Ngan Le

Trong-Thang Pham, Loc Nguyen, Anh Nguyen et al.

Generative diffusion models are increasingly used for medical imaging data augmentation, but text prompting cannot produce causal training data. Re-prompting rerolls the entire generation trajectory, altering anatomy, texture, and background. Inversion-based editing methods introduce reconstruction error that causes structural drift. We propose MedSteer, a training-free activation-steering framework for endoscopic synthesis. MedSteer identifies a pathology vector for each contrastive prompt pair in the cross-attention layers of a diffusion transformer. At inference time, it steers image activations along this vector, generating counterfactual pairs from scratch where the only difference is the steered concept. All other structure is preserved by construction. We evaluate MedSteer across three experiments on Kvasir v3 and HyperKvasir. On counterfactual generation across three clinical concept pairs, MedSteer achieves flip rates of 0.800, 0.925, and 0.950, outperforming the best inversion-based baseline in both concept flip rate and structural preservation. On dye disentanglement, MedSteer achieves 75% dye removal against 20% (PnP) and 10% (h-Edit). On downstream polyp detection, augmenting with MedSteer counterfactual pairs achieves ViT AUC of 0.9755 versus 0.9083 for quantity-matched re-prompting, confirming that counterfactual structure drives the gain. Code is at link https://github.com/phamtrongthang123/medsteer

Duy M. H. Nguyen, Tuan A. Tran, Duong Nguyen et al.

Recent token merging techniques for Vision Transformers (ViTs) provide substantial speedups by reducing the number of tokens processed by self-attention, often without retraining. However, their direct application to the Segment Anything Model (SAM) family is nontrivial: SAM's image encoder mixes windowed and global attention, and its mask decoder relies on dense, prompt-conditioned features for precise boundary prediction. We systematically evaluate representative token-merging methods on SAM and Medical SAM in a strict off-the-shelf setting, and find that existing destination-selection heuristics can erode boundaries and leak prompt information as merge rates increase. We propose \textbf{StructSAM}, a resolution-preserving merge-unmerge framework tailored to SAM. StructSAM computes a lightweight token-energy score from first-order feature gradients, uses grid-based flatness screening to protect boundary and prompt regions, and merges tokens within flat areas toward low-energy destinations with explicit token recovery. We further provide a spectral graph coarsening view showing that score-guided merging yields bounded Laplacian spectral distortion compared to random or window-restricted baselines. Across eight natural and medical benchmarks, StructSAM reduces encoder FLOPs by 25-30\% (up to 40\%+ with prompt-aware merging) with minor drops in mIoU/Dice, consistently outperforming ToMe, PiToMe, ToMeSD, VidToMe, and ALGM at the same compute.