arXiv subjects

Kyungsang Kim

Publications and source records attributed to Kyungsang Kim.

At least 19 recordsLinked to original sources

arXiv2026

Mixture of Multicenter Experts in Multimodal AI for Debiased Radiotherapy Target Delineation

Clinical decision-making reflects diverse strategies shaped by regional patient populations and institutional protocols. However, most existing medical artificial intelligence (AI) models are trained on highly prevalent data patterns, which reinforces biases and fails to capture the breadth of clinical expertise. Inspired by the recent advances in Mixture of Experts (MoE), we propose a Mixture of Multicenter Experts (MoME) framework to address AI bias in the medical domain without requiring data sharing across institutions. MoME integrates specialized expertise from diverse clinical strategies to enhance model generalizability and adaptability across medical centers. We validate this framework using a multimodal target volume delineation model for prostate cancer radiotherapy. With few-shot training that combines imaging and clinical notes from each center, the model outperformed baselines, particularly in settings with high inter-center variability or limited data availability. Furthermore, MoME enables model customization to local clinical preferences without cross-institutional data exchange, making it especially suitable for resource-constrained settings while promoting broadly generalizable medical AI.

eess.IV↗

arXiv2026

Coding-Free and Privacy-Preserving Agentic Framework for Data-Driven Clinical Research

Clinical data-driven research requires clinical expertise, programming skills, access to patient data, and extensive documentation, creating barriers and slowing the pace for clinicians and external researchers. To address this, we developed the Clinical Agentic Research Intelligence System (CARIS) that automates the workflow: research planning, literature search, cohort construction, Institutional Review Board (IRB) documentation, Vibe Machine Learning (ML), and report generation, with human-in-the-loop refinement. CARIS integrates Large Language Models (LLMs) with modular tools through the Model Context Protocol (MCP), enabling natural language-driven research without coding while allowing users to access only outputs. We evaluated CARIS on three heterogeneous datasets with distinct clinical tasks, where it completed planning and IRB documentation within four iterations, supported Vibe ML, and generated reports, achieving 96% completeness in LLM-based evaluation and 82% in human evaluation. CARIS demonstrates potential to reduce documentation burden and technical barriers, accelerating data-driven clinical research across public and private data environments.

cs.CL↗

arXiv2025

Voice-Interactive Surgical Agent for Multimodal Patient Data Control

In robotic surgery, surgeons fully engage their hands and visual attention in procedures, making it difficult to access and manipulate multimodal patient data without interrupting the workflow. To overcome this problem, we propose a Voice-Interactive Surgical Agent (VISA) built on a hierarchical multi-agent framework consisting of an orchestration agent and three task-specific agents driven by Large Language Models (LLMs). These LLM-based agents autonomously plan, refine, validate, and reason to interpret voice commands and execute tasks such as retrieving clinical information, manipulating CT scans, or navigating 3D anatomical models within surgical video. We construct a dataset of 240 user commands organized into hierarchical categories and introduce the Multi-level Orchestration Evaluation Metric (MOEM) that evaluates the performance and robustness at both the command and category levels. Experimental results demonstrate that VISA achieves high stage-level accuracy and workflow-level success rates, while also enhancing its robustness by correcting transcription errors, resolving linguistic ambiguity, and interpreting diverse free-form expressions. These findings highlight the strong potential of VISA to support robotic surgery and its scalability for integrating new functions and agents.

cs.CL↗

arXiv2025

Distribution-aware Fairness Learning in Medical Image Segmentation From A Control-Theoretic Perspective

Ensuring fairness in medical image segmentation is critical due to biases in imbalanced clinical data acquisition caused by demographic attributes (e.g., age, sex, race) and clinical factors (e.g., disease severity). To address these challenges, we introduce Distribution-aware Mixture of Experts (dMoE), inspired by optimal control theory. We provide a comprehensive analysis of its underlying mechanisms and clarify dMoE's role in adapting to heterogeneous distributions in medical image segmentation. Furthermore, we integrate dMoE into multiple network architectures, demonstrating its broad applicability across diverse medical image analysis tasks. By incorporating demographic and clinical factors, dMoE achieves state-of-the-art performance on two 2D benchmark datasets and a 3D in-house dataset. Our results highlight the effectiveness of dMoE in mitigating biases from imbalanced distributions, offering a promising approach to bridging control theory and medical image segmentation within fairness learning paradigms. The source code will be made available. The source code is available at https://github.com/tvseg/dMoE.

