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Ulas Bagci

Publications and source records attributed to Ulas Bagci.

At least 19 recordsLinked to original sources

Decentralized Gossip Learning and Federated Averaging for Histopathology Image Classification

Breast histopathology analysis increasingly relies on distributed learning because direct data pooling across institutions is often restricted by privacy, governance, and communication constraints. This study compares server-based Federated Averaging (FedAvg), fully decentralized gossip learning, and Hybrid Gossip-FedAvg for invasive ductal carcinoma (IDC) patch classification. Experiments used 277,524 color image patches with patient-disjoint training, validation, and test partitions and a workload-balanced, Dirichlet-guided allocation across six nodes. Ring, random degree-3, and fully connected gossip topologies were evaluated together with sensitivity analyses for statistical heterogeneity, mixing coefficient, learning rate, model drift, prediction disagreement, calibration, clinically motivated operating points, communication payload, and patient-level IDC burden, together with auxiliary backbone robustness analyses. In the principal alpha=0.3 experiment, Hybrid Gossip-FedAvg achieved a test area under the receiver operating characteristic curve (ROC-AUC) of 0.8811, closely followed by FedAvg at 0.8801 and fully connected gossip at 0.8751. Across three independent patient-level repetitions, FedAvg and Hybrid Gossip-FedAvg obtained the same mean ROC-AUC of 0.9082, with standard deviations of 0.0037 and 0.0043, respectively. Hybrid achieved the highest mean area under the precision-recall curve of 0.8240, whereas FedAvg produced the lowest mean Brier score of 0.1335. Denser gossip graphs improved discrimination but increased theoretical model payload, while ring gossip remained sensitive to learning rate and mixing strength. Overall, FedAvg provided the most consistently reliable server-based baseline, topology-aware gossip offered a viable decentralized alternative, and Hybrid Gossip-FedAvg provided a balanced compromise between peer-to-peer diffusion and periodic global coordination.

cs.CV

Patient-Level, Leakage-Aware Deep Learning for Cross-Center Periapical Radiograph Classification

Dental caries and endodontic disease are among the most common health conditions worldwide, and intraoral periapical radiographs are central to their detection, treatment planning, and follow-up. Automated tooth-level classification of these images, however, lacks reproducible benchmarks, is often evaluated with image-level splits that leak patients between training and test, and is rarely validated across clinics. This paper presents the first patient-level, leakage-aware classification benchmark for single-tooth intraoral periapical radiographs on the DentIRO dataset, which comprises 5,300 images from 3,243 patients across two clinics and four classes: Healthy, Caries, Crowned, and Root Canal. Five transfer-learning models are compared with patient-grouped stratified cross-validation, so that every patient remains within a single fold. DenseNet121 gave the strongest and most stable result at a mean macro-F1 of 0.9787, while the four ImageNet-initialized backbones performed comparably. A controlled comparison on a fixed architecture showed that chest-radiograph pretraining transferred less effectively than ImageNet initialization. Bidirectional cross-center validation produced a small average generalization gap of 0.0077, and Grad-CAM confirmed that predictions rely on clinically meaningful tooth regions rather than acquisition artifacts. The benchmark offers a rigorous and reproducible baseline for intraoral radiograph classification.

cs.CV

Unified CT and MRI Pancreas Segmentation for Label-Efficient Cross-Modality Subregion Transfer

Robust medical image segmentation across imaging modalities is challenging because of large differences in appearance and intensity distributions. Models trained on a single modality often show substantial performance drops when applied to unseen domains. In this work, we develop a unified 3D pancreas segmentation framework that applies domain-adversarial learning to 4,604 heterogeneous CT and MRI scans to learn anatomical representations. A shared nnU-Net encoder-decoder is trained for whole-pancreas segmentation, with a latent domain discriminator encouraging CT-MRI feature alignment. The learned encoder is subsequently transferred to pancreatic head-body-tail segmentation using limited MRI-only subregion annotations. An average Dice score of 87.31% on the in-distribution test set and Dice scores ranging from 84.20% to 88.09% across external OOD datasets were achieved in whole pancreas segmentation. Dice scores of 80.53% on MRI and 83.05% on CT were achieved for downstream subregion segmentation, without using CT subregion annotations. These results demonstrate that a unified anatomical representation can support both cross-modality pancreas segmentation and label-efficient downstream transfer.

