arXiv subjects

Andrea M. Bejar

Publications and source records attributed to Andrea M. Bejar.

5 recordsLinked to original sources

arXiv2026

Gaussian Meta-Space Augmentation for Stacking Ensembles in Multimodal IPMN Risk Stratification

Pancreatic cancer is among the most lethal malignancies; risk stratification of intraductal papillary mucinous neoplasms (IPMNs) offers a crucial opportunity for early intervention but typically requires invasive tissue biopsy. Dominant vision-based approaches, including radiomics and deep learning, provide promising but initially separate discrimination opportunities. Similarly, multisequence MRI (T1W/T2W) and anatomically decomposed (head, body and tail) analysis of the pancreas provide additional and potentially complementary signals. Effective fusion of this information is crucial in ordinal IPMN dysplasia risk prediction and can be accomplished via a meticulously regularized and calibrated ensemble stacking combiner. We present cUPMI, a class-conditional Gaussian augmentation of a combiner's log-probability meta-features, and test it on various prediction paradigms. In our multi-center analysis, we find cUPMI adds limited value to properly regularized L2-logistic binary classification stacks, but consistently regularizes higher-capacity tree combiners in the binary and radiomics-only setting (RF +0.015 and XGBoost +0.024 binary AUC, positive in all seeds). Its cleanest ordinal benefit appears for XGBoost on an 8-stream radiomics task (3-class no < low < high, +0.022 QWK in all seeds). Separately, fold-locked fusion of radiomics and 2.5D CNN streams yields the strongest overall model, an RF stack reaching QWK 0.595 (95% CI [0.54, 0.64]) and binary AUC 0.839, surpassing radiomics, 2.5D ResNet, and 3D DenseNet-121 baselines.

cs.CV↗

arXiv2026

Beyond Medical Diagnostics: How Medical Multimodal Large Language Models Think in Space

Visual spatial intelligence is critical for medical image interpretation, yet remains largely unexplored in Multimodal Large Language Models (MLLMs) for 3D imaging. This gap persists due to a systemic lack of datasets featuring structured 3D spatial annotations beyond basic labels. In this study, we introduce an agentic pipeline that autonomously synthesizes spatial visual question-answering (VQA) data by orchestrating computational tools such as volume estimation and bounding boxes extraction with multi-agent collaboration and expert radiologist validation. We present SpatialMed, the first comprehensive benchmark for evaluating 3D spatial intelligence in medical MLLMs, comprising 31,253 question-answer pairs across multiple organs and tumor types. Our evaluations on 24 state-of-the-art MLLMs and extensive analyses reveal that current models lack robust spatial reasoning capabilities for medical imaging.

cs.CV↗

arXiv2026

Revisiting LLM Adaptation for 3D CT Report Generation: A Study of Scaling and Diagnostic Priors

Recent advances in multimodal learning, including large language models (LLMs) and vision-language models (VLMs), have demonstrated strong adaptability to natural images. However, extending their use to the medical domain, particularly for volumetric (3D) images, is challenging due to high computational complexity, volumetric dependencies and the semantic gap between visual features and clinical terminology. Naively fine-tuning LLMs on limited medical data often leads to overfitting and clinical hallucination, where linguistic fluency is prioritized over clinical factuality. In this study, we investigate parameter-efficient adaptation strategies for volumetric CT report generation and introduce RAD3D-Prefix, a lightweight diagnostic-prior conditioning framework that minimizes the need for extensive parameter training. This module integrates image embeddings with multi-label diagnostic classification logits, preserving critical clinical details while bridging the semantic gap. By keeping the LLM frozen, our method requires minimal trainable parameters and mitigates the risk of overfitting on small, domain-specific datasets. Through a systematic study spanning LLMs from 96.1M to 1.6B parameters, we find that fine-tuning is most beneficial for smaller LLMs, whereas freezing larger (~1B+ LLMs and training only lightweight projection layers provides a superior trade-off between performance, generalization, and computational efficiency. Across multiple automatic metrics and a clinical reader study, RAD3D-Prefix outperforms comparable parameter-efficient baselines and demonstrates strong out-of-domain generalization while using substantially fewer trainable parameters than fully fine-tuned alternatives.

cs.CL↗

arXiv2026

LUMINA: A Multi-Vendor Mammography Benchmark with Energy Harmonization Protocol

Publicly available full-field digital mammography (FFDM) datasets remain limited in size, clinical annotations, and vendor diversity, hindering the development of robust models. We introduce LUMINA, a curated, multi-vendor FFDM dataset that explicitly encodes acquisition energy and vendor metadata to capture clinically relevant appearance variations often overlooked in existing benchmarks. This dataset contains 1824 images from 468 patients (960 benign, 864 malignant), with pathology-confirmed labels, BI-RADS assessments, and breast-density annotations. LUMINA spans six acquisition systems and includes both high- and low-energy imaging styles, enabling systematic analysis of vendor- and energy-induced domain shifts. To address these variations, we propose a foreground-only pixel-space alignment method (''energy harmonization'') that maps images to a low-energy reference while preserving lesion morphology. We benchmark CNN and transformer models on three clinically relevant tasks: diagnosis (benign vs. malignant), BI-RADS classification, and density estimation. Two-view models consistently outperform single-view models. EfficientNet-B0 achieves an AUC of 93.54% for diagnosis, while Swin-T achieves the best macro-AUC of 89.43% for density prediction. Harmonization improves performance across architectures and produces more localized Grad-CAM responses. Overall, LUMINA provides (1) a vendor-diverse benchmark and (2) a model-agnostic harmonization framework for reliable and deployable mammography AI.

eess.IV↗

arXiv2025

Rethink Domain Generalization in Heterogeneous Sequence MRI Segmentation

Clinical magnetic-resonance (MR) protocols generate many T1 and T2 sequences whose appearance differs more than the acquisition sites that produce them. Existing domain-generalization benchmarks focus almost on cross-center shifts and overlook this dominant source of variability. Pancreas segmentation remains a major challenge in abdominal imaging: the gland is small, irregularly, surrounded by organs and fat, and often suffers from low T1 contrast. State-of-the-art deep networks that already achieve >90% Dice on the liver or kidneys still miss 20-30% of the pancreas. The organ is also systematically under-represented in public cross-domain benchmarks, despite its clinical importance in early cancer detection, surgery, and diabetes research. To close this gap, we present PancreasDG, a large-scale multi-center 3D MRI pancreas segmentation dataset for investigating domain generalization in medical imaging. The dataset comprises 563 MRI scans from six institutions, spanning both venous phase and out-of-phase sequences, enabling study of both cross-center and cross-sequence variations with pixel-accurate pancreas masks created by a double-blind, two-pass protocol. Through comprehensive analysis, we reveal three insights: (i) limited sampling introduces significant variance that may be mistaken for distribution shifts, (ii) cross-center performance correlates with source domain performance for identical sequences, and (iii) cross-sequence shifts require specialized solutions. We also propose a semi-supervised approach that leverages anatomical invariances, significantly outperforming state-of-the-art domain generalization techniques with 61.63% Dice score improvements and 87.00% on two test centers for cross-sequence segmentation. PancreasDG sets a new benchmark for domain generalization in medical imaging. Dataset, code, and models will be available at https://pancreasdg.netlify.app.

eess.IV↗