Cong Cong

Qiangguo Jin, Xianyao Zheng, Hui Cui et al.

Medical visual question answering (Med-VQA) is a crucial multimodal task in clinical decision support and telemedicine. Recent self-attention based methods struggle to effectively handle cross-modal semantic alignments between vision and language. Moreover, classification-based methods rely on predefined answer sets. Treating this task as a simple classification problem may make it unable to adapt to the diversity of free-form answers and overlook the detailed semantic information of free-form answers. In order to tackle these challenges, we introduce a Cross-Mamba Interaction based Multi-Task Learning (CMI-MTL) framework that learns cross-modal feature representations from images and texts. CMI-MTL comprises three key modules: fine-grained visual-text feature alignment (FVTA), cross-modal interleaved feature representation (CIFR), and free-form answer-enhanced multi-task learning (FFAE). FVTA extracts the most relevant regions in image-text pairs through fine-grained visual-text feature alignment. CIFR captures cross-modal sequential interactions via cross-modal interleaved feature representation. FFAE leverages auxiliary knowledge from open-ended questions through free-form answer-enhanced multi-task learning, improving the model's capability for open-ended Med-VQA. Experimental results show that CMI-MTL outperforms the existing state-of-the-art methods on three Med-VQA datasets: VQA-RAD, SLAKE, and OVQA. Furthermore, we conduct more interpretability experiments to prove the effectiveness. The code is publicly available at https://github.com/BioMedIA-repo/CMI-MTL.

Yizhi Zhang, Lei Fan, Zhulin Tao et al.

Universal, transferable whole-slide image (WSI) representations are central to computational pathology. Incorporating multiple markers (e.g., immunohistochemistry, IHC) alongside H&E enriches H&E-based features with diverse, biologically meaningful information. However, progress is limited by the scarcity of well-aligned multi-stain datasets. Inter-stain misalignment shifts corresponding tissue across slides, hindering consistent patch-level features and degrading slide-level embeddings. To address this, we curated a slide-level aligned, five-stain dataset (H&E, HER2, KI67, ER, PGR) to enable paired H&E-IHC learning and robust cross-stain representation. Leveraging this dataset, we propose Cross-Stain Contrastive Learning (CSCL), a two-stage pretraining framework with a lightweight adapter trained using patch-wise contrastive alignment to improve the compatibility of H&E features with corresponding IHC-derived contextual cues, and slide-level representation learning with Multiple Instance Learning (MIL), which uses a cross-stain attention fusion module to integrate stain-specific patch features and a cross-stain global alignment module to enforce consistency among slide-level embeddings across different stains. Experiments on cancer subtype classification, IHC biomarker status classification, and survival prediction show consistent gains, yielding high-quality, transferable H&E slide-level representations. The code and data are available at https://github.com/lily-zyz/CSCL.

Linkuan Zhou, Yinghao Xia, Yufei Shen et al.

Unsupervised Domain Adaptation (UDA) is essential for deploying medical segmentation models across diverse clinical environments. Existing methods are fundamentally limited, suffering from semantically unaware feature alignment that results in poor distributional fidelity and from pseudo-label validation that disregards global anatomical constraints, thus failing to prevent the formation of globally implausible structures. To address these issues, we propose SHAPE (Structure-aware Hierarchical Unsupervised Domain Adaptation with Plausibility Evaluation), a framework that reframes adaptation towards global anatomical plausibility. Built on a DINOv3 foundation, its Hierarchical Feature Modulation (HFM) module first generates features with both high fidelity and class-awareness. This shifts the core challenge to robustly validating pseudo-labels. To augment conventional pixel-level validation, we introduce Hypergraph Plausibility Estimation (HPE), which leverages hypergraphs to assess the global anatomical plausibility that standard graphs cannot capture. This is complemented by Structural Anomaly Pruning (SAP) to purge remaining artifacts via cross-view stability. SHAPE significantly outperforms prior methods on cardiac and abdominal cross-modality benchmarks, achieving state-of-the-art average Dice scores of 90.08% (MRI->CT) and 78.51% (CT->MRI) on cardiac data, and 87.48% (MRI->CT) and 86.89% (CT->MRI) on abdominal data. The code is available at https://github.com/BioMedIA-repo/SHAPE.

Cong Cong, Shiyu Xuan, Sidong Liu et al.

Deep neural networks (DNNs) have exhibited remarkable success in the field of histopathology image analysis. On the other hand, the contemporary trend of employing large models and extensive datasets has underscored the significance of dataset distillation, which involves compressing large-scale datasets into a condensed set of synthetic samples, offering distinct advantages in improving training efficiency and streamlining downstream applications. In this work, we introduce a novel dataset distillation algorithm tailored for histopathology image datasets (Histo-DD), which integrates stain normalisation and model augmentation into the distillation progress. Such integration can substantially enhance the compatibility with histopathology images that are often characterised by high colour heterogeneity. We conduct a comprehensive evaluation of the effectiveness of the proposed algorithm and the generated histopathology samples in both patch-level and slide-level classification tasks. The experimental results, carried out on three publicly available WSI datasets, including Camelyon16, TCGA-IDH, and UniToPath, demonstrate that the proposed Histo-DD can generate more informative synthetic patches than previous coreset selection and patch sampling methods. Moreover, the synthetic samples can preserve discriminative information, substantially reduce training efforts, and exhibit architecture-agnostic properties. These advantages indicate that synthetic samples can serve as an alternative to large-scale datasets.

Luru Jing, Cong Cong, Yanyuan Chen et al.

Federated learning (FL) offers a promising framework for collaborative digital pathology by enabling model training across institutions. However, real-world deployments face heterogeneity arising from diverse multiple instance learning (MIL) architectures and heterogeneous feature extractors across institutions. We propose FedHD, a novel FL framework that performs local Gaussian-mixture feature alignment tailored for WSI analysis. Instead of exchanging model parameters, each client independently distills semantically rich synthetic feature representations aligned with the distribution of real WSIs. To preserve diagnostic diversity, FedHD adopts a one-to-one distillation strategy, generating a synthetic counterpart for each real slide to avoid over-compression. During federation, a curriculum-based integration strategy progressively incorporates cross-site synthetic features into local training once performance plateaus. Furthermore, an optional interpretation module reconstructs pseudo-patches from synthetic embeddings, enhancing transparency. FedHD is architecture-agnostic, privacy-preserving, and supports personalized yet collaborative training across diverse institutions. Experiments on TCGA-IDH, CAMELYON16, and CAMELYON17 show that FedHD consistently outperforms state-of-the-art federated and distillation baselines.

Junze Wang, Lei Fan, Dezheng Zhang et al.

Visual Prompt Tuning (VPT) adapts a frozen Vision Transformer (ViT) to downstream tasks by inserting a small number of learnable prompt tokens into the token sequence at each layer. However, we observe that existing VPT variants often suffer from unstable training dynamics, characterized by gradient oscillations. A layer-wise analysis reveals that shallow-layer prompts tend to stagnate early, while deeper-layer prompts exhibit high-variance oscillations, leading to cross-layer mismatch. These issues slow convergence and degrade final performance. To address these challenges, we propose Prompt-Agnostic Evolution ($\mathtt{PAE}$), which strengthens vision prompt tuning by explicitly modeling prompt dynamics. From a frequency-domain perspective, we initialize prompts in a task-aware direction by uncovering and propagating frequency shortcut patterns that the backbone inherently exploits for recognition. To ensure coherent evolution across layers, we employ a shared Koopman operator that imposes a global linear transformation instead of uncoordinated, layer-specific updates. Finally, inspired by Lyapunov stability theory, we introduce a regularizer that constrains error amplification during evolution. Extensive experiments show that $\mathtt{PAE}$ accelerates convergence with an average $1.41\times$ speedup and improves accuracy by 1--3% on 25 datasets across multiple downstream tasks. Beyond performance, $\mathtt{PAE}$ is prompt-agnostic and lightweight, and it integrates seamlessly with diverse VPT variants without backbone modification or inference-time changes.

Haolong Jin, Shenglin Liu, Cong Cong et al.

Federated learning (FL) has emerged as a promising approach for collaborative medical image analysis, enabling multiple institutions to build robust predictive models while preserving sensitive patient data. In the context of Whole Slide Image (WSI) classification, FL faces significant challenges, including heterogeneous computational resources across participating medical institutes and privacy concerns. To address these challenges, we propose FedWSIDD, a novel FL paradigm that leverages dataset distillation (DD) to learn and transmit synthetic slides. On the server side, FedWSIDD aggregates synthetic slides from participating centres and distributes them across all centres. On the client side, we introduce a novel DD algorithm tailored to histopathology datasets which incorporates stain normalisation into the distillation process to generate a compact set of highly informative synthetic slides. These synthetic slides, rather than model parameters, are transmitted to the server. After communication, the received synthetic slides are combined with original slides for local tasks. Extensive experiments on multiple WSI classification tasks, including CAMELYON16 and CAMELYON17, demonstrate that FedWSIDD offers flexibility for heterogeneous local models, enhances local WSI classification performance, and preserves patient privacy. This makes it a highly effective solution for complex WSI classification tasks. The code is available at FedWSIDD.

Junze Wang, Lei Fan, Weipeng Jing et al.

Existing methods for multimodal MRI segmentation with missing modalities typically assume that all MRI modalities are available during training. However, in clinical practice, some modalities may be missing due to the sequential nature of MRI acquisition, leading to performance degradation. Furthermore, retraining models to accommodate newly available modalities can be inefficient and may cause overfitting, potentially compromising previously learned knowledge. To address these challenges, we propose Replay-based Hypergraph Domain Incremental Learning (ReHyDIL) for brain tumor segmentation with missing modalities. ReHyDIL leverages Domain Incremental Learning (DIL) to enable the segmentation model to learn from newly acquired MRI modalities without forgetting previously learned information. To enhance segmentation performance across diverse patient scenarios, we introduce the Cross-Patient Hypergraph Segmentation Network (CHSNet), which utilizes hypergraphs to capture high-order associations between patients. Additionally, we incorporate Tversky-Aware Contrastive (TAC) loss to effectively mitigate information imbalance both across and within different modalities. Extensive experiments on the BraTS2019 dataset demonstrate that ReHyDIL outperforms state-of-the-art methods, achieving an improvement of over 2% in the Dice Similarity Coefficient across various tumor regions. Our code is available at https://github.com/reeive/ReHyDIL.

Qiangguo Jin, Hui Cui, Junbo Wang et al.

Semi-supervised learning (SSL) has attracted considerable attention in medical image processing. The latest SSL methods use a combination of consistency regularization and pseudo-labeling to achieve remarkable success. However, most existing SSL studies focus on segmenting large organs, neglecting the challenging scenarios where there are numerous tumors or tumors of small volume. Furthermore, the extensive capabilities of data augmentation strategies, particularly in the context of both labeled and unlabeled data, have yet to be thoroughly investigated. To tackle these challenges, we introduce a straightforward yet effective approach, termed iterative pseudo-labeling based adaptive copy-paste supervision (IPA-CP), for tumor segmentation in CT scans. IPA-CP incorporates a two-way uncertainty based adaptive augmentation mechanism, aiming to inject tumor uncertainties present in the mean teacher architecture into adaptive augmentation. Additionally, IPA-CP employs an iterative pseudo-label transition strategy to generate more robust and informative pseudo labels for the unlabeled samples. Extensive experiments on both in-house and public datasets show that our framework outperforms state-of-the-art SSL methods in medical image segmentation. Ablation study results demonstrate the effectiveness of our technical contributions.

Linkuan Zhou, Zhexin Chen, Yufei Shen et al.

Automated segmentation of the fetal head in ultrasound images is critical for prenatal monitoring. However, achieving robust segmentation remains challenging due to the poor quality of ultrasound images and the lack of annotated data. Semi-supervised methods alleviate the lack of annotated data but struggle with the unique characteristics of fetal head ultrasound images, making it challenging to generate reliable pseudo-labels and enforce effective consistency regularization constraints. To address this issue, we propose a novel semi-supervised framework, ERSR, for fetal head ultrasound segmentation. Our framework consists of the dual-scoring adaptive filtering strategy, the ellipse-constrained pseudo-label refinement, and the symmetry-based multiple consistency regularization. The dual-scoring adaptive filtering strategy uses boundary consistency and contour regularity criteria to evaluate and filter teacher outputs. The ellipse-constrained pseudo-label refinement refines these filtered outputs by fitting least-squares ellipses, which strengthens pixels near the center of the fitted ellipse and suppresses noise simultaneously. The symmetry-based multiple consistency regularization enforces multi-level consistency across perturbed images, symmetric regions, and between original predictions and pseudo-labels, enabling the model to capture robust and stable shape representations. Our method achieves state-of-the-art performance on two benchmarks. On the HC18 dataset, it reaches Dice scores of 92.05% and 95.36% with 10% and 20% labeled data, respectively. On the PSFH dataset, the scores are 91.68% and 93.70% under the same settings.