arXiv subjects

Nicha C. Dvornek

Publications and source records attributed to Nicha C. Dvornek.

At least 19 recordsLinked to original sources

arXiv2026

MammoFlow: Multiview Mammogram Synthesis with Anatomically Consistent Flow Matching

Multiview mammography relies on paired craniocaudal (CC) and mediolateral oblique (MLO) views to provide complementary projections of a 3D breast volume, enabling precise anomaly localization. However, acquiring high-quality, balanced datasets remains challenging for deep learning applications. We propose a novel method to synthesize multiview mammograms by leveraging the inherent geometric relationship between CC and MLO views. To enforce an implicit 3D consistency prior during generation, we develop an alignment module that searches a 2D affine transformation subspace to establish optimal anatomical correspondence. Leveraging this alignment, we introduce a pixel-space self-consistency loss based on the Earth Mover's Distance (EMD) between the 1D anteroposterior (AP) axis tissue distributions of the generated images. Integrated into a pretrained flow matching model, MammoFlow forces synthesized pairs to share physically plausible tissue distributions from the chest wall to the nipple. To our knowledge, this is the first work to guide multiview mammogram generation using implicit geometric tissue correspondence. Our method demonstrates superior image quality, passes expert radiologist evaluation, and generates physically consistent pairs that improve downstream classification AUC by 5%. Code is available at https://github.com/XYPB/MammoFlow

cs.CV↗

arXiv2026

FM-fMRI: Event Conditioned Flow Matching for Rest-to-Task fMRI Time-Series Synthesis

Task-based fMRI provides a direct readout of task-evoked neural dynamics, but it is expensive and difficult to acquire at scale, motivating rest-to-task synthesis from widely available resting-state fMRI (rsfMRI). We propose FM-fMRI, an event-conditioned flow-matching model that learns a continuous-time conditional vector field to generate task ROI time series from a subject's rsfMRI and the task event information. The formulation enables fast ODE-based sampling and flexible conditioning over heterogeneous event schedules. Rather than optimizing for pointwise reconstruction, we evaluated generated signals using complementary criteria that probe temporal and spectral structure, subject and group-level connectome consistency, and distributional alignment. On the public Human Connectome Project and internal BioPoint autism cohort, FM-fMRI achieves the strongest spectral and connectivity agreement and improved distribution-level matching over conditional diffusion, generative adversarial networks (GANs), and variational autoencoders (VAEs) baselines. Furthermore, we augment the BioPoint cohort by synthesizing task-fMRI ROI time series with our method, improving downstream autism classification and demonstrating practical utility in data-limited clinical settings. The code will be available on GitHub.

cs.LG↗

arXiv2026

Benchmarking Ultrasound Foundation Models for Fetal Plane Classification

Ultrasound is widely used in obstetric care due to its safety, accessibility, and real-time imaging. However, interpretation remains operator-dependent and susceptible to noise and artifacts. Deep learning models have shown strong performance to solve these problem, but they typically require large annotated datasets that are difficult to obtain in clinical ultrasound. Foundation models (FMs) offer an alternative, using a large number of ultrasound images to learn transferable representations that can generalize with limited labeled data. This work presents a comprehensive benchmark of ultrasound-specific FMs for fetal plane classification. We evaluated four ultrasound FMs (USFM, MOFO, UltraSAM, FetalCLIP) against two CNN baselines (ResNet50, EfficientNet-V2) and a ViT (DINOv3) pretrained on natural images. We trained all models under two complementary settings: full fine-tuning and linear probing with a frozen encoder. All models were trained using 5-fold patient-level cross-validation on a Spanish fetal ultrasound dataset and tested on both in-domain data and an external African cohort to assess cross-population generalization. We found that FetalCLIP achieved the best results in the linear probing setting (F1 = 0.9261 for in-domain, F1 = 0.9731 for out-of-domain), while USFM performed best in the full fine-tuning setting (F1 = 0.9476 for in-domain, F1 = 0.9515 for out-of-domain). MOFO and UltraSAM degraded most in both settings, underperforming natural image pretrained models in some cases. These findings highlight how the choice of pretrained model strongly affects fetal plane classification performance, since different pretraining objectives lead to different levels of transferability.