eess.IV↗

arXiv2025

A foundation model for human-AI collaboration in medical literature mining

Systematic literature review is essential for evidence-based medicine, requiring comprehensive analysis of clinical trial publications. However, the application of artificial intelligence (AI) models for medical literature mining has been limited by insufficient training and evaluation across broad therapeutic areas and diverse tasks. Here, we present LEADS, an AI foundation model for study search, screening, and data extraction from medical literature. The model is trained on 633,759 instruction data points in LEADSInstruct, curated from 21,335 systematic reviews, 453,625 clinical trial publications, and 27,015 clinical trial registries. We showed that LEADS demonstrates consistent improvements over four cutting-edge generic large language models (LLMs) on six tasks. Furthermore, LEADS enhances expert workflows by providing supportive references following expert requests, streamlining processes while maintaining high-quality results. A study with 16 clinicians and medical researchers from 14 different institutions revealed that experts collaborating with LEADS achieved a recall of 0.81 compared to 0.77 experts working alone in study selection, with a time savings of 22.6%. In data extraction tasks, experts using LEADS achieved an accuracy of 0.85 versus 0.80 without using LEADS, alongside a 26.9% time savings. These findings highlight the potential of specialized medical literature foundation models to outperform generic models, delivering significant quality and efficiency benefits when integrated into expert workflows for medical literature mining.

cs.CL↗

arXiv2025

End-to-End Deep Learning for Interior Tomography with Low-Dose X-ray CT

Objective: There exist several X-ray computed tomography (CT) scanning strategies to reduce a radiation dose, such as (1) sparse-view CT, (2) low-dose CT, and (3) region-of-interest (ROI) CT (called interior tomography). To further reduce the dose, the sparse-view and/or low-dose CT settings can be applied together with interior tomography. Interior tomography has various advantages in terms of reducing the number of detectors and decreasing the X-ray radiation dose. However, a large patient or small field-of-view (FOV) detector can cause truncated projections, and then the reconstructed images suffer from severe cupping artifacts. In addition, although the low-dose CT can reduce the radiation exposure dose, analytic reconstruction algorithms produce image noise. Recently, many researchers have utilized image-domain deep learning (DL) approaches to remove each artifact and demonstrated impressive performances, and the theory of deep convolutional framelets supports the reason for the performance improvement. Approach: In this paper, we found that the image-domain convolutional neural network (CNN) is difficult to solve coupled artifacts, based on deep convolutional framelets. Significance: To address the coupled problem, we decouple it into two sub-problems: (i) image domain noise reduction inside truncated projection to solve low-dose CT problem and (ii) extrapolation of projection outside truncated projection to solve the ROI CT problem. The decoupled sub-problems are solved directly with a novel proposed end-to-end learning using dual-domain CNNs. Main results: We demonstrate that the proposed method outperforms the conventional image-domain deep learning methods, and a projection-domain CNN shows better performance than the image-domain CNNs which are commonly used by many researchers.

eess.IV↗

arXiv2024

MediViSTA: Medical Video Segmentation via Temporal Fusion SAM Adaptation for Echocardiography

Despite achieving impressive results in general-purpose semantic segmentation with strong generalization on natural images, the Segment Anything Model (SAM) has shown less precision and stability in medical image segmentation. In particular, the original SAM architecture is designed for 2D natural images and is therefore not support to handle three-dimensional information, which is particularly important for medical imaging modalities that are often volumetric or video data. In this paper, we introduce MediViSTA, a parameter-efficient fine-tuning method designed to adapt the vision foundation model for medical video, with a specific focus on echocardiographic segmentation. To achieve spatial adaptation, we propose a frequency feature fusion technique that injects spatial frequency information from a CNN branch. For temporal adaptation, we integrate temporal adapters within the transformer blocks of the image encoder. Using a fine-tuning strategy, only a small subset of pre-trained parameters is updated, allowing efficient adaptation to echocardiographic data. The effectiveness of our method has been comprehensively evaluated on three datasets, comprising two public datasets and one multi-center in-house dataset. Our method consistently outperforms various state-of-the-art approaches without using any prompts. Furthermore, our model exhibits strong generalization capabilities on unseen datasets, surpassing the second-best approach by 2.15\% in Dice and 0.09 in temporal consistency. The results demonstrate the potential of MediViSTA to significantly advance echocardiographical video segmentation, offering improved accuracy and robustness in cardiac assessment applications.

