Semi-Supervised Domain Adaptation with Latent Diffusion for Pathology Image Classification

Deep learning models in computational pathology often fail to generalize across cohorts and institutions due to domain shift. Existing approaches either fail to leverage unlabeled data from the target domain or rely on image-to-image translation, which can distort tissue structures and compromise model accuracy. In this work, we propose a semi-supervised domain adaptation (SSDA) framework that utilizes a latent diffusion model trained on unlabeled data from both the source and target domains to generate morphology-preserving and target-aware synthetic images. By conditioning the diffusion model on foundation model features, cohort identity, and tissue preparation method, we preserve tissue structure in the source domain while introducing target-domain appearance characteristics. The target-aware synthetic images, combined with real, labeled images from the source cohort, are subsequently used to train a downstream classifier, which is then tested on the target cohort. The effectiveness of the proposed SSDA framework is demonstrated on the task of lung adenocarcinoma prognostication. The proposed augmentation yielded substantially better performance on the held-out test set from the target cohort, without degrading source-cohort performance. The approach improved the weighted F1 score on the target-cohort held-out test set from 0.611 to 0.706 and the macro F1 score from 0.641 to 0.716. Our results demonstrate that target-aware diffusion-based synthetic data augmentation provides a promising and effective approach for improving domain generalization in computational pathology.

SAGE: Agentic Framework for Interpretable and Clinically Translatable Computational Pathology Biomarker Discovery

Despite significant progress in computational pathology, many AI models remain black-box and difficult to interpret, posing a major barrier to clinical adoption due to limited transparency and explainability. This has motivated continued interest in engineered image-based biomarkers, which offer greater interpretability but are often proposed based on anecdotal evidence or fragmented prior literature rather than systematic biological validation. We introduce SAGE (Structured Agentic system for hypothesis Generation and Evaluation), an agentic AI system designed to identify interpretable, engineered pathology biomarkers by grounding them in biological evidence. SAGE integrates literature-anchored reasoning with multimodal data analysis to correlate image-derived features with molecular biomarkers, such as gene expression, and clinically relevant outcomes. By coordinating specialized agents for biological contextualization and empirical hypothesis validation, SAGE prioritizes transparent, biologically supported biomarkers and advances the clinical translation of computational pathology.

Cross-Domain Object Detection Using Unsupervised Image Translation

Unsupervised domain adaptation for object detection addresses the adaption of detectors trained in a source domain to work accurately in an unseen target domain. Recently, methods approaching the alignment of the intermediate features proven to be promising, achieving state-of-the-art results. However, these methods are laborious to implement and hard to interpret. Although promising, there is still room for improvements to close the performance gap toward the upper-bound (when training with the target data). In this work, we propose a method to generate an artificial dataset in the target domain to train an object detector. We employed two unsupervised image translators (CycleGAN and an AdaIN-based model) using only annotated data from the source domain and non-annotated data from the target domain. Our key contributions are the proposal of a less complex yet more effective method that also has an improved interpretability. Results on real-world scenarios for autonomous driving show significant improvements, outperforming state-of-the-art methods in most cases, further closing the gap toward the upper-bound.

PAINT: Pathology-Aware Integrated Next-Scale Transformation for Virtual Immunohistochemistry

Virtual immunohistochemistry (IHC) aims to computationally synthesize molecular staining patterns from routine Hematoxylin and Eosin (H\&E) images, offering a cost-effective and tissue-efficient alternative to traditional physical staining. However, this task is particularly challenging: H\&E morphology provides ambiguous cues about protein expression, and similar tissue structures may correspond to distinct molecular states. Most existing methods focus on direct appearance synthesis to implicitly achieve cross-modal generation, often resulting in semantic inconsistencies due to insufficient structural priors. In this paper, we propose Pathology-Aware Integrated Next-Scale Transformation (PAINT), a visual autoregressive framework that reformulates the synthesis process as a structure-first conditional generation task. Unlike direct image translation, PAINT enforces a causal order by resolving molecular details conditioned on a global structural layout. Central to this approach is the introduction of a Spatial Structural Start Map (3S-Map), which grounds the autoregressive initialization in observed morphology, ensuring deterministic, spatially aligned synthesis. Experiments on the IHC4BC and MIST datasets demonstrate that PAINT outperforms state-of-the-art methods in structural fidelity and clinical downstream tasks, validating the potential of structure-guided autoregressive modeling.

