The clinical utility of deep learning models for medical image segmentation is severely constrained by their inability to generalize to unseen domains. This failure is often rooted in the models learning spurious correlations between anatomical content and domain-specific imaging styles. To overcome this fundamental challenge, we introduce Causal-SAM-LLM, a novel framework that elevates Large Language Models (LLMs) to the role of causal reasoners. Our framework, built upon a frozen Segment Anything Model (SAM) encoder, incorporates two synergistic innovations. First, Linguistic Adversarial Disentanglement (LAD) employs a Vision-Language Model to generate rich, textual descriptions of confounding image styles. By training the segmentation model's features to be contrastively dissimilar to these style descriptions, it learns a representation robustly purged of non-causal information. Second, Test-Time Causal Intervention (TCI) provides an interactive mechanism where an LLM interprets a clinician's natural language command to modulate the segmentation decoder's features in real-time, enabling targeted error correction. We conduct an extensive empirical evaluation on a composite benchmark from four public datasets (BTCV, CHAOS, AMOS, BraTS), assessing generalization under cross-scanner, cross-modality, and cross-anatomy settings. Causal-SAM-LLM establishes a new state of the art in out-of-distribution (OOD) robustness, improving the average Dice score by up to 6.2 points and reducing the Hausdorff Distance by 15.8 mm over the strongest baseline, all while using less than 9% of the full model's trainable parameters. Our work charts a new course for building robust, efficient, and interactively controllable medical AI systems.

Brain stroke is one of the leading causes of mortality and long-term disability worldwide, highlighting the need for precise and fast prediction techniques. Computed Tomography (CT) scan is considered one of the most effective methods for diagnosing brain strokes. The majority of stroke classification techniques rely on a single slice-level prediction mechanism, allowing the radiologist to manually choose the most critical CT slice from the original CT volume. Although clinical evaluations are often used in traditional diagnostic procedures, machine learning (ML) has opened up new avenues for improving stroke diagnosis. To supplement traditional diagnostic techniques, this study investigates the use of machine learning models, specifically concerning the prediction of brain stroke at an early stage utilizing CT scan images. In this research, we proposed a novel approach to brain stroke detection leveraging machine learning techniques, focusing on optimizing classification performance with pre-trained deep learning models and advanced optimization strategies. Pre-trained models, including DenseNet201, InceptionV3, MobileNetV2, ResNet50, and Xception, are utilized for feature extraction. Additionally, we employed feature engineering techniques, including BFO, PCA, and LDA, to enhance models' performance further. These features are subsequently classified using machine learning algorithms such as SVC, RF, XGB, DT, LR, KNN, and GNB. Our experiments demonstrate that the combination of MobileNetV2, LDA, and SVC achieved the highest classification accuracy of 97.93%, significantly outperforming other model-optimizer-classifier combinations. The results underline the effectiveness of integrating lightweight pre-trained models with robust optimization and classification techniques for brain stroke diagnosis.

Image quality assessment (IQA) is crucial in the evaluation stage of novel algorithms operating on images, including traditional and machine learning based methods. Due to the lack of available quality-rated medical images, most commonly used IQA methods employing reference images (i.e. full-reference IQA) have been developed and tested for natural images. Reported application inconsistencies arising when employing such measures for medical images are not surprising, as they rely on different properties than natural images. In photoacoustic imaging (PAI), especially, standard benchmarking approaches for assessing the quality of image reconstructions are lacking. PAI is a multi-physics imaging modality, in which two inverse problems have to be solved, which makes the application of IQA measures uniquely challenging due to both, acoustic and optical, artifacts. To support the development and testing of full- and no-reference IQA measures we assembled PhotIQA, a data set consisting of 1134 reconstructed photoacoustic (PA) images that were rated by 2 experts across five quality properties (overall quality, edge visibility, homogeneity, inclusion and background intensity), where the detailed rating enables usage beyond PAI. To allow full-reference assessment, highly characterised imaging test objects were used, providing a ground truth. Our baseline experiments show that HaarPSI$_{med}$ significantly outperforms SSIM in correlating with the quality ratings (SRCC: 0.83 vs. 0.62). The dataset is publicly available at https://doi.org/10.5281/zenodo.13325196.