eess.IV↗

arXiv2026

Learning Robust and Task-Invariant Functional Representation from fMRI through Siamese Self-Supervised Learning

Functional magnetic resonance imaging (fMRI) is a powerful tool for investigating human brain function. However, the high cost of data acquisition and the inherent subjectivity of psychiatric rating scales often lead to datasets with small sample sizes and variable label quality, especially when targeting a specific neurological condition. Combined with the inherently high dimensionality of fMRI data, these limitations substantially increase the risk of model overfitting. Recent years have seen growing interest in developing fMRI foundation models by combining multiple datasets; however, the computational resources needed for pretraining and fine-tuning are often prohibitive. We show that a lightweight self-supervised framework yields representations that generalize across diverse downstream tasks, outperforming fully supervised baselines and approaching the performance of large-scale models. We introduce BrainSimSiam, a data-efficient self-supervised representation learning framework that leverages positive-only data pairs to learn robust and generalizable features. We demonstrate that the learned representations achieve strong performance across multiple downstream classification and regression tasks, highlighting the potential of BrainSimSiam for data-limited neuroimaging applications.

cs.LG↗

arXiv2026

BioFact-MoE: Biologically Factorized Mixture of Experts for Vision-Language Prognostic Modeling in Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is biologically heterogeneous, shaped by the interplay between hepatic functional reserve and tumor-related oncologic factors; thus, similar survival outcomes may reflect fundamentally different underlying biological processes. Prognostic modeling in HCC is informed by rich multimodal information from multiparametric MRI and radiology reports from routine clinical practice. Existing prognostic vision-language models (VLMs) learn a single entangled latent representation that blends hepatic and tumor-related factors, limiting both accuracy and biological interpretability. We present BioFact-MoE, a biologically factorized Mixture of Experts (MoE) framework that explicitly decomposes liver and tumor factors via biologically supervised experts within a residual MoE survival architecture. On a HCC cohort of N=588 patients (pretrained on 4,582 3D MRI image-report pairs), BioFact-MoE consistently improves survival prediction over all baselines across time horizons, achieving 12-, 18-, and 24-month AUCs of 75.33%, 75.85%, and 73.96%. Beyond scalar risk prediction, gated expert weights enable phenotype-aware risk stratification. Pathway-informed gating uncovers clinically meaningful treatment-associated survival heterogeneity. In held-out validation, hepatic and tumor embeddings show selective associations with liver function and tumor burden markers, respectively (p<0.05), without supervision. The code is available at https://github.com/jy-639/BioFact-MoE.

cs.CV↗

arXiv2026

CARE: Towards Clinical Accountability in Multi-Modal Medical Reasoning with an Evidence-Grounded Agentic Framework

Large visual language models (VLMs) have shown strong multi-modal medical reasoning ability, but most operate as end-to-end black boxes, diverging from clinicians' evidence-based, staged workflows and hindering clinical accountability. Complementarily, expert visual grounding models can accurately localize regions of interest (ROIs), providing explicit, reliable evidence that improves both reasoning accuracy and trust. In this paper, we introduce CARE, advancing Clinical Accountability in multi-modal medical Reasoning with an Evidence-grounded agentic framework. Unlike existing approaches that couple grounding and reasoning within a single generalist model, CARE decomposes the task into coordinated sub-modules to reduce shortcut learning and hallucination: a compact VLM proposes relevant medical entities; an expert entity-referring segmentation model produces pixel-level ROI evidence; and a grounded VLM reasons over the full image augmented by ROI hints. The VLMs are optimized with reinforcement learning with verifiable rewards to align answers with supporting evidence. Furthermore, a VLM coordinator plans tool invocation and reviews evidence-answer consistency, providing agentic control and final verification. Evaluated on standard medical VQA benchmarks, our CARE-Flow (coordinator-free) improves average accuracy by 10.9% over the same size (10B) state-of-the-art (SOTA). With dynamic planning and answer review, our CARE-Coord yields a further gain, outperforming the heavily pre-trained SOTA by 5.2%. Our experiments demonstrate that an agentic framework that emulates clinical workflows, incorporating decoupled specialized models and explicit evidence, yields more accurate and accountable medical AI. Project page: https://xypb.github.io/CARE-Project-Page/