eess.IV↗

arXiv2024

Volumetric Conditional Score-based Residual Diffusion Model for PET/MR Denoising

PET imaging is a powerful modality offering quantitative assessments of molecular and physiological processes. The necessity for PET denoising arises from the intrinsic high noise levels in PET imaging, which can significantly hinder the accurate interpretation and quantitative analysis of the scans. With advances in deep learning techniques, diffusion model-based PET denoising techniques have shown remarkable performance improvement. However, these models often face limitations when applied to volumetric data. Additionally, many existing diffusion models do not adequately consider the unique characteristics of PET imaging, such as its 3D volumetric nature, leading to the potential loss of anatomic consistency. Our Conditional Score-based Residual Diffusion (CSRD) model addresses these issues by incorporating a refined score function and 3D patch-wise training strategy, optimizing the model for efficient volumetric PET denoising. The CSRD model significantly lowers computational demands and expedites the denoising process. By effectively integrating volumetric data from PET and MRI scans, the CSRD model maintains spatial coherence and anatomical detail. Lastly, we demonstrate that the CSRD model achieves superior denoising performance in both qualitative and quantitative evaluations while maintaining image details and outperforms existing state-of-the-art methods.

eess.IV↗

arXiv2024

Autonomous Robotic Ultrasound System for Liver Follow-up Diagnosis: Pilot Phantom Study

The paper introduces a novel autonomous robot ultrasound (US) system targeting liver follow-up scans for outpatients in local communities. Given a computed tomography (CT) image with specific target regions of interest, the proposed system carries out the autonomous follow-up scan in three steps: (i) initial robot contact to surface, (ii) coordinate mapping between CT image and robot, and (iii) target US scan. Utilizing 3D US-CT registration and deep learning-based segmentation networks, we can achieve precise imaging of 3D hepatic veins, facilitating accurate coordinate mapping between CT and the robot. This enables the automatic localization of follow-up targets within the CT image, allowing the robot to navigate precisely to the target's surface. Evaluation of the ultrasound phantom confirms the quality of the US-CT registration and shows the robot reliably locates the targets in repeated trials. The proposed framework holds the potential to significantly reduce time and costs for healthcare providers, clinicians, and follow-up patients, thereby addressing the increasing healthcare burden associated with chronic disease in local communities.

cs.RO↗

arXiv2024

Prompt-driven Universal Model for View-Agnostic Echocardiography Analysis

Echocardiography segmentation for cardiac analysis is time-consuming and resource-intensive due to the variability in image quality and the necessity to process scans from various standard views. While current automated segmentation methods in echocardiography show promising performance, they are trained on specific scan views to analyze corresponding data. However, this solution has a limitation as the number of required models increases with the number of standard views. To address this, in this paper, we present a prompt-driven universal method for view-agnostic echocardiography analysis. Considering the domain shift between standard views, we first introduce a method called prompt matching, aimed at learning prompts specific to different views by matching prompts and querying input embeddings using a pre-trained vision model. Then, we utilized a pre-trained medical language model to align textual information with pixel data for accurate segmentation. Extensive experiments on three standard views showed that our approach significantly outperforms the state-of-the-art universal methods and achieves comparable or even better performances over the segmentation model trained and tested on same views.

cs.CV↗

arXiv2023

Large-scale Graph Representation Learning of Dynamic Brain Connectome with Transformers

Graph Transformers have recently been successful in various graph representation learning tasks, providing a number of advantages over message-passing Graph Neural Networks. Utilizing Graph Transformers for learning the representation of the brain functional connectivity network is also gaining interest. However, studies to date have underlooked the temporal dynamics of functional connectivity, which fluctuates over time. Here, we propose a method for learning the representation of dynamic functional connectivity with Graph Transformers. Specifically, we define the connectome embedding, which holds the position, structure, and time information of the functional connectivity graph, and use Transformers to learn its representation across time. We perform experiments with over 50,000 resting-state fMRI samples obtained from three datasets, which is the largest number of fMRI data used in studies by far. The experimental results show that our proposed method outperforms other competitive baselines in gender classification and age regression tasks based on the functional connectivity extracted from the fMRI data.

