Anatomical Prior-Driven Framework for Autonomous Robotic Cardiac Ultrasound Standard View Acquisition

Cardiac ultrasound diagnosis is critical for cardiovascular disease assessment, but acquiring standard views remains highly operator-dependent. Existing medical segmentation models often yield anatomically inconsistent results in images with poor textural differentiation between distinct feature classes, while autonomous probe adjustment methods either rely on simplistic heuristic rules or black-box learning. To address these issues, our study proposed an anatomical prior (AP)-driven framework integrating cardiac structure segmentation and autonomous probe adjustment for standard view acquisition. A YOLO-based multi-class segmentation model augmented by a spatial-relation graph (SRG) module is designed to embed AP into the feature pyramid. Quantifiable anatomical features of standard views are extracted. Their priors are fitted to Gaussian distributions to construct probabilistic APs. The probe adjustment process of robotic ultrasound scanning is formalized as a reinforcement learning (RL) problem, with the RL state built from real-time anatomical features and the reward reflecting the AP matching. Experiments validate the efficacy of the framework. The SRG-YOLOv11s improves mAP50 by 11.3% and mIoU by 6.8% on the Special Case dataset, while the RL agent achieves a 92.5% success rate in simulation and 86.7% in phantom experiments.

SHAPE: Structure-aware Hierarchical Unsupervised Domain Adaptation with Plausibility Evaluation for Medical Image Segmentation

Unsupervised Domain Adaptation (UDA) is essential for deploying medical segmentation models across diverse clinical environments. Existing methods are fundamentally limited, suffering from semantically unaware feature alignment that results in poor distributional fidelity and from pseudo-label validation that disregards global anatomical constraints, thus failing to prevent the formation of globally implausible structures. To address these issues, we propose SHAPE (Structure-aware Hierarchical Unsupervised Domain Adaptation with Plausibility Evaluation), a framework that reframes adaptation towards global anatomical plausibility. Built on a DINOv3 foundation, its Hierarchical Feature Modulation (HFM) module first generates features with both high fidelity and class-awareness. This shifts the core challenge to robustly validating pseudo-labels. To augment conventional pixel-level validation, we introduce Hypergraph Plausibility Estimation (HPE), which leverages hypergraphs to assess the global anatomical plausibility that standard graphs cannot capture. This is complemented by Structural Anomaly Pruning (SAP) to purge remaining artifacts via cross-view stability. SHAPE significantly outperforms prior methods on cardiac and abdominal cross-modality benchmarks, achieving state-of-the-art average Dice scores of 90.08% (MRI->CT) and 78.51% (CT->MRI) on cardiac data, and 87.48% (MRI->CT) and 86.89% (CT->MRI) on abdominal data. The code is available at https://github.com/BioMedIA-repo/SHAPE.

LGESynthNet: Controlled Scar Synthesis for Improved Scar Segmentation in Cardiac LGE-MRI Imaging

Segmentation of enhancement in LGE cardiac MRI is critical for diagnosing various ischemic and non-ischemic cardiomyopathies. However, creating pixel-level annotations for these images is challenging and labor-intensive, leading to limited availability of annotated data. Generative models, particularly diffusion models, offer promise for synthetic data generation, yet many rely on large training datasets and often struggle with fine-grained conditioning control, especially for small or localized features. We introduce LGESynthNet, a latent diffusion-based framework for controllable enhancement synthesis, enabling explicit control over size, location, and transmural extent. Formulated as inpainting using a ControlNet-based architecture, the model integrates: (a) a reward model for conditioning-specific supervision, (b) a captioning module for anatomically descriptive text prompts, and (c) a biomedical text encoder. Trained on just 429 images (79 patients), it produces realistic, anatomically coherent samples. A quality control filter selects outputs with high conditioning-fidelity, which when used for training augmentation, improve downstream segmentation and detection performance, by up-to 6 and 20 points respectively.

