BPC-Net: Annotation-Free Skin Lesion Segmentation via Boundary Probability Calibration

Annotation-free skin lesion segmentation is attractive for low-resource dermoscopic deployment. However, its performance remains constrained by three coupled challenges: noisy pseudo-label supervision, unstable transfer under limited target-domain data, and boundary probability under-confidence. Most existing annotation-free methods primarily focus on pseudo-label denoising. In contrast, the effect of compressed boundary probabilities on final mask quality has received less explicit attention, although it directly affects contour completeness and cannot be adequately corrected by global threshold adjustment alone. To address this issue, we propose BPC-Net, a boundary probability calibration framework for annotation-free skin lesion segmentation. The core of the framework is Gaussian Probability Smoothing (GPS), which performs localized probability-space calibration before thresholding to recover under-confident lesion boundaries without inducing indiscriminate foreground expansion. To support this calibration under noisy pseudo-supervision and cross-domain transfer, we further incorporate two auxiliary designs: a feature-decoupled decoder that separately handles context suppression, detail recovery, and boundary refinement, and an interaction-branch adaptation strategy that updates only the pseudo-label interaction branch while preserving the deployed image-only segmentation path. Under a strictly annotation-free protocol, no manual masks are used during training or target-domain adaptation, and validation labels, when available, are used only for final operating-point selection. Experiments on ISIC-2017, ISIC-2018, and PH2 show that the proposed framework achieves state-of-the-art performance among published unsupervised methods, reaching a macro-average Dice coefficient and Jaccard index of 85.80\% and 76.97\%, respectively, while approaching supervised reference performance on PH2.

Emulating Clinician Cognition via Self-Evolving Deep Clinical Research

Clinical diagnosis is a complex cognitive process, grounded in dynamic cue acquisition and continuous expertise accumulation. Yet most current artificial intelligence (AI) systems are misaligned with this reality, treating diagnosis as single-pass retrospective prediction while lacking auditable mechanisms for governed improvement. We developed DxEvolve, a self-evolving diagnostic agent that bridges these gaps through an interactive deep clinical research workflow. The framework autonomously requisitions examinations and continually externalizes clinical experience from increasing encounter exposure as diagnostic cognition primitives. On the MIMIC-CDM benchmark, DxEvolve improved diagnostic accuracy by 11.2% on average over backbone models and reached 90.4% on a reader-study subset, comparable to the clinician reference (88.8%). DxEvolve improved accuracy on an independent external cohort by 10.2% (categories covered by the source cohort) and 17.1% (uncovered categories) compared to the competitive method. By transforming experience into a governable learning asset, DxEvolve supports an accountable pathway for the continual evolution of clinical AI.