CSWinUNETR: Segmentation of Thin Anatomical Structures in Medical Images

Accurate segmentation of thin, tortuous anatomical structures, such as retinal vessels, cerebral vasculature, and facial wrinkles, remains challenging due to low contrast, frequent discontinuities, and severe class imbalance. Although recent convolutional and Transformer-based models have improved performance, they often yield fragmented predictions and fail to recover fine branches. We propose CSWinUNETR, a general-purpose backbone for 2D and 3D thin-structure segmentation. It employs cross-shaped stripe self-attention to model long-range principal-axis context and incorporates cyclic shifts to enhance information exchange across stripes. To better preserve fine-grained details, we further introduce a detail-enhanced multi-scale self-attention module that aggregates contextual features from multi-resolution representations. In addition, we propose sparse-control dynamic snake convolution, which reconstructs reliable dense curvilinear kernels from sparsely predicted control points to better follow tortuous geometry. Extensive experiments on four benchmarks across ophthalmology, neurovascular imaging, and dermatology demonstrate that CSWinUNETR consistently outperforms state-of-the-art methods without task-specific post-processing or topology-aware losses. The code is available at https://github.com/labhai/CSWinUNETR.

To forget is to preserve: Machine Unlearning for 3D medical image segmentation

With new data privacy laws such as the General Data Protection Regulation (GDPR) [1] that allow individuals to ask that any of their personal information be erased from trained machine learning models, there has been a push to investigate the unlearning of data from models as a way to comply with these laws. In this regard, based on four mechanics, we consider several approximate unlearning strategies applied to the MRBrainS18 dataset [2]. We use a 3D ResNet-50 [3] as a backbone architecture for segmentation that has been pre-trained with the Med3D framework [4]. Considering the pre-trained model as a baseline, we evaluate respective retention accuracy on 2 types of subjects, i.e., retain and forget. We assess these approaches through their Dice similarity coefficient and mean absolute error (MAE) values using two separate training horizons 20 and 50 epochs. The results show that the Noisy Label strategy had the best overall trade-off with a decrease of 93% in the forget set while maintaining 84% accuracy for the retained set after 50 epochs. All other strategies showed extreme levels of forgetting at higher epoch numbers while also demonstrating catastrophic degradation of their retain set performance. The results of this study provide a strict baseline of performance metrics for unlearning on a subject-specific level and provide practitioners with clear criteria for selecting the proper strategies.

Structural MRI Synthesis for Alzheimer's Disease via Conditional Diffusion on Anatomical Masks

Recent advances in generative machine learning models have significantly improved medical imaging, offering promising solutions for data augmentation, privacy preservation, and improved model generalization. However, synthesizing high-quality structural MRI data for Alzheimer's Disease (AD) remains challenging due to the subtle, region-specific, and progressive anatomical changes associated with neurodegeneration. In this paper, we extend the Med-DDPM conditional diffusion model -- originally designed for brain tumor synthesis -- to generate 3D structural MRIs specifically tailored to AD. We adopted Med-DDPM due to its established stability and structural fidelity compared to other generative models, which makes it particularly suitable for capturing the subtle anatomical changes characteristic of AD. Our approach conditions the diffusion process on anatomical segmentation masks derived from the ADNI dataset, incorporating key AD-relevant brain structures into the generation process. We systematically evaluate the quality and utility of the synthetic images by training segmentation models on real, synthetic, and hybrid (mixed) datasets. Experimental results demonstrate that segmentation models trained exclusively on synthetic data achieve comparable Dice scores (0.6532) to those trained on real data (0.6513), while exhibiting significantly enhanced recall. Notably, models trained on hybrid datasets (mixing real and synthetic images) outperform both real and synthetic-only baselines, achieving a Dice score of 0.7244. These findings underscore the successful use of conditional diffusion models for generating anatomically accurate, AD-specific synthetic MRIs, and highlight their potential for enhancing training data availability, improving diagnostic accuracy, and promoting research reproducibility in neuroimaging studies.

Parameter-Efficient Adaptation of SAM 3 for Automated ITV Generation from 4DCT Images

Four-dimensional computed tomography (4DCT) captures the full respiratory cycle of thoracic anatomy, yet current Internal Target Volume contouring workflows process each phase in isolation, discarding temporal coherence and leaving contours vulnerable to phase-specific artifacts. We present a lightweight framework that applies parameter-efficient fine-tuning to the Segment Anything Model 3 (SAM 3) via low-rank adaptation (LoRA) to align its text-prompted segmentation with the medical domain using only seven annotated 3D CT volumes. Furthermore, the framework incorporates a hard negative mining strategy to improve boundary discrimination in low-contrast thoracic regions. At inference, phase-wise predictions are refined through phase-coherent temporal filtering and spatial connectivity analysis. Since respiratory motion is continuous and periodic, genuine anatomy appears in contiguous blocks of phases, whereas transient artifacts appear sporadically and are thus effectively suppressed. Experiments on pulmonary and cardiac structures yield median Dice scores of 0.968 and 0.910 with 95th-percentile Hausdorff distances of 0.998 mm and 2.931 mm, respectively. The proposed framework effectively eliminates the severe false-positive predictions inherent in the zero-shot inference of the unadapted SAM 3. With only seven annotated volumes, the framework retains over 95% of full-data accuracy, and the entire pipeline is trainable on a single consumer-grade GPU, demonstrating a scalable, data-efficient solution for adaptive radiotherapy.

