Accurate segmentation of small lesions in Breast Dynamic Contrast-Enhanced MRI (DCE-MRI) is critical for early cancer detection, especially in high-risk patients. While recent deep learning methods have advanced lesion segmentation, they primarily target large lesions and neglect valuable longitudinal and clinical information routinely used by radiologists. In real-world screening, detecting subtle or emerging lesions requires radiologists to compare across timepoints and consider previous radiology assessments, such as the BI-RADS score. We propose LesiOnTime, a novel 3D segmentation approach that mimics clinical diagnostic workflows by jointly leveraging longitudinal imaging and BIRADS scores. The key components are: (1) a Temporal Prior Attention (TPA) block that dynamically integrates information from previous and current scans; and (2) a BI-RADS Consistency Regularization (BCR) loss that enforces latent space alignment for scans with similar radiological assessments, thus embedding domain knowledge into the training process. Evaluated on a curated in-house longitudinal dataset of high-risk patients with DCE-MRI, our approach outperforms state-of-the-art single-timepoint and longitudinal baselines by 5% in terms of Dice. Ablation studies demonstrate that both TPA and BCR contribute complementary performance gains. These results highlight the importance of incorporating temporal and clinical context for reliable early lesion segmentation in real-world breast cancer screening. Our code is publicly available at https://github.com/cirmuw/LesiOnTime

Reducing MRI scan times can improve patient care and lower healthcare costs. Many acceleration methods are designed to reconstruct diagnostic-quality images from sparse k-space data, via an ill-posed or ill-conditioned linear inverse problem (LIP). To address the resulting ambiguities, it is crucial to incorporate prior knowledge into the optimization problem, e.g., in the form of regularization. Another form of prior knowledge less commonly used in medical imaging is the readily available auxiliary data (a.k.a. side information) obtained from sources other than the current acquisition. In this paper, we present the Trust-Guided Variational Network (TGVN), an end-to-end deep learning framework that effectively and reliably integrates side information into LIPs. We demonstrate its effectiveness in multi-coil, multi-contrast MRI reconstruction, where incomplete or low-SNR measurements from one contrast are used as side information to reconstruct high-quality images of another contrast from heavily under-sampled data. TGVN is robust across different contrasts, anatomies, and field strengths. Compared to baselines utilizing side information, TGVN achieves superior image quality while preserving subtle pathological features even at challenging acceleration levels, drastically speeding up acquisition while minimizing hallucinations. Source code and dataset splits are available on github.com/sodicksonlab/TGVN.

Existing volumetric medical image segmentation models are typically task-specific, excelling at specific targets but struggling to generalize across anatomical structures or modalities. This limitation restricts their broader clinical use. In this article, we introduce segment anything model (SAM)-Med3D, a vision foundation model (VFM) for general-purpose segmentation on volumetric medical images. Given only a few 3-D prompt points, SAM-Med3D can accurately segment diverse anatomical structures and lesions across various modalities. To achieve this, we gather and preprocess a large-scale 3-D medical image segmentation dataset, SA-Med3D-140K, from 70 public datasets and 8K licensed private cases from hospitals. This dataset includes 22K 3-D images and 143K corresponding masks. SAM-Med3D, a promptable segmentation model characterized by its fully learnable 3-D structure, is trained on this dataset using a two-stage procedure and exhibits impressive performance on both seen and unseen segmentation targets. We comprehensively evaluate SAM-Med3D on 16 datasets covering diverse medical scenarios, including different anatomical structures, modalities, targets, and zero-shot transferability to new/unseen tasks. The evaluation demonstrates the efficiency and efficacy of SAM-Med3D, as well as its promising application to diverse downstream tasks as a pretrained model. Our approach illustrates that substantial medical resources can be harnessed to develop a general-purpose medical AI for various potential applications. Our dataset, code, and models are available at: https://github.com/uni-medical/SAM-Med3D.

Medical image annotation is constrained by privacy concerns and labor-intensive labeling, significantly limiting the performance and generalization of segmentation models. While mask-controllable diffusion models excel in synthesis, they struggle with precise lesion-mask alignment. We propose \textbf{Adaptively Distilled ControlNet}, a task-agnostic framework that accelerates training and optimization through dual-model distillation. Specifically, during training, a teacher model, conditioned on mask-image pairs, regularizes a mask-only student model via predicted noise alignment in parameter space, further enhanced by adaptive regularization based on lesion-background ratios. During sampling, only the student model is used, enabling privacy-preserving medical image generation. Comprehensive evaluations on two distinct medical datasets demonstrate state-of-the-art performance: TransUNet improves mDice/mIoU by 2.4%/4.2% on KiTS19, while SANet achieves 2.6%/3.5% gains on Polyps, highlighting its effectiveness and superiority. Code is available at GitHub.

Access to medical imaging and associated text data has the potential to drive major advances in healthcare research and patient outcomes. However, the presence of Protected Health Information (PHI) and Personally Identifiable Information (PII) in Digital Imaging and Communications in Medicine (DICOM) files presents a significant barrier to the ethical and secure sharing of imaging datasets. This paper presents a hybrid de-identification framework developed by Impact Business Information Solutions (IBIS) that combines rule-based and AI-driven techniques, and rigorous uncertainty quantification for comprehensive PHI/PII removal from both metadata and pixel data. Our approach begins with a two-tiered rule-based system targeting explicit and inferred metadata elements, further augmented by a large language model (LLM) fine-tuned for Named Entity Recognition (NER), and trained on a suite of synthetic datasets simulating realistic clinical PHI/PII. For pixel data, we employ an uncertainty-aware Faster R-CNN model to localize embedded text, extract candidate PHI via Optical Character Recognition (OCR), and apply the NER pipeline for final redaction. Crucially, uncertainty quantification provides confidence measures for AI-based detections to enhance automation reliability and enable informed human-in-the-loop verification to manage residual risks. This uncertainty-aware deidentification framework achieves robust performance across benchmark datasets and regulatory standards, including DICOM, HIPAA, and TCIA compliance metrics. By combining scalable automation, uncertainty quantification, and rigorous quality assurance, our solution addresses critical challenges in medical data de-identification and supports the secure, ethical, and trustworthy release of imaging data for research.

Teacher-Student (TS) networks have become the mainstream frameworks of semi-supervised deep learning, and are widely used in medical image segmentation. However, traditional TSs based on single or homogeneous encoders often struggle to capture the rich semantic details required for complex, fine-grained tasks. To address this, we propose a novel semi-supervised medical image segmentation framework (IHE-Net), which makes good use of the feature discrepancies of two heterogeneous encoders to improve segmentation performance. The two encoders are instantiated by different learning paradigm networks, namely CNN and Transformer/Mamba, respectively, to extract richer and more robust context representations from unlabeled data. On this basis, we propose a simple yet powerful multi-level feature discrepancy fusion module (MFDF), which effectively integrates different modal features and their discrepancies from two heterogeneous encoders. This design enhances the representational capacity of the model through efficient fusion without introducing additional computational overhead. Furthermore, we introduce a triple consistency learning strategy to improve predictive stability by setting dual decoders and adding mixed output consistency. Extensive experimental results on three skin lesion segmentation datasets, ISIC2017, ISIC2018, and PH2, demonstrate the superiority of our framework. Ablation studies further validate the rationale and effectiveness of the proposed method. Code is available at: https://github.com/joey-AI-medical-learning/IHE-Net.

Accurate fetal biometric measurements, such as abdominal circumference, play a vital role in prenatal care. However, obtaining high-quality ultrasound images for these measurements heavily depends on the expertise of sonographers, posing a significant challenge in low-income countries due to the scarcity of trained personnel. To address this issue, we leverage FetalCLIP, a vision-language model pretrained on a curated dataset of over 210,000 fetal ultrasound image-caption pairs, to perform automated fetal ultrasound image quality assessment (IQA) on blind-sweep ultrasound data. We introduce FetalCLIP$_{CLS}$, an IQA model adapted from FetalCLIP using Low-Rank Adaptation (LoRA), and evaluate it on the ACOUSLIC-AI dataset against six CNN and Transformer baselines. FetalCLIP$_{CLS}$ achieves the highest F1 score of 0.757. Moreover, we show that an adapted segmentation model, when repurposed for classification, further improves performance, achieving an F1 score of 0.771. Our work demonstrates how parameter-efficient fine-tuning of fetal ultrasound foundation models can enable task-specific adaptations, advancing prenatal care in resource-limited settings. The experimental code is available at: https://github.com/donglihe-hub/FetalCLIP-IQA.

Accurate and reliable brain tumor segmentation, particularly when dealing with missing modalities, remains a critical challenge in medical image analysis. Previous studies have not fully resolved the challenges of tumor boundary segmentation insensitivity and feature transfer in the absence of key imaging modalities. In this study, we introduce MST-KDNet, aimed at addressing these critical issues. Our model features Multi-Scale Transformer Knowledge Distillation to effectively capture attention weights at various resolutions, Dual-Mode Logit Distillation to improve the transfer of knowledge, and a Global Style Matching Module that integrates feature matching with adversarial learning. Comprehensive experiments conducted on the BraTS and FeTS 2024 datasets demonstrate that MST-KDNet surpasses current leading methods in both Dice and HD95 scores, particularly in conditions with substantial modality loss. Our approach shows exceptional robustness and generalization potential, making it a promising candidate for real-world clinical applications. Our source code is available at https://github.com/Quanato607/MST-KDNet.

Mitochondrial morphology and structural changes are closely associated with metabolic dysfunction and disease progression. However, the structural complexity of mitochondria presents a major challenge for accurate segmentation and analysis. Most existing methods focus on delineating entire mitochondria but lack the capability to resolve fine internal features, particularly cristae. In this study, we introduce MitoStructSeg, a deep learning-based framework for mitochondrial structure segmentation and quantitative analysis. The core of MitoStructSeg is AMM-Seg, a novel model that integrates domain adaptation to improve cross-sample generalization, dual-channel feature fusion to enhance structural detail extraction, and continuity learning to preserve spatial coherence. This architecture enables accurate segmentation of both mitochondrial membranes and intricately folded cristae. MitoStructSeg further incorporates a quantitative analysis module that extracts key morphological metrics, including surface area, volume, and cristae density, allowing comprehensive and scalable assessment of mitochondrial morphology. The effectiveness of our approach has been validated on both human myocardial tissue and mouse kidney tissue, demonstrating its robustness in accurately segmenting mitochondria with diverse morphologies. In addition, we provide an open source, user-friendly tool to ensure practical usability.

The Artificial Intelligence in Medical Imaging (AIMI) initiative aims to enhance the National Cancer Institute's (NCI) Image Data Commons (IDC) by releasing fully reproducible nnU-Net models, along with AI-assisted segmentation for cancer radiology images. In this extension of our earlier work, we created high-quality, AI-annotated imaging datasets for 11 IDC collections, spanning computed tomography (CT) and magnetic resonance imaging (MRI) of the lungs, breast, brain, kidneys, prostate, and liver. Each nnU-Net model was trained on open-source datasets, and a portion of the AI-generated annotations was reviewed and corrected by board-certified radiologists. Both the AI and radiologist annotations were encoded in compliance with the Digital Imaging and Communications in Medicine (DICOM) standard, ensuring seamless integration into the IDC collections. By making these models, images, and annotations publicly accessible, we aim to facilitate further research and development in cancer imaging.