Phuoc-Nguyen Bui

Phuoc-Nguyen Bui, Van-Vi Vo, Duc-Tai Le et al.

Long-term visual acuity (VA) outcomes after anti-VEGF therapy are central to patient counseling, expectation setting, and follow-up planning in diabetic macular edema (DME). However, in clinical practice, physicians must often estimate long-term visual trajectories based only on early post-treatment findings, making reliable prognostication difficult. Although prior OCT-based learning approaches have largely focused on short-term response or single-endpoint prediction, modeling VA trajectories across multiple future time points from early longitudinal observations remains insufficiently explored. In this study, we assembled a real-world cohort of 188 anti-VEGF-treated DME patients with paired baseline and month-1 OCT scans, along with tabular OCT-derived biomarkers and non-imaging clinical variables. Using only these early data, we formulate a multi-horizon VA forecasting problem aimed at predicting visual outcomes at 3, 6, 12, 18, and 24 months, reflecting clinically meaningful follow-up intervals. We propose ReVA, a response-aware multimodal framework that integrates structural features from baseline and month-1 OCT with the tabular variables to capture baseline disease status and early treatment response. ReVA uses spatial attention to preserve localized prognostic imaging features and a dependency-aware tabular encoder to model interactions among clinical variables. These multimodal representations are fused to predict patient-specific long-term visual acuity trajectories. The proposed framework achieves MAE=0.1246, RMSE=0.1621, and R^2=0.6064 for 24-month VA prediction, with consistent performance across all forecast horizons. Our findings show that incorporating early treatment-response signals enables clinically meaningful long-term visual acuity forecasting, supporting data-driven decision support for routine anti-VEGF management.

Dillan Imans, Phuoc-Nguyen Bui, Duc-Tai Le et al.

Retinal fundus imaging enables low-cost and scalable hypertension (HTN) screening, but HTN-related retinal cues are subtle, yielding high-variance predictions. Brain MRI provides stronger vascular and small-vessel-disease markers of HTN, yet it is expensive and rarely acquired alongside fundus images, resulting in modality-siloed datasets with disjoint MRI and fundus cohorts. We study this unpaired MRI-fundus regime and introduce Clinical Graph-Mediated Distillation (CGMD), a framework that transfers MRI-derived HTN knowledge to a fundus model without paired multimodal data. CGMD leverages shared structured biomarkers as a bridge by constructing a clinical similarity kNN graph spanning both cohorts. We train an MRI teacher, propagate its representations over the graph, and impute brain-informed representation targets for fundus patients. A fundus student is then trained with a joint objective combining HTN supervision, target distillation, and relational distillation. Experiments on our newly collected unpaired MRI-fundus-biomarker dataset show that CGMD consistently improves fundus-based HTN prediction over standard distillation and non-graph imputation baselines, with ablations confirming the importance of clinically grounded graph connectivity. Code is available at https://github.com/DillanImans/CGMD-unpaired-distillation.

Phuoc-Nguyen Bui, Toan Duc Nguyen, Junghyun Bum et al.

Medical contrastive vision-language pre-training (VLP) has demonstrated significant potential in improving performance on downstream tasks. Traditional approaches typically employ contrastive learning, treating paired image-report samples as positives and unpaired ones as negatives. However, in medical datasets, there can be substantial similarities between images or reports from different patients. Rigidly treating all unpaired samples as negatives, can disrupt the underlying semantic structure and negatively impact the quality of the learned representations. In this paper, we propose a multi-level alignment framework, Representation Learning with Semantic-aware Instance and Sparse Token Alignments (SISTA) by exploiting the semantic correspondence between medical image and radiology reports at two levels, i.e., image-report and patch-word levels. Specifically, we improve the conventional contrastive learning by incorporating inter-report similarity to eliminate the false negatives and introduce a method to effectively align image patches with relevant word tokens. Experimental results demonstrate the effectiveness of the proposed framework in improving transfer performance across different datasets on three downstream tasks: image classification, image segmentation, and object detection. Notably, our framework achieves significant improvements in fine-grained tasks even with limited labeled data. Codes and pre-trained models will be made available.

Phuoc-Nguyen Bui, Van-Nguyen Pham, Duc-Tai Le et al.

Medical image segmentation is a critical task in computer-aided diagnosis and treatment planning. However, deep learning models often struggle to generalize across datasets due to domain shifts arising from variations in imaging protocols, scanner types, and patient populations. Traditional domain generalization (DG) methods utilize causal feature learning, adversarial consistency, and style augmentation to improve segmentation robustness. While effective, these approaches rely on explicit feature alignment, adversarial objectives, or handcrafted augmentations, which may not fully exploit the capabilities of foundation models. Recently, the Segment Anything Model (SAM) has demonstrated strong generalization capabilities in segmentation tasks. SAM-based DG methods attempt to improve medical image segmentation. However, these approaches primarily operate in the spatial domain and overlook frequency-based discrepancies that significantly affect model robustness. In this work, we propose Frequency-based Domain Generalization with SAM (FSAM), a novel framework that integrates Low-Rank Adaptation (LoRA) for efficient fine-tuning and a frequency adapter to incorporate frequency-domain representations for single-source domain generalization. FSAM enhances SAM's segmentation robustness by extracting domain-invariant high-frequency features, mitigating frequency-related domain shifts. Experimental results on fundus and prostate datasets demonstrate that FSAM outperforms existing traditional DG and SAM-based DG approaches in domain generalization. Codes and pre-trained models will be made available on GitHub.

Phuoc-Nguyen Bui, Duc-Tai Le, Junghyun Bum et al.

Traditional deep learning methods in medical imaging often focus solely on segmentation or classification, limiting their ability to leverage shared information. Multi-task learning (MTL) addresses this by combining both tasks through shared representations but often struggles to balance local spatial features for segmentation and global semantic features for classification, leading to suboptimal performance. In this paper, we propose a simple yet effective UNet-based MTL model, where features extracted by the encoder are used to predict classification labels, while the decoder produces the segmentation mask. The model introduces an advanced encoder incorporating a novel ResFormer block that integrates local context from convolutional feature extraction with long-range dependencies modeled by the Transformer. This design captures broader contextual relationships and fine-grained details, improving classification and segmentation accuracy. To enhance classification performance, multi-scale features from different encoder levels are combined to leverage the hierarchical representation of the input image. For segmentation, the features passed to the decoder via skip connections are refined using a novel dilated feature enhancement (DFE) module, which captures information at different scales through three parallel convolution branches with varying dilation rates. This allows the decoder to detect lesions of varying sizes with greater accuracy. Experimental results across multiple medical datasets confirm the superior performance of our model in both segmentation and classification tasks, compared to state-of-the-art single-task and multi-task learning methods.

Khanh-Binh Nguyen, Phuoc-Nguyen Bui, Hyunseung Choo et al.

Vision-language models (VLMs) exhibit remarkable zero-shot generalization but suffer performance degradation under distribution shifts in downstream tasks, particularly in the absence of labeled data. Test-Time Adaptation (TTA) addresses this challenge by enabling online optimization of VLMs during inference, eliminating the need for annotated data. Cache-based TTA methods exploit historical knowledge by maintaining a dynamic memory cache of low-entropy or high-confidence samples, promoting efficient adaptation to out-of-distribution data. Nevertheless, these methods face two critical challenges: (1) unreliable confidence metrics under significant distribution shifts, resulting in error accumulation within the cache and degraded adaptation performance; and (2) rigid decision boundaries that fail to accommodate substantial distributional variations, leading to suboptimal predictions. To overcome these limitations, we introduce the Adaptive Cache Enhancement (ACE) framework, which constructs a robust cache by selectively storing high-confidence or low-entropy image embeddings per class, guided by dynamic, class-specific thresholds initialized from zero-shot statistics and iteratively refined using an exponential moving average and exploration-augmented updates. This approach enables adaptive, class-wise decision boundaries, ensuring robust and accurate predictions across diverse visual distributions. Extensive experiments on 15 diverse benchmark datasets demonstrate that ACE achieves state-of-the-art performance, delivering superior robustness and generalization compared to existing TTA methods in challenging out-of-distribution scenarios.

Phuoc-Nguyen Bui, Khanh-Binh Nguyen, Hyunseung Choo

Vision-language models (VLMs) like CLIP excel in zero-shot learning but often require resource-intensive training to adapt to new tasks. Prompt learning techniques, such as CoOp and CoCoOp, offer efficient adaptation but tend to overfit to known classes, limiting generalization to unseen categories. We introduce ProMIM, a plug-and-play framework that enhances conditional prompt learning by integrating masked image modeling (MIM) into existing VLM pipelines. ProMIM leverages a simple yet effective masking strategy to generate robust, instance-conditioned prompts, seamlessly augmenting methods like CoOp and CoCoOp without altering their core architectures. By masking only visible image patches and using these representations to guide prompt generation, ProMIM improves feature robustness and mitigates overfitting, all while introducing negligible additional computational cost. Extensive experiments across zero-shot and few-shot classification tasks demonstrate that ProMIM consistently boosts generalization performance when plugged into existing approaches, providing a practical, lightweight solution for real-world vision-language applications.

Phuoc-Nguyen Bui, Khanh-Binh Nguyen, Hyunseung Choo

Contrastive vision-language models excel in zero-shot image recognition but face challenges in few-shot scenarios due to computationally intensive offline fine-tuning using prompt learning, which risks overfitting. To overcome these limitations, we propose Attn-Adapter, a novel online few-shot learning framework that enhances CLIP's adaptability via a dual attention mechanism. Our design incorporates dataset-specific information through two components: the Memory Attn-Adapter, which refines category embeddings using support examples, and the Local-Global Attn-Adapter, which enriches image embeddings by integrating local and global features. This architecture enables dynamic adaptation from a few labeled samples without retraining the base model. Attn-Adapter outperforms state-of-the-art methods in cross-category and cross-dataset generalization, maintaining efficient inference and scaling across CLIP backbones.