Dual Agreement Consistency Learning with Foundation Models for Semi-Supervised Fetal Heart Ultrasound Segmentation and Diagnosis

Congenital heart disease (CHD) screening from fetal echocardiography requires accurate analysis of multiple standard cardiac views, yet developing reliable artificial intelligence models remains challenging due to limited annotations and variable image quality. In this work, we propose FM-DACL, a semi-supervised Dual Agreement Consistency Learning framework for the FETUS 2026 challenge on fetal heart ultrasound segmentation and diagnosis. The method combines a pretrained ultrasound foundation model (EchoCare) with a convolutional network through heterogeneous co-training and an exponential moving average teacher to better exploit unlabeled data. Experiments on the multi-center challenge dataset show that FM-DACL achieves a Dice score of 59.66 and NSD of 42.82 using heterogeneous backbones, demonstrating the feasibility of the proposed semi-supervised framework. These results suggest that FM-DACL provides a flexible approach for leveraging heterogeneous models in low-annotation fetal cardiac ultrasound analysis. The code is available on https://github.com/13204942/FM-DACL.

Unrolled Reconstruction with Integrated Super-Resolution for Accelerated 3D LGE MRI

Accelerated 3D late gadolinium enhancement (LGE) MRI requires robust reconstruction methods to recover thin atrial structures from undersampled k-space data. While unrolled model-based networks effectively integrate physics-driven data consistency with learned priors, they operate at the acquired resolution and may fail to fully recover high-frequency detail. We propose a hybrid unrolled reconstruction framework in which an Enhanced Deep Super-Resolution (EDSR) network replaces the proximal operator within each iteration of the optimization loop, enabling joint super-resolution enhancement and data consistency enforcement. The model is trained end-to-end on retrospectively undersampled preclinical 3D LGE datasets and compared against compressed sensing, Model-Based Deep Learning (MoDL), and self-guided Deep Image Prior (DIP) baselines. Across acceleration factors, the proposed method consistently improves PSNR and SSIM over standard unrolled reconstruction and better preserves fine cardiac structures, leading to improved LA (left atrium) segmentation performance. These results demonstrate that integrating super-resolution priors directly within model-based reconstruction provides measurable gains in accelerated 3D LGE MRI.

No Image, No Problem: End-to-End Multi-Task Cardiac Analysis from Undersampled k-Space

Conventional clinical CMR pipelines rely on a sequential "reconstruct-then-analyze" paradigm, forcing an ill-posed intermediate step that introduces avoidable artifacts and information bottlenecks. This creates a fundamental mathematical paradox: it attempts to recover high-dimensional pixel arrays (i.e., images) from undersampled k-space, rather than directly extracting the low-dimensional physiological labels actually required for diagnosis. To unlock the direct diagnostic potential of k-space, we propose k-MTR (k-space Multi-Task Representation), a k-space representation learning framework that aligns undersampled k-space data and fully-sampled images into a shared semantic manifold. Leveraging a large-scale controlled simulation of 42,000 subjects, k-MTR forces the k-space encoder to restore anatomical information lost to undersampling directly within the latent space, bypassing the explicit inverse problem for downstream analysis. We demonstrate that this latent alignment enables the dense latent space embedded with high-level physiological semantics directly from undersampled frequencies. Across continuous phenotype regression, disease classification, and anatomical segmentation, k-MTR achieves highly competitive performance against state-of-the-art image-domain baselines. By showcasing that precise spatial geometries and multi-task features can be successfully recovered directly from the k-space representations, k-MTR provides a robust architectural blueprint for task-aware cardiac MRI workflows.

Tell2Adapt: A Unified Framework for Source Free Unsupervised Domain Adaptation via Vision Foundation Model

