arXiv subjects

Alejandro F. Frangi

Publications and source records attributed to Alejandro F. Frangi.

At least 19 recordsLinked to original sources

arXiv2026

DINO-3DRA: Leveraging 2D Foundation Model Semantics for 3D Cerebral Aneurysm Segmentation

Accurate aneurysm segmentation in 3D rotational angiography (3DRA) is hindered by extreme class imbalance, morphological similarity to vessels, and absent large-scale 3D pretraining. 2D vision foundation models encode dense structural priors from 1.7 billion images, yet naïve slice-wise transfer fragments anatomical continuity and destabilises optimisation. We propose DINO-3DRA, a dual-path framework achieving effective cross-dimensional semantic transfer by injecting frozen DINOv3 features into a 3D U-Net backbone via Room-Lite spatial mixing and calibrated residual fusion. On multi-centre 3DRA data, DINO-3DRA achieves state-of-the-art aneurysm segmentation (Dice: 0.758; HD95: 2.75 mm; +13% over nnU-Net) with only 5.72M trainable parameters. Ablation studies confirm that gains arise from structured cross-dimensional transfer rather than loss design alone, with bridged foundation features improving anatomical continuity between aneurysms and parent vessels. Without fine-tuning on CADA and SHINY-ICARUS, DINO-3DRA eliminates all catastrophic failure cases observed in baseline architectures, demonstrating robust generalisation across heterogeneous imaging protocols.

cs.CV↗

arXiv2026

Conditional Latent Diffusion Model with Fourier-based Motion Modelling for Virtual Population Synthesis

In-silico trials of medical devices require the generation of virtual populations of anatomies. In cardiovascular applications, virtual anatomy is typically represented as a 3D+t mesh sampled from a generative model. However, most existing mesh generators focus on static anatomy, while sequence models often lack explicit periodicity. To this end, we propose 4D F-MeshLDM, a conditional generative framework comprising a convolutional mesh VAE to encode meshes, a structural latent space that parameterises motion using a truncated Fourier series, and a diffusion prior that learns the latent distribution over Fourier coefficient tokens. By conditioning the diffusion process on clinical covariates via affine modulation, we enable controllable synthesis. Sampling tokens and performing inverse Fourier synthesis yield cycle-consistent latent trajectories, which can be decoded into 3D+t cardiac mesh sequences. Experiments on 5,000 UK Biobank subjects demonstrate that 4D F-MeshLDM outperforms state-of-the-art baselines in anatomical fidelity and achieves near-zero cycle closure error. Furthermore, the generated cohorts accurately preserve clinical functional indices, highlighting the potential of our framework for reliable in-silico cardiac trials.

cs.CV↗

arXiv2026

MARVEL: Universal Murray's Law-informed Vessel Tree Segmentation and Topology Estimation

Vascular circulation follows fundamental biophysical principles that optimize mass transport and metabolic energy expenditure, which can be effectively modeled by Murray's law. However, contemporary deep learning methods for vascular segmentation often neglect these biophysical constraints. This leads to physiologically implausible branching and misclassification vascular trees, rendering. These automated segmentation results are unreliable unreliable for downstream clinical tasks such as blood flow simulation or disease quantification. In this paper, we introduce MARVEL (Universal MurrAy's law-infoRmed Vessel sEgmentation and topoLogy estimation), a backbone-agnostic framework that integrates biophysical priors into vascular tree extraction. MARVEL combines per-pixel supervision with explicit radius predictions to enforce local bifurcation constraints derived from an empirical width-exponent mapping. We implement these constraints as differentiable regularizers during training to guide models toward physiologically consistent reconstructions. We evaluate MARVEL on eight public datasets across multiple vascular modalities and segmentation backbones. Results demonstrate MARVEL's superior performance in segmentation accuracy, topological consistency, and physiological plausibility. By converting segmented masks into graph-based hemodynamic simulations, we demonstrate that MARVEL preserves the subtle pathological narrowing and topological connectivity required to distinguish hypertensive from normotensive eyes. Results show that MARVEL significantly improves the classification of hypertension via arteriovenous pressure differences in the eye (p < 0.001), outperforming baseline models in both topological consistency and clinical predictive value.

cs.CV↗

arXiv2026

ReportMedSAM: Guiding Segmentation Through Radiology Reports

Free-form radiology reports contain rich clinical descriptions, yet converting them for reliable segmentation remains challenging due to the inherent variability of natural language. Existing pipelines often rely on predefined organ phrases or brittle rule-based inference-time extraction, which limits their scalability to novel anatomical structures and makes them sensitive to linguistic variations. To address this, we propose ReportMedSAM, a report-driven framework that replaces discrete extraction with a learnable concept bank. By leveraging a frozen medical vision-language encoder (BiomedCLIP), we align organ-level concept embeddings with large-scale clinical corpora through contrastive learning, establishing mutually orthogonal semantic anchors. Our approach explicitly mitigates organ-level semantic collapse and ensures high robustness against diverse clinical synonyms (e.g., "renal" vs. "kidney" ). During inference, a clinical report is embedded and matched against this concept bank to dynamically activate task-specific Mixture-of-Experts (MoE) modules. This decoupled design allows new concepts and experts to be added without retraining existing components, providing a parameter-isolated extension mechanism while keeping previously learned experts unchanged. Evaluated on the AbdomenAtlas 3.0 dataset, ReportMedSAM effectively interprets free-form reports, achieves competitive segmentation accuracy, and demonstrates seamless, non-interfering extension to novel clinical tasks.

cs.CL↗

arXiv2026

Artificial Intelligence for Detecting Fetal Orofacial Clefts and Advancing Medical Education

Orofacial clefts are among the most common congenital craniofacial abnormalities, yet accurate prenatal detection remains challenging due to the scarcity of experienced specialists and the relative rarity of the condition. Early and reliable diagnosis is essential to enable timely clinical intervention and reduce associated morbidity. Here we show that an artificial intelligence system, trained on over 45,139 ultrasound images from 9,215 fetuses across 22 hospitals, can diagnose fetal orofacial clefts with sensitivity and specificity exceeding 93% and 95% respectively, matching the performance of senior radiologists and substantially outperforming junior radiologists. When used as a medical copilot, the system raises junior radiologists' sensitivity by more than 6%. Beyond direct diagnostic assistance, the system also accelerates the development of clinical expertise. A pilot study involving 24 radiologists and trainees demonstrated that the model can improve the expertise development for rare conditions. This dual-purpose approach offers a scalable solution for improving both diagnostic accuracy and specialist training in settings where experienced radiologists are scarce.

cs.CV↗

arXiv2026

Ctrl-GenAug: Controllable Generative Augmentation for Medical Sequence Classification

In the medical field, the limited availability of large-scale datasets and labor-intensive annotation processes hinder the performance of deep models. Diffusion-based generative augmentation approaches present a promising solution to this issue, having been proven effective in advancing downstream medical recognition tasks. Nevertheless, existing works lack sufficient semantic and sequential steerability for challenging video/3D sequence generation, and neglect quality control of noisy synthesized samples, resulting in unreliable synthetic databases and severely limiting the performance of downstream tasks. In this work, we present Ctrl-GenAug, a novel and general generative augmentation framework that enables highly semantic- and sequential-customized sequence synthesis and suppresses incorrectly synthesized samples, to aid medical sequence classification. Specifically, we first design a multimodal conditions-guided sequence generator for controllably synthesizing diagnosis-promotive samples. A sequential augmentation module is integrated to enhance the temporal/stereoscopic coherence of generated samples. Then, we propose a noisy synthetic data filter to suppress unreliable cases at semantic and sequential levels. Extensive experiments on 3 medical datasets, using 11 networks trained on 3 paradigms, comprehensively analyze the effectiveness and generality of Ctrl-GenAug, particularly in underrepresented high-risk populations and out-domain conditions.

cs.CV↗

arXiv2025

Metrics that matter: Evaluating image quality metrics for medical image generation

Evaluating generative models for synthetic medical imaging is crucial yet challenging, especially given the high standards of fidelity, anatomical accuracy, and safety required for clinical applications. Standard evaluation of generated images often relies on no-reference image quality metrics when ground truth images are unavailable, but their reliability in this complex domain is not well established. This study comprehensively assesses commonly used no-reference image quality metrics using brain MRI data, including tumour and vascular images, providing a representative exemplar for the field. We systematically evaluate metric sensitivity to a range of challenges, including noise, distribution shifts, and, critically, localised morphological alterations designed to mimic clinically relevant inaccuracies. We then compare these metric scores against model performance on a relevant downstream segmentation task, analysing results across both controlled image perturbations and outputs from different generative model architectures. Our findings reveal significant limitations: many widely-used no-reference image quality metrics correlate poorly with downstream task suitability and exhibit a profound insensitivity to localised anatomical details crucial for clinical validity. Furthermore, these metrics can yield misleading scores regarding distribution shifts, e.g. data memorisation. This reveals the risk of misjudging model readiness, potentially leading to the deployment of flawed tools that could compromise patient safety. We conclude that ensuring generative models are truly fit for clinical purpose requires a multifaceted validation framework, integrating performance on relevant downstream tasks with the cautious interpretation of carefully selected no-reference image quality metrics.

eess.IV↗

arXiv2025

From Pixels to Polygons: A Survey of Deep Learning Approaches for Medical Image-to-Mesh Reconstruction

Deep learning-based medical image-to-mesh reconstruction has rapidly evolved, enabling the transformation of medical imaging data into three-dimensional mesh models that are critical in computational medicine and in silico trials for advancing our understanding of disease mechanisms, and diagnostic and therapeutic techniques in modern medicine. This survey systematically categorizes existing approaches into four main categories: template models, statistical models, generative models, and implicit models. Each category is analysed in detail, examining their methodological foundations, strengths, limitations, and applicability to different anatomical structures and imaging modalities. We provide an extensive evaluation of these methods across various anatomical applications, from cardiac imaging to neurological studies, supported by quantitative comparisons using standard metrics. Additionally, we compile and analyze major public datasets available for medical mesh reconstruction tasks and discuss commonly used evaluation metrics and loss functions. The survey identifies current challenges in the field, including requirements for topological correctness, geometric accuracy, and multi-modality integration. Finally, we present promising future research directions in this domain. This systematic review aims to serve as a comprehensive reference for researchers and practitioners in medical image analysis and computational medicine.

cs.CV↗

arXiv2025

Multi-view Hybrid Graph Convolutional Network for Volume-to-mesh Reconstruction in Cardiovascular MRI

Cardiovascular magnetic resonance imaging is emerging as a crucial tool to examine cardiac morphology and function. Essential to this endeavour are anatomical 3D surface and volumetric meshes derived from CMR images, which facilitate computational anatomy studies, biomarker discovery, and in-silico simulations. Traditional approaches typically follow complex multi-step pipelines, first segmenting images and then reconstructing meshes, making them time-consuming and prone to error propagation. In response, we introduce HybridVNet, a novel architecture for direct image-to-mesh extraction seamlessly integrating standard convolutional neural networks with graph convolutions, which we prove can efficiently handle surface and volumetric meshes by encoding them as graph structures. To further enhance accuracy, we propose a multi-view HybridVNet architecture which processes both long axis and short axis CMR, showing that it can increase the performance of cardiac MR mesh generation. Our model combines traditional convolutional networks with variational graph generative models, deep supervision and mesh-specific regularisation. Experiments on a comprehensive dataset from the UK Biobank confirm the potential of HybridVNet to significantly advance cardiac imaging and computational cardiology by efficiently generating high-fidelity meshes from CMR images. Multi-view HybridVNet outperforms the state-of-the-art, achieving improvements of up to $\sim$27\% reduction in Mean Contour Distance (from 1.86 mm to 1.35 mm for the LV Myocardium), up to $\sim$18\% improvement in Hausdorff distance (from 4.74 mm to 3.89mm, for the LV Endocardium), and up to $\sim$8\% in Dice Coefficient (from 0.78 to 0.84, for the LV Myocardium), highlighting its superior accuracy.

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arXiv2025

SACB-Net: Spatial-awareness Convolutions for Medical Image Registration

Deep learning-based image registration methods have shown state-of-the-art performance and rapid inference speeds. Despite these advances, many existing approaches fall short in capturing spatially varying information in non-local regions of feature maps due to the reliance on spatially-shared convolution kernels. This limitation leads to suboptimal estimation of deformation fields. In this paper, we propose a 3D Spatial-Awareness Convolution Block (SACB) to enhance the spatial information within feature representations. Our SACB estimates the spatial clusters within feature maps by leveraging feature similarity and subsequently parameterizes the adaptive convolution kernels across diverse regions. This adaptive mechanism generates the convolution kernels (weights and biases) tailored to spatial variations, thereby enabling the network to effectively capture spatially varying information. Building on SACB, we introduce a pyramid flow estimator (named SACB-Net) that integrates SACBs to facilitate multi-scale flow composition, particularly addressing large deformations. Experimental results on the brain IXI and LPBA datasets as well as Abdomen CT datasets demonstrate the effectiveness of SACB and the superiority of SACB-Net over the state-of-the-art learning-based registration methods. The code is available at https://github.com/x-xc/SACB_Net .

cs.CV↗

arXiv2024

A Symmetric Dynamic Learning Framework for Diffeomorphic Medical Image Registration

Diffeomorphic image registration is crucial for various medical imaging applications because it can preserve the topology of the transformation. This study introduces DCCNN-LSTM-Reg, a learning framework that evolves dynamically and learns a symmetrical registration path by satisfying a specified control increment system. This framework aims to obtain symmetric diffeomorphic deformations between moving and fixed images. To achieve this, we combine deep learning networks with diffeomorphic mathematical mechanisms to create a continuous and dynamic registration architecture, which consists of multiple Symmetric Registration (SR) modules cascaded on five different scales. Specifically, our method first uses two U-nets with shared parameters to extract multiscale feature pyramids from the images. We then develop an SR-module comprising a sequential CNN-LSTM architecture to progressively correct the forward and reverse multiscale deformation fields using control increment learning and the homotopy continuation technique. Through extensive experiments on three 3D registration tasks, we demonstrate that our method outperforms existing approaches in both quantitative and qualitative evaluations.

eess.IV↗

arXiv2024

Statistical Distance-Guided Unsupervised Domain Adaptation for Automated Multi-Class Cardiovascular Magnetic Resonance Image Quality Assessment

This study proposes an attention-based statistical distance-guided unsupervised domain adaptation model for multi-class cardiovascular magnetic resonance (CMR) image quality assessment. The proposed model consists of a feature extractor, a label predictor and a statistical distance estimator. An annotated dataset as the source set and an unlabeled dataset as the target set with different statistical distributions are considered inputs. The statistical distance estimator approximates the Wasserstein distance between the extracted feature vectors from the source and target data in a mini-batch. The label predictor predicts data labels of source data and uses a combinational loss function for training, which includes cross entropy and centre loss functions plus the estimated value of the distance estimator. Four datasets, including imaging and k-space data, were used to evaluate the proposed model in identifying four common CMR imaging artefacts: respiratory and cardiac motions, Gibbs ringing and Aliasing. The results of the extensive experiments showed that the proposed model, both in image and k-space analysis, has an acceptable performance in covering the domain shift between the source and target sets. The model explainability evaluations and the ablation studies confirmed the proper functioning and effectiveness of all the model's modules. The proposed model outperformed the previous studies regarding performance and the number of examined artefacts. The proposed model can be used for CMR post-imaging quality control or in large-scale cohort studies for image and k-space quality assessment due to the appropriate performance in domain shift coverage without a tedious data-labelling process.

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arXiv2024

Multiple Teachers-Meticulous Student: A Domain Adaptive Meta-Knowledge Distillation Model for Medical Image Classification

Background: Image classification can be considered one of the key pillars of medical image analysis. Deep learning (DL) faces challenges that prevent its practical applications despite the remarkable improvement in medical image classification. The data distribution differences can lead to a drop in the efficiency of DL, known as the domain shift problem. Besides, requiring bulk annotated data for model training, the large size of models, and the privacy-preserving of patients are other challenges of using DL in medical image classification. This study presents a strategy that can address the mentioned issues simultaneously. Method: The proposed domain adaptive model based on knowledge distillation can classify images by receiving limited annotated data of different distributions. The designed multiple teachers-meticulous student model trains a student network that tries to solve the challenges by receiving the parameters of several teacher networks. The proposed model was evaluated using six available datasets of different distributions by defining the respiratory motion artefact detection task. Results: The results of extensive experiments using several datasets show the superiority of the proposed model in addressing the domain shift problem and lack of access to bulk annotated data. Besides, the privacy preservation of patients by receiving only the teacher network parameters instead of the original data and consolidating the knowledge of several DL models into a model with almost similar performance are other advantages of the proposed model. Conclusions: The proposed model can pave the way for practical clinical applications of deep classification methods by achieving the mentioned objectives simultaneously.

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arXiv2024

An End-to-End Deep Learning Generative Framework for Refinable Shape Matching and Generation

Generative modelling for shapes is a prerequisite for In-Silico Clinical Trials (ISCTs), which aim to cost-effectively validate medical device interventions using synthetic anatomical shapes, often represented as 3D surface meshes. However, constructing AI models to generate shapes closely resembling the real mesh samples is challenging due to variable vertex counts, connectivities, and the lack of dense vertex-wise correspondences across the training data. Employing graph representations for meshes, we develop a novel unsupervised geometric deep-learning model to establish refinable shape correspondences in a latent space, construct a population-derived atlas and generate realistic synthetic shapes. We additionally extend our proposed base model to a joint shape generative-clustering multi-atlas framework to incorporate further variability and preserve more details in the generated shapes. Experimental results using liver and left-ventricular models demonstrate the approach's applicability to computational medicine, highlighting its suitability for ISCTs through a comparative analysis.

cs.CV↗

arXiv2024

A Generative Shape Compositional Framework to Synthesise Populations of Virtual Chimaeras

Generating virtual populations of anatomy that capture sufficient variability while remaining plausible is essential for conducting in-silico trials of medical devices. However, not all anatomical shapes of interest are always available for each individual in a population. Hence, missing/partially-overlapping anatomical information is often available across individuals in a population. We introduce a generative shape model for complex anatomical structures, learnable from datasets of unpaired datasets. The proposed generative model can synthesise complete whole complex shape assemblies coined virtual chimaeras, as opposed to natural human chimaeras. We applied this framework to build virtual chimaeras from databases of whole-heart shape assemblies that each contribute samples for heart substructures. Specifically, we propose a generative shape compositional framework which comprises two components - a part-aware generative shape model which captures the variability in shape observed for each structure of interest in the training population; and a spatial composition network which assembles/composes the structures synthesised by the former into multi-part shape assemblies (viz. virtual chimaeras). We also propose a novel self supervised learning scheme that enables the spatial composition network to be trained with partially overlapping data and weak labels. We trained and validated our approach using shapes of cardiac structures derived from cardiac magnetic resonance images available in the UK Biobank. Our approach significantly outperforms a PCA-based shape model (trained with complete data) in terms of generalisability and specificity. This demonstrates the superiority of the proposed approach as the synthesised cardiac virtual populations are more plausible and capture a greater degree of variability in shape than those generated by the PCA-based shape model.

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arXiv2024

Unsupervised Domain Adaptation for Brain Vessel Segmentation through Transwarp Contrastive Learning

Unsupervised domain adaptation (UDA) aims to align the labelled source distribution with the unlabelled target distribution to obtain domain-invariant predictive models. Since cross-modality medical data exhibit significant intra and inter-domain shifts and most are unlabelled, UDA is more important while challenging in medical image analysis. This paper proposes a simple yet potent contrastive learning framework for UDA to narrow the inter-domain gap between labelled source and unlabelled target distribution. Our method is validated on cerebral vessel datasets. Experimental results show that our approach can learn latent features from labelled 3DRA modality data and improve vessel segmentation performance in unlabelled MRA modality data.

cs.CV↗

arXiv2024

GS-EMA: Integrating Gradient Surgery Exponential Moving Average with Boundary-Aware Contrastive Learning for Enhanced Domain Generalization in Aneurysm Segmentation

The automated segmentation of cerebral aneurysms is pivotal for accurate diagnosis and treatment planning. Confronted with significant domain shifts and class imbalance in 3D Rotational Angiography (3DRA) data from various medical institutions, the task becomes challenging. These shifts include differences in image appearance, intensity distribution, resolution, and aneurysm size, all of which complicate the segmentation process. To tackle these issues, we propose a novel domain generalization strategy that employs gradient surgery exponential moving average (GS-EMA) optimization technique coupled with boundary-aware contrastive learning (BACL). Our approach is distinct in its ability to adapt to new, unseen domains by learning domain-invariant features, thereby improving the robustness and accuracy of aneurysm segmentation across diverse clinical datasets. The results demonstrate that our proposed approach can extract more domain-invariant features, minimizing over-segmentation and capturing more complete aneurysm structures.

cs.CV↗

arXiv2023

Learned Local Attention Maps for Synthesising Vessel Segmentations

Magnetic resonance angiography (MRA) is an imaging modality for visualising blood vessels. It is useful for several diagnostic applications and for assessing the risk of adverse events such as haemorrhagic stroke (resulting from the rupture of aneurysms in blood vessels). However, MRAs are not acquired routinely, hence, an approach to synthesise blood vessel segmentations from more routinely acquired MR contrasts such as T1 and T2, would be useful. We present an encoder-decoder model for synthesising segmentations of the main cerebral arteries in the circle of Willis (CoW) from only T2 MRI. We propose a two-phase multi-objective learning approach, which captures both global and local features. It uses learned local attention maps generated by dilating the segmentation labels, which forces the network to only extract information from the T2 MRI relevant to synthesising the CoW. Our synthetic vessel segmentations generated from only T2 MRI achieved a mean Dice score of $0.79 \pm 0.03$ in testing, compared to state-of-the-art segmentation networks such as transformer U-Net ($0.71 \pm 0.04$) and nnU-net($0.68 \pm 0.05$), while using only a fraction of the parameters. The main qualitative difference between our synthetic vessel segmentations and the comparative models was in the sharper resolution of the CoW vessel segments, especially in the posterior circulation.

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