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Alexander Jaus

Publications and source records attributed to Alexander Jaus.

At least 19 recordsLinked to original sources

Case2Flow: Bridging Patient Cases and Guideline Flowcharts through Multimodal Retrieval

Medical guidelines encode rich, evidence-based decision logic, yet the specific decision artifact a clinician needs is hard to locate within a guideline, let alone across guidelines covering plausible diseases and treatments. While guideline passages have supported end-to-end question answering, flowcharts remain largely underused in decision support despite their ability to encode actionable clinical pathways. We therefore introduce Case2Flow, a task designed to retrieve the most relevant guideline flowchart for a given patient case from a collection of guideline documents. To support it, we construct FlowAtlas, a curated corpus of 202 flowcharts extracted from 2,080 medical guidelines, together with a pipeline that synthesises 1,911 aligned case-flowchart pairs. Our evaluation of multimodal retrieval methods reveals systematic failure modes, including overreliance on keywords and spurious token-patch matches induced by uninformative background regions in flowcharts. Motivated by this, we propose CRISP, a training-free scoring method that sharpens late-interaction retrieval by suppressing uninformative patches, discounting ambiguous token matches, and incorporating bidirectional query-image alignment. CRISP improves Recall@1 by up to 18.71 percentage points, while a blinded physician assessment on published case narratives provides preliminary feasibility evidence beyond synthetic queries.

cs.CL

Quo Vadis, Visual In-Context Learning? A Unified Benchmark Across Domains and Tasks

Visual in-context learning has been proposed as a pathway towards dynamic models that can generate predictions based on a provided context and thereby can adapt to new vision tasks at test-time. Yet, the evaluation of the adaptation capabilities of these models has been limited to narrow setups that mainly mirror tasks or image domains from pre-training for which real adaptation is not required. We address this gap by constructing a broad Visual In-Context BEnchmark (VIBE) with a focus on diverse imaging domains and a wide range of tasks. With this, we are able to get a much clearer picture of the adaptive capabilities of visual in-context models when faced with new image- and task distributions. We stress test six models on $14$ datasets and $12$ tasks (in total, we explore $106$ dataset-task combinations) and compare them under a unified, reproducible evaluation protocol, in an one-shot setting. Our evaluation uncovers key insights on the state of visual in-context learning, including limitations, systematic failure modes and promising directions. To foster broader evaluation, we will openly release our VIBE toolkit.

cs.CV

The autoPET3 Challenge: Automated Lesion Segmentation in Whole-Body PET/CT $\unicode{x2013}$ Multitracer Multicenter Generalization

We report the design and results of the third autoPET challenge (MICCAI 2024), which benchmarked automated lesion segmentation in whole-body PET/CT under a compositional generalization setting. Training data comprised 1,014 [18F]-FDG PET/CT studies from the University Hospital T\"ubingen and 597 [18F]/[68Ga]-PSMA PET/CT studies from the LMU University Hospital Munich, constituting the largest publicly available annotated PSMA PET/CT dataset to date. The held-out test set of 200 studies covered four tracer-center combinations, two of which represented unseen compositional pairings. A complementary data-centric award category isolated the contribution of data handling strategies by restricting participants to a fixed baseline model. Seventeen teams submitted 27 algorithms, predominantly nnU-Net-based 3D networks with PET/CT channel concatenation. The top-ranked algorithm achieved a mean DSC of 0.66, FNV of 3.18 mL, and FPV of 2.78 mL across all four test conditions, improving DSC by 8% and reducing the false-negative volume by 5 mL relative to the provided baseline. Ranking was stable across bootstrap resampling and alternative ranking schemes for the top tier. Beyond the benchmark, we provide an in-depth analysis of segmentation performance at the patient and lesion level. Three main conclusions can be drawn: (1) in-domain multitracer PET/CT segmentation is sufficient and probably approaching reader agreement; (2) compositional generalization to unseen tracer-center combinations remains an open problem mainly driven by systematic volume overestimation; (3) heterogeneity and case difficulty drive performance variation substantially more than the choice of algorithm among top-ranked teams.

cs.CV

IMPACT-HOI: Supervisory Control for Onset-Anchored Partial HOI Event Construction

We present IMPACT-HOI, a mixed-initiative framework for annotating egocentric procedural video by constructing structured event graphs for Human-Object Interactions (HOI), motivated by the need for high-quality structured supervision for learning robot manipulation from human demonstration. IMPACT-HOI frames this task as the incremental resolution of a partially specified, onset-anchored event state. A trust-calibrated controller selects among direct queries, human-confirmed suggestions, and conservative completions based on empirical annotator behavior and evidence quality. A risk-bounded execution protocol, utilizing atomic rollback, ensures that human-confirmed decisions are preserved against conflicting automated updates. A user study with 9 participants shows a 13.5% reduction in manual annotation actions, a 46.67% event match rate, and zero confirmed-field violations under the studied protocol. The code will be made publicly available at https://github.com/541741106/IMPACT_HOI.

cs.CV

IMPACT-Scribe: Interactive Temporal Action Segmentation with Boundary Scribbles and Query Planning

Dense temporal annotation of procedural activity videos is vital for action understanding and embodied intelligence but remains labor-intensive due to reactive tools. Each correction is treated as an isolated edit, limiting reuse of information on annotator uncertainty and model reliability. We introduce IMPACT-Scribe, a correction-driven framework for dense labeling that uses each correction to improve future human-machine collaboration. IMPACT-Scribe combines uncertainty-aware boundary scribble supervision, local proposal modeling, cost-aware query planning, structured propagation, and correction-driven adaptation. Experiments and a human study show that this closed-loop design improves labeling quality per effort, enhances boundary accuracy, and fosters better human-machine interaction over time. The code will be made publicly available at https://github.com/BanzQians/IMPACT_AS.

cs.CV

IMPACT-CYCLE: A Contract-Based Multi-Agent System for Claim-Level Supervisory Correction of Long-Video Semantic Memory

Correcting errors in long-video understanding is disproportionately costly: existing multimodal pipelines produce opaque, end-to-end outputs that expose no intermediate state for inspection, forcing annotators to revisit raw video and reconstruct temporal logic from scratch. The core bottleneck is not generation quality alone, but the absence of a supervisory interface through which human effort can be proportional to the scope of each error. We present IMPACT-CYCLE, a supervisory multi-agent system that reformulates long-video understanding as iterative claim-level maintenance of a shared semantic memory -- a structured, versioned state encoding typed claims, a claim dependency graph, and a provenance log. Role-specialized agents operating under explicit authority contracts decompose verification into local object-relation correctness, cross-temporal consistency, and global semantic coherence, with corrections confined to structurally dependent claims. When automated evidence is insufficient, the system escalates to human arbitration as the supervisory authority with final override rights; dependency-closure re-verification then ensures correction cost remains proportional to error scope. Experiments on VidOR show substantially improved downstream reasoning (VQA: 0.71 to 0.79) and a 4.8x reduction in human arbitration cost, with workload significantly lower than manual annotation. Code will be released at https://github.com/MKong17/IMPACT_CYCLE.

cs.CV

Learning to Look Closer: A New Instance-Wise Loss for Small Cerebral Lesion Segmentation

Traditional loss functions in medical image segmentation, such as Dice, often under-segment small lesions because their small relative volume contributes negligibly to the overall loss. To address this, instance-wise loss functions and metrics have been proposed to evaluate segmentation quality on a per-lesion basis. We introduce CC-DiceCE, a loss function based on the CC-Metrics framework, and compare it with the existing blob loss. Both are benchmarked against a DiceCE baseline within the nnU-Net framework, which provides a robust and standardized setup. We find that CC-DiceCE loss increases detection (recall) with minimal to no degradation in segmentation performance, though with dataset-dependent trade-offs in precision. Furthermore, our multi-dataset study shows that CC-DiceCE generally outperforms blob loss.

cs.CV

GRASPing Anatomy to Improve Pathology Segmentation

Radiologists rely on anatomical understanding to accurately delineate pathologies, yet most current deep learning approaches use pure pattern recognition and ignore the anatomical context in which pathologies develop. To narrow this gap, we introduce GRASP (Guided Representation Alignment for the Segmentation of Pathologies), a modular plug-and-play framework that enhances pathology segmentation models by leveraging existing anatomy segmentation models through pseudolabel integration and feature alignment. Unlike previous approaches that obtain anatomical knowledge via auxiliary training, GRASP integrates into standard pathology optimization regimes without retraining anatomical components. We evaluate GRASP on two PET/CT datasets, conduct systematic ablation studies, and investigate the framework's inner workings. We find that GRASP consistently achieves top rankings across multiple evaluation metrics and diverse architectures. The framework's dual anatomy injection strategy, combining anatomical pseudo-labels as input channels with transformer-guided anatomical feature fusion, effectively incorporates anatomical context.

cs.CV

Semantic Segmentation for Preoperative Planning in Transcatheter Aortic Valve Replacement

When preoperative planning for surgeries is conducted on the basis of medical images, artificial intelligence methods can support medical doctors during assessment. In this work, we consider medical guidelines for preoperative planning of the transcatheter aortic valve replacement (TAVR) and identify tasks, that may be supported via semantic segmentation models by making relevant anatomical structures measurable in computed tomography scans. We first derive fine-grained TAVR-relevant pseudo-labels from coarse-grained anatomical information, in order to train segmentation models and quantify how well they are able to find these structures in the scans. Furthermore, we propose an adaptation to the loss function in training these segmentation models and through this achieve a +1.27% Dice increase in performance. Our fine-grained TAVR-relevant pseudo-labels and the computed tomography scans we build upon are available at https://doi.org/10.5281/zenodo.16274176.

eess.IV

Is Visual in-Context Learning for Compositional Medical Tasks within Reach?

In this paper, we explore the potential of visual in-context learning to enable a single model to handle multiple tasks and adapt to new tasks during test time without re-training. Unlike previous approaches, our focus is on training in-context learners to adapt to sequences of tasks, rather than individual tasks. Our goal is to solve complex tasks that involve multiple intermediate steps using a single model, allowing users to define entire vision pipelines flexibly at test time. To achieve this, we first examine the properties and limitations of visual in-context learning architectures, with a particular focus on the role of codebooks. We then introduce a novel method for training in-context learners using a synthetic compositional task generation engine. This engine bootstraps task sequences from arbitrary segmentation datasets, enabling the training of visual in-context learners for compositional tasks. Additionally, we investigate different masking-based training objectives to gather insights into how to train models better for solving complex, compositional tasks. Our exploration not only provides important insights especially for multi-modal medical task sequences but also highlights challenges that need to be addressed.

cs.CV

Good Enough? An Investigation on the Impact of Label Quality in Large-Scale Medical Datasets

Manually refining radiological segmentation masks is highly resource-intensive. To determine when this expert commitment is truly justified for the training of segmentation models, we investigate the relationship between label quality and model performance. Expanding beyond models trained directly for inference, we conduct the first study isolating the impact of label quality in pre-training datasets. While high-quality labels remain essential for models proceeding directly to deployment, we find no evidence that strict label quality is crucial for pre-training efficacy. These results question the necessity of exhaustive human-in-the-loop refinement for massive corpora intended for pretraining and suggest that expert effort is more effectively invested in well-curated downstream target datasets.

cs.CV

OmniFall: From Staged Through Synthetic to Wild, A Unified Multi-Domain Dataset for Robust Fall Detection

Visual fall detection models are usually trained on small, staged datasets. Their real-world utility remains unclear; such data lacks diversity and evaluation protocols differ from paper to paper. We propose OmniFall, a unified benchmark of 15k videos (80 hours) with frame-level annotations in a single 16-class taxonomy. It spans three domains: OF-Staged unifies eight staged datasets with cross-subject and cross-view splits; OF-Synthetic adds 12k videos (17 h) with controlled demographic and environmental diversity; and OF-In-the-Wild provides a test-only set of genuine accident videos. We evaluate fine-tuned models as well as much larger zero-shot multimodal LLMs. On in-the-wild fall events, both do comparably well. The clinically critical fallen state is where they part: zero-shot models keep confusing fallen with lying, whereas models fine-tuned on synthetic data with explicit fallen-state scenes do substantially better. We release the unified annotations, the synthetic data, and the in-the-wild test set to foster the development of fall and fallen-state detectors for uncontrolled environments. Dataset: https://hf.co/datasets/simplexsigil2/omnifall

cs.CV

Muscles in Time: Learning to Understand Human Motion by Simulating Muscle Activations

Exploring the intricate dynamics between muscular and skeletal structures is pivotal for understanding human motion. This domain presents substantial challenges, primarily attributed to the intensive resources required for acquiring ground truth muscle activation data, resulting in a scarcity of datasets. In this work, we address this issue by establishing Muscles in Time (MinT), a large-scale synthetic muscle activation dataset. For the creation of MinT, we enriched existing motion capture datasets by incorporating muscle activation simulations derived from biomechanical human body models using the OpenSim platform, a common approach in biomechanics and human motion research. Starting from simple pose sequences, our pipeline enables us to extract detailed information about the timing of muscle activations within the human musculoskeletal system. Muscles in Time contains over nine hours of simulation data covering 227 subjects and 402 simulated muscle strands. We demonstrate the utility of this dataset by presenting results on neural network-based muscle activation estimation from human pose sequences with two different sequence-to-sequence architectures. Data and code are provided under https://simplexsigil.github.io/mint.

cs.CV

Every Component Counts: Rethinking the Measure of Success for Medical Semantic Segmentation in Multi-Instance Segmentation Tasks

We present Connected-Component~(CC)-Metrics, a novel semantic segmentation evaluation protocol, targeted to align existing semantic segmentation metrics to a multi-instance detection scenario in which each connected component matters. We motivate this setup in the common medical scenario of semantic metastases segmentation in a full-body PET/CT. We show how existing semantic segmentation metrics suffer from a bias towards larger connected components contradicting the clinical assessment of scans in which tumor size and clinical relevance are uncorrelated. To rebalance existing segmentation metrics, we propose to evaluate them on a per-component basis thus giving each tumor the same weight irrespective of its size. To match predictions to ground-truth segments, we employ a proximity-based matching criterion, evaluating common metrics locally at the component of interest. Using this approach, we break free of biases introduced by large metastasis for overlap-based metrics such as Dice or Surface Dice. CC-Metrics also improves distance-based metrics such as Hausdorff Distances which are uninformative for small changes that do not influence the maximum or 95th percentile, and avoids pitfalls introduced by directly combining counting-based metrics with overlap-based metrics as it is done in Panoptic Quality.

cs.CV

LIMIS: Towards Language-based Interactive Medical Image Segmentation

Within this work, we introduce LIMIS: The first purely language-based interactive medical image segmentation model. We achieve this by adapting Grounded SAM to the medical domain and designing a language-based model interaction strategy that allows radiologists to incorporate their knowledge into the segmentation process. LIMIS produces high-quality initial segmentation masks by leveraging medical foundation models and allows users to adapt segmentation masks using only language, opening up interactive segmentation to scenarios where physicians require using their hands for other tasks. We evaluate LIMIS on three publicly available medical datasets in terms of performance and usability with experts from the medical domain confirming its high-quality segmentation masks and its interactive usability.

cs.CV

Data Diet: Can Trimming PET/CT Datasets Enhance Lesion Segmentation?

In this work, we describe our approach to compete in the autoPET3 datacentric track. While conventional wisdom suggests that larger datasets lead to better model performance, recent studies indicate that excluding certain training samples can enhance model accuracy. We find that in the autoPETIII dataset, a model that is trained on the entire dataset exhibits undesirable characteristics by producing a large number of false positives particularly for PSMA-PETs. We counteract this by removing the easiest samples from the training dataset as measured by the model loss before retraining from scratch. Using the proposed approach we manage to drive down the false negative volume and improve upon the baseline model in both false negative volume and dice score on the preliminary test set. Code and pre-trained models are available at github.com/alexanderjaus/autopet3_datadiet.

eess.IV

Anatomy-guided Pathology Segmentation

Pathological structures in medical images are typically deviations from the expected anatomy of a patient. While clinicians consider this interplay between anatomy and pathology, recent deep learning algorithms specialize in recognizing either one of the two, rarely considering the patient's body from such a joint perspective. In this paper, we develop a generalist segmentation model that combines anatomical and pathological information, aiming to enhance the segmentation accuracy of pathological features. Our Anatomy-Pathology Exchange (APEx) training utilizes a query-based segmentation transformer which decodes a joint feature space into query-representations for human anatomy and interleaves them via a mixing strategy into the pathology-decoder for anatomy-informed pathology predictions. In doing so, we are able to report the best results across the board on FDG-PET-CT and Chest X-Ray pathology segmentation tasks with a margin of up to 3.3% as compared to strong baseline methods. Code and models will be publicly available at github.com/alexanderjaus/APEx.

cs.CV

Towards Unifying Anatomy Segmentation: Automated Generation of a Full-body CT Dataset via Knowledge Aggregation and Anatomical Guidelines

In this study, we present a method for generating automated anatomy segmentation datasets using a sequential process that involves nnU-Net-based pseudo-labeling and anatomy-guided pseudo-label refinement. By combining various fragmented knowledge bases, we generate a dataset of whole-body CT scans with $142$ voxel-level labels for 533 volumes providing comprehensive anatomical coverage which experts have approved. Our proposed procedure does not rely on manual annotation during the label aggregation stage. We examine its plausibility and usefulness using three complementary checks: Human expert evaluation which approved the dataset, a Deep Learning usefulness benchmark on the BTCV dataset in which we achieve 85% dice score without using its training dataset, and medical validity checks. This evaluation procedure combines scalable automated checks with labor-intensive high-quality expert checks. Besides the dataset, we release our trained unified anatomical segmentation model capable of predicting $142$ anatomical structures on CT data.

eess.IV