arXiv subjects

Adinath Dukre

Publications and source records attributed to Adinath Dukre.

5 recordsLinked to original sources

arXiv2026

Counterfactual Anatomy-guided Spatial-Temporal Decoding for Annotation-Free Hallucination Mitigation in Medical VLMs

Medical vision-language models (Med-VLMs) have demonstrated strong performance on medical visual question answering, yet they remain prone to hallucination, generating clinically unsupported statements that are insufficiently grounded in image evidence. Mitigation methods applied during decoding offer a practical solution, but they typically lack anatomical awareness or rely heavily on ground truth annotations, which limits their applicability. We propose Counterfactual Anatomy-guided Spatial-Temporal decoding (CAST), a framework that operates entirely during inference and requires no manual annotations for anatomically grounded hallucination mitigation. CAST automatically discovers anatomical regions relevant to the given query through broad medical segmentation. It then selects a compact, causally informative area using counterfactual intervention based on the drop in answer likelihood under occlusion. Guided by this chosen region, CAST performs a unified contrastive decoding process, combining classifier-free guidance to correct spatial attention with stepwise temporal contrast to regulate generation dynamics. Experiments on the SLAKE and MIMIC-CXR datasets across three Med-VLMs demonstrate that CAST consistently outperforms strong baselines and surpasses decoding strategies reliant on ground truth. Our results indicate that compact, automatically selected regions provide highly effective contrastive guidance without expert annotations, offering a practical and generalizable solution for improving spatial grounding and reducing hallucinations. Code is available at https://github.com/csyifan/CAST.

cs.CV↗

arXiv2026

PROTON: Prototype-Based Test-Time Online OOD Detection for Medical VLMs

Medical vision-language models (VLMs) enable zero-shot clinical image classification, yet reliably detecting out-of-distribution (OOD) inputs at deployment remains an open problem. No static scoring method works across all shift types: Maximum Concept Matching (MCM) on FLAIR achieves 76.4% AUROC for far-OOD but only 42.4% for covariate shifts such as ultra-wide-field fundus images, effectively random. We trace this to a structural mismatch: covariate-shifted inputs are indistinguishable from in-distribution samples in softmax space, yet occupy distinct regions in the VLM embedding space. To exploit this untapped signal, we propose PROTON (PROtotype-based Test-time ONline OOD detection), a lightweight post-hoc module that maintains an online prototype bank from high-confidence test predictions and adaptively fuses prototype distance with MCM scoring via stream-level variance statistics, requiring no model modification, training data, or prompt engineering. On the ophthalmology benchmark FLAIR + FIVES, PROTON improves MCM by +23.9 AUROC on covariate shift, +8.8 on semantic shift, and +8.1 on far-OOD, making it the only zero-shot method to improve all three without hierarchical prompts or labeled data. Code is available at https://github.com/GenMI-Lab/PROTON, and the project page is available at https://genmi-lab.github.io/PROTON.

cs.CV↗

arXiv2026

Mitosis Detection in the Wild: Multi-Tumor and Context-Aware Generalization in the MIDOG 2025 Challenge

Automated mitosis detection is a well-established task in computational pathology. While previous benchmarks focused on scanner-induced domain shift, clinical "real-world" application requires models to be robust across the vast variance to be expected in the histological landscape. The MItosis DOmain Generalization (MIDOG) 2025 challenge was designed to evaluate algorithmic performance across unprecedented biological and contextual diversity. We curated a test dataset of 365 cases, encompassing 12 distinct human, canine and feline tumor types, digitized across multiple scanning platforms. Moving beyond hand-selected hotspots, the challenge required detection also in random tissue areas (representative of the whole slide detection situation) and challenging areas (areas rich in hard negatives). In the second track, we introduced the classification of atypical mitotic figures (AMFs). There were 18 teams submitting to the detection track, with F1 scores ranging up to 0.740. In the AMF detection track, we had 21 submissions with balanced accuracy values up to 0.908. Our analysis reveals that while most models perform reliably in traditional hotspots, significant performance degradation occurs in challenging ROIs, where false positive rates tripled. Furthermore, performance varied significantly across the 12 tumor types, highlighting "blind spots" in current state-of-the-art architectures when encountering rare or highly pleomorphic malignancies. Moreover, we evaluated the effectiveness of ensembling and found a mean increases of 1.5 and 1.3 percentage points in F1 score and balanced accuracy, respectively. In contrast, TTA showed no relevant improvement. MIDOG 2025 demonstrates that "in the wild" mitosis detection remains a significant hurdle. The transition from hotspot-only evaluation to a multi-contextual framework provides a more realistic proxy for clinical reliability.

cs.CV↗

arXiv2026

TriALS: Triphasic-Aided Liver Lesion Segmentation Benchmark in Non-Contrast CT

Automated segmentation of liver lesions on non-contrast computed tomography (NCCT) is clinically important but fundamentally challenging, particularly in low-resource settings across Africa and Asia where contrast agents are frequently unavailable. Progress has been limited by the absence of annotated NCCT benchmarks. Here we describe the TriALS challenge for automated liver lesion segmentation under contrast-limited conditions, supported by a multi-centre dataset of 150 cases with four-phase CT acquisitions (600 volumes) from Egyptian and Chinese institutions. Algorithms were evaluated on 70 cases from three institutions, including an independent external cohort. The top-performing method achieved a mean venous-phase Dice of 0.754, consistent with human-level performance, yet dropped to 0.57 on NCCT. On external validation, the leading method outperformed off-the-shelf models by up to 28% in Dice on NCCT. Algorithm performance was most strongly predicted by training data scale and pre-training strategy. A cross-year comparison exposed a persistent perceptual barrier on NCCT that scaling pre-training alone cannot overcome. Data, annotations, and code are available at https://github.com/xmed-lab/TriALS.

cs.CV↗

arXiv2025

Robust Atypical Mitosis Classification with DenseNet121: Stain-Aware Augmentation and Hybrid Loss for Domain Generalization

Atypical mitotic figures are important biomarkers of tumor aggressiveness in histopathology, yet reliable recognition remains challenging due to severe class imbalance and variability across imaging domains. We present a DenseNet-121-based framework tailored for atypical mitosis classification in the MIDOG 2025 (Track 2) setting. Our method integrates stain-aware augmentation (Macenko), geometric and intensity transformations, and imbalance-aware learning via weighted sampling with a hybrid objective combining class-weighted binary cross-entropy and focal loss. Trained end-to-end with AdamW and evaluated across multiple independent domains, the model demonstrates strong generalization under scanner and staining shifts, achieving balanced accuracy 85.0%, AUROC 0.927, sensitivity 89.2%, and specificity 80.9% on the official test set. These results indicate that combining DenseNet-121 with stain-aware augmentation and imbalance-adaptive objectives yields a robust, domain-generalizable framework for atypical mitosis classification suitable for real-world computational pathology workflows.

cs.CV↗