Prostate cancer (PCa) is a leading cause of cancer-related mortality in men, and accurate identification of clinically significant PCa (csPCa) is critical for timely intervention. Transrectal ultrasound (TRUS) is widely used for prostate biopsy; however, its low contrast and anisotropic spatial resolution pose diagnostic challenges. To address these limitations, we propose a novel hybrid-view attention (HVA) network for csPCa classification in 3D TRUS that leverages complementary information from transverse and sagittal views. Our approach integrates a CNN-transformer hybrid architecture, where convolutional layers extract fine-grained local features and transformer-based HVA models global dependencies. Specifically, the HVA comprises intra-view attention to refine features within a single view and cross-view attention to incorporate complementary information across views. Furthermore, a hybrid-view adaptive fusion module dynamically aggregates features along both channel and spatial dimensions, enhancing the overall representation. Experiments are conducted on an in-house dataset containing 590 subjects who underwent prostate biopsy. Comparative and ablation results prove the efficacy of our method. The code is available at https://github.com/mock1ngbrd/HVAN.

Magnetic Resonance Fingerprinting (MRF) enables fast quantitative imaging by matching signal evolutions to a predefined dictionary. However, conventional dictionary matching suffers from exponential growth in computational cost and memory usage as the number of parameters increases, limiting its scalability to multi-parametric mapping. To address this, recent work has explored deep learning-based approaches as alternatives to DM. We propose GAST-Mamba, an end-to-end framework that combines a dual Mamba-based encoder with a Gate-Aware Spatial-Temporal (GAST) processor. Built on structured state-space models, our architecture efficiently captures long-range spatial dependencies with linear complexity. On 5 times accelerated simulated MRF data (200 frames), GAST-Mamba achieved a T1 PSNR of 33.12~dB, outperforming SCQ (31.69~dB). For T2 mapping, it reached a PSNR of 30.62~dB and SSIM of 0.9124. In vivo experiments further demonstrated improved anatomical detail and reduced artifacts. Ablation studies confirmed that each component contributes to performance, with the GAST module being particularly important under strong undersampling. These results demonstrate the effectiveness of GAST-Mamba for accurate and robust reconstruction from highly undersampled MRF acquisitions, offering a scalable alternative to traditional DM-based methods.

Prostate cancer (PCa) is a leading cause of cancer-related mortality in men, and accurate identification of clinically significant PCa (csPCa) is critical for timely intervention. Transrectal ultrasound (TRUS) is widely used for prostate biopsy; however, its low contrast and anisotropic spatial resolution pose diagnostic challenges. To address these limitations, we propose a novel hybrid-view attention (HVA) network for csPCa classification in 3D TRUS that leverages complementary information from transverse and sagittal views. Our approach integrates a CNN-transformer hybrid architecture, where convolutional layers extract fine-grained local features and transformer-based HVA models global dependencies. Specifically, the HVA comprises intra-view attention to refine features within a single view and cross-view attention to incorporate complementary information across views. Furthermore, a hybrid-view adaptive fusion module dynamically aggregates features along both channel and spatial dimensions, enhancing the overall representation. Experiments are conducted on an in-house dataset containing 590 subjects who underwent prostate biopsy. Comparative and ablation results prove the efficacy of our method. The code is available at https://github.com/mock1ngbrd/HVAN.

Recent evidence suggests that modeling higher-order interactions (HOIs) in functional magnetic resonance imaging (fMRI) data can enhance the diagnostic accuracy of machine learning systems. However, effectively extracting and utilizing HOIs remains a significant challenge. In this work, we propose MvHo-IB, a novel multi-view learning framework that integrates both pairwise interactions and HOIs for diagnostic decision-making, while automatically compressing task-irrelevant redundant information. MvHo-IB introduces several key innovations: (1) a principled method that combines O-information from information theory with a matrix-based Renyi alpha-order entropy estimator to quantify and extract HOIs, (2) a purpose-built Brain3DCNN encoder to effectively utilize these interactions, and (3) a new multi-view learning information bottleneck objective to enhance representation learning. Experiments on three benchmark fMRI datasets demonstrate that MvHo-IB achieves state-of-the-art performance, significantly outperforming previous methods, including recent hypergraph-based techniques. The implementation of MvHo-IB is available at https://github.com/zky04/MvHo-IB.

Deep Learning (DL) has revolutionized medical imaging, yet its adoption is constrained by data scarcity and privacy regulations, limiting access to diverse datasets. Federated Learning (FL) enables decentralized training but suffers from high communication costs and is often restricted to a single downstream task, reducing flexibility. We propose a data-sharing method via Differentially Private (DP) generative models. By adopting foundation models, we extract compact, informative embeddings, reducing redundancy and lowering computational overhead. Clients collaboratively train a Differentially Private Conditional Variational Autoencoder (DP-CVAE) to model a global, privacy-aware data distribution, supporting diverse downstream tasks. Our approach, validated across multiple feature extractors, enhances privacy, scalability, and efficiency, outperforming traditional FL classifiers while ensuring differential privacy. Additionally, DP-CVAE produces higher-fidelity embeddings than DP-CGAN while requiring $5{\times}$ fewer parameters.

Echocardiography (echo) plays an indispensable role in the clinical practice of heart diseases. However, ultrasound imaging typically provides only two-dimensional (2D) cross-sectional images from a few specific views, making it challenging to interpret and inaccurate for estimation of clinical parameters like the volume of left ventricle (LV). 3D ultrasound imaging provides an alternative for 3D quantification, but is still limited by the low spatial and temporal resolution and the highly demanding manual delineation. To address these challenges, we propose an innovative framework for reconstructing personalized 3D heart anatomy from 2D echo slices that are frequently used in clinical practice. Specifically, a novel 3D reconstruction pipeline is designed, which alternatively optimizes between the 3D pose estimation of these 2D slices and the 3D integration of these slices using an implicit neural network, progressively transforming a prior 3D heart shape into a personalized 3D heart model. We validate the method with two datasets. When six planes are used, the reconstructed 3D heart can lead to a significant improvement for LV volume estimation over the bi-plane method (error in percent: 1.98\% VS. 20.24\%). In addition, the whole reconstruction framework makes even an important breakthrough that can estimate RV volume from 2D echo slices (with an error of 5.75\% ). This study provides a new way for personalized 3D structure and function analysis from cardiac ultrasound and is of great potential in clinical practice.

Pixel-wise annotations are notoriously labourious and costly to obtain in the medical domain. To mitigate this burden, weakly supervised approaches based on bounding box annotations-much easier to acquire-offer a practical alternative. Vision foundation models have recently shown noteworthy segmentation performance when provided with prompts such as points or bounding boxes. Prompt learning exploits these models by adapting them to downstream tasks and automating segmentation, thereby reducing user intervention. However, existing prompt learning approaches depend on fully annotated segmentation masks. This paper proposes a novel framework that combines the representational power of foundation models with the annotation efficiency of weakly supervised segmentation. More specifically, our approach automates prompt generation for foundation models using only bounding box annotations. Our proposed optimization scheme integrates multiple constraints derived from box annotations with pseudo-labels generated by the prompted foundation model. Extensive experiments across multimodal datasets reveal that our weakly supervised method achieves an average Dice score of 84.90% in a limited data setting, outperforming existing fully-supervised and weakly-supervised approaches. The code is available at https://github.com/Minimel/box-prompt-learning-VFM.git