Source Free Unsupervised Domain Adaptation (SFUDA) is critical for deploying deep learning models across diverse clinical settings. However, existing methods are typically designed for low-gap, specific domain shifts and cannot generalize into a unified, multi-modalities, and multi-target framework, which presents a major barrier to real-world application. To overcome this issue, we introduce Tell2Adapt, a novel SFUDA framework that harnesses the vast, generalizable knowledge of the Vision Foundation Model (VFM). Our approach ensures high-fidelity VFM prompts through Context-Aware Prompts Regularization (CAPR), which robustly translates varied text prompts into canonical instructions. This enables the generation of high-quality pseudo-labels for efficiently adapting the lightweight student model to target domain. To guarantee clinical reliability, the framework incorporates Visual Plausibility Refinement (VPR), which leverages the VFM's anatomical knowledge to re-ground the adapted model's predictions in target image's low-level visual features, effectively removing noise and false positives. We conduct one of the most extensive SFUDA evaluations to date, validating our framework across 10 domain adaptation directions and 22 anatomical targets, including brain, cardiac, polyp, and abdominal targets. Our results demonstrate that Tell2Adapt consistently outperforms existing approaches, achieving SOTA for a unified SFUDA framework in medical image segmentation. Code are avaliable at https://github.com/derekshiii/Tell2Adapt.

Balancing Fidelity, Utility, and Privacy in Synthetic Cardiac MRI Generation: A Comparative Study

Deep learning in cardiac MRI (CMR) is fundamentally constrained by both data scarcity and privacy regulations. This study systematically benchmarks three generative architectures: Denoising Diffusion Probabilistic Models (DDPM), Latent Diffusion Models (LDM), and Flow Matching (FM) for synthetic CMR generation. Utilizing a two-stage pipeline where anatomical masks condition image synthesis, we evaluate generated data across three critical axes: fidelity, utility, and privacy. Our results show that diffusion-based models, particularly DDPM, provide the most effective balance between downstream segmentation utility, image fidelity, and privacy preservation under limited-data conditions, while FM demonstrates promising privacy characteristics with slightly lower task-level performance. These findings quantify the trade-offs between cross-domain generalization and patient confidentiality, establishing a framework for safe and effective synthetic data augmentation in medical imaging.

RhythmBERT: A Self-Supervised Language Model Based on Latent Representations of ECG Waveforms for Heart Disease Detection

Electrocardiogram (ECG) analysis is crucial for diagnosing heart disease, but most self-supervised learning methods treat ECG as a generic time series, overlooking physiologic semantics and rhythm-level structure. Existing contrastive methods utilize augmentations that distort morphology, whereas generative approaches employ fixed-window segmentation, which misaligns cardiac cycles. To address these limitations, we propose RhythmBERT, a generative ECG language model that considers ECG as a language paradigm by encoding P, QRS, and T segments into symbolic tokens via autoencoder-based latent representations. These discrete tokens capture rhythm semantics, while complementary continuous embeddings retain fine-grained morphology, enabling a unified view of waveform structure and rhythm. RhythmBERT is pretrained on approximately 800,000 unlabeled ECG recordings with a masked prediction objective, allowing it to learn contextual representations in a label-efficient manner. Evaluations show that despite using only a single lead, RhythmBERT achieves comparable or superior performance to strong 12-lead baselines. This generalization extends from prevalent conditions such as atrial fibrillation to clinically challenging cases such as subtle ST-T abnormalities and myocardial infarction. Our results suggest that considering ECG as structured language offers a scalable and physiologically aligned pathway for advancing cardiac analysis.

Flow Matching-enabled Test-Time Refinement for Unsupervised Cardiac MR Registration

Diffusion-based unsupervised image registration has been explored for cardiac cine MR, but expensive multi-step inference limits practical use. We propose FlowReg, a flow-matching framework in displacement field space that achieves strong registration in as few as two steps and supports further refinement with more steps. FlowReg uses warmup-reflow training: a single-step network first acts as a teacher, then a student learns to refine from arbitrary intermediate states, removing the need for a pre-trained model as in existing methods. An Initial Guess strategy feeds back the model prediction as the next starting point, improving refinement from step two onward. On ACDC and MM2 across six tasks (including cross-dataset generalization), FlowReg outperforms the state of the art on five tasks (+0.6% mean Dice score on average), with the largest gain in the left ventricle (+1.09%), and reduces LVEF estimation error on all six tasks (-2.58 percentage points), using only 0.7% extra parameters and no segmentation labels. Code is available at https://github.com/mathpluscode/FlowReg.