cs.AI↗

arXiv2026

DECADE: A Temporally-Consistent Unsupervised Diffusion Model for Enhanced Rb-82 Dynamic Cardiac PET Image Denoising

Rb-82 dynamic cardiac PET imaging is widely used for the clinical diagnosis of coronary artery disease (CAD), but its short half-life results in high noise levels that degrade dynamic frame quality and parametric imaging. The lack of paired clean-noisy training data, rapid tracer kinetics, and frame-dependent noise variations further limit the effectiveness of existing deep learning denoising methods. We propose DECADE (A Temporally-Consistent Unsupervised Diffusion model for Enhanced Rb-82 CArdiac PET DEnoising), an unsupervised diffusion framework that generalizes across early- to late-phase dynamic frames. DECADE incorporates temporal consistency during both training and iterative sampling, using noisy frames as guidance to preserve quantitative accuracy. The method was trained and evaluated on datasets acquired from Siemens Vision 450 and Siemens Biograph Vision Quadra scanners. On the Vision 450 dataset, DECADE consistently produced high-quality dynamic and parametric images with reduced noise while preserving myocardial blood flow (MBF) and myocardial flow reserve (MFR). On the Quadra dataset, using 15%-count images as input and full-count images as reference, DECADE outperformed UNet-based and other diffusion models in image quality and K1/MBF quantification. The proposed framework enables effective unsupervised denoising of Rb-82 dynamic cardiac PET without paired training data, supporting clearer visualization while maintaining quantitative integrity.

cs.CV↗

arXiv2026

Equi-ViT: Rotational Equivariant Vision Transformer for Robust Histopathology Analysis

Vision Transformers (ViTs) have gained rapid adoption in computational pathology for their ability to model long-range dependencies through self-attention, addressing the limitations of convolutional neural networks that excel at local pattern capture but struggle with global contextual reasoning. Recent pathology-specific foundation models have further advanced performance by leveraging large-scale pretraining. However, standard ViTs remain inherently non-equivariant to transformations such as rotations and reflections, which are ubiquitous variations in histopathology imaging. To address this limitation, we propose Equi-ViT, which integrates an equivariant convolution kernel into the patch embedding stage of a ViT architecture, imparting built-in rotational equivariance to learned representations. Equi-ViT achieves superior rotation-consistent patch embeddings and stable classification performance across image orientations. Our results on a public colorectal cancer dataset demonstrate that incorporating equivariant patch embedding enhances data efficiency and robustness, suggesting that equivariant transformers could potentially serve as more generalizable backbones for the application of ViT in histopathology, such as digital pathology foundation models.

eess.IV↗

arXiv2026

Assessment of Clonal Hematopoiesis of Indeterminate Potential and Future Cardiomyopathy from Cardiac Magnetic Resonance Imaging using Deep Learning in a Cardio-oncology Population

