arXiv subjects

Bartłomiej W. Papież

Publications and source records attributed to Bartłomiej W. Papież.

16 recordsLinked to original sources

arXiv2026

Beyond the Encoder: Object-Centric Representations Emerging from Segmentation Foundation Models

Foundation models are increasingly used as feature extractors for downstream tasks with limited data, typically through representations obtained from their encoders. However, foundation models trained for structured tasks such as segmentation also form object-specific representations during task execution, whose transferability remains largely unexplored. We investigate Segment Anything Model 2 (SAM2) object pointers, compact object-level representations produced through the segmentation pathway, as transferable representations for downstream tumour prediction. Through experiments on two PET/CT tumour prediction tasks, we find that object pointers learned using segmentation supervision alone already encode tumour-discriminative information, despite never being optimised for the downstream labels. We further introduce task-guided object pointers, where an auxiliary objective jointly shapes the object pointer space for the downstream prediction together with segmentation. Task-guided pointers improve cancer-type classification, outperforming conventional encoder-based transfer and radiomics, while segmentation-only pointers perform best on the more challenging recurrence prediction task. Representation analyses reveal associations between object pointers and interpretable radiomics features, class-dependent organisation of the learned representation space, and explicit spatial grounding around the segmented tumour. Together, these findings suggest that useful transferable representations can emerge through the execution of a foundation model's primary task, providing an alternative to conventional encoder-based transfer.

cs.CV↗

arXiv2026

When Two Tracers Disagree: An Investigation of Multimodal Fusion for Clinical PET/CT Segmentation

PSMA and FDG PET/CT visualise complementary biological information in prostate cancer. Combining both tracers could capture heterogeneous tumour phenotypes that may be missed by either alone, yet there is no consensus on effective deep learning architectures for fusing these modalities. We evaluated multimodal image-fusion strategies for automatic whole-body PET/CT lesion segmentation to estimate total tumour burden. Using the public DEEP-PSMA Challenge dataset, we trained tracer-specific 3D nnU-Net baselines and compared (i) early fusion with a single encoder and one decoder (OEOD) or two decoders (OETD), and (ii) intermediate fusion via a dual-encoder cross-attention U-Net (DECA-UNet). Tracer-specific baselines performed strongly (PSMA Dice = 0.93; FDG = 0.81). Fusion yielded mixed results: OEOD produced a combined Dice of 0.90 (on an easier, non-tracer-specific task), whilst the tracer-specific fusion models reached PSMA/FDG = 0.69/0.64 (OETD) and 0.76/0.57 (DECA-UNet). Whilst fusion often provided reasonable PSMA segmentation, FDG performance degraded and no strategy consistently exceeded the single-tracer baselines. Under the evaluated setting, tracer-specific models remain the stronger baseline; clinically useful gains from multimodal fusion will likely require architectures that better preserve tracer specific representations. Our code is available at: https://github.com/JackJ3636/DEEP_PSMA_code

cs.CV↗

arXiv2026

Evaluation of Clinically Steerable Retinal Image Generation from Foundation Model Latent Spaces

Medical foundation models learn latent representations of clinically meaningful phenotypes, yet their ability to support controllable image generation remains largely unexplored. We evaluate four retinal foundation models within the representation tokenizer framework and examine whether demographic and clinical information encoded in latent representations from foundation models is preserved during synthetic image generation. We show that generated representations and images faithfully inherit phenotype information when evaluated within their originating foundation models, consistently outperforming conventional latent diffusion on multiple downstream prediction tasks. However, these gains largely disappear when evaluated using classifiers trained on real images, revealing a previously uncharacterised synthetic-to-real representation gap. These findings demonstrate that foundation-model latent spaces provide a powerful substrate for controllable retinal synthesis while highlighting the need to better align synthetic representations with real-image distributions.

cs.CV↗

arXiv2026

PET/CT Radiogenomic Mutation Prediction in Non-Small Cell Lung Cancer Using Multi-Label Learning

Lung cancer remains one of the leading causes of cancer- related mortality worldwide. Although targeted therapies have improved outcomes for patients with non-small cell lung cancer (NSCLC), they rely on mutation profiling through tissue biopsy, an invasive procedure with several limitations. This study investigates PET/CT-based radio- genomic prediction of epidermal growth factor receptor (EGFR), tumour protein 53 (TP53), and Kirsten rat sarcoma viral oncogene (KRAS) mutations using deep learning. We further evaluate whether pairwise multi-label learning improves mutation prediction compared with conventional single-gene classification. To the best of our knowledge, this is among the first studies to systematically investigate multi-label learning for PET/CT radiogenomic mutation prediction in NSCLC. Experiments were conducted on a novel UK-based radiogenomics cohort. Joint pre- diction of KRAS and TP53 improved AUC from 0.58 to 0.64 for KRAS and from 0.69 to 0.71 for TP53. For the EGFR/KRAS pair, only EGFR benefited from joint learning, while no improvement was observed for the EGFR/TP53 pair. These findings demonstrate that the effectiveness of multi-label learning depends on the specific combination of gene mutations being modelled, suggesting that mutation-specific modelling strategies may be preferable for PET/CT radiogenomic prediction.

