Sekeun Kim

Cheng Chen, Juzheng Miao, Dufan Wu et al.

The Segment Anything Model (SAM), a foundation model for general image segmentation, has demonstrated impressive zero-shot performance across numerous natural image segmentation tasks. However, SAM's performance significantly declines when applied to medical images, primarily due to the substantial disparity between natural and medical image domains. To effectively adapt SAM to medical images, it is important to incorporate critical third-dimensional information, i.e., volumetric or temporal knowledge, during fine-tuning. Simultaneously, we aim to harness SAM's pre-trained weights within its original 2D backbone to the fullest extent. In this paper, we introduce a modality-agnostic SAM adaptation framework, named as MA-SAM, that is applicable to various volumetric and video medical data. Our method roots in the parameter-efficient fine-tuning strategy to update only a small portion of weight increments while preserving the majority of SAM's pre-trained weights. By injecting a series of 3D adapters into the transformer blocks of the image encoder, our method enables the pre-trained 2D backbone to extract third-dimensional information from input data. The effectiveness of our method has been comprehensively evaluated on four medical image segmentation tasks, by using 10 public datasets across CT, MRI, and surgical video data. Remarkably, without using any prompt, our method consistently outperforms various state-of-the-art 3D approaches, surpassing nnU-Net by 0.9%, 2.6%, and 9.9% in Dice for CT multi-organ segmentation, MRI prostate segmentation, and surgical scene segmentation respectively. Our model also demonstrates strong generalization, and excels in challenging tumor segmentation when prompts are used. Our code is available at: https://github.com/cchen-cc/MA-SAM.

Zhengliang Liu, Aoxiao Zhong, Yiwei Li et al.

We introduce Radiology-GPT, a large language model for radiology. Using an instruction tuning approach on an extensive dataset of radiology domain knowledge, Radiology-GPT demonstrates superior performance compared to general language models such as StableLM, Dolly and LLaMA. It exhibits significant versatility in radiological diagnosis, research, and communication. This work serves as a catalyst for future developments in clinical NLP. The successful implementation of Radiology-GPT is indicative of the potential of localizing generative large language models, specifically tailored for distinctive medical specialties, while ensuring adherence to privacy standards such as HIPAA. The prospect of developing individualized, large-scale language models that cater to specific needs of various hospitals presents a promising direction. The fusion of conversational competence and domain-specific knowledge in these models is set to foster future development in healthcare AI. A demo of Radiology-GPT is available at https://huggingface.co/spaces/allen-eric/radiology-gpt.

Zhengliang Liu, Yiwei Li, Peng Shu et al.

This paper introduces Radiology-Llama2, a large language model specialized for radiology through a process known as instruction tuning. Radiology-Llama2 is based on the Llama2 architecture and further trained on a large dataset of radiology reports to generate coherent and clinically useful impressions from radiological findings. Quantitative evaluations using ROUGE metrics on the MIMIC-CXR and OpenI datasets demonstrate that Radiology-Llama2 achieves state-of-the-art performance compared to other generative language models, with a Rouge-1 score of 0.4834 on MIMIC-CXR and 0.4185 on OpenI. Additional assessments by radiology experts highlight the model's strengths in understandability, coherence, relevance, conciseness, and clinical utility. The work illustrates the potential of localized language models designed and tuned for specialized domains like radiology. When properly evaluated and deployed, such models can transform fields like radiology by automating rote tasks and enhancing human expertise.

Jaeik Jeon, Yeonggul Jang, Youngtaek Hong et al.

Medical imaging, including MRI, CT, and Ultrasound, plays a vital role in clinical decisions. Accurate segmentation is essential to measure the structure of interest from the image. However, manual segmentation is highly operator-dependent, which leads to high inter and intra-variability of quantitative measurements. In this paper, we explore the feasibility that Bayesian predictive distribution parameterized by deep neural networks can capture the clinicians' inter-intra variability. By exploring and analyzing recently emerged approximate inference schemes, we evaluate whether approximate Bayesian deep learning with the posterior over segmentations can learn inter-intra rater variability both in segmentation and clinical measurements. The experiments are performed with two different imaging modalities: MRI and ultrasound. We empirically demonstrated that Bayesian predictive distribution parameterized by deep neural networks could approximate the clinicians' inter-intra variability. We show a new perspective in analyzing medical images quantitatively by providing clinical measurement uncertainty.

Hyeryun Park, Byung Mo Gu, Jun Hee Lee et al.

In da Vinci robotic surgery, surgeons' hands and eyes are fully engaged in the procedure, making it difficult to access and manipulate multimodal patient data without interruption. We propose a voice-directed Surgical Agent Orchestrator Platform (SAOP) built on a hierarchical multi-agent framework, consisting of an orchestration agent and three task-specific agents driven by Large Language Models (LLMs). These LLM-based agents autonomously plan, refine, validate, and reason to map voice commands into specific tasks such as retrieving clinical information, manipulating CT scans, or navigating 3D anatomical models on the surgical video. We also introduce a Multi-level Orchestration Evaluation Metric (MOEM) to comprehensively assess the performance and robustness from command-level and category-level perspectives. The SAOP achieves high accuracy and success rates across 240 voice commands, while LLM-based agents improve robustness against speech recognition errors and diverse or ambiguous free-form commands, demonstrating strong potential to support minimally invasive da Vinci robotic surgery.

Zhiling Yan, Sifan Song, Dingjie Song et al.

Recent "segment anything" efforts show promise by learning from large-scale data, but adapting such models directly to medical images remains challenging due to the complexity of medical data, noisy annotations, and continual learning requirements across diverse modalities and anatomical structures. In this work, we propose SAMed-2, a new foundation model for medical image segmentation built upon the SAM-2 architecture. Specifically, we introduce a temporal adapter into the image encoder to capture image correlations and a confidence-driven memory mechanism to store high-certainty features for later retrieval. This memory-based strategy counters the pervasive noise in large-scale medical datasets and mitigates catastrophic forgetting when encountering new tasks or modalities. To train and evaluate SAMed-2, we curate MedBank-100k, a comprehensive dataset spanning seven imaging modalities and 21 medical segmentation tasks. Our experiments on both internal benchmarks and 10 external datasets demonstrate superior performance over state-of-the-art baselines in multi-task scenarios. The code is available at: https://github.com/ZhilingYan/Medical-SAM-Bench.

Yujin Oh, Pengfei Jin, Sangjoon Park et al.

Ensuring fairness in medical image segmentation is critical due to biases in imbalanced clinical data acquisition caused by demographic attributes (e.g., age, sex, race) and clinical factors (e.g., disease severity). To address these challenges, we introduce Distribution-aware Mixture of Experts (dMoE), inspired by optimal control theory. We provide a comprehensive analysis of its underlying mechanisms and clarify dMoE's role in adapting to heterogeneous distributions in medical image segmentation. Furthermore, we integrate dMoE into multiple network architectures, demonstrating its broad applicability across diverse medical image analysis tasks. By incorporating demographic and clinical factors, dMoE achieves state-of-the-art performance on two 2D benchmark datasets and a 3D in-house dataset. Our results highlight the effectiveness of dMoE in mitigating biases from imbalanced distributions, offering a promising approach to bridging control theory and medical image segmentation within fairness learning paradigms. The source code will be made available. The source code is available at https://github.com/tvseg/dMoE.

Sekeun Kim, Pengfei Jin, Sifan Song et al.

Foundation models have recently gained significant attention because of their generalizability and adaptability across multiple tasks and data distributions. Although medical foundation models have emerged, solutions for cardiac imaging, especially echocardiography videos, are still unexplored. In this paper, we introduce EchoFM, a foundation model specifically designed to represent and analyze echocardiography videos. In EchoFM, we propose a self-supervised learning framework that captures both spatial and temporal variability patterns through a spatio-temporal consistent masking strategy and periodic-driven contrastive learning. This framework can effectively capture the spatio-temporal dynamics of echocardiography and learn the representative video features without any labels. We pre-train our model on an extensive dataset comprising over 290,000 echocardiography videos covering 26 scan views across different imaging modes, with up to 20 million frames of images. The pre-trained EchoFM can then be easily adapted and fine-tuned for a variety of downstream tasks, serving as a robust backbone model. Our evaluation was systemically designed for four downstream tasks after the echocardiography examination routine. Experiment results show that EchoFM surpasses state-of-the-art methods, including specialized echocardiography methods, self-supervised pre-training models, and general-purposed pre-trained foundation models, across all downstream tasks.

Pengfei Jin, Peng Shu, Sifan Song et al.

Recent advances in parameter-efficient transfer learning have demonstrated the utility of composing LoRA adapters from libraries of pretrained modules. However, most existing approaches rely on simple retrieval heuristics or uniform averaging, which overlook the latent structure of task relationships in representation space. We propose a new framework for adapter reuse that moves beyond retrieval, formulating adapter composition as a geometry-aware sparse reconstruction problem. Specifically, we represent each task by a latent prototype vector derived from the base model's encoder and aim to approximate the target task prototype as a sparse linear combination of retrieved reference prototypes, under an $\ell_1$-regularized optimization objective. The resulting combination weights are then used to blend the corresponding LoRA adapters, yielding a composite adapter tailored to the target task. This formulation not only preserves the local geometric structure of the task representation manifold, but also promotes interpretability and efficient reuse by selecting a minimal set of relevant adapters. We demonstrate the effectiveness of our approach across multiple domains-including medical image segmentation, medical report generation and image synthesis. Our results highlight the benefit of coupling retrieval with latent geometry-aware optimization for improved zero-shot generalization.

Siyeop Yoon, Sifan Song, Pengfei Jin et al.

We propose a cascaded 3D diffusion model framework to synthesize high-fidelity 3D PET/CT volumes directly from demographic variables, addressing the growing need for realistic digital twins in oncologic imaging, virtual trials, and AI-driven data augmentation. Unlike deterministic phantoms, which rely on predefined anatomical and metabolic templates, our method employs a two-stage generative process. An initial score-based diffusion model synthesizes low-resolution PET/CT volumes from demographic variables alone, providing global anatomical structures and approximate metabolic activity. This is followed by a super-resolution residual diffusion model that refines spatial resolution. Our framework was trained on 18-F FDG PET/CT scans from the AutoPET dataset and evaluated using organ-wise volume and standardized uptake value (SUV) distributions, comparing synthetic and real data between demographic subgroups. The organ-wise comparison demonstrated strong concordance between synthetic and real images. In particular, most deviations in metabolic uptake values remained within 3-5% of the ground truth in subgroup analysis. These findings highlight the potential of cascaded 3D diffusion models to generate anatomically and metabolically accurate PET/CT images, offering a robust alternative to traditional phantoms and enabling scalable, population-informed synthetic imaging for clinical and research applications.

Sifan Song, Siyeop Yoon, Pengfei Jin et al.

Recent advances in representation learning often rely on holistic embeddings that entangle multiple semantic components, limiting interpretability and generalization. These issues are especially critical in medical imaging, where downstream tasks depend on anatomically interpretable features. To address these limitations, we propose an Organ-Wise Tokenization (OWT) framework with a Token Group-based Reconstruction (TGR) training paradigm. Unlike conventional approaches, OWT explicitly disentangles an image into separable token groups, each corresponding to a distinct organ or semantic entity. Our design ensures each token group encapsulates organ-specific information, boosting interpretability, generalization, and efficiency while enabling fine-grained control for targeted clinical applications. Experiments on CT and MRI datasets demonstrate OWT's power: it not only achieves strong performance on standard tasks like image reconstruction and segmentation, but also unlocks novel, high-impact clinical capabilities including organ-specific tumor identification, organ-level retrieval and semantic-level generation, without requiring any additional training. These findings underscore the potential of OWT as a foundational framework for semantically disentangled representation learning, offering broad scalability and a new perspective on how representations can be leveraged.

Siyeop Yoon, Yujin Oh, Matthew Tivnan et al.

This study presents a 3D flow-matching model designed to predict the progression of the frozen region (iceball) during kidney cryoablation. Precise intraoperative guidance is critical in cryoablation to ensure complete tumor eradication while preserving adjacent healthy tissue. However, conventional methods, typically based on physics driven or diffusion based simulations, are computationally demanding and often struggle to represent complex anatomical structures accurately. To address these limitations, our approach leverages intraoperative CT imaging to inform the model. The proposed 3D flow matching model is trained to learn a continuous deformation field that maps early-stage CT scans to future predictions. This transformation not only estimates the volumetric expansion of the iceball but also generates corresponding segmentation masks, effectively capturing spatial and morphological changes over time. Quantitative analysis highlights the model robustness, demonstrating strong agreement between predictions and ground-truth segmentations. The model achieves an Intersection over Union (IoU) score of 0.61 and a Dice coefficient of 0.75. By integrating real time CT imaging with advanced deep learning techniques, this approach has the potential to enhance intraoperative guidance in kidney cryoablation, improving procedural outcomes and advancing the field of minimally invasive surgery.

Tianpeng Zhang, Sekeun Kim, Jerome Charton et al.

The paper introduces a novel autonomous robot ultrasound (US) system targeting liver follow-up scans for outpatients in local communities. Given a computed tomography (CT) image with specific target regions of interest, the proposed system carries out the autonomous follow-up scan in three steps: (i) initial robot contact to surface, (ii) coordinate mapping between CT image and robot, and (iii) target US scan. Utilizing 3D US-CT registration and deep learning-based segmentation networks, we can achieve precise imaging of 3D hepatic veins, facilitating accurate coordinate mapping between CT and the robot. This enables the automatic localization of follow-up targets within the CT image, allowing the robot to navigate precisely to the target's surface. Evaluation of the ultrasound phantom confirms the quality of the US-CT registration and shows the robot reliably locates the targets in repeated trials. The proposed framework holds the potential to significantly reduce time and costs for healthcare providers, clinicians, and follow-up patients, thereby addressing the increasing healthcare burden associated with chronic disease in local communities.

Sekeun Kim, Hui Ren, Peng Guo et al.

Echocardiography segmentation for cardiac analysis is time-consuming and resource-intensive due to the variability in image quality and the necessity to process scans from various standard views. While current automated segmentation methods in echocardiography show promising performance, they are trained on specific scan views to analyze corresponding data. However, this solution has a limitation as the number of required models increases with the number of standard views. To address this, in this paper, we present a prompt-driven universal method for view-agnostic echocardiography analysis. Considering the domain shift between standard views, we first introduce a method called prompt matching, aimed at learning prompts specific to different views by matching prompts and querying input embeddings using a pre-trained vision model. Then, we utilized a pre-trained medical language model to align textual information with pixel data for accurate segmentation. Extensive experiments on three standard views showed that our approach significantly outperforms the state-of-the-art universal methods and achieves comparable or even better performances over the segmentation model trained and tested on same views.

Zhennong Chen, Sekeun Kim, Hui Ren et al.

Accurate myocardium segmentation across all phases in one cardiac cycle in cine cardiac magnetic resonance (CMR) scans is crucial for comprehensively cardiac function analysis. Despite advancements in deep learning (DL) for automatic cine CMR segmentation, generalizability on unseen data remains a significant challenge. Recently, the segment-anything-model (SAM) has been invented as a segmentation foundation model, known for its accurate segmentation and more importantly, zero-shot generalization. SAM was trained on two-dimensional (2D) natural images; to adapt it for comprehensive cine CMR segmentation, we propose cineCMR-SAM which incorporates both temporal and spatial information through a modified model architecture. Compared to other state-of-the-art (SOTA) methods, our model achieved superior data-specific model segmentation accuracy on the STACOM2011 when fine-tuned on this dataset and demonstrated superior zero-shot generalization on two other large public datasets (ACDC and M&Ms) unseen during fine-tuning. Additionally, we introduced a text prompt feature in cineCMR-SAM to specify the view type of input slices (short-axis or long-axis), enhancing performance across all view types.