cs.CV

TRIUNE-Net: Harmonizing Scale, Shape, and Efficiency in Pancreatic Tumor Segmentation

Pancreatic tumor segmentation in 3D CT volumes is challenged by extreme scale variability across both the pancreas and tumor, and highly irregular tumor morphology. While recent advances have pushed segmentation performance, existing methods do not explicitly address these challenges and come at the cost of excessive computational complexity, limiting their practicality in resource-constrained clinical environments. We propose TRIUNE-Net, a lightweight unified architecture that harmonizes scale, shape, and efficiency through three synergistic innovations. A multi-scale context aggregation module with stage-adaptive dilated convolutions enables the model to reason across the broad range of anatomical scales present in both organs. A serial linear-deformable attention mechanism combines large effective receptive fields with shapeadaptive deformable convolutions to capture irregular, non-convex tumor morphologies. Finally, an information-preserving downsampling module replaces conventional max pooling entirely, retaining all spatial information while adding negligible parameters, preventing small tumors from being discarded before they can be recognized. On both the MSD Pancreas and NVD Pancreas datasets, TRIUNE-Net achieves state-of-theart results with only 5.86 M parameters and no external pre-training, outperforming all baselines across all key tumor metrics. Specifically, it surpasses the next-best model by 0.45% in tumor Dice, 6.0 points in F1 score, 6.6 points in sensitivity, and 3.4 points in precision, simultaneously reflecting its ability to suppress both missed tumors and false alarms in clinically realistic conditions. Our code is available at: https://github.com/abdora-ai/TRIUNE-Net

cs.CV

Improved Segmentation of Polyps and Visual Explainability Analysis

Colorectal cancer (CRC) remains one of the leading causes of cancer-related morbidity and mortality worldwide, with gastrointestinal (GI) polyps serving as critical precursors according to the World Health Organization (WHO). Early and accurate segmentation of polyps during colonoscopy is essential for reducing CRC progression, yet manual delineation is labor-intensive and prone to observer variability. Deep learning methods have demonstrated strong potential for automated polyp analysis, but their limited interpretability remains a barrier to clinical adoption. In this study, we present PolypSeg-GradCAM, an explainable deep learning framework that integrates a U-Net architecture with a pre-trained ResNet-34 backbone and Gradient-weighted Class Activation Mapping (Grad-CAM) for transparent polyp segmentation. To ensure rigorous benchmarking, the model was trained and evaluated using 5-Fold Cross-Validation on the Kvasir-SEG dataset of 1,000 annotated endoscopic images. Experimental results show a mean Dice coefficient of 0.8902 +/- 0.0125, a mean Intersection-over-Union (IoU) of 0.8023, and an Area Under the Receiver Operating Characteristic Curve (AUC-ROC) of 0.9722. Advanced quantitative analysis using an optimal threshold yielded a Sensitivity of 0.9058 and Precision of 0.9083. Additionally, Grad-CAM visualizations confirmed that predictions were guided by clinically relevant regions, offering insight into the model's decision-making process. This study demonstrates that integrating segmentation accuracy with interpretability can support the development of trustworthy AI-assisted colonoscopy tools.

cs.CV

Asymmetric Paired-Annotation Learning for Multi-Structure ULF Pediatric Brain MRI Segmentation