cs.LG↗

arXiv2026

Deformation-Recovery Diffusion Model (DRDM): Instance Deformation for Image Manipulation and Synthesis

In medical imaging, the diffusion models have shown great potential for synthetic image generation tasks. However, these approaches often lack the interpretable connections between the generated and real images and can create anatomically implausible structures or illusions. To address these limitations, we propose the Deformation-Recovery Diffusion Model (DRDM), a novel diffusion-based generative model that emphasises morphological transformation through deformation fields rather than direct image synthesis. DRDM introduces a topology-preserving deformation field generation strategy, which randomly samples and integrates multi-scale Deformation Velocity Fields (DVFs). DRDM is trained to learn to recover unrealistic deformation components, thus restoring randomly deformed images to a realistic distribution. This formulation enables the generation of diverse yet anatomically plausible deformations that preserve structural integrity, thereby improving data augmentation and synthesis for downstream tasks such as few-shot learning and image registration. Experiments on cardiac Magnetic Resonance Imaging and pulmonary Computed Tomography show that DRDM is capable of creating diverse, large-scale deformations, while maintaining anatomical plausibility of deformation fields. Additional evaluations on 2D image segmentation and 3D image registration tasks indicate notable performance gains, underscoring DRDM's potential to enhance both image manipulation and generative modelling in medical imaging applications. Project page: https://jianqingzheng.github.io/def_diff_rec/

eess.IV↗

arXiv2025

Subgroups Matter for Robust Bias Mitigation

Despite the constant development of new bias mitigation methods for machine learning, no method consistently succeeds, and a fundamental question remains unanswered: when and why do bias mitigation techniques fail? In this paper, we hypothesise that a key factor may be the often-overlooked but crucial step shared by many bias mitigation methods: the definition of subgroups. To investigate this, we conduct a comprehensive evaluation of state-of-the-art bias mitigation methods across multiple vision and language classification tasks, systematically varying subgroup definitions, including coarse, fine-grained, intersectional, and noisy subgroups. Our results reveal that subgroup choice significantly impacts performance, with certain groupings paradoxically leading to worse outcomes than no mitigation at all. Our findings suggest that observing a disparity between a set of subgroups is not a sufficient reason to use those subgroups for mitigation. Through theoretical analysis, we explain these phenomena and uncover a counter-intuitive insight that, in some cases, improving fairness with respect to a particular set of subgroups is best achieved by using a different set of subgroups for mitigation. Our work highlights the importance of careful subgroup definition in bias mitigation and presents it as an alternative lever for improving the robustness and fairness of machine learning models.

cs.LG↗

arXiv2025

SpineFM: Leveraging Foundation Models for Automatic Spine X-ray Segmentation

This paper introduces SpineFM, a novel pipeline that achieves state-of-the-art performance in the automatic segmentation and identification of vertebral bodies in cervical and lumbar spine radiographs. SpineFM leverages the regular geometry of the spine, employing a novel inductive process to sequentially infer the location of each vertebra along the spinal column. Vertebrae are segmented using Medical-SAM-Adaptor, a robust foundation model that diverges from commonly used CNN-based models. We achieved outstanding results on two publicly available spine X-Ray datasets, with successful identification of 97.8\% and 99.6\% of annotated vertebrae, respectively. Of which, our segmentation reached an average Dice of 0.942 and 0.921, surpassing previous state-of-the-art methods.

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arXiv2024

Autopet Challenge 2023: nnUNet-based whole-body 3D PET-CT Tumour Segmentation

Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) combined with Computed Tomography (CT) scans are critical in oncology to the identification of solid tumours and the monitoring of their progression. However, precise and consistent lesion segmentation remains challenging, as manual segmentation is time-consuming and subject to intra- and inter-observer variability. Despite their promise, automated segmentation methods often struggle with false positive segmentation of regions of healthy metabolic activity, particularly when presented with such a complex range of tumours across the whole body. In this paper, we explore the application of the nnUNet to tumour segmentation of whole-body PET-CT scans and conduct different experiments on optimal training and post-processing strategies. Our best model obtains a Dice score of 69\% and a false negative and false positive volume of 6.27 and 5.78 mL respectively, on our internal test set. This model is submitted as part of the autoPET 2023 challenge. Our code is available at: https://github.com/anissa218/autopet\_nnunet