We propose a novel deep learning framework to identify clonal hematopoiesis of indeterminate potential (CHIP), a somatic mutation condition associated with adverse cardiovascular outcomes, using routine cardiac magnetic resonance (CMR) imaging. Utilizing 152 multi-view late gadolinium enhancement (LGE) scans from 136 cardio-oncology patients, we developed a convolutional neural network to (1) detect CHIP status and (2) stratify the risk of future cardiomyopathy specifically within the CHIP-positive cohort. To ensure robustness, we performed rigorous feature importance analysis to rule out reliance on demographic confounders such as age and immune checkpoint inhibitor usage. The model achieved an AUC of 0.71 for CHIP detection and, notably, an AUC of 0.87 for predicting future cardiomyopathy in CHIP-positive patients, significantly outperforming demographic-only baselines. These results demonstrate the feasibility of using LGE-CMR signatures as a non-invasive "radiogenomic" screening tool, potentially enabling accessible risk stratification and precision medicine for high-risk cardiovascular populations.

eess.IV↗

arXiv2025

Acquisition Time-Informed Breast Tumor Segmentation from Dynamic Contrast-Enhanced MRI

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) plays an important role in breast cancer screening, tumor assessment, and treatment planning and monitoring. The dynamic changes in contrast in different tissues help to highlight the tumor in post-contrast images. However, varying acquisition protocols and individual factors result in large variation in the appearance of tissues, even for images acquired in the same phase (e.g., first post-contrast phase), making automated tumor segmentation challenging. Here, we propose a tumor segmentation method that leverages knowledge of the image acquisition time to modulate model features according to the specific acquisition sequence. We incorporate the acquisition times using feature-wise linear modulation (FiLM) layers, a lightweight method for incorporating temporal information that also allows for capitalizing on the full, variables number of images acquired per imaging study. We trained baseline and different configurations for the time-modulated models with varying backbone architectures on a large public multisite breast DCE-MRI dataset. Evaluation on in-domain images and a public out-of-domain dataset showed that incorporating knowledge of phase acquisition time improved tumor segmentation performance and model generalization.

cs.CV↗

arXiv2025

GLAM: Geometry-Guided Local Alignment for Multi-View VLP in Mammography

Mammography screening is an essential tool for early detection of breast cancer. The speed and accuracy of mammography interpretation have the potential to be improved with deep learning methods. However, the development of a foundation visual language model (VLM) is hindered by limited data and domain differences between natural and medical images. Existing mammography VLMs, adapted from natural images, often ignore domain-specific characteristics, such as multi-view relationships in mammography. Unlike radiologists who analyze both views together to process ipsilateral correspondence, current methods treat them as independent images or do not properly model the multi-view correspondence learning, losing critical geometric context and resulting in suboptimal prediction. We propose GLAM: Global and Local Alignment for Multi-view mammography for VLM pretraining using geometry guidance. By leveraging the prior knowledge about the multi-view imaging process of mammograms, our model learns local cross-view alignments and fine-grained local features through joint global and local, visual-visual, and visual-language contrastive learning. Pretrained on EMBED [14], one of the largest open mammography datasets, our model outperforms baselines across multiple datasets under different settings.

cs.CV↗

arXiv2025

CXR-LT 2024: A MICCAI challenge on long-tailed, multi-label, and zero-shot disease classification from chest X-ray

The CXR-LT series is a community-driven initiative designed to enhance lung disease classification using chest X-rays (CXR). It tackles challenges in open long-tailed lung disease classification and enhances the measurability of state-of-the-art techniques. The first event, CXR-LT 2023, aimed to achieve these goals by providing high-quality benchmark CXR data for model development and conducting comprehensive evaluations to identify ongoing issues impacting lung disease classification performance. Building on the success of CXR-LT 2023, the CXR-LT 2024 expands the dataset to 377,110 chest X-rays (CXRs) and 45 disease labels, including 19 new rare disease findings. It also introduces a new focus on zero-shot learning to address limitations identified in the previous event. Specifically, CXR-LT 2024 features three tasks: (i) long-tailed classification on a large, noisy test set, (ii) long-tailed classification on a manually annotated "gold standard" subset, and (iii) zero-shot generalization to five previously unseen disease findings. This paper provides an overview of CXR-LT 2024, detailing the data curation process and consolidating state-of-the-art solutions, including the use of multimodal models for rare disease detection, advanced generative approaches to handle noisy labels, and zero-shot learning strategies for unseen diseases. Additionally, the expanded dataset enhances disease coverage to better represent real-world clinical settings, offering a valuable resource for future research. By synthesizing the insights and innovations of participating teams, we aim to advance the development of clinically realistic and generalizable diagnostic models for chest radiography.

