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Linghan Cai

Publications and source records attributed to Linghan Cai.

At least 19 recordsLinked to original sources
arXiv2026

EviPathBench: Benchmarking Evidence Acquisition and Reasoning in Vision-Language Models for Whole-Slide Pathology

Whole-slide image (WSI) diagnosis requires identifying diagnostically relevant regions, examining them across magnifications, and integrating multi-scale evidence. However, most pathology benchmarks evaluate models on pre-cropped patches or pre-extracted slide features, leaving their ability to acquire evidence from gigapixel WSIs largely untested. We introduce EviPathBench, a benchmark for evaluating evidence acquisition and reasoning in vision-language models (VLMs) for whole-slide pathology. It evaluates four capabilities: image-to-text matching for evidence interpretation, text-to-image retrieval for evidence verification, diagnostic-region localization for evidence acquisition, and multi-scale reasoning for evidence integration. The benchmark is organized as a diagnostic tree linking nested regions across magnifications with scale-specific findings and path-level diagnoses. It contains 1,822 TCGA WSIs and 17,135 diagnostic paths annotated by ten board-certified pathologists. A private cohort of 190 breast cancer WSIs with detailed annotations further evaluates autonomous whole-slide exploration. We evaluate 19 VLMs spanning general-purpose, medical, and pathology-specialized families, plus one text-only reference model. Leading open-weight models achieve over 93% accuracy in multi-scale reasoning and over 50% in both cross-modal matching tasks. In contrast, diagnostic-region localization remains challenging: the best text-guided mean intersection-over-union is below 0.09, underperforming a center-based heuristic. During autonomous exploration, the unconditional hit rate drops from 0.522 at low magnification to 0.185 at intermediate magnification and 0.020 at high magnification. These results reveal a pronounced gap between reasoning over curated evidence and acquiring it from WSIs. EviPathBench provides a unified framework for measuring and improving both capabilities.

cs.CV↗
arXiv2026

Agentic Visual Reasoning in Whole-Slide Pathology Images via Active Perception

Whole-slide visual reasoning requires identifying sparse diagnostic evidence in gigapixel pathology slides and integrating observations across spatial scales. Existing WSI methods either compress densely sampled patches into global representations or use pretrained vision-language models with heuristic region selection, weakening links between predictions and morphology or lacking pathology-trained observation policies. We present AdaptivePath, an active-perception framework that formulates WSI evidence acquisition as sequential decision making. The Navigator learns question-agnostic abnormality-driven navigation from pathologist-reviewed labels to select observation locations and spatial extents, avoiding costly question-specific trajectory annotations. We train this policy through alternating representation learning and proximal policy optimization, followed by fine-tuning with geometric and appearance consistency objectives to stabilize focus trajectories. During inference, the Navigator hierarchically acquires sparse observations from low to high magnification under a limited ROI budget. A Morphology Interpreter converts observations into question-conditioned evidence, while the Deliberator evaluates evidence and revises intermediate answers across magnifications. The Arbiter integrates deliberation history to produce final answers. AdaptivePath achieves state-of-the-art zero-shot performance on WSI and region pathology VQA benchmarks and reaches 80.14% accuracy for cancer subtype classification across six TCGA cohorts. In a blinded diagnostic-utility study, pathologists using AdaptivePath-selected observation sequences achieve 82.9% accuracy. These results demonstrate that learned active perception enables effective and traceable visual reasoning over gigapixel pathology slides.

cs.CV↗
arXiv2026

PathScale-R1: Cross-scale Reasoning for Pathological Image Analysis

Pathological diagnosis is inherently multi-scale, requiring the integration of global tissue architecture at low magnification with cellular morphology at higher magnification. However, existing pathology benchmarks and vision-language models (VLMs) are still largely developed under single-scale settings, limiting their ability to learn clinically meaningful multi-magnification reasoning. Moreover, naively constructed visual question answering (VQA) tasks may be susceptible to text-only or superficial visual shortcuts, leading to unreliable assessments of visual understanding. To address these limitations, we introduce a benchmark and training framework for shortcut-resistant cross-scale pathology reasoning. We design an Adversarial Text-only Screening strategy for semantic reasoning questions and a Structure-controlled Distractor Sampling strategy for visual grounding questions, encouraging models to rely on cross-scale visual evidence. Based on this pipeline, we construct PathScale-VQA, a high-quality cross-scale pathology VQA benchmark with 10,373 multiple-choice questions grounded in 1,368 diagnostic paths across multiple magnification levels. Building on the semantic reasoning set, PathScale-R1 is optimized through Difficulty-driven Reasoning Distillation supervised fine-tuning followed by reinforcement learning with a Scale-aware Reasoning Structure reward, which encourages the use of evidence across magnifications. Extensive experiments demonstrate state-of-the-art performance of PathScale-R1 on cross-scale reasoning tasks and effective transfer to conventional single-scale pathology VQA. Our code is available at https://github.com/iMVR-PL/PathScale-R1.

