arXiv subjects

Ferdinand Luger

Publications and source records attributed to Ferdinand Luger.

3 recordsLinked to original sources

arXiv2026

ProtoCouncil: Multi-Encoder Anatomical Prototypes for Prostate Cancer Detection in Micro-Ultrasound

Purpose: Micro-ultrasound ($μ$US) is a promising modality for prostate cancer (PCa) detection, but identifying suspicious tissue depends heavily on clinical experience. Models trained on sparse, noisy core-level pathology offer little insight into their decisions and can fail under domain shift. Clinical use needs a traceable decision process and a flag for uncertain predictions. Methods: We introduce ProtoCouncil, in which three foundation encoders (MedSAM, DINOv3 and V-JEPA 2.1) learn case-based prototypes at three anatomical levels: whole gland, needle track and gland sectors. Prototypes are projected onto real training-core regions, and label-free fusion keeps every class logit as a bias plus an exact sum of prototype similarity contributions. Encoder disagreement triggers selective prediction. Results: In five-fold patient-level cross-validation (6,588 cores, 693 patients), ProtoCouncil reaches 82.9% AUROC for clinically significant PCa (csPCa, Grade Group $\geq$3), 4.3 points above the best previously published method. In zero-shot evaluation on two external cohorts, ProtoCouncil achieves higher all-cancer and csPCa AUROC than all previous methods. Nearest same-class exemplars match test-core tumor involvement better than random same-class cases. Externally, csPCa accuracy falls from 79% when encoders agree to 27% when two oppose the fused call. Abstaining on disagreement raises balanced accuracy by 7 and 15 points, while retaining 58% and 54% of the cores. Conclusion: ProtoCouncil grounds core-level predictions in exact similarity-based evidence from real, anatomically indexed training cases, which makes its reasoning interpretable. It achieves the highest csPCa AUROC across three cohorts and identifies unreliable predictions through encoder disagreement.

cs.CV↗

arXiv2026

Weakly Supervised Spatial Grounding for Discriminative Attention-Based Ultrasound-Histopathology Alignment in Prostate Cancer Grading

Unpaired cross-modal distillation transfers grade structure from histopathology into a micro-ultrasound (micro-US) encoder by aligning a pooled needle-region embedding to a frozen histopathology teacher under grade-group correspondence alone. A single objective is thereby required to serve two distinct functions: rendering patch features discriminative of tissue state, and selecting which patches enter the pooled representation. We decouple them. Weak spatial supervision derived from percentage involvement, recorded routinely at biopsy, constrains the predicted proportion of malignant tissue within each core, acting on the encoder features independently of the alignment objective. The alignment loss then operates on features that differ across a core, and attention concentrates on a subset of patches rather than remaining near-uniform. On 7,166 biopsy cores from 811 patients across seven centers under patient-level 5-fold cross-validation, the method reaches 67.1 macro AUC and 68.5 csPCa AUC, against 61.2 and 52.8 for the existing unpaired alignment method and 63.1 and 62.6 for the strongest unimodal baselines. Ablation against existing attention regularizers designed to prevent attention-uniformity collapse shows that such regularizers do not substitute for label-derived supervision: they constrain the attention distribution, whereas the signal required acts on the features that attention reads.

cs.CV↗

arXiv2026

Learning Prostate Anatomy at Test Time for Cancer Detection in Micro-Ultrasound

Domain shift across clinical centers using different imaging hardware or acquisition protocols remains a fundamental barrier to deploying deep learning models for prostate cancer (PCa) detection. Existing test-time adaptation (TTA) methods address distribution shift through entropy minimization or augmentation-based self-supervision, correcting for statistical differences in image appearance but ignoring the anatomical structure of the target domain. We propose ANT, a segmentation-guided TTA framework that adapts a pretrained cancer detection encoder to the target domain by solving an auxiliary prostate segmentation task at test time, supervised by pseudo-masks from a frozen pretrained segmentation network. By aligning encoder representations to prostate anatomy in the target domain, ANT corrects domain-specific feature drift while preserving cancer-discriminative structure. The model was trained on 693 patients imaged with an earlier-generation micro-ultrasound scanner in a multi-center clinical trial, and evaluated on 118 patients acquired with a newer-generation system across two centers in another clinical trial. Under a leave-one-center-out protocol with identical evaluation conditions across all methods, ANT improves mean AUC by 2.9% and 3.6% at the biopsy-core and patient levels, respectively, over no adaptation, outperforming TTA baselines. Code is available at: https://github.com/ObedDzik/ant.git.

cs.CV↗