Sim2real Image Translation Enables Viewpoint-Robust Policies from Fixed-Camera Datasets

Vision-based policies for robot manipulation have achieved significant recent success, but are still brittle to distribution shifts such as camera viewpoint variations. Robot demonstration data is scarce and often lacks appropriate variation in camera viewpoints. Simulation offers a way to collect robot demonstrations at scale with comprehensive coverage of different viewpoints, but presents a visual sim2real challenge. To bridge this gap, we propose MANGO -- an unpaired image translation method with a novel segmentation-conditioned InfoNCE loss, a highly-regularized discriminator design, and a modified PatchNCE loss. We find that these elements are crucial for maintaining viewpoint consistency during sim2real translation. When training MANGO, we only require a small amount of fixed-camera data from the real world, but show that our method can generate diverse unseen viewpoints by translating simulated observations. In this domain, MANGO outperforms all other image translation methods we tested. Imitation-learning policies trained on data augmented by MANGO are able to achieve success rates as high as 60\% on views that the non-augmented policy fails completely on.

A General Model for Retinal Segmentation and Quantification

Retinal imaging is fast, non-invasive, and widely available, offering quantifiable structural and vascular signals for ophthalmic and systemic health assessment. This accessibility creates an opportunity to study how quantitative retinal phenotypes relate to ocular and systemic diseases. However, such analyses remain difficult at scale due to the limited availability of public multi-label datasets and the lack of a unified segmentation-to-quantification pipeline. We present RetSAM, a general retinal segmentation and quantification framework for fundus imaging. It delivers robust multi-target segmentation and standardized biomarker extraction, supporting downstream ophthalmologic studies and oculomics correlation analyses. Trained on over 200,000 fundus images, RetSAM supports three task categories and segments five anatomical structures, four retinal phenotypic patterns, and more than 20 distinct lesion types. It converts these segmentation results into over 30 standardized biomarkers that capture structural morphology, vascular geometry, and degenerative changes. Trained with a multi-stage strategy using both private and public fundus data, RetSAM achieves superior segmentation performance on 17 public datasets. It improves on prior best methods by 3.9 percentage points in DSC on average, with up to 15 percentage points on challenging multi-task benchmarks, and generalizes well across diverse populations, imaging devices, and clinical settings. The resulting biomarkers enable systematic correlation analyses across major ophthalmic diseases, including diabetic retinopathy, age-related macular degeneration, glaucoma, and pathologic myopia. Together, RetSAM transforms fundus images into standardized, interpretable quantitative phenotypes, enabling large-scale ophthalmic research and translation.

Predicting Camera Pose from Perspective Descriptions for Spatial Reasoning

Multi-image spatial reasoning remains challenging for current multimodal large language models (MLLMs). While single-view perception is inherently 2D, reasoning over multiple views requires building a coherent scene understanding across viewpoints. In particular, we study perspective taking, where a model must build a coherent 3D understanding from multi-view observations and use it to reason from a new, language-specified viewpoint. We introduce CAMCUE, a pose-aware multi-image framework that uses camera pose as an explicit geometric anchor for cross-view fusion and novel-view reasoning. CAMCUE injects per-view pose into visual tokens, grounds natural-language viewpoint descriptions to a target camera pose, and synthesizes a pose-conditioned imagined target view to support answering. To support this setting, we curate CAMCUE-DATA with 27,668 training and 508 test instances pairing multi-view images and poses with diverse target-viewpoint descriptions and perspective-shift questions. We also include human-annotated viewpoint descriptions in the test split to evaluate generalization to human language. CAMCUE improves overall accuracy by 9.06% and predicts target poses from natural-language viewpoint descriptions with over 90% rotation accuracy within 20° and translation accuracy within a 0.5 error threshold. This direct grounding avoids expensive test-time search-and-match, reducing inference time from 256.6s to 1.45s per example and enabling fast, interactive use in real-world scenarios.