MNet++: Extended 2D/3D Networks for Anisotropic Medical Image Segmentation

This work demonstrates a full reproduction and extension of MNet, a hybrid 2D/3D convolutional network designed for anisotropic medical image segmentation. The original architecture was re-implemented within the nnU-Net framework to verify its reported performance and robustness to variable voxel spacing, known as anisotropy. Experiments were conducted on PROMISE prostate MRI and a controlled subset of LiTS liver CT under matched preprocessing and compute constraints. The reproduced MNet achieved a Dice similarity coefficient (DSC) of 89.0 +/- 0.9% on PROMISE, within 0.8% of the published result, and 94.3 +/- 1.9% / 54.6 +/- 3.1% for liver and tumor segmentation on LiTS, respectively. Two lightweight extensions were further introduced: (1) a learned Fusion Gating mechanism enabling adaptive 2D-3D feature blending, and (2) a VMamba state-space module for efficient long-range depth modelling. The Spatial Gating variant improved DSC by +0.8% with less than 3% inference overhead, while VMamba improved performance consistency, reducing PROMISE Dice variation to +/- 0.7% and achieving the strongest LiTS liver performance at 95.8% Dice. Both extensions preserved MNet robustness to anisotropy, with delta Dice = 1.5% across 1-4 mm voxel spacing. Overall, the study confirms MNet reproducibility and demonstrates that adaptive fusion and state-space modelling have the potential to further strengthen segmentation reliability under anisotropic conditions. However, further tests are required to provide definitive conclusions.

Transformer-Guided Graph Attention for Direct Cardiac Mesh Reconstruction: A Structural Digital Twin Framework

Building patient-specific cardiac models sits at the heart of precision cardiology, yet getting those models into clinical use keeps running into the same wall: mesh generation is slow, messy, and frustrating. The standard workflow -- segmenting the image, running Marching Cubes, and then manually cleaning up the result -- is time-consuming, inconsistent across operators, and demands specialist knowledge most clinical teams do not have. We take a fundamentally different approach. Instead of treating segmentation and mesh generation as two separate problems, we train a single end-to-end network that goes directly from a raw 3D medical image to a smooth, simulation-ready cardiac surface mesh. The core is a 3D Swin Transformer encoder-decoder that extracts volumetric features from CT or MRI volumes, paired with a Graph Attention Network (GAT) head that iteratively deforms a template mesh to fit the patient's cardiac boundary. We tested on the MM-WHS 2017 benchmark using both CT and MRI. Segmentation scores were competitive (Dice of 0.84 on CT, 0.83 on MRI), but the primary focus is mesh quality: mean Chamfer distance of 1.8 mm, with 95th-percentile surface distance below 5 mm. Every mesh is produced in a single forward pass -- no Marching Cubes, no smoothing filters, no manual cleanup. We argue that for cardiac digital twin pipelines, geometric fidelity and topological correctness matter more than pixel-level Dice scores. By removing the post-processing bottleneck, this approach makes patient-specific cardiac simulation substantially more accessible for clinical use.

Masked and Predictive Self-Supervised Foundation Models for 3D Brain MRI

Self-supervised foundation models have shown strong promise in medical imaging. However, existing MRI foundation-model studies have primarily emphasized segmentation and dense prediction tasks, while systematic investigation of self-supervised foundation models for MRI-based disease detection remains limited. In this work, we investigate two major self-supervised pretraining paradigms for MRI-based disease detection: reconstruction-based learning via Masked Autoencoders (MAE) and predictive representation learning via Joint Embedding Predictive Architectures (JEPA). We study the role of auxiliary objectives by introducing a novel spectral-domain reconstruction loss for MAE to enhance sensitivity to fine-grained anatomical structure, and by integrating variance--covariance regularization (VCR) within our JEPA framework to encourage decorrelated latent representations. Our models are pretrained on heterogeneous single-contrast MRI volumes in a contrast-agnostic setting, without modality concatenation. Across five downstream disease detection tasks, our results highlight the importance of self-supervised objective design for medical foundation model pretraining, demonstrating that the downstream benefit of each objective is determined by its relevance to the task's structure. Specifically, spectral regularization yields the largest improvements when the downstream discriminative signal is characterized by strong high-frequency anatomical structures, while covariance regularization is most beneficial when discriminative information spans multiple decorrelated feature dimensions. MAE with spectral-domain supervision consistently achieves superior downstream performance for MRI-based disease detection. These findings suggest that self-supervised objectives in medical imaging encode specific biases, and their downstream benefit is fundamentally conditioned on the task's structure.