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arXiv2024

On Biases in a UK Biobank-based Retinal Image Classification Model

Recent work has uncovered alarming disparities in the performance of machine learning models in healthcare. In this study, we explore whether such disparities are present in the UK Biobank fundus retinal images by training and evaluating a disease classification model on these images. We assess possible disparities across various population groups and find substantial differences despite strong overall performance of the model. In particular, we discover unfair performance for certain assessment centres, which is surprising given the rigorous data standardisation protocol. We compare how these differences emerge and apply a range of existing bias mitigation methods to each one. A key insight is that each disparity has unique properties and responds differently to the mitigation methods. We also find that these methods are largely unable to enhance fairness, highlighting the need for better bias mitigation methods tailored to the specific type of bias.

cs.LG↗

arXiv2024

Deep Neural Networks for Predicting Recurrence and Survival in Patients with Esophageal Cancer After Surgery

Esophageal cancer is a major cause of cancer-related mortality internationally, with high recurrence rates and poor survival even among patients treated with curative-intent surgery. Investigating relevant prognostic factors and predicting prognosis can enhance post-operative clinical decision-making and potentially improve patients' outcomes. In this work, we assessed prognostic factor identification and discriminative performances of three models for Disease-Free Survival (DFS) and Overall Survival (OS) using a large multicenter international dataset from ENSURE study. We first employed Cox Proportional Hazards (CoxPH) model to assess the impact of each feature on outcomes. Subsequently, we utilised CoxPH and two deep neural network (DNN)-based models, DeepSurv and DeepHit, to predict DFS and OS. The significant prognostic factors identified by our models were consistent with clinical literature, with post-operative pathologic features showing higher significance than clinical stage features. DeepSurv and DeepHit demonstrated comparable discriminative accuracy to CoxPH, with DeepSurv slightly outperforming in both DFS and OS prediction tasks, achieving C-index of 0.735 and 0.74, respectively. While these results suggested the potential of DNNs as prognostic tools for improving predictive accuracy and providing personalised guidance with respect to risk stratification, CoxPH still remains an adequately good prediction model, with the data used in this study.

cs.LG↗

arXiv2024

Multimodal Deformable Image Registration for Long-COVID Analysis Based on Progressive Alignment and Multi-perspective Loss

Long COVID is characterized by persistent symptoms, particularly pulmonary impairment, which necessitates advanced imaging for accurate diagnosis. Hyperpolarised Xenon-129 MRI (XeMRI) offers a promising avenue by visualising lung ventilation, perfusion, as well as gas transfer. Integrating functional data from XeMRI with structural data from Computed Tomography (CT) is crucial for comprehensive analysis and effective treatment strategies in long COVID, requiring precise data alignment from those complementary imaging modalities. To this end, CT-MRI registration is an essential intermediate step, given the significant challenges posed by the direct alignment of CT and Xe-MRI. Therefore, we proposed an end-to-end multimodal deformable image registration method that achieves superior performance for aligning long-COVID lung CT and proton density MRI (pMRI) data. Moreover, our method incorporates a novel Multi-perspective Loss (MPL) function, enhancing state-of-the-art deep learning methods for monomodal registration by making them adaptable for multimodal tasks. The registration results achieve a Dice coefficient score of 0.913, indicating a substantial improvement over the state-of-the-art multimodal image registration techniques. Since the XeMRI and pMRI images are acquired in the same sessions and can be roughly aligned, our results facilitate subsequent registration between XeMRI and CT, thereby potentially enhancing clinical decision-making for long COVID management.

eess.IV↗

arXiv2024

TiBiX: Leveraging Temporal Information for Bidirectional X-ray and Report Generation

With the emergence of vision language models in the medical imaging domain, numerous studies have focused on two dominant research activities: (1) report generation from Chest X-rays (CXR), and (2) synthetic scan generation from text or reports. Despite some research incorporating multi-view CXRs into the generative process, prior patient scans and reports have been generally disregarded. This can inadvertently lead to the leaving out of important medical information, thus affecting generation quality. To address this, we propose TiBiX: Leveraging Temporal information for Bidirectional X-ray and Report Generation. Considering previous scans, our approach facilitates bidirectional generation, primarily addressing two challenging problems: (1) generating the current image from the previous image and current report and (2) generating the current report based on both the previous and current images. Moreover, we extract and release a curated temporal benchmark dataset derived from the MIMIC-CXR dataset, which focuses on temporal data. Our comprehensive experiments and ablation studies explore the merits of incorporating prior CXRs and achieve state-of-the-art (SOTA) results on the report generation task. Furthermore, we attain on-par performance with SOTA image generation efforts, thus serving as a new baseline in longitudinal bidirectional CXR-to-report generation. The code is available at https://github.com/BioMedIA-MBZUAI/TiBiX.

cs.CV↗

arXiv2024

Prediction of recurrence free survival of head and neck cancer using PET/CT radiomics and clinical information