q-bio.NC↗

arXiv2023

DULDA: Dual-domain Unsupervised Learned Descent Algorithm for PET image reconstruction

Deep learning based PET image reconstruction methods have achieved promising results recently. However, most of these methods follow a supervised learning paradigm, which rely heavily on the availability of high-quality training labels. In particular, the long scanning time required and high radiation exposure associated with PET scans make obtaining this labels impractical. In this paper, we propose a dual-domain unsupervised PET image reconstruction method based on learned decent algorithm, which reconstructs high-quality PET images from sinograms without the need for image labels. Specifically, we unroll the proximal gradient method with a learnable l2,1 norm for PET image reconstruction problem. The training is unsupervised, using measurement domain loss based on deep image prior as well as image domain loss based on rotation equivariance property. The experimental results domonstrate the superior performance of proposed method compared with maximum likelihood expectation maximazation (MLEM), total-variation regularized EM (EM-TV) and deep image prior based method (DIP).

eess.IV↗

arXiv2022

A Noise-level-aware Framework for PET Image Denoising

In PET, the amount of relative (signal-dependent) noise present in different body regions can be significantly different and is inherently related to the number of counts present in that region. The number of counts in a region depends, in principle and among other factors, on the total administered activity, scanner sensitivity, image acquisition duration, radiopharmaceutical tracer uptake in the region, and patient local body morphometry surrounding the region. In theory, less amount of denoising operations is needed to denoise a high-count (low relative noise) image than images a low-count (high relative noise) image, and vice versa. The current deep-learning-based methods for PET image denoising are predominantly trained on image appearance only and have no special treatment for images of different noise levels. Our hypothesis is that by explicitly providing the local relative noise level of the input image to a deep convolutional neural network (DCNN), the DCNN can outperform itself trained on image appearance only. To this end, we propose a noise-level-aware framework denoising framework that allows embedding of local noise level into a DCNN. The proposed is trained and tested on 30 and 15 patient PET images acquired on a GE Discovery MI PET/CT system. Our experiments showed that the increases in both PSNR and SSIM from our backbone network with relative noise level embedding (NLE) versus the same network without NLE were statistically significant with p<0.001, and the proposed method significantly outperformed a strong baseline method by a large margin.

eess.IV↗

arXiv2022

Federated Active Learning (F-AL): an Efficient Annotation Strategy for Federated Learning

Federated learning (FL) has been intensively investigated in terms of communication efficiency, privacy, and fairness. However, efficient annotation, which is a pain point in real-world FL applications, is less studied. In this project, we propose to apply active learning (AL) and sampling strategy into the FL framework to reduce the annotation workload. We expect that the AL and FL can improve the performance of each other complementarily. In our proposed federated active learning (F-AL) method, the clients collaboratively implement the AL to obtain the instances which are considered as informative to FL in a distributed optimization manner. We compare the test accuracies of the global FL models using the conventional random sampling strategy, client-level separate AL (S-AL), and the proposed F-AL. We empirically demonstrate that the F-AL outperforms baseline methods in image classification tasks.

cs.LG↗

arXiv2020

Deep Metric Learning-based Image Retrieval System for Chest Radiograph and its Clinical Applications in COVID-19

In recent years, deep learning-based image analysis methods have been widely applied in computer-aided detection, diagnosis and prognosis, and has shown its value during the public health crisis of the novel coronavirus disease 2019 (COVID-19) pandemic. Chest radiograph (CXR) has been playing a crucial role in COVID-19 patient triaging, diagnosing and monitoring, particularly in the United States. Considering the mixed and unspecific signals in CXR, an image retrieval model of CXR that provides both similar images and associated clinical information can be more clinically meaningful than a direct image diagnostic model. In this work we develop a novel CXR image retrieval model based on deep metric learning. Unlike traditional diagnostic models which aims at learning the direct mapping from images to labels, the proposed model aims at learning the optimized embedding space of images, where images with the same labels and similar contents are pulled together. It utilizes multi-similarity loss with hard-mining sampling strategy and attention mechanism to learn the optimized embedding space, and provides similar images to the query image. The model is trained and validated on an international multi-site COVID-19 dataset collected from 3 different sources. Experimental results of COVID-19 image retrieval and diagnosis tasks show that the proposed model can serve as a robust solution for CXR analysis and patient management for COVID-19. The model is also tested on its transferability on a different clinical decision support task, where the pre-trained model is applied to extract image features from a new dataset without any further training. These results demonstrate our deep metric learning based image retrieval model is highly efficient in the CXR retrieval, diagnosis and prognosis, and thus has great clinical value for the treatment and management of COVID-19 patients.

