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Purang Abolmaesumi

Publications and source records attributed to Purang Abolmaesumi.

At least 19 recordsLinked to original sources
arXiv2026

Consistent Distribution Matching for Data-Free Diffusion Distillation

Flow and diffusion models suffer from slow inference due to computationally expensive numerical integration. Distillation provides a promising way for a student model to learn from a teacher's dynamics, enabling one-step or few-step generation. However, existing methods often depend on curated distillation datasets, costly teacher rollouts, or auxiliary proxy networks, which complicate model training and scaling. In this work, we propose Consistent Distribution Matching, a simulation-free and data-free distillation method for accelerating diffusion and flow models while preserving strong generative capacity. Our key insight is to unify sample generation and score estimation with one student network. Thus, our framework uses only two models, a frozen teacher and a trainable student, and optimizes one objective. We prove that minimizing our objective indicates Wasserstein convergence of the student flow-map pushforwards to the teacher marginals. On ImageNet 256$\times$256, our method attains an FID of 2.04 with a single function evaluation (1-NFE) and a 4-NFE FID of 1.37 within 40 epochs of training, surpassing the state-of-the-art distillation baselines without data. Our code code and model are available at https://consistentdmd.github.io/.

cs.LG↗
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

A Dataset and Benchmarks for Atrial Fibrillation Detection from Electrocardiograms of Intensive Care Unit Patients

Objective: Atrial fibrillation (AF) is the most common cardiac arrhythmia experienced by intensive care unit (ICU) patients and can cause adverse health effects. In this study, we publish a labelled ICU dataset and benchmarks for AF detection. Methods: We compared machine learning models across three data-driven artificial intelligence (AI) approaches: feature-based classifiers, deep learning (DL), and ECG foundation models (FMs). This comparison addresses a critical gap in the literature and aims to pinpoint which AI approach is best for accurate AF detection. Electrocardiograms (ECGs) from a Canadian ICU and the 2021 PhysioNet/Computing in Cardiology Challenge were used to conduct the experiments. Multiple training configurations were tested, ranging from zero-shot inference to transfer learning. Results: On average and across both datasets, ECG FMs performed best, followed by DL, then feature-based classifiers. The model that achieved the top F1 score on our ICU test set was ECG-FM through a transfer learning strategy (F1=0.89). Conclusion: This study demonstrates promising potential for using AI to build an automatic patient monitoring system. Significance: By publishing our labelled ICU dataset (LinkToBeAdded) and performance benchmarks, this work enables the research community to continue advancing the state-of-the-art in AF detection in the ICU. https://physionet.org/content/kingston-icu-af/

cs.LG↗
arXiv2026

Steering Geometry: Validating Human Value Geometry in LLM Steering Space

As large language models (LLMs) are increasingly deployed in alignment-sensitive contexts, activation steering has emerged as a lightweight, inference-time alternative to fine-tuning methods (e.g., RLHF, DPO) for behavioral control. However, existing work typically validates steering on isolated behaviors, leaving it unclear whether steering vectors encode coherent semantic structure or merely exploit behavior-specific shortcuts. We investigate whether the latent geometry of LLM steering vectors reflects theory-specified structure in human values and morality. Using Schwartz's Theory of Basic Human Values as our primary fine-grained framework, we introduce a 26K-sample benchmark covering 20 human values and analyze distribution-driven methods (e.g., CAA, SphericalSteer, ODESteer) and behavior-centric approaches (e.g., COLD-Steer, BiPO) across diverse model families and sizes. We find that distribution-driven methods recover human value topologies aligned with theoretical predictions (Spearman $ρ$ up to 0.51, $p < 10^{-13}$). In contrast, behavior-centric methods achieve comparable steering performance but show little correlation with the expected value geometry. Geometric fidelity improves with model scale but drops after instruction tuning. Finally, better geometric alignment also leads to more human-consistent transfer across values: steering one value correctly lifts compatible values and suppresses opposing ones. Code and data are available at: https://github.com/DeepRCL/Steering_Geometry.

