The results demonstrate that MagNet achieves state-of-the-art performance at both spot level and high-resolution bin levels, providing a novel methodology and benchmark for future research and applications in high-resolution HD-level spatial transcriptomics. Code is available at https://github.com/Junchao-Zhu/MagNet.

KPIs 2024 Challenge: Advancing Glomerular Segmentation from Patch- to Slide-Level

Chronic kidney disease (CKD) is a major global health issue, affecting over 10% of the population and causing significant mortality. While kidney biopsy remains the gold standard for CKD diagnosis and treatment, the lack of comprehensive benchmarks for kidney pathology segmentation hinders progress in the field. To address this, we organized the Kidney Pathology Image Segmentation (KPIs) Challenge, introducing a dataset that incorporates preclinical rodent models of CKD with over 10,000 annotated glomeruli from 60+ Periodic Acid Schiff (PAS)-stained whole slide images. The challenge includes two tasks, patch-level segmentation and whole slide image segmentation and detection, evaluated using the Dice Similarity Coefficient (DSC) and F1-score. By encouraging innovative segmentation methods that adapt to diverse CKD models and tissue conditions, the KPIs Challenge aims to advance kidney pathology analysis, establish new benchmarks, and enable precise, large-scale quantification for disease research and diagnosis.

Post-Training Quantization for 3D Medical Image Segmentation: A Practical Study on Real Inference Engines

Quantizing deep neural networks ,reducing the precision (bit-width) of their computations, can remarkably decrease memory usage and accelerate processing, making these models more suitable for large-scale medical imaging applications with limited computational resources. However, many existing methods studied "fake quantization", which simulates lower precision operations during inference, but does not actually reduce model size or improve real-world inference speed. Moreover, the potential of deploying real 3D low-bit quantization on modern GPUs is still unexplored. In this study, we introduce a real post-training quantization (PTQ) framework that successfully implements true 8-bit quantization on state-of-the-art (SOTA) 3D medical segmentation models, i.e., U-Net, SegResNet, SwinUNETR, nnU-Net, UNesT, TransUNet, ST-UNet,and VISTA3D. Our approach involves two main steps. First, we use TensorRT to perform fake quantization for both weights and activations with unlabeled calibration dataset. Second, we convert this fake quantization into real quantization via TensorRT engine on real GPUs, resulting in real-world reductions in model size and inference latency. Extensive experiments demonstrate that our framework effectively performs 8-bit quantization on GPUs without sacrificing model performance. This advancement enables the deployment of efficient deep learning models in medical imaging applications where computational resources are constrained. The code and models have been released, including U-Net, TransUNet pretrained on the BTCV dataset for abdominal (13-label) segmentation, UNesT pretrained on the Whole Brain Dataset for whole brain (133-label) segmentation, and nnU-Net, SegResNet, SwinUNETR and VISTA3D pretrained on TotalSegmentator V2 for full body (104-label) segmentation. https://github.com/hrlblab/PTQ.

ScaleMAI: Accelerating the Development of Trusted Datasets and AI Models

Building trusted datasets is critical for transparent and responsible Medical AI (MAI) research, but creating even small, high-quality datasets can take years of effort from multidisciplinary teams. This process often delays AI benefits, as human-centric data creation and AI-centric model development are treated as separate, sequential steps. To overcome this, we propose ScaleMAI, an agent of AI-integrated data curation and annotation, allowing data quality and AI performance to improve in a self-reinforcing cycle and reducing development time from years to months. We adopt pancreatic tumor detection as an example. First, ScaleMAI progressively creates a dataset of 25,362 CT scans, including per-voxel annotations for benign/malignant tumors and 24 anatomical structures. Second, through progressive human-in-the-loop iterations, ScaleMAI provides Flagship AI Model that can approach the proficiency of expert annotators (30-year experience) in detecting pancreatic tumors. Flagship Model significantly outperforms models developed from smaller, fixed-quality datasets, with substantial gains in tumor detection (+14%), segmentation (+5%), and classification (72%) on three prestigious benchmarks. In summary, ScaleMAI transforms the speed, scale, and reliability of medical dataset creation, paving the way for a variety of impactful, data-driven applications.