cs.CV↗
arXiv2026

PathFLIP: Fine-grained Language-Image Pretraining for Versatile Computational Pathology

While Vision-Language Models (VLMs) have achieved notable progress in computational pathology (CPath), the gigapixel scale and spatial heterogeneity of Whole Slide Images (WSIs) continue to pose challenges for multimodal understanding. Existing alignment methods struggle to capture fine-grained correspondences between textual descriptions and visual cues across thousands of patches from a slide, compromising their performance on downstream tasks. In this paper, we propose PathFLIP (Pathology Fine-grained Language-Image Pretraining), a novel framework for holistic WSI interpretation. PathFLIP decomposes slide-level captions into region-level subcaptions and generates text-conditioned region embeddings to facilitate precise visual-language grounding. By harnessing Large Language Models (LLMs), PathFLIP can seamlessly follow diverse clinical instructions and adapt to varied diagnostic contexts. Furthermore, it exhibits versatile capabilities across multiple paradigms, efficiently handling slide-level classification and retrieval, fine-grained lesion localization, and instruction following. Extensive experiments demonstrate that PathFLIP outperforms existing large-scale pathological VLMs on four representative benchmarks while requiring significantly less training data, paving the way for fine-grained, instruction-aware WSI interpretation in clinical practice.

cs.CV↗
arXiv2026

Johnson-Lindenstrauss Lemma Guided Network for Efficient 3D Medical Segmentation

Lightweight 3D medical image segmentation remains constrained by a fundamental \textit{``efficiency / robustness conflict''}, particularly when processing complex anatomical structures and heterogeneous modalities. In this paper, we study how to redesign the framework based on the characteristics of high-dimensional 3D images, and explore data synergy to overcome the fragile representation of lightweight methods. Our approach, VeloxSeg, begins with a deployable and extensible dual-stream CNN-Transformer architecture composed of Paired Window Attention (PWA) and Johnson-Lindenstrauss lemma-guided convolution (JLC). For each 3D image, we invoke a ``glance-and-focus'' principle, where PWA rapidly retrieves multi-scale information, and JLC ensures robust local feature extraction with minimal parameters, significantly enhancing the model's ability to operate with low computational budget. Followed by an extension of the dual-stream architecture that incorporates modal interaction into the multi-scale image-retrieval process, VeloxSeg efficiently models heterogeneous modalities. Finally, Spatially Decoupled Knowledge Transfer (SDKT) via Gram matrices injects the texture prior extracted by a self-supervised network into the segmentation network, yielding stronger representations than baselines at no extra inference cost. Experimental results on multimodal benchmarks show that VeloxSeg achieves a 26\% Dice improvement, alongside increasing GPU throughput by 11$\times$, CPU by 48$\times$, and reducing training peak GPU memory usage by $1/20$, inference by $1/24$. Code is available at https://github.com/JinPLu/VeloxSeg.

cs.CV↗
arXiv2026

Current World Models Lack a Persistent State Core

World models are increasingly regarded as a decisive step toward artificial general intelligence, yet modeling the physical world demands more than rendering convincing frames on demand: it requires an internal world state that keeps evolving over time, decoupled from observation, so that objects endure and events run to their conclusions whether or not a camera is watching, much as the moon holds to its orbit when no one is looking. This requirement is a blind spot of existing benchmarks, which reward surface properties such as fidelity, motion, and camera controllability while never asking whether a generated world keeps evolving once it is unobserved. We introduce \textbf{WRBench}, the first systematic diagnostic benchmark that treats camera motion as an intervention on observability and resolves evaluation into a human-calibrated chain that asks whether the camera executes the requested interaction, whether the scene stays continuous and identifiable while in view, and whether a returning target remains consistent with the event that was set in motion. Across 9{,}600 videos from 23 models spanning four control paradigms, one finding proves stubborn: current systems maintain the observed world as a tracking shot, resuming a returning target in the state at which it was abandoned rather than advancing the event while it went unseen. Because this failure recurs across control paradigms, model families, and increments of scale, robust world-state evolution does not follow from cleaner imagery, tighter control, richer geometric priors, or sheer parameter count We therefore argue that the stability of the physical state kernel and the consistency of worldlines under viewpoint intervention should become first-class objectives of world-model design, so that a world model captures how the world will unfold rather than how the next frame appears.