Performance uncertainty in medical image analysis: a large-scale investigation of confidence intervals

Performance uncertainty quantification is essential for reliable validation and eventual clinical translation of medical imaging artificial intelligence (AI). Confidence intervals (CIs) play a central role in this process by indicating how precise a reported performance estimate is. Yet, due to the limited amount of work examining CI behavior in medical imaging, the community remains largely unaware of how many diverse CI methods exist and how they behave in specific settings. The purpose of this study is to close this gap. To this end, we conducted a large-scale empirical analysis across a total of 24 segmentation and classification tasks, using 19 trained models per task group, a broad spectrum of commonly used performance metrics, multiple aggregation strategies, and several widely adopted CI methods. Reliability (coverage) and precision (width) of each CI method were estimated across all settings to characterize their dependence on study characteristics. Our analysis revealed five principal findings: 1) the sample size required for reliable CIs varies from a few dozens to several thousands of cases depending on study parameters; 2) CI behavior is strongly affected by the choice of performance metric; 3) aggregation strategy substantially influences the reliability of CIs, e.g. they require more observations for macro than for micro; 4) the machine learning problem (segmentation versus classification) modulates these effects; 5) different CI methods are not equally reliable and precise depending on the use case. These results form key components for the development of future guidelines on reporting performance uncertainty in medical imaging AI.

Language-Grounded Multi-Domain Image Translation via Semantic Difference Guidance

Multi-domain image-to-image translation re quires grounding semantic differences ex pressed in natural language prompts into corresponding visual transformations, while preserving unrelated structural and seman tic content. Existing methods struggle to maintain structural integrity and provide fine grained, attribute-specific control, especially when multiple domains are involved. We propose LACE (Language-grounded Attribute Controllable Translation), built on two compo nents: (1) a GLIP-Adapter that fuses global semantics with local structural features to pre serve consistency, and (2) a Multi-Domain Control Guidance mechanism that explicitly grounds the semantic delta between source and target prompts into per-attribute translation vec tors, aligning linguistic semantics with domain level visual changes. Together, these modules enable compositional multi-domain control with independent strength modulation for each attribute. Experiments on CelebA(Dialog) and BDD100K demonstrate that LACE achieves high visual fidelity, structural preservation, and interpretable domain-specific control, surpass ing prior baselines. This positions LACE as a cross-modal content generation framework bridging language semantics and controllable visual translation.

SRU-Pix2Pix: A Fusion-Driven Generator Network for Medical Image Translation with Few-Shot Learning

Magnetic Resonance Imaging (MRI) provides detailed tissue information, but its clinical application is limited by long acquisition time, high cost, and restricted resolution. Image translation has recently gained attention as a strategy to address these limitations. Although Pix2Pix has been widely applied in medical image translation, its potential has not been fully explored. In this study, we propose an enhanced Pix2Pix framework that integrates Squeeze-and-Excitation Residual Networks (SEResNet) and U-Net++ to improve image generation quality and structural fidelity. SEResNet strengthens critical feature representation through channel attention, while U-Net++ enhances multi-scale feature fusion. A simplified PatchGAN discriminator further stabilizes training and refines local anatomical realism. Experimental results demonstrate that under few-shot conditions with fewer than 500 images, the proposed method achieves consistent structural fidelity and superior image quality across multiple intra-modality MRI translation tasks, showing strong generalization ability. These results suggest an effective extension of Pix2Pix for medical image translation.