eess.IV↗

arXiv2020

Deep Learning-based Four-region Lung Segmentation in Chest Radiography for COVID-19 Diagnosis

Purpose. Imaging plays an important role in assessing severity of COVID 19 pneumonia. However, semantic interpretation of chest radiography (CXR) findings does not include quantitative description of radiographic opacities. Most current AI assisted CXR image analysis framework do not quantify for regional variations of disease. To address these, we proposed a four region lung segmentation method to assist accurate quantification of COVID 19 pneumonia. Methods. A segmentation model to separate left and right lung is firstly applied, and then a carina and left hilum detection network is used, which are the clinical landmarks to separate the upper and lower lungs. To improve the segmentation performance of COVID 19 images, ensemble strategy incorporating five models is exploited. Using each region, we evaluated the clinical relevance of the proposed method with the Radiographic Assessment of the Quality of Lung Edema (RALE). Results. The proposed ensemble strategy showed dice score of 0.900, which is significantly higher than conventional methods (0.854 0.889). Mean intensities of segmented four regions indicate positive correlation to the extent and density scores of pulmonary opacities under the RALE framework. Conclusion. A deep learning based model in CXR can accurately segment and quantify regional distribution of pulmonary opacities in patients with COVID 19 pneumonia.

eess.IV↗

arXiv2020

MR-Based PET Attenuation Correction using a Combined Ultrashort Echo Time/Multi-Echo Dixon Acquisition

We propose a magnetic resonance (MR)-based method for estimation of continuous linear attenuation coefficients (LAC) in positron emission tomography (PET) using a physical compartmental model and ultrashort echo time (UTE)/multi-echo Dixon (mUTE) acquisitions. Specifically, we propose a three-dimensional (3D) mUTE sequence to acquire signals from water, fat, and short-T2 components (e.g., bones) simultaneously in a single acquisition. The proposed mUTE sequence integrates 3D UTE with multi-echo Dixon acquisitions and uses sparse radial trajectories to accelerate imaging speed. Errors in the radial k-space trajectories are measured using a special k-space trajectory mapping sequence and corrected for image reconstruction. A physical compartmental model is used to fit the measured multi-echo MR signals to obtain fractions of water, fat and bone components for each voxel, which are then used to estimate the continuous LAC map for PET attenuation correction. The performance of the proposed method was evaluated via phantom and in vivo human studies, using LACs from Computed Tomography (CT) as reference. Compared to Dixon- and atlas-based MRAC methods, the proposed method yielded PET images with higher correlation and similarity in relation to the reference. The relative absolute errors of PET activity values reconstructed by the proposed method were below 5% in all of the four lobes (frontal, temporal, parietal, occipital), cerebellum, whole white matter and gray matter regions across all subjects (n=6). The proposed mUTE method can generate subject-specific, continuous LAC map for PET attenuation correction in PET/MR.

physics.med-ph↗

arXiv2019

Consensus Neural Network for Medical Imaging Denoising with Only Noisy Training Samples

Deep neural networks have been proved efficient for medical image denoising. Current training methods require both noisy and clean images. However, clean images cannot be acquired for many practical medical applications due to naturally noisy signal, such as dynamic imaging, spectral computed tomography, arterial spin labeling magnetic resonance imaging, etc. In this paper we proposed a training method which learned denoising neural networks from noisy training samples only. Training data in the acquisition domain was split to two subsets and the network was trained to map one noisy set to the other. A consensus loss function was further proposed to efficiently combine the outputs from both subsets. A mathematical proof was provided that the proposed training scheme was equivalent to training with noisy and clean samples when the noise in the two subsets was uncorrelated and zero-mean. The method was validated on Low-dose CT Challenge dataset and NYU MRI dataset and achieved improved performance compared to existing unsupervised methods.

eess.IV↗