cs.CL↗
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↗
arXiv2026

Compass: Prostate Cancer Detection Needs Multi-View Context

Artificial intelligence (AI) analysis of micro-ultrasound ($μ$US) has shown promise for prostate cancer (PCa) detection. However, most existing AI methods focus on the analysis of single $μ$US images in isolation. By contrast, expert $μ$US readers typically assess a full recorded video study, which provides three-dimensional context, to improve PCa detection compared to single-frame analysis. Inspired by this clinical workflow, we propose Compass, a novel AI methodology which models a $μ$US study as a stream of 2D images. Compass jointly integrates rotational sweep videos of the prostate with $μ$US frames acquired at the moment of biopsy, and performs evidence aggregation across the study using a transformer conditioned on the probe's rotational angle. Finally, a decoder head predicts frame-level and study-level risk scores for the patient. The model is trained and evaluated using a multi-center clinical trial dataset of $μ$US studies, including continuous rotational scans of the prostate and videos captured during biopsy acquisition. We compare the proposed method to baseline AI methods from the literature and to risk scores provided by clinical experts. Our framework shows strong performance, highlighting the value of multi-view context for $μ$US PCa detection, and providing a potentially powerful tool to complement human expertise in $μ$US-based PCa diagnosis. Our code is available at: https://github.com/mharmanani/Compass.

cs.CV↗
arXiv2026

Learning Where to Look: A Reinforcement Learning Framework for Robust Micro-Ultrasound Prostate Cancer Detection

Micro-ultrasound ($μ$US) is a new, emerging, and promising imaging modality for prostate cancer (PCa) detection, but accurate identification of suspicious tissue remains highly dependent on clinical experience, leading to substantial inter-observer variability. Machine-learning assistance can reduce this variability; however, training reliable deep models is challenging because supervision is sparse and noisy -- typically limited to core-level histopathology outcomes (e.g., cancer grade and its percentage in a biopsy core) without pixel-level lesion annotations and under severe class imbalance. We introduce Prost-RL, which reframes $μ$US PCa detection as a spatially aware, policy-driven inference problem by learning where to look before decoding. Prost-RL integrates a lightweight reinforcement-learning policy into a foundation-model encoder-decoder to generate interpretable spatial attention maps that act as soft prompts for both cancer-likelihood heatmap prediction and image-level classification. We further propose Adaptive Policy Optimization (APO) to stabilize hybrid supervised-RL training and a noise-robust objective combining symmetric cross-entropy with negative-entropy regularization to mitigate weak-label noise and encourage sharp localization. On a cohort of 6,607 biopsy cores from 693 patients across five clinical sites, Prost-RL achieves $79.0\pm3.5$ AUROC with $64.6\pm6.3$% sensitivity at 80% specificity for core-level detection (+2.1 AUROC and +4.5 sensitivity points over the strongest baseline), and $79.3\pm5.8$ AUROC for clinically significant cancer classification. The learned policy highlights biopsy-aligned regions, providing transparent, spatially grounded evidence alongside quantitative risk predictions. Code is available at: https://github.com/DeepRCL/Prost-RL.

cs.CV↗
arXiv2026

HypOProto: Hyperbolic Ordinal Prototypes for Left Ventricular Filling Pressure Classification

Echocardiography (echo) is a widely used imaging modality for assessing cardiac function, with Left Ventricular Filling Pressure (LVFP) serving as a critical physiological marker for conditions such as heart failure. Standard LVFP classification into normal \emph{vs} elevated categories relies on the Doppler-derived $E/e'$ ratio, which is operator-dependent and often unavailable in resource-limited settings, motivating methods that infer LVFP directly from B-mode echo. Existing deep learning approaches achieve high performance but remain largely black-box, limiting clinical interpretability. We propose HypOProto, a hyperbolic, ordinal prototype-based framework for interpretable LVFP classification using a frozen, explainable foundation model backbone. HypOProto arranges prototypes along the physiological $E/e'$ scale, placing borderline cases near the hyperboloid root where small angular differences separate similar cases, while normal and elevated cases occupy outward positions reflecting increasing diagnostic certainty. This hyperbolic geometry encodes clinically meaningful ordinal relationships and improves interpretability. We also introduce a novel Hyperbolic Prototype Angular Separation (HyperPAS) loss, enforcing inter-class prototype separation in hyperbolic space. HypOProto achieves SOTA performance while maintaining transparency, and highlights clinically relevant regions in visualizations. This work represents the first prototype-based framework for LVFP classification in echo. Our code can be found at https://github.com/DeepRCL/HypOProto.