cs.CV↗
arXiv2026

3DMedAgent: Unified Perception-to-Understanding for 3D Medical Analysis

3D CT analysis spans a continuum from low-level perception to high-level clinical understanding. Existing 3D-oriented analysis methods adopt either isolated task-specific modeling or task-agnostic end-to-end paradigms to produce one-hop outputs, impeding the systematic accumulation of perceptual evidence for downstream reasoning. In parallel, recent multimodal large language models (MLLMs) exhibit improved visual perception and can integrate visual and textual information effectively, yet their predominantly 2D-oriented designs fundamentally limit their ability to perceive and analyze volumetric medical data. To bridge this gap, we propose 3DMedAgent, a unified agent that enables 2D MLLMs to perform general 3D CT analysis without 3D-specific fine-tuning. 3DMedAgent coordinates heterogeneous visual and textual tools through a flexible MLLM agent, progressively decomposing complex 3D analysis into tractable subtasks that transition from global to regional views, from 3D volumes to informative 2D slices, and from visual evidence to structured textual representations. Central to this design, 3DMedAgent maintains a long-term structured memory that aggregates intermediate tool outputs and supports query-adaptive, evidence-driven multi-step reasoning. We further introduce the DeepChestVQA benchmark for evaluating unified perception-to-understanding capabilities in 3D thoracic imaging. Experiments across over 40 tasks demonstrate that 3DMedAgent consistently outperforms general, medical, and 3D-specific MLLMs, highlighting a scalable path toward general-purpose 3D clinical assistants.Code and data are available at \href{https://github.com/jinlab-imvr/3DMedAgent}{https://github.com/jinlab-imvr/3DMedAgent}.

cs.CV↗
arXiv2026

PathReasoner-R1: Instilling Structured Reasoning into Pathology Vision-Language Model via Knowledge-Guided Policy Optimization

Vision-Language Models (VLMs) are advancing computational pathology with superior visual understanding capabilities. However, current systems often reduce diagnosis to directly output conclusions without verifiable evidence-linked reasoning, which severely limits clinical trust and hinders expert error rectification. To address these barriers, we construct PathReasoner, the first large-scale dataset of whole-slide image (WSI) reasoning. Unlike previous work reliant on unverified distillation, we develop a rigorous knowledge-guided generation pipeline. By leveraging medical knowledge graphs, we explicitly align structured pathological findings and clinical reasoning with diagnoses, generating over 20K high-quality instructional samples. Based on the database, we propose PathReasoner-R1, which synergizes trajectory-masked supervised fine-tuning with reasoning-oriented reinforcement learning to instill structured chain-of-thought capabilities. To ensure medical rigor, we engineer a knowledge-aware multi-granular reward function incorporating an Entity Reward mechanism strictly aligned with knowledge graphs. This effectively guides the model to optimize for logical consistency rather than mere outcome matching, thereby enhancing robustness. Extensive experiments demonstrate that PathReasoner-R1 achieves state-of-the-art performance on both PathReasoner and public benchmarks across various image scales, equipping pathology models with transparent, clinically grounded reasoning capabilities. Dataset and code are available at https://github.com/cyclexfy/PathReasoner-R1.

cs.CV↗
arXiv2026

Does DINOv3 Set a New Medical Vision Standard? Benchmarking 2D and 3D Classification, Segmentation, and Registration

The advent of large-scale vision foundation models, pre-trained on diverse natural images, has marked a paradigm shift in computer vision. However, how the frontier vision foundation models' efficacies transfer to specialised domains such as medical imaging remains an open question. This report investigates whether DINOv3, a state-of-the-art self-supervised vision transformer (ViT) pre-trained on natural images, can directly serve as a powerful, unified encoder for medical vision tasks without domain-specific fine-tuning. To answer this, we benchmark DINOv3 across common medical vision tasks, including 2D and 3D classification, segmentation, and registration on a wide range of medical imaging modalities. We systematically analyse its scalability by varying model sizes and input image resolutions. Our findings reveal that DINOv3 shows impressive performance and establishes a formidable new baseline. Remarkably, it can even outperform medical-specific foundation models like BiomedCLIP and CT-Net on several tasks, despite being trained solely on natural images. However, we identify clear limitations: The model's features degrade in scenarios requiring deep domain specialisation, such as in whole-slide images (WSIs), electron microscopy (EM), and positron emission tomography (PET). Furthermore, we observe that DINOv3 does not consistently follow the scaling law in the medical domain. Its performance does not reliably increase with larger models or finer feature resolutions, showing diverse scaling behaviours across tasks. Overall, our work establishes DINOv3 as a strong baseline, whose powerful visual features can serve as a robust prior for multiple medical tasks. This opens promising future directions, such as leveraging its features to enforce multiview consistency in 3D reconstruction.

cs.CV↗
arXiv2025

PathAgent: Toward Interpretable Analysis of Whole-slide Pathology Images via Large Language Model-based Agentic Reasoning

Analyzing whole-slide images (WSIs) requires an iterative, evidence-driven reasoning process that parallels how pathologists dynamically zoom, refocus, and self-correct while collecting the evidence. However, existing computational pipelines often lack this explicit reasoning trajectory, resulting in inherently opaque and unjustifiable predictions. To bridge this gap, we present PathAgent, a training-free, large language model (LLM)-based agent framework that emulates the reflective, stepwise analytical approach of human experts. PathAgent can autonomously explore WSI, iteratively and precisely locating significant micro-regions using the Navigator module, extracting morphology visual cues using the Perceptor, and integrating these findings into the continuously evolving natural language trajectories in the Executor. The entire sequence of observations and decisions forms an explicit chain-of-thought, yielding fully interpretable predictions. Evaluated across five challenging datasets, PathAgent exhibits strong zero-shot generalization, surpassing task-specific baselines in both open-ended and constrained visual question-answering tasks. Moreover, a collaborative evaluation with human pathologists confirms PathAgent's promise as a transparent and clinically grounded diagnostic assistant.

cs.CV↗
arXiv2025

IPGPhormer: Interpretable Pathology Graph-Transformer for Survival Analysis

Pathological images play an essential role in cancer prognosis, while survival analysis, which integrates computational techniques, can predict critical clinical events such as patient mortality or disease recurrence from whole-slide images (WSIs). Recent advancements in multiple instance learning have significantly improved the efficiency of survival analysis. However, existing methods often struggle to balance the modeling of long-range spatial relationships with local contextual dependencies and typically lack inherent interpretability, limiting their clinical utility. To address these challenges, we propose the Interpretable Pathology Graph-Transformer (IPGPhormer), a novel framework that captures the characteristics of the tumor microenvironment and models their spatial dependencies across the tissue. IPGPhormer uniquely provides interpretability at both tissue and cellular levels without requiring post-hoc manual annotations, enabling detailed analyses of individual WSIs and cross-cohort assessments. Comprehensive evaluations on four public benchmark datasets demonstrate that IPGPhormer outperforms state-of-the-art methods in both predictive accuracy and interpretability. In summary, our method, IPGPhormer, offers a promising tool for cancer prognosis assessment, paving the way for more reliable and interpretable decision-support systems in pathology. The code is publicly available at https://anonymous.4open.science/r/IPGPhormer-6EEB.

cs.CV↗
arXiv2025

MedAgent-Pro: Towards Evidence-based Multi-modal Medical Diagnosis via Reasoning Agentic Workflow

In modern medicine, clinical diagnosis relies on the comprehensive analysis of primarily textual and visual data, drawing on medical expertise to ensure systematic and rigorous reasoning. Recent advances in large Vision-Language Models (VLMs) and agent-based methods hold great potential for medical diagnosis, thanks to the ability to effectively integrate multi-modal patient data. However, they often provide direct answers and draw empirical-driven conclusions without quantitative analysis, which reduces their reliability and clinical usability. We propose MedAgent-Pro, a new agentic reasoning paradigm that follows the diagnosis principle in modern medicine, to decouple the process into sequential components for step-by-step, evidence-based reasoning. Our MedAgent-Pro workflow presents a hierarchical diagnostic structure to mirror this principle, consisting of disease-level standardized plan generation and patient-level personalized step-by-step reasoning. To support disease-level planning, an RAG-based agent is designed to retrieve medical guidelines to ensure alignment with clinical standards. For patient-level reasoning, we propose to integrate professional tools such as visual models to enable quantitative assessments. Meanwhile, we propose to verify the reliability of each step to achieve evidence-based diagnosis, enforcing rigorous logical reasoning and a well-founded conclusion. Extensive experiments across a wide range of anatomical regions, imaging modalities, and diseases demonstrate the superiority of MedAgent-Pro to mainstream VLMs, agentic systems and state-of-the-art expert models. Ablation studies and human evaluation by clinical experts further validate its robustness and clinical relevance. Code is available at https://github.com/jinlab-imvr/MedAgent-Pro.

cs.AI↗
arXiv2025

Prototype-Guided Cross-Modal Knowledge Enhancement for Adaptive Survival Prediction

Histo-genomic multimodal survival prediction has garnered growing attention for its remarkable model performance and potential contributions to precision medicine. However, a significant challenge in clinical practice arises when only unimodal data is available, limiting the usability of these advanced multimodal methods. To address this issue, this study proposes a prototype-guided cross-modal knowledge enhancement (ProSurv) framework, which eliminates the dependency on paired data and enables robust learning and adaptive survival prediction. Specifically, we first introduce an intra-modal updating mechanism to construct modality-specific prototype banks that encapsulate the statistics of the whole training set and preserve the modality-specific risk-relevant features/prototypes across intervals. Subsequently, the proposed cross-modal translation module utilizes the learned prototypes to enhance knowledge representation for multimodal inputs and generate features for missing modalities, ensuring robust and adaptive survival prediction across diverse scenarios. Extensive experiments on four public datasets demonstrate the superiority of ProSurv over state-of-the-art methods using either unimodal or multimodal input, and the ablation study underscores its feasibility for broad applicability. Overall, this study addresses a critical practical challenge in computational pathology, offering substantial significance and potential impact in the field.

cs.LG↗
arXiv2025

DAWN: Domain-Adaptive Weakly Supervised Nuclei Segmentation via Cross-Task Interactions

Weakly supervised segmentation methods have gained significant attention due to their ability to reduce the reliance on costly pixel-level annotations during model training. However, the current weakly supervised nuclei segmentation approaches typically follow a two-stage pseudo-label generation and network training process. The performance of the nuclei segmentation heavily relies on the quality of the generated pseudo-labels, thereby limiting its effectiveness. This paper introduces a novel domain-adaptive weakly supervised nuclei segmentation framework using cross-task interaction strategies to overcome the challenge of pseudo-label generation. Specifically, we utilize weakly annotated data to train an auxiliary detection task, which assists the domain adaptation of the segmentation network. To enhance the efficiency of domain adaptation, we design a consistent feature constraint module integrating prior knowledge from the source domain. Furthermore, we develop pseudo-label optimization and interactive training methods to improve the domain transfer capability. To validate the effectiveness of our proposed method, we conduct extensive comparative and ablation experiments on six datasets. The results demonstrate the superiority of our approach over existing weakly supervised approaches. Remarkably, our method achieves comparable or even better performance than fully supervised methods. Our code will be released in https://github.com/zhangye-zoe/DAWN.

eess.IV↗
arXiv2024

Multimodal Cross-Task Interaction for Survival Analysis in Whole Slide Pathological Images

Survival prediction, utilizing pathological images and genomic profiles, is increasingly important in cancer analysis and prognosis. Despite significant progress, precise survival analysis still faces two main challenges: (1) The massive pixels contained in whole slide images (WSIs) complicate the process of pathological images, making it difficult to generate an effective representation of the tumor microenvironment (TME). (2) Existing multimodal methods often rely on alignment strategies to integrate complementary information, which may lead to information loss due to the inherent heterogeneity between pathology and genes. In this paper, we propose a Multimodal Cross-Task Interaction (MCTI) framework to explore the intrinsic correlations between subtype classification and survival analysis tasks. Specifically, to capture TME-related features in WSIs, we leverage the subtype classification task to mine tumor regions. Simultaneously, multi-head attention mechanisms are applied in genomic feature extraction, adaptively performing genes grouping to obtain task-related genomic embedding. With the joint representation of pathological images and genomic data, we further introduce a Transport-Guided Attention (TGA) module that uses optimal transport theory to model the correlation between subtype classification and survival analysis tasks, effectively transferring potential information. Extensive experiments demonstrate the superiority of our approaches, with MCTI outperforming state-of-the-art frameworks on three public benchmarks. \href{https://github.com/jsh0792/MCTI}{https://github.com/jsh0792/MCTI}.

eess.IV↗
arXiv2024

Dynamic Pseudo Label Optimization in Point-Supervised Nuclei Segmentation

Deep learning has achieved impressive results in nuclei segmentation, but the massive requirement for pixel-wise labels remains a significant challenge. To alleviate the annotation burden, existing methods generate pseudo masks for model training using point labels. However, the generated masks are inevitably different from the ground truth, and these dissimilarities are not handled reasonably during the network training, resulting in the subpar performance of the segmentation model. To tackle this issue, we propose a framework named DoNuSeg, enabling \textbf{D}ynamic pseudo label \textbf{O}ptimization in point-supervised \textbf{Nu}clei \textbf{Seg}mentation. Specifically, DoNuSeg takes advantage of class activation maps (CAMs) to adaptively capture regions with semantics similar to annotated points. To leverage semantic diversity in the hierarchical feature levels, we design a dynamic selection module to choose the optimal one among CAMs from different encoder blocks as pseudo masks. Meanwhile, a CAM-guided contrastive module is proposed to further enhance the accuracy of pseudo masks. In addition to exploiting the semantic information provided by CAMs, we consider location priors inherent to point labels, developing a task-decoupled structure for effectively differentiating nuclei. Extensive experiments demonstrate that DoNuSeg outperforms state-of-the-art point-supervised methods. The code is available at https://github.com/shinning0821/MICCAI24-DoNuSeg.

cs.CV↗
arXiv2024

Rethinking Attention-Based Multiple Instance Learning for Whole-Slide Pathological Image Classification: An Instance Attribute Viewpoint

Multiple instance learning (MIL) is a robust paradigm for whole-slide pathological image (WSI) analysis, processing gigapixel-resolution images with slide-level labels. As pioneering efforts, attention-based MIL (ABMIL) and its variants are increasingly becoming popular due to the characteristics of simultaneously handling clinical diagnosis and tumor localization. However, the attention mechanism exhibits limitations in discriminating between instances, which often misclassifies tissues and potentially impairs MIL performance. This paper proposes an Attribute-Driven MIL (AttriMIL) framework to address these issues. Concretely, we dissect the calculation process of ABMIL and present an attribute scoring mechanism that measures the contribution of each instance to bag prediction effectively, quantifying instance attributes. Based on attribute quantification, we develop a spatial attribute constraint and an attribute ranking constraint to model instance correlations within and across slides, respectively. These constraints encourage the network to capture the spatial correlation and semantic similarity of instances, improving the ability of AttriMIL to distinguish tissue types and identify challenging instances. Additionally, AttriMIL employs a histopathology adaptive backbone that maximizes the pre-trained model's feature extraction capability for collecting pathological features. Extensive experiments on three public benchmarks demonstrate that our AttriMIL outperforms existing state-of-the-art frameworks across multiple evaluation metrics. The implementation code is available at https://github.com/MedCAI/AttriMIL.

cs.CV↗
arXiv2024

H2ASeg: Hierarchical Adaptive Interaction and Weighting Network for Tumor Segmentation in PET/CT Images

Positron emission tomography (PET) combined with computed tomography (CT) imaging is routinely used in cancer diagnosis and prognosis by providing complementary information. Automatically segmenting tumors in PET/CT images can significantly improve examination efficiency. Traditional multi-modal segmentation solutions mainly rely on concatenation operations for modality fusion, which fail to effectively model the non-linear dependencies between PET and CT modalities. Recent studies have investigated various approaches to optimize the fusion of modality-specific features for enhancing joint representations. However, modality-specific encoders used in these methods operate independently, inadequately leveraging the synergistic relationships inherent in PET and CT modalities, for example, the complementarity between semantics and structure. To address these issues, we propose a Hierarchical Adaptive Interaction and Weighting Network termed H2ASeg to explore the intrinsic cross-modal correlations and transfer potential complementary information. Specifically, we design a Modality-Cooperative Spatial Attention (MCSA) module that performs intra- and inter-modal interactions globally and locally. Additionally, a Target-Aware Modality Weighting (TAMW) module is developed to highlight tumor-related features within multi-modal features, thereby refining tumor segmentation. By embedding these modules across different layers, H2ASeg can hierarchically model cross-modal correlations, enabling a nuanced understanding of both semantic and structural tumor features. Extensive experiments demonstrate the superiority of H2ASeg, outperforming state-of-the-art methods on AutoPet-II and Hecktor2022 benchmarks. The code is released at https://github.com/JinPLu/H2ASeg.

eess.IV↗