cs.CV↗

arXiv2025

Equivariant Imaging Biomarkers for Robust Unsupervised Segmentation of Histopathology

Histopathology evaluation of tissue specimens through microscopic examination is essential for accurate disease diagnosis and prognosis. However, traditional manual analysis by specially trained pathologists is time-consuming, labor-intensive, cost-inefficient, and prone to inter-rater variability, potentially affecting diagnostic consistency and accuracy. As digital pathology images continue to proliferate, there is a pressing need for automated analysis to address these challenges. Recent advancements in artificial intelligence-based tools such as machine learning (ML) models, have significantly enhanced the precision and efficiency of analyzing histopathological slides. However, despite their impressive performance, ML models are invariant only to translation, lacking invariance to rotation and reflection. This limitation restricts their ability to generalize effectively, particularly in histopathology, where images intrinsically lack meaningful orientation. In this study, we develop robust, equivariant histopathological biomarkers through a novel symmetric convolutional kernel via unsupervised segmentation. The approach is validated using prostate tissue micro-array (TMA) images from 50 patients in the Gleason 2019 Challenge public dataset. The biomarkers extracted through this approach demonstrate enhanced robustness and generalizability against rotation compared to models using standard convolution kernels, holding promise for enhancing the accuracy, consistency, and robustness of ML models in digital pathology. Ultimately, this work aims to improve diagnostic and prognostic capabilities of histopathology beyond prostate cancer through equivariant imaging.

eess.IV↗

arXiv2025

STNAGNN: Data-driven Spatio-temporal Brain Connectivity beyond FC

In recent years, graph neural networks (GNNs) have been widely applied in the analysis of brain fMRI, yet defining the connectivity between ROIs remains a challenge in noisy fMRI data. Among all approaches, Functional Connectome (FC) is the most popular method. Computed by the correlation coefficients between ROI time series, FC is a powerful and computationally efficient way to estimate ROI connectivity. However, it is well known for neglecting structural connections and causality in ROI interactions. Also, FC becomes much more noisy in the short spatio-temporal sliding-window subsequences of fMRI. Effective Connectome (EC) is proposed as a directional alternative, but is difficult to accurately estimate. Furthermore, for optimal GNN performance, usually only a small percentage of the strongest connections are selected as sparse edges, resulting in oversimplification of complex brain connections. To tackle these challenges, we propose the Spatio-Temporal Node Attention Graph Neural Network (STNAGNN) as a data-driven alternative that combines sparse predefined FC with dense data-driven spatio-temporal connections, allowing for flexible and spatio-temporal learning of ROI interaction patterns.

cs.LG↗

arXiv2025

GMR-Conv: An Efficient Rotation and Reflection Equivariant Convolution Kernel Using Gaussian Mixture Rings

Symmetry, where certain features remain invariant under geometric transformations, can often serve as a powerful prior in designing convolutional neural networks (CNNs). While conventional CNNs inherently support translational equivariance, extending this property to rotation and reflection has proven challenging, often forcing a compromise between equivariance, efficiency, and information loss. In this work, we introduce Gaussian Mixture Ring Convolution (GMR-Conv), an efficient convolution kernel that smooths radial symmetry using a mixture of Gaussian-weighted rings. This design mitigates discretization errors of circular kernels, thereby preserving robust rotation and reflection equivariance without incurring computational overhead. We further optimize both the space and speed efficiency of GMR-Conv via a novel parameterization and computation strategy, allowing larger kernels at an acceptable cost. Extensive experiments on eight classification and one segmentation datasets demonstrate that GMR-Conv not only matches conventional CNNs' performance but can also surpass it in applications with orientation-less data. GMR-Conv is also proven to be more robust and efficient than the state-of-the-art equivariant learning methods. Our work provides inspiring empirical evidence that carefully applied radial symmetry can alleviate the challenges of information loss, marking a promising advance in equivariant network architectures. The code is available at https://github.com/XYPB/GMR-Conv.