Interpretable and Frugal Learning Systems Employing Multiresolution Pyramids and Volterra Kernels

Deep learning models are widely used to process multidimensional signals such as time series, images, and volumetric medical images, but their learned representations often lack explicit signal structure and are difficult to inspect. This thesis develops model-based, signal-theoretic learning systems guided by data and task objectives. It combines multiresolution analysis, wavelets and filter banks, multirate representations, nonlinear Volterra systems, and neural computation graphs. Scale, directional geometry, memory, and nonlinear input-output interactions are represented as differentiable operator modules trainable by backpropagation. The design keeps intermediate variables tied to kernels, subbands, recursions, and transform-domain coefficients rather than only to opaque feature channels. The thesis formulates fast GPU-compatible D-dimensional convolution layers, multirate sampling layers, Volterra-kernel layers in natural and wavelet coefficient domains, rational polynomial cascade heads, stability-constrained multidimensional IIR filters, wavelet banks, and digital shearlet layers with learnable gains. These modules are composed into task-specific architectures for inverse modeling, classification, and segmentation across atmospheric, audio, texture, and medical-imaging problems. In microwave radiometric inversion, InVeRt retrieves vertical temperature and humidity profiles from microwave brightness temperature observations using learnable Volterra kernels in wavelet bases. Multiresolution filter-bank encoders with Volterra heads are used for efficient classification. WaveletViT and ShearViT serve as subband transformer blocks for WaveNETR and ShearNETR, direction-sensitive segmenters for image and MRI segmentation. MRILong deploys trained 3D T1-weighted brain MRI segmenter checkpoints for automatic segmentation and longitudinal analysis of ischemic stroke MRI volumes.

BiSegMamba: Efficient Bidirectional Tri-Oriented Mamba for 3D Medical Image Segmentation

Accurate 3D medical image segmentation requires both long-range volumetric context and fine boundary preservation. CNN-based methods have limited global dependency modeling, while Transformer-based models are often computationally expensive for dense 3D inputs. Recent Mamba-based methods provide an efficient alternative, but existing volumetric designs still depend on repeated high-resolution scanning, forward-only sequential modeling, and fixed directional summation, causing high cost, scan-order bias, and suboptimal directional aggregation. We propose BiSegMamba, an efficient bidirectional tri-oriented Mamba network for 3D medical image segmentation. BiSegMamba follows a compact-to-detail design, where a progressive compacting stem (PCS) enables efficient latent-space reasoning while retaining shallow high-resolution features for reconstruction. A multi-scale spatial mixer (MSSM) captures local anatomical patterns in early stages, and the proposed bidirectional tri-oriented Ortho Mamba (Bi-ToOM) block models long-range dependencies from multiple orthogonal views using jointly processed forward and backward scan sequences. Adaptive directional fusion (ADF) learns input-dependent channel-wise weights across scan orientations, replacing fixed summation with orientation-aware fusion. Experiments on a collected carotid CTA dataset and three public benchmarks, BraTS2023, ACDC, and AMOS-CT, show that BiSegMamba generalizes well across vascular, cardiac, brain tumor, and abdominal multi-organ segmentation tasks. Compared with SegMamba-V2, BiSegMamba achieves slightly better performance on BraTS2023 and clear improvements on ACDC and the carotid dataset, while reducing computational cost by up to 77.9% FLOPs, demonstrating a strong accuracy-efficiency balance for general 3D medical image segmentation.

MedSyn2: Flexible Control of 3D CT Generation via Text and Semantically-Defined Segmentation Prompts

Generative models for volumetric medical images have found many applications in medical imaging, ranging from data augmentation to serving as priors for inverse problems. For these applications, generating high-resolution 3D images with strong controllability is essential but remains highly challenging. Existing approaches typically control generation either through radiology reports used as text prompts or through full image segmentation. While text-based prompting is flexible, it provides limited spatial control over the location, shape, and boundary of abnormalities. In contrast, segmentation-based methods receive precise spatial guidance but are restrictive in requiring full-organ annotations. In this work, we propose a flexible multimodal framework for controllable volumetric image generation that supports input from radiology reports and segmentation prompts (both optional). Our approach allows users to provide segmentation of a specific anatomy or abnormality without requiring full-organ annotations. The semantic meaning of the segmentation mask is specified through an accompanying text description, resulting in a highly flexible and scalable conditioning mechanism. We develop a memory-efficient architecture based on a modified diffusion transformer that jointly processes image and segmentation tokens. The model further incorporates gated attention to effectively attend to long radiology reports. Experiments demonstrate that our method achieves state-of-the-art perceptual and semantic scores (e.g., 24% relative improvement in mean FID), generates high-resolution anatomically consistent CT volumes, and improves data efficiency when used for data augmentation. Radiologists' evaluation further confirms strong alignment between generated and real medical images.