cs.CV↗
arXiv2026

ProtoTTA: Prototype-Guided Test-Time Adaptation

Deep networks that rely on prototypes-interpretable representations that can be related to the model input-have gained significant attention for balancing high accuracy with inherent interpretability, which makes them suitable for critical domains such as healthcare. However, these models are limited by their reliance on training data, which hampers their robustness to distribution shifts. While test-time adaptation (TTA) improves the robustness of deep networks by updating parameters and statistics, the prototypes of interpretable models have not been explored for this purpose. We introduce ProtoTTA, a general framework for prototypical models that leverages intermediate prototype signals rather than relying solely on model outputs. ProtoTTA minimizes the entropy of the prototype-similarity distribution to encourage more confident and prototype-specific activations on shifted data. To maintain stability, we employ geometric filtering to restrict updates to samples with reliable prototype activations, regularized by prototype-importance weights and model-confidence scores. Experiments across four prototypical backbones on four diverse benchmarks spanning fine-grained vision, histopathology, and NLP demonstrate that ProtoTTA improves robustness over standard output entropy minimization while restoring correct semantic focus in prototype activations. We also introduce novel interpretability metrics and a vision-language model (VLM) evaluation framework to explain TTA dynamics, confirming ProtoTTA restores human-aligned semantic focus and correlates reliably with VLM-rated reasoning quality. Code is available at: https://github.com/DeepRCL/ProtoTTA.

cs.LG↗
arXiv2026

Vision-Language Models Encode Clinical Guidelines for Concept-Based Medical Reasoning

Concept Bottleneck Models (CBMs) are a prominent framework for interpretable AI that map learned visual features to a set of meaningful concepts for task-specific downstream predictions. Their sequential structure enhances transparency by connecting model predictions to the underlying concepts that support them. In medical imaging, where transparency is essential, CBMs offer an appealing foundation for explainable model design. However, discrete concept representations often overlook broader clinical context such as diagnostic guidelines and expert heuristics, reducing reliability in complex cases. We propose MedCBR, a concept-based reasoning framework that integrates clinical guidelines with vision-language and reasoning models. Labeled clinical descriptors are transformed into guideline-conformant text, and a concept-based model is trained with a multitask objective combining multimodal contrastive alignment, concept supervision, and diagnostic classification to jointly ground image features, concepts, and pathology. A reasoning model then converts these predictions into structured clinical narratives that explain the diagnosis, emulating expert reasoning based on established guidelines. MedCBR achieves superior diagnostic and concept-level performance, with AUROCs of 94.2% on ultrasound and 84.0% on mammography. Further experiments on non-medical datasets achieve 86.1% accuracy. Our framework enhances interpretability and forms an end-to-end bridge from medical image analysis to decision-making.

cs.CV↗
arXiv2026

GUIDE-US: Grade-Informed Unpaired Distillation of Encoder Knowledge from Histopathology to Micro-UltraSound

Purpose: Non-invasive grading of prostate cancer (PCa) from micro-ultrasound (micro-US) could expedite triage and guide biopsies toward the most aggressive regions, yet current models struggle to infer tissue micro-structure at coarse imaging resolutions. Methods: We introduce an unpaired histopathology knowledge-distillation strategy that trains a micro-US encoder to emulate the embedding distribution of a pretrained histopathology foundation model, conditioned on International Society of Urological Pathology (ISUP) grades. Training requires no patient-level pairing or image registration, and histopathology inputs are not used at inference. Results: Compared to the current state of the art, our approach increases sensitivity to clinically significant PCa (csPCa) at 60% specificity by 3.5% and improves overall sensitivity at 60% specificity by 1.2%. Conclusion: By enabling earlier and more dependable cancer risk stratification solely from imaging, our method advances clinical feasibility. Source code will be publicly released upon publication.

cs.CV↗
arXiv2026

Optimizing Point-of-Care Ultrasound Video Acquisition for Probabilistic Multi-Task Heart Failure Detection

Purpose: Echocardiography with point-of-care ultrasound (POCUS) must support clinical decision-making under tight bedside time and operator-effort constraints. We introduce a personalized data acquisition strategy in which an RL agent, given a partially observed multi-view study, selects the next view to acquire or terminates acquisition to support heart-failure (HF) assessment. Upon termination, a diagnostic model jointly predicts aortic stenosis (AS) severity and left ventricular ejection fraction (LVEF), two key HF biomarkers, and outputs uncertainty, enabling an explicit trade-off between diagnostic performance and acquisition cost. Methods: We model POCUS as a sequential acquisition problem: at each step, a video selector (RL agent) chooses the next view to acquire or terminates acquisition. Upon termination, a shared multi-view transformer performs multi-task inference with two heads, ordinal AS classification, and LVEF regression, and outputs Gaussian predictive distributions yielding ordinal probabilities over AS classes and EF thresholds. These probabilities drive a reward that balances expected diagnostic benefit against acquisition cost, producing patient-specific acquisition pathways. Results: The dataset comprises 12,180 patient-level studies, split into training/validation/test sets (75/15/15). On the 1,820 test studies, our method matches full-study performance while using 32% fewer videos, achieving 77.2% mean balanced accuracy (bACC) across AS severity classification and LVEF estimation, demonstrating robust multi-task performance under acquisition budgets. Conclusion: Patient-tailored, cost-aware acquisition can streamline POCUS workflows while preserving decision quality, producing interpretable scan pathways suited to bedside use. The framework is extensible to additional cardiac endpoints and merits prospective evaluation for clinical integration.

cs.CV↗
arXiv2026

Point Tracking as a Temporal Cue for Robust Myocardial Segmentation in Echocardiography Videos

Purpose: Myocardium segmentation in echocardiography videos is a challenging task due to low contrast, noise, and anatomical variability. Traditional deep learning models either process frames independently, ignoring temporal information, or rely on memory-based feature propagation, which accumulates error over time. Methods: We propose Point-Seg, a transformer-based segmentation framework that integrates point tracking as a temporal cue to ensure stable and consistent segmentation of myocardium across frames. Our method leverages a point-tracking module trained on a synthetic echocardiography dataset to track key anatomical landmarks across video sequences. These tracked trajectories provide an explicit motion-aware signal that guides segmentation, reducing drift and eliminating the need for memory-based feature accumulation. Additionally, we incorporate a temporal smoothing loss to further enhance temporal consistency across frames. Results: We evaluate our approach on both public and private echocardiography datasets. Experimental results demonstrate that Point-Seg has statistically similar accuracy in terms of Dice to state-of-the-art segmentation models in high quality echo data, while it achieves better segmentation accuracy in lower quality echo with improved temporal stability. Furthermore, Point-Seg has the key advantage of pixel-level myocardium motion information as opposed to other segmentation methods. Such information is essential in the computation of other downstream tasks such as myocardial strain measurement and regional wall motion abnormality detection. Conclusion: Point-Seg demonstrates that point tracking can serve as an effective temporal cue for consistent video segmentation, offering a reliable and generalizable approach for myocardium segmentation in echocardiography videos. The code is available at https://github.com/DeepRCL/PointSeg.

cs.CV↗
arXiv2025

ProtoEFNet: Dynamic Prototype Learning for Inherently Interpretable Ejection Fraction Estimation in Echocardiography

Ejection fraction (EF) is a crucial metric for assessing cardiac function and diagnosing conditions such as heart failure. Traditionally, EF estimation requires manual tracing and domain expertise, making the process time-consuming and subject to interobserver variability. Most current deep learning methods for EF prediction are black-box models with limited transparency, which reduces clinical trust. Some post-hoc explainability methods have been proposed to interpret the decision-making process after the prediction is made. However, these explanations do not guide the model's internal reasoning and therefore offer limited reliability in clinical applications. To address this, we introduce ProtoEFNet, a novel video-based prototype learning model for continuous EF regression. The model learns dynamic spatiotemporal prototypes that capture clinically meaningful cardiac motion patterns. Additionally, the proposed Prototype Angular Separation (PAS) loss enforces discriminative representations across the continuous EF spectrum. Our experiments on the EchonetDynamic dataset show that ProtoEFNet can achieve accuracy on par with its non-interpretable counterpart while providing clinically relevant insight. The ablation study shows that the proposed loss boosts performance with a 2% increase in F1 score from 77.67$\pm$2.68 to 79.64$\pm$2.10. Our source code is available at: https://github.com/DeepRCL/ProtoEF

cs.CV↗
arXiv2025

EchoAgent: Guideline-Centric Reasoning Agent for Echocardiography Measurement and Interpretation

Purpose: Echocardiographic interpretation requires video-level reasoning and guideline-based measurement analysis, which current deep learning models for cardiac ultrasound do not support. We present EchoAgent, a framework that enables structured, interpretable automation for this domain. Methods: EchoAgent orchestrates specialized vision tools under Large Language Model (LLM) control to perform temporal localization, spatial measurement, and clinical interpretation. A key contribution is a measurement-feasibility prediction model that determines whether anatomical structures are reliably measurable in each frame, enabling autonomous tool selection. We curated a benchmark of diverse, clinically validated video-query pairs for evaluation. Results: EchoAgent achieves accurate, interpretable results despite added complexity of spatiotemporal video analysis. Outputs are grounded in visual evidence and clinical guidelines, supporting transparency and traceability. Conclusion: This work demonstrates the feasibility of agentic, guideline-aligned reasoning for echocardiographic video analysis, enabled by task-specific tools and full video-level automation. EchoAgent sets a new direction for trustworthy AI in cardiac ultrasound.

cs.CV↗
arXiv2025

ProstNFound+: A Prospective Study using Medical Foundation Models for Prostate Cancer Detection

Purpose: Medical foundation models (FMs) offer a path to build high-performance diagnostic systems. However, their application to prostate cancer (PCa) detection from micro-ultrasound (μUS) remains untested in clinical settings. We present ProstNFound+, an adaptation of FMs for PCa detection from μUS, along with its first prospective validation. Methods: ProstNFound+ incorporates a medical FM, adapter tuning, and a custom prompt encoder that embeds PCa-specific clinical biomarkers. The model generates a cancer heatmap and a risk score for clinically significant PCa. Following training on multi-center retrospective data, the model is prospectively evaluated on data acquired five years later from a new clinical site. Model predictions are benchmarked against standard clinical scoring protocols (PRI-MUS and PI-RADS). Results: ProstNFound+ shows strong generalization to the prospective data, with no performance degradation compared to retrospective evaluation. It aligns closely with clinical scores and produces interpretable heatmaps consistent with biopsy-confirmed lesions. Conclusion: The results highlight its potential for clinical deployment, offering a scalable and interpretable alternative to expert-driven protocols.

eess.IV↗
arXiv2025

To Sink or Not to Sink: Visual Information Pathways in Large Vision-Language Models

Large Vision Language Models (LVLMs) have recently emerged as powerful architectures capable of understanding and reasoning over both visual and textual information. These models typically rely on two key components: a Vision Transformer (ViT) and a Large Language Model (LLM). ViT encodes visual content into a sequence of image tokens and serves as the perceptual front-end -- the eyes of the model. In contrast, the LLM interprets these tokens to perform high-level reasoning, generates responses, and functions as the cognitive core -- the brain of the model. However, it remains unclear which visual tokens contribute most significantly to understanding and reasoning, and how effectively these signals are propagated from ViT to the LLM. While most existing works have focused on identifying attention sinks, low-semantic tokens receiving disproportionately high attention, within the LLM, we shift the focus to the vision encoder by identifying a class of high-norm visual tokens from ViT, referred to as ViT attention sinks -- a problem that has been rarely studied but is indeed very important for LVLMs. Our findings show that these ViT sinks encapsulate high-level semantic concepts from images, allowing the LLM to perform more effective understanding and reasoning. Despite their importance, these sink tokens are often overlooked in existing LVLM architectures. To explore their contribution, we present both qualitative and quantitative analyses of the information embedded in these sink tokens. We also propose both training-free and training-based approaches to better leverage how this information is interpreted by the LLM, and to what extent. By explicitly utilizing these tokens, we demonstrate substantial improvements across a range of LVLMs and visual reasoning tasks, highlighting the untapped potential of ViT attention sinks in enhancing visual reasoning.

cs.CV↗
arXiv2025

TREAT-Net: Tabular-Referenced Echocardiography Analysis for Acute Coronary Syndrome Treatment Prediction

Coronary angiography remains the gold standard for diagnosing Acute Coronary Syndrome (ACS). However, its resource-intensive and invasive nature can expose patients to procedural risks and diagnostic delays, leading to postponed treatment initiation. In this work, we introduce TREAT-Net, a multimodal deep learning framework for ACS treatment prediction that leverages non-invasive modalities, including echocardiography videos and structured clinical records. TREAT-Net integrates tabular-guided cross-attention to enhance video interpretation, along with a late fusion mechanism to align predictions across modalities. Trained on a dataset of over 9000 ACS cases, the model outperforms unimodal and non-fused baselines, achieving a balanced accuracy of 67.6% and an AUROC of 71.1%. Cross-modality agreement analysis demonstrates 88.6% accuracy for intervention prediction. These findings highlight the potential of TREAT-Net as a non-invasive tool for timely and accurate patient triage, particularly in underserved populations with limited access to coronary angiography.

cs.CV↗