cs.CV↗

arXiv2025

Multi-View and Multi-Scale Alignment for Contrastive Language-Image Pre-training in Mammography

Contrastive Language-Image Pre-training (CLIP) demonstrates strong potential in medical image analysis but requires substantial data and computational resources. Due to these restrictions, existing CLIP applications in medical imaging focus mainly on modalities like chest X-rays that have abundant image-report data available, leaving many other important modalities underexplored. Here, we propose one of the first adaptations of the full CLIP model to mammography, which presents significant challenges due to labeled data scarcity, high-resolution images with small regions of interest, and class-wise imbalance. We first develop a specialized supervision framework for mammography that leverages its multi-view nature. Furthermore, we design a symmetric local alignment module to better focus on detailed features in high-resolution images. Lastly, we incorporate a parameter-efficient fine-tuning approach for large language models pre-trained with medical knowledge to address data limitations. Our multi-view and multi-scale alignment (MaMA) method outperforms state-of-the-art baselines for three different tasks on two large real-world mammography datasets, EMBED and RSNA-Mammo, with only 52% model size compared with the largest baseline. The code is available at https://github.com/XYPB/MaMA

cs.CV↗

arXiv2025

Causal Modeling of fMRI Time-series for Interpretable Autism Spectrum Disorder Classification

Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects social and communicative behaviors. It emerges in early life and is generally associated with lifelong disabilities. Thus, accurate and early diagnosis could facilitate treatment outcomes for those with ASD. Functional magnetic resonance imaging (fMRI) is a useful tool that measures changes in brain signaling to facilitate our understanding of ASD. Much effort is being made to identify ASD biomarkers using various connectome-based machine learning and deep learning classifiers. However, correlation-based models cannot capture the non-linear interactions between brain regions. To solve this problem, we introduce a causality-inspired deep learning model that uses time-series information from fMRI and captures causality among ROIs useful for ASD classification. The model is compared with other baseline and state-of-the-art models with 5-fold cross-validation on the ABIDE dataset. We filtered the dataset by choosing all the images with mean FD less than 15mm to ensure data quality. Our proposed model achieved the highest average classification accuracy of 71.9% and an average AUC of 75.8%. Moreover, the inter-ROI causality interpretation of the model suggests that the left precuneus, right precuneus, and cerebellum are placed in the top 10 ROIs in inter-ROI causality among the ASD population. In contrast, these ROIs are not ranked in the top 10 in the control population. We have validated our findings with the literature and found that abnormalities in these ROIs are often associated with ASD.

eess.IV↗

arXiv2025

Towards Zero-Shot Task-Generalizable Learning on fMRI

Functional MRI measuring BOLD signal is an increasingly important imaging modality in studying brain functions and neurological disorders. It can be acquired in either a resting-state or a task-based paradigm. Compared to resting-state fMRI, task-based fMRI is acquired while the subject is performing a specific task designed to enhance study-related brain activities. Consequently, it generally has more informative task-dependent signals. However, due to the variety of task designs, it is much more difficult than in resting state to aggregate task-based fMRI acquired in different tasks to train a generalizable model. To resolve this complication, we propose a supervised task-aware network TA-GAT that jointly learns a general-purpose encoder and task-specific contextual information. The encoder-generated embedding and the learned contextual information are then combined as input to multiple modules for performing downstream tasks. We believe that the proposed task-aware architecture can plug-and-play in any neural network architecture to incorporate the prior knowledge of fMRI tasks into capturing functional brain patterns.

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