Portable ultra-low-field (ULF) MRI can expand access to pediatric neuroimaging, but segmentation at 0.064 T remains challenging because anatomical boundaries are weakly delineated, small structures may be only partially visible, and high-field references can be locally misregistered. The LISA 2026 Challenge provides two non-equivalent annotations reflecting different sources of anatomical evidence: a highfield-derived (HF) mask defining the scored target and a low-field-edited (LF) mask aligned with visible ULF anatomy. In this challenge report, we describe AURA, an nnU-Net-based asymmetric supervision strategy that treats these annotations as distinct observations rather than interchangeable ground truths. AURA anchors training to the HF mask and incorporates the LF mask through a bounded reliability gate based on label disagreement, boundaries, predictive uncertainty, class reliability, and training stage. On a 16-case development split, the HF-supervised baseline, AURA, and their ensemble achieved Dice scores of 0.7984, 0.7950, and 0.7988, respectively, while the ensemble achieved an HD95 of 1.8892 and an ASSD of 0.7855. These results provide a preliminary evaluation of AURA within the LISA 2026 Challenge and motivate further assessment on the hidden test set and external ULF cohorts. Our code and pretrained models are available at https://github.com/minhdang050806/ A-nnU-Net-based-asymmetric-supervision-strategy.

cs.CV

GazeRefine: Expert Gaze as a Test-Time Prompt for Training-Free Medical Image Segmentation

Medical image segmentation remains difficult to scale because high-performing methods typically rely on dense expert annotations and task-specific training. We introduce GazeRefine, a training-free framework that uses gaze as an inference-time prompt for zero-shot medical image segmentation. Sparse, duration-weighted fixations are converted into foreground and background priors that initialize semantic prototypes in frozen DINOv3 feature space. These prototypes are iteratively refined through foreground-background discrimination, feature-space affinity propagation, and anchoring to the initial gaze guidance, allowing segmentation to extend beyond directly fixated regions while limiting semantic drift. GazeRefine requires no segmentation masks, fine-tuning, adapters, prompt encoders, or gradient updates. We evaluate the method on gaze-annotated polyp segmentation and prostate MRI segmentation. The results show strong performance on colonoscopy images and competitive performance on prostate MRI, supporting gaze-guided prototype refinement as a promising approach for segmentation-label-efficient, human-in-the-loop medical image segmentation. Our tools and code can be found in the following repository: https://github.com/MohammedOussamaBEN/GazeRefine.git

eess.IV

Hierarchical MoE for Multi-Modal ILD Diagnosis

Mixture-of-experts (MoE) models combine specialized predictors under learned routing, offering a principled mechanism for leveraging heterogeneity in medical data. We present a hierarchical multimodal MoE for interstitial lung disease (ILD) classification that integrates a frozen, pre-trained imaging expert with structured electronic health records (EHR) via two-stage gating. A modality-level gate assigns patient-specific weights to imaging and EHR predictions, while a sub-gating module decomposes the EHR branch into clinically defined feature groups with learned, group-specific contributions. This design preserves stable imaging representations while enabling input-dependent clinical weighting and explicit EHR specialization. Under strict patient-level cross-validation, the model achieved the highest mean AUC among the evaluated methods (0.8750 +- 0.0443), compared with 0.8646 for imaging-only REN and 0.7685 for SwinUNETR. The framework extends interpretability across anatomical regions, imaging--EHR utilization, and clinically defined EHR feature groups.

cs.AI

Matched Outcomes, Divergent Gaze: How Foveated MLLMs Search Compared to Humans

Human visual search is serial: the fovea must land on a candidate to confirm it, and those landings form a scanpath. Whether multimodal large language models (MLLMs), given the same foveated input, search as humans do bears on their use as models of human vision and on attention-alignment scores. We compare three general-purpose MLLMs with human eye-movement scanpaths on goal-directed search (COCO-Search18), driving each model fixation by fixation through an identical, human-matched foveated view and assessing it along three axes: the decision of target presence, the efficiency of reaching the target, and the gaze process itself. The axes dissociate. On the decision and on target acquisition the models match or exceed humans, detecting present targets near ceiling and reaching them on the first saccade more often than people do. The gaze process is not human. Under the human-matched condition, all three share one signature: low-entropy, large-amplitude, self-consistent scanpaths that agree with themselves far more closely than two humans agree with each other. That is consistent with a single-pass, non-serial architecture rather than a limit of acuity. Matched retinal input reproduces where humans look but not how the looking unfolds in time, and no degradation regime recovers human-like search at human-like success. The gap sits on a process axis that answer-alignment and saliency metrics do not measure. Because they miss it, such metrics cannot certify human-like vision, and zero-shot models suit outcome and spatial questions but not temporal, process-level ones.

cs.CV

A decodability criterion predicts when hidden-state selection beats majority voting in large language models

Combining the answers a large language model (LLM) samples for a question into one decision is a test-time information fusion problem, usually solved by majority voting. Voting is unreliable on difficult questions, where the sampled answers share correlated errors, so the wrong answer can win and drawing more samples makes the decision worse. Selecting a candidate by reading a correctness signal from the model's hidden states is a promising alternative, but its accuracy varies across models and tasks, and no measure indicates when it can be trusted. In this paper, we propose CASE (Correctness-Axis SElection), a dynamic selection combiner that trains a linear gate on the answer-token hidden state and selects the highest-scoring candidate. Its main contribution is decodability, a leakage-free measure of how well the gate ranks a question's correct candidates above its incorrect ones, which predicts whether hidden-state selection will outperform voting. A conventional probe appears accurate only because of question-identity leakage, which vanishes under question-grouped evaluation. On held-out data, decodability predicts the accuracy gain of selection over voting with a Pearson correlation r=0.75 and a decision threshold near AUC=0.60. Across general and medical LLMs, CASE improves over voting by up to 19 points on medium-difficulty questions and 16.8 points on hard questions. Decodability depends on the aligned knowledge a model must recall, not on its scale, and its prediction transfers to an unseen scientific domain within 3.8 points. It thus provides a practical criterion, measurable in advance for a given model and task, for choosing between learned selection and majority voting.

cs.AI

Gaussian Meta-Space Augmentation for Stacking Ensembles in Multimodal IPMN Risk Stratification

Pancreatic cancer is among the most lethal malignancies; risk stratification of intraductal papillary mucinous neoplasms (IPMNs) offers a crucial opportunity for early intervention but typically requires invasive tissue biopsy. Dominant vision-based approaches, including radiomics and deep learning, provide promising but initially separate discrimination opportunities. Similarly, multisequence MRI (T1W/T2W) and anatomically decomposed (head, body and tail) analysis of the pancreas provide additional and potentially complementary signals. Effective fusion of this information is crucial in ordinal IPMN dysplasia risk prediction and can be accomplished via a meticulously regularized and calibrated ensemble stacking combiner. We present cUPMI, a class-conditional Gaussian augmentation of a combiner's log-probability meta-features, and test it on various prediction paradigms. In our multi-center analysis, we find cUPMI adds limited value to properly regularized L2-logistic binary classification stacks, but consistently regularizes higher-capacity tree combiners in the binary and radiomics-only setting (RF +0.015 and XGBoost +0.024 binary AUC, positive in all seeds). Its cleanest ordinal benefit appears for XGBoost on an 8-stream radiomics task (3-class no < low < high, +0.022 QWK in all seeds). Separately, fold-locked fusion of radiomics and 2.5D CNN streams yields the strongest overall model, an RF stack reaching QWK 0.595 (95% CI [0.54, 0.64]) and binary AUC 0.839, surpassing radiomics, 2.5D ResNet, and 3D DenseNet-121 baselines.

cs.CV

BreastMammo and DenseMammo: Benchmarks for Mammography Domain Generalization

Breast density classification is a critical component of breast cancer risk assessment, yet AI models often struggle to generalize across clinical sites due to vendor-specific acquisition styles. In this work, we introduce two new datasets, BreastMammo and DenseMammo, to facilitate robust multi-view mammography research. We propose a domain generalization framework that utilizes a foreground-only histogram matching protocol to resolve the domain shift issue arising from disparate clinical sources. Internal evaluation using a 5-fold cross-validation protocol demonstrates the efficacy of our approach, with the Swin Transformer backbone achieving a peak AUC of 98.32% for density classification. External evaluation on the TNMammo and LUMINA datasets demonstrates that the proposed approach consistently reduces domain shift, significantly outperforming prominent domain generalization paradigms, including MixStyle and Discrete-Fourier-Transform-based frameworks.

eess.IV

Ethical Framework for Responsible Foundational Models in Medical Imaging

The emergence of foundational models represents a paradigm shift in medical imaging, offering extraordinary capabilities in disease detection, diagnosis, and treatment planning. These large-scale artificial intelligence systems, trained on extensive multimodal and multi-center datasets, demonstrate remarkable versatility across diverse medical applications. However, their integration into clinical practice presents complex ethical challenges that extend beyond technical performance metrics. This study examines the critical ethical considerations at the intersection of healthcare and artificial intelligence. Patient data privacy remains a fundamental concern, particularly given these models' requirement for extensive training data and their potential to inadvertently memorize sensitive information. Algorithmic bias poses a significant challenge in healthcare, as historical disparities in medical data collection may perpetuate or exacerbate existing healthcare inequities across demographic groups. The complexity of foundational models presents significant challenges regarding transparency and explainability in medical decision-making. We propose a comprehensive ethical framework that addresses these challenges while promoting responsible innovation. This framework emphasizes robust privacy safeguards, systematic bias detection and mitigation strategies, and mechanisms for maintaining meaningful human oversight. By establishing clear guidelines for development and deployment, we aim to harness the transformative potential of foundational models while preserving the fundamental principles of medical ethics and patient-centered care.

cs.CY

Rad-JEPA 3D: Radiology Joint-Embedding Predictive Model for 3D Computed Tomography

Self-supervised pretraining is central to 3D medical image analysis, where unlabeled CT volumes are abundant but expert annotations are scarce. Yet existing volumetric encoders often fail to preserve the coarse spatial and geometric structure that downstream reasoning depends on, limiting their performance on organ disentanglement, abnormality detection, and spatial understanding when paired with language models. We introduce Rad-JEPA 3D, a joint-embedding predictive framework that learns volumetric CT representations by predicting the latent features of a complete scan from a masked view. At its core is a hybrid H-Mamba encoder that fuses a Mamba state-space branch, which models inter-slice continuity through sequential scanning, with a grouped-query attention branch, which captures cross-plane spatial context, combined through a lightweight per-token router. To improve the quality of intermediate representations, we further propose Hidden States Orthogonal Regularization (HSOR), which aligns student-teacher hidden states and reduces feature redundancy throughout the encoder. This layer-wise regularization produces more consistent and discriminative volumetric representations, leading to improved performance on organ recognition and spatial reasoning tasks. Pretrained on approximately 120,000 CT scans, Rad-JEPA 3D attains state-of-the-art results despite its compact size: with only 4.0B total parameters, it achieves competitive results with state-of-the-art on closed-ended VQA and the best average spatial-reasoning score on the Spatial-Med benchmark. Ablation studies confirm that the hybrid block and HSOR contribute complementary gains, and that the induced spatial structure can substitute for raw language-model scale on volumetric reasoning tasks.

cs.CV

Beyond Medical Diagnostics: How Medical Multimodal Large Language Models Think in Space

Visual spatial intelligence is critical for medical image interpretation, yet remains largely unexplored in Multimodal Large Language Models (MLLMs) for 3D imaging. This gap persists due to a systemic lack of datasets featuring structured 3D spatial annotations beyond basic labels. In this study, we introduce an agentic pipeline that autonomously synthesizes spatial visual question-answering (VQA) data by orchestrating computational tools such as volume estimation and bounding boxes extraction with multi-agent collaboration and expert radiologist validation. We present SpatialMed, the first comprehensive benchmark for evaluating 3D spatial intelligence in medical MLLMs, comprising 31,253 question-answer pairs across multiple organs and tumor types. Our evaluations on 24 state-of-the-art MLLMs and extensive analyses reveal that current models lack robust spatial reasoning capabilities for medical imaging.

cs.CV

CORA: Generalizable coronary artery disease assessment and risk stratification from coronary CT angiography using pathology-centric representation learning

Coronary artery disease, a leading cause of cardiovascular mortality worldwide, can be assessed non-invasively by coronary computed tomography angiography (CCTA). Although deep learning has advanced automated CCTA analysis, clinical translