Yuanhan Wang

Wenjing Yu, Shuo Jiang, Yifei Chen et al.

Test time Adaptation is a promising approach for mitigating domain shift in medical image segmentation; however, current evaluations remain limited in terms of modality coverage, task diversity, and methodological consistency. We present MedSeg-TTA, a comprehensive benchmark that examines twenty representative adaptation methods across seven imaging modalities, including MRI, CT, ultrasound, pathology, dermoscopy, OCT, and chest X-ray, under fully unified data preprocessing, backbone configuration, and test time protocols. The benchmark encompasses four significant adaptation paradigms: Input-level Transformation, Feature-level Alignment, Output-level Regularization, and Prior Estimation, enabling the first systematic cross-modality comparison of their reliability and applicability. The results show that no single paradigm performs best in all conditions. Input-level methods are more stable under mild appearance shifts. Feature-level and Output-level methods offer greater advantages in boundary-related metrics, whereas prior-based methods exhibit strong modality dependence. Several methods degrade significantly under large inter-center and inter-device shifts, which highlights the importance of principled method selection for clinical deployment. MedSeg-TTA provides standardized datasets, validated implementations, and a public leaderboard, establishing a rigorous foundation for future research on robust, clinically reliable test-time adaptation. All source codes and open-source datasets are available at https://github.com/wenjing-gg/MedSeg-TTA.

Shenghao Zhu, Yifei Chen, Shuo Jiang et al.

Neurogliomas are among the most aggressive forms of cancer, presenting considerable challenges in both treatment and monitoring due to their unpredictable biological behavior. Magnetic resonance imaging (MRI) is currently the preferred method for diagnosing and monitoring gliomas. However, the lack of specific imaging techniques often compromises the accuracy of tumor segmentation during the imaging process. To address this issue, we introduce the XLSTM-HVED model. This model integrates a hetero-modal encoder-decoder framework with the Vision XLSTM module to reconstruct missing MRI modalities. By deeply fusing spatial and temporal features, it enhances tumor segmentation performance. The key innovation of our approach is the Self-Attention Variational Encoder (SAVE) module, which improves the integration of modal features. Additionally, it optimizes the interaction of features between segmentation and reconstruction tasks through the Squeeze-Fusion-Excitation Cross Awareness (SFECA) module. Our experiments using the BraTS 2024 dataset demonstrate that our model significantly outperforms existing advanced methods in handling cases where modalities are missing. Our source code is available at https://github.com/Quanato607/XLSTM-HVED.

Yuanhan Wang, Yifei Chen, Shuo Jiang et al.

Reliable brain tumor segmentation in MRI is indispensable for treatment planning and outcome monitoring, yet models trained on curated benchmarks often fail under domain shifts arising from scanner and protocol variability as well as population heterogeneity. Such gaps are especially severe in low-resource and pediatric cohorts, where conventional test-time or source-free adaptation strategies often suffer from instability and structural inconsistency. We propose SmaRT, a style-modulated robust test-time adaptation framework that enables source-free cross-domain generalization. SmaRT integrates style-aware augmentation to mitigate appearance discrepancies, a dual-branch momentum strategy for stable pseudo-label refinement, and structural priors enforcing consistency, integrity, and connectivity. This synergy ensures both adaptation stability and anatomical fidelity under extreme domain shifts. Extensive evaluations on sub-Saharan Africa and pediatric glioma datasets show that SmaRT consistently outperforms state-of-the-art methods, with notable gains in Dice accuracy and boundary precision. Overall, SmaRT bridges the gap between algorithmic advances and equitable clinical applicability, supporting robust deployment of MRI-based neuro-oncology tools in diverse clinical environments. Our source code is available at https://github.com/baiyou1234/SmaRT.

Shenghao Zhu, Yifei Chen, Weihong Chen et al.

Accurate brain tumor segmentation is essential for preoperative evaluation and personalized treatment. Multi-modal MRI is widely used due to its ability to capture complementary tumor features across different sequences. However, in clinical practice, missing modalities are common, limiting the robustness and generalizability of existing deep learning methods that rely on complete inputs, especially under non-dominant modality combinations. To address this, we propose AdaMM, a multi-modal brain tumor segmentation framework tailored for missing-modality scenarios, centered on knowledge distillation and composed of three synergistic modules. The Graph-guided Adaptive Refinement Module explicitly models semantic associations between generalizable and modality-specific features, enhancing adaptability to modality absence. The Bi-Bottleneck Distillation Module transfers structural and textural knowledge from teacher to student models via global style matching and adversarial feature alignment. The Lesion-Presence-Guided Reliability Module predicts prior probabilities of lesion types through an auxiliary classification task, effectively suppressing false positives under incomplete inputs. Extensive experiments on the BraTS 2018 and 2024 datasets demonstrate that AdaMM consistently outperforms existing methods, exhibiting superior segmentation accuracy and robustness, particularly in single-modality and weak-modality configurations. In addition, we conduct a systematic evaluation of six categories of missing-modality strategies, confirming the superiority of knowledge distillation and offering practical guidance for method selection and future research. Our source code is available at https://github.com/Quanato607/AdaMM.