David Dreizin

Yifan Li, Mehrdad Salimitari, Taiyu Zhang et al.

Detection of rare lesions in whole-body CT is fundamentally limited by extreme class imbalance and low target-to-volume ratios, producing precision collapse despite high AUROC. Synthetic augmentation with diffusion models offers promise, yet pixel-space diffusion is computationally expensive, and existing mask-conditioned approaches lack controllable attribute-level regulation and paired supervision for accountable training. We introduce SALIENT, a mask-conditioned wavelet-domain diffusion framework that synthesizes paired lesion-masking volumes for controllable CT augmentation under long-tail regimes. Instead of denoising in pixel space, SALIENT performs structured diffusion over discrete wavelet coefficients, explicitly separating low-frequency brightness from high-frequency structural detail. Learnable frequency-aware objectives disentangle target and background attributes (structure, contrast, edge fidelity), enabling interpretable and stable optimization. A 3D VAE generates diverse volumetric lesion masks, and a semi-supervised teacher produces paired slice-level pseudo-labels for downstream mask-guided detection. SALIENT improves generative realism, as reflected by higher MS-SSIM (0.63 to 0.83) and lower FID (118.4 to 46.5). In a separate downstream evaluation, SALIENT-augmented training improves long-tail detection performance, yielding disproportionate AUPRC gains across low prevalences and target-to-volume ratios. Optimal synthetic ratios shift from 2x to 4x as labeled seed size decreases, indicating a seed-dependent augmentation regime under low-label conditions. SALIENT demonstrates that frequency-aware diffusion enables controllable, computationally efficient precision rescue in long-tail CT detection.

Yiqing Shen, Jingxing Li, Xinyuan Shao et al.

Segment anything models (SAMs) are gaining attention for their zero-shot generalization capability in segmenting objects of unseen classes and in unseen domains when properly prompted. Interactivity is a key strength of SAMs, allowing users to iteratively provide prompts that specify objects of interest to refine outputs. However, to realize the interactive use of SAMs for 3D medical imaging tasks, rapid inference times are necessary. High memory requirements and long processing delays remain constraints that hinder the adoption of SAMs for this purpose. Specifically, while 2D SAMs applied to 3D volumes contend with repetitive computation to process all slices independently, 3D SAMs suffer from an exponential increase in model parameters and FLOPS. To address these challenges, we present FastSAM3D which accelerates SAM inference to 8 milliseconds per 128*128*128 3D volumetric image on an NVIDIA A100 GPU. This speedup is accomplished through 1) a novel layer-wise progressive distillation scheme that enables knowledge transfer from a complex 12-layer ViT-B to a lightweight 6-layer ViT-Tiny variant encoder without training from scratch; and 2) a novel 3D sparse flash attention to replace vanilla attention operators, substantially reducing memory needs and improving parallelization. Experiments on three diverse datasets reveal that FastSAM3D achieves a remarkable speedup of 527.38x compared to 2D SAMs and 8.75x compared to 3D SAMs on the same volumes without significant performance decline. Thus, FastSAM3D opens the door for low-cost truly interactive SAM-based 3D medical imaging segmentation with commonly used GPU hardware. Code is available at https://github.com/arcadelab/FastSAM3D.

Anna Zapaishchykova, David Dreizin, Zhaoshuo Li et al.

Pelvic ring disruptions result from blunt injury mechanisms and are often found in patients with multi-system trauma. To grade pelvic fracture severity in trauma victims based on whole-body CT, the Tile AO/OTA classification is frequently used. Due to the high volume of whole-body trauma CTs generated in busy trauma centers, an automated approach to Tile classification would provide substantial value, e.,g., to prioritize the reading queue of the attending trauma radiologist. In such scenario, an automated method should perform grading based on a transparent process and based on interpretable features to enable interaction with human readers and lower their workload by offering insights from a first automated read of the scan. This paper introduces an automated yet interpretable pelvic trauma decision support system to assist radiologists in fracture detection and Tile grade classification. The method operates similarly to human interpretation of CT scans and first detects distinct pelvic fractures on CT with high specificity using a Faster-RCNN model that are then interpreted using a structural causal model based on clinical best practices to infer an initial Tile grade. The Bayesian causal model and finally, the object detector are then queried for likely co-occurring fractures that may have been rejected initially due to the highly specific operating point of the detector, resulting in an updated list of detected fractures and corresponding final Tile grade. Our method is transparent in that it provides finding location and type using the object detector, as well as information on important counterfactuals that would invalidate the system's recommendation and achieves an AUC of 83.3%/85.1% for translational/rotational instability. Despite being designed for human-machine teaming, our approach does not compromise on performance compared to previous black-box approaches.

Yuyin Zhou, David Dreizin, Yingwei Li et al.

Trauma is the worldwide leading cause of death and disability in those younger than 45 years, and pelvic fractures are a major source of morbidity and mortality. Automated segmentation of multiple foci of arterial bleeding from abdominopelvic trauma CT could provide rapid objective measurements of the total extent of active bleeding, potentially augmenting outcome prediction at the point of care, while improving patient triage, allocation of appropriate resources, and time to definitive intervention. In spite of the importance of active bleeding in the quick tempo of trauma care, the task is still quite challenging due to the variable contrast, intensity, location, size, shape, and multiplicity of bleeding foci. Existing work [4] presents a heuristic rule-based segmentation technique which requires multiple stages and cannot be efficiently optimized end-to-end. To this end, we present, Multi-Scale Attentional Network (MSAN), the first yet reliable end-to-end network, for automated segmentation of active hemorrhage from contrast-enhanced trauma CT scans. MSAN consists of the following components: 1) an encoder which fully integrates the global contextual information from holistic 2D slices; 2) a multi-scale strategy applied both in the training stage and the inference stage to handle the challenges induced by variation of target sizes; 3) an attentional module to further refine the deep features, leading to better segmentation quality; and 4) a multi-view mechanism to fully leverage the 3D information. Our MSAN reports a significant improvement of more than 7% compared to prior arts in terms of DSC.