The 5-year survival rate of Head and Neck Cancer (HNC) has not improved over the past decade and one common cause of treatment failure is recurrence. In this paper, we built Cox proportional hazard (CoxPH) models that predict the recurrence free survival (RFS) of oropharyngeal HNC patients. Our models utilise both clinical information and multimodal radiomics features extracted from tumour regions in Computed Tomography (CT) and Positron Emission Tomography (PET). Furthermore, we were one of the first studies to explore the impact of segmentation accuracy on the predictive power of the extracted radiomics features, through under- and over-segmentation study. Our models were trained using the HEad and neCK TumOR (HECKTOR) challenge data, and the best performing model achieved a concordance index (C-index) of 0.74 for the model utilising clinical information and multimodal CT and PET radiomics features, which compares favourably with the model that only used clinical information (C-index of 0.67). Our under- and over-segmentation study confirms that segmentation accuracy affects radiomics extraction, however, it affects PET and CT differently.

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arXiv2023

Towards Automatic Scoring of Spinal X-ray for Ankylosing Spondylitis

Manually grading structural changes with the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) on spinal X-ray imaging is costly and time-consuming due to bone shape complexity and image quality variations. In this study, we address this challenge by prototyping a 2-step auto-grading pipeline, called VertXGradeNet, to automatically predict mSASSS scores for the cervical and lumbar vertebral units (VUs) in X-ray spinal imaging. The VertXGradeNet utilizes VUs generated by our previously developed VU extraction pipeline (VertXNet) as input and predicts mSASSS based on those VUs. VertXGradeNet was evaluated on an in-house dataset of lateral cervical and lumbar X-ray images for axial spondylarthritis patients. Our results show that VertXGradeNet can predict the mSASSS score for each VU when the data is limited in quantity and imbalanced. Overall, it can achieve a balanced accuracy of 0.56 and 0.51 for 4 different mSASSS scores (i.e., a score of 0, 1, 2, 3) on two test datasets. The accuracy of the presented method shows the potential to streamline the spinal radiograph readings and therefore reduce the cost of future clinical trials.

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arXiv2022

An Ensemble Method to Automatically Grade Diabetic Retinopathy with Optical Coherence Tomography Angiography Images

Diabetic retinopathy (DR) is a complication of diabetes, and one of the major causes of vision impairment in the global population. As the early-stage manifestation of DR is usually very mild and hard to detect, an accurate diagnosis via eye-screening is clinically important to prevent vision loss at later stages. In this work, we propose an ensemble method to automatically grade DR using ultra-wide optical coherence tomography angiography (UW-OCTA) images available from Diabetic Retinopathy Analysis Challenge (DRAC) 2022. First, we adopt the state-of-the-art classification networks, i.e., ResNet, DenseNet, EfficientNet, and VGG, and train them to grade UW-OCTA images with different splits of the available dataset. Ultimately, we obtain 25 models, of which, the top 16 models are selected and ensembled to generate the final predictions. During the training process, we also investigate the multi-task learning strategy, and add an auxiliary classification task, the Image Quality Assessment, to improve the model performance. Our final ensemble model achieved a quadratic weighted kappa (QWK) of 0.9346 and an Area Under Curve (AUC) of 0.9766 on the internal testing dataset, and the QWK of 0.839 and the AUC of 0.8978 on the DRAC challenge testing dataset.

cs.CV↗

arXiv2021

Multimodal PET/CT Tumour Segmentation and Prediction of Progression-Free Survival using a Full-Scale UNet with Attention

Segmentation of head and neck (H\&N) tumours and prediction of patient outcome are crucial for patient's disease diagnosis and treatment monitoring. Current developments of robust deep learning models are hindered by the lack of large multi-centre, multi-modal data with quality annotations. The MICCAI 2021 HEad and neCK TumOR (HECKTOR) segmentation and outcome prediction challenge creates a platform for comparing segmentation methods of the primary gross target volume on fluoro-deoxyglucose (FDG)-PET and Computed Tomography images and prediction of progression-free survival in H\&N oropharyngeal cancer.For the segmentation task, we proposed a new network based on an encoder-decoder architecture with full inter- and intra-skip connections to take advantage of low-level and high-level semantics at full scales. Additionally, we used Conditional Random Fields as a post-processing step to refine the predicted segmentation maps. We trained multiple neural networks for tumor volume segmentation, and these segmentations were ensembled achieving an average Dice Similarity Coefficient of 0.75 in cross-validation, and 0.76 on the challenge testing data set. For prediction of patient progression free survival task, we propose a Cox proportional hazard regression combining clinical, radiomic, and deep learning features. Our survival prediction model achieved a concordance index of 0.82 in cross-validation, and 0.62 on the challenge testing data set.

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