Jens Kleesiek

Hamza Kalisch, Constantin Seibold, Jens Kleesiek et al.

While dense pixel-wise annotations remain the gold standard for medical image segmentation, they are costly to obtain and limit scalability. In contrast, many deployed systems already produce inexpensive automatic quality-control (QC) signals like model agreement, uncertainty measures, or learned mask-quality scores which can be used for further model training without additional ground-truth annotation. However, these signals can be noisy and biased, making preference-based fine-tuning susceptible to harmful updates. We study Direct Preference Optimization (DPO) for segmentation from such noisy judges using proposals generated by a supervised base segmenter trained on a small labeled set. We find that outcomes depend strongly on how preference pairs are mined: selecting the judge's top-ranked proposal can improve peak performance when the judge is reliable, but can amplify harmful errors under weaker judges. We propose Region-Normalized DPO (RN-DPO), a segmentation-aware objective which normalizes preference updates by the size of the disagreement region between masks, reducing the leverage of harmful comparisons and improving optimization stability. Across two medical datasets and multiple regimes, RN-DPO improves sustained performance and stabilizes preference-based fine-tuning, outperforming standard DPO and strong baselines without requiring additional pixel annotations.

Moritz Rempe, Lukas T. Rotkopf, Marco Schlimbach et al.

Deep learning applications in Magnetic Resonance Imaging (MRI) predominantly operate on reconstructed magnitude images, a process that discards phase information and requires computationally expensive transforms. Standard neural network architectures rely on local operations (convolutions or grid-patches) that are ill-suited for the global, non-local nature of raw frequency-domain (k-Space) data. In this work, we propose a novel complex-valued Vision Transformer (kViT) designed to perform classification directly on k-Space data. To bridge the geometric disconnect between current architectures and MRI physics, we introduce a radial k-Space patching strategy that respects the spectral energy distribution of the frequency-domain. Extensive experiments on the fastMRI and in-house datasets demonstrate that our approach achieves classification performance competitive with state-of-the-art image-domain baselines (ResNet, EfficientNet, ViT). Crucially, kViT exhibits superior robustness to high acceleration factors and offers a paradigm shift in computational efficiency, reducing VRAM consumption during training by up to 68$\times$ compared to standard methods. This establishes a pathway for resource-efficient, direct-from-scanner AI analysis.