MIAS-SAM: Medical Image Anomaly Segmentation without thresholding

This paper presents MIAS-SAM, a novel approach for the segmentation of anomalous regions in medical images. MIAS-SAM uses a patch-based memory bank to store relevant image features, which are extracted from normal data using the SAM encoder. At inference time, the embedding patches extracted from the SAM encoder are compared with those in the memory bank to obtain the anomaly map. Finally, MIAS-SAM computes the center of gravity of the anomaly map to prompt the SAM decoder, obtaining an accurate segmentation from the previously extracted features. Differently from prior works, MIAS-SAM does not require to define a threshold value to obtain the segmentation from the anomaly map. Experimental results conducted on three publicly available datasets, each with a different imaging modality (Brain MRI, Liver CT, and Retina OCT) show accurate anomaly segmentation capabilities measured using DICE score. The code is available at: https://github.com/warpcut/MIAS-SAM

Toward Patient-specific Partial Point Cloud to Surface Completion for Pre- to Intra-operative Registration in Image-guided Liver Interventions

Intra-operative data captured during image-guided surgery lacks sub-surface information, where key regions of interest, such as vessels and tumors, reside. Image-to-physical registration enables the fusion of pre-operative information and intra-operative data, typically represented as a point cloud. However, this registration process struggles due to partial visibility of the intra-operative point cloud. In this research, we propose a patient-specific point cloud completion approach to assist with the registration process. Specifically, we leverage VN-OccNet to generate a complete liver surface from a partial intra-operative point cloud. The network is trained in a patient-specific manner, where simulated deformations from the pre-operative model are used to train the model. First, we conduct an in-depth analysis of VN-OccNet's rotation-equivariant property and its effectiveness in recovering complete surfaces from partial intra-operative surfaces. Next, we integrate the completed intra-operative surface into the Go-ICP registration algorithm to demonstrate its utility in improving initial rigid registration outcomes. Our results highlight the promise of this patient-specific completion approach in mitigating the challenges posed by partial intra-operative visibility. The rotation equivariant and surface generation capabilities of VN-OccNet hold strong promise for developing robust registration frameworks for variations of the intra-operative point cloud.

SPARS: Self-Play Adversarial Reinforcement Learning for Segmentation of Liver Tumours

Accurate tumour segmentation is vital for various targeted diagnostic and therapeutic procedures for cancer, e.g., planning biopsies or tumour ablations. Manual delineation is extremely labour-intensive, requiring substantial expert time. Fully-supervised machine learning models aim to automate such localisation tasks, but require a large number of costly and often subjective 3D voxel-level labels for training. The high-variance and subjectivity in such labels impacts model generalisability, even when large datasets are available. Histopathology labels may offer more objective labels but the infeasibility of acquiring pixel-level annotations to develop tumour localisation methods based on histology remains challenging in-vivo. In this work, we propose a novel weakly-supervised semantic segmentation framework called SPARS (Self-Play Adversarial Reinforcement Learning for Segmentation), which utilises an object presence classifier, trained on a small number of image-level binary cancer presence labels, to localise cancerous regions on CT scans. Such binary labels of patient-level cancer presence can be sourced more feasibly from biopsies and histopathology reports, enabling a more objective cancer localisation on medical images. Evaluating with real patient data, we observed that SPARS yielded a mean dice score of $77.3 \pm 9.4$, which outperformed other weakly-supervised methods by large margins. This performance was comparable with recent fully-supervised methods that require voxel-level annotations. Our results demonstrate the potential of using SPARS to reduce the need for extensive human-annotated labels to detect cancer in real-world healthcare settings.

Pathobiological Dictionary Defining Pathomics and Texture Features: Addressing Understandable AI Issues in Personalized Liver Cancer; Dictionary Version LCP1.0

Artificial intelligence (AI) holds strong potential for medical diagnostics, yet its clinical adoption is limited by a lack of interpretability and generalizability. This study introduces the Pathobiological Dictionary for Liver Cancer (LCP1.0), a practical framework designed to translate complex Pathomics and Radiomics Features (PF and RF) into clinically meaningful insights aligned with existing diagnostic workflows. QuPath and PyRadiomics, standardized according to IBSI guidelines, were used to extract 333 imaging features from hepatocellular carcinoma (HCC) tissue samples, including 240 PF-based-cell detection/intensity, 74 RF-based texture, and 19 RF-based first-order features. Expert-defined ROIs from the public dataset excluded artifact-prone areas, and features were aggregated at the case level. Their relevance to the WHO grading system was assessed using multiple classifiers linked with feature selectors. The resulting dictionary was validated by 8 experts in oncology and pathology. In collaboration with 10 domain experts, we developed a Pathobiological dictionary of imaging features such as PFs and RF. In our study, the Variable Threshold feature selection algorithm combined with the SVM model achieved the highest accuracy (0.80, P-value less than 0.05), selecting 20 key features, primarily clinical and pathomics traits such as Centroid, Cell Nucleus, and Cytoplasmic characteristics. These features, particularly nuclear and cytoplasmic, were strongly associated with tumor grading and prognosis, reflecting atypia indicators like pleomorphism, hyperchromasia, and cellular orientation.The LCP1.0 provides a clinically validated bridge between AI outputs and expert interpretation, enhancing model transparency and usability. Aligning AI-derived features with clinical semantics supports the development of interpretable, trustworthy diagnostic tools for liver cancer pathology.

ViCTr: Vital Consistency Transfer for Pathology Aware Image Synthesis

Synthesizing medical images remains challenging due to limited annotated pathological data, modality domain gaps, and the complexity of representing diffuse pathologies such as liver cirrhosis. Existing methods often struggle to maintain anatomical fidelity while accurately modeling pathological features, frequently relying on priors derived from natural images or inefficient multi-step sampling. In this work, we introduce ViCTr (Vital Consistency Transfer), a novel two-stage framework that combines a rectified flow trajectory with a Tweedie-corrected diffusion process to achieve high-fidelity, pathology-aware image synthesis. First, we pretrain ViCTr on the ATLAS-8k dataset using Elastic Weight Consolidation (EWC) to preserve critical anatomical structures. We then fine-tune the model adversarially with Low-Rank Adaptation (LoRA) modules for precise control over pathology severity. By reformulating Tweedie's formula within a linear trajectory framework, ViCTr supports one-step sampling, reducing inference from 50 steps to just 4, without sacrificing anatomical realism. We evaluate ViCTr on BTCV (CT), AMOS (MRI), and CirrMRI600+ (cirrhosis) datasets. Results demonstrate state-of-the-art performance, achieving a Medical Frechet Inception Distance (MFID) of 17.01 for cirrhosis synthesis 28% lower than existing approaches and improving nnUNet segmentation by +3.8% mDSC when used for data augmentation. Radiologist reviews indicate that ViCTr-generated liver cirrhosis MRIs are clinically indistinguishable from real scans. To our knowledge, ViCTr is the first method to provide fine-grained, pathology-aware MRI synthesis with graded severity control, closing a critical gap in AI-driven medical imaging research.

STG: Spatiotemporal Graph Neural Network with Fusion and Spatiotemporal Decoupling Learning for Prognostic Prediction of Colorectal Cancer Liver Metastasis

We propose a multimodal spatiotemporal graph neural network (STG) framework to predict colorectal cancer liver metastasis (CRLM) progression. Current clinical models do not effectively integrate the tumor's spatial heterogeneity, dynamic evolution, and complex multimodal data relationships, limiting their predictive accuracy. Our STG framework combines preoperative CT imaging and clinical data into a heterogeneous graph structure, enabling joint modeling of tumor distribution and temporal evolution through spatial topology and cross-modal edges. The framework uses GraphSAGE to aggregate spatiotemporal neighborhood information and leverages supervised and contrastive learning strategies to enhance the model's ability to capture temporal features and improve robustness. A lightweight version of the model reduces parameter count by 78.55%, maintaining near-state-of-the-art performance. The model jointly optimizes recurrence risk regression and survival analysis tasks, with contrastive loss improving feature representational discriminability and cross-modal consistency. Experimental results on the MSKCC CRLM dataset show a time-adjacent accuracy of 85% and a mean absolute error of 1.1005, significantly outperforming existing methods. The innovative heterogeneous graph construction and spatiotemporal decoupling mechanism effectively uncover the associations between dynamic tumor microenvironment changes and prognosis, providing reliable quantitative support for personalized treatment decisions.

A Vision-Language Model for Focal Liver Lesion Classification

Accurate classification of focal liver lesions is crucial for diagnosis and treatment in hepatology. However, traditional supervised deep learning models depend on large-scale annotated datasets, which are often limited in medical imaging. Recently, Vision-Language models (VLMs) such as Contrastive Language-Image Pre-training model (CLIP) has been applied to image classifications. Compared to the conventional convolutional neural network (CNN), which classifiers image based on visual information only, VLM leverages multimodal learning with text and images, allowing it to learn effectively even with a limited amount of labeled data. Inspired by CLIP, we pro-pose a Liver-VLM, a model specifically designed for focal liver lesions (FLLs) classification. First, Liver-VLM incorporates class information into the text encoder without introducing additional inference overhead. Second, by calculating the pairwise cosine similarities between image and text embeddings and optimizing the model with a cross-entropy loss, Liver-VLM ef-fectively aligns image features with class-level text features. Experimental results on MPCT-FLLs dataset demonstrate that the Liver-VLM model out-performs both the standard CLIP and MedCLIP models in terms of accuracy and Area Under the Curve (AUC). Further analysis shows that using a lightweight ResNet18 backbone enhances classification performance, particularly under data-constrained conditions.

Glucagon and insulin production in pancreatic cells modeled using Petri nets and Boolean networks

Diabetes is a civilization chronic disease characterized by a constant elevated concentration of glucose in the blood. Many processes are involved in the glucose regulation, and their interactions are very complex. To better understand those processes we set ourselves a goal to create a Petri net model of the glucose regulation in the whole body. So far we have managed to create a model of glycolysis and synthesis of glucose in the liver, and the general overview models of the glucose regulation in a healthy and diabetic person. In this paper we introduce Petri nets models of insulin secretion in beta cell of the pancreas, and glucagon in the pancreas alpha cells. Those two hormones have mutually opposite effects: insulin preventing hyperglycemia, and glucagon preventing hypoglycemia. Understanding the mechanisms of insulin and glucagon secretion constitutes the basis for understanding diabetes. We also present a model in which both processes occur together, depending on the blood glucose level. The dynamics of each model is analysed. Additionally, we transform the overall insulin and glucagon secretion system to a Boolean network, following standard transformation rules.

Boosting 3D Liver Shape Datasets with Diffusion Models and Implicit Neural Representations

While the availability of open 3D medical shape datasets is increasing, offering substantial benefits to the research community, we have found that many of these datasets are, unfortunately, disorganized and contain artifacts. These issues limit the development and training of robust models, particularly for accurate 3D reconstruction tasks. In this paper, we examine the current state of available 3D liver shape datasets and propose a solution using diffusion models combined with implicit neural representations (INRs) to augment and expand existing datasets. Our approach utilizes the generative capabilities of diffusion models to create realistic, diverse 3D liver shapes, capturing a wide range of anatomical variations and addressing the problem of data scarcity. Experimental results indicate that our method enhances dataset diversity, providing a scalable solution to improve the accuracy and reliability of 3D liver reconstruction and generation in medical applications. Finally, we suggest that diffusion models can also be applied to other downstream tasks in 3D medical imaging.

Hybrid Approach Combining Ultrasound and Blood Test Analysis with a Voting Classifier for Accurate Liver Fibrosis and Cirrhosis Assessment

Liver cirrhosis is an insidious condition involving the substitution of normal liver tissue with fibrous scar tissue and causing major health complications. The conventional method of diagnosis using liver biopsy is invasive and, therefore, inconvenient for use in regular screening. In this paper,we present a hybrid model that combines machine learning techniques with clinical data and ultrasoundscans to improve liver fibrosis and cirrhosis detection accuracy is presented. The model integrates fixed blood test probabilities with deep learning model predictions (DenseNet-201) for ultrasonic images. The combined hybrid model achieved an accuracy of 92.5%. The findings establish the viability of the combined model in enhancing diagnosis accuracy and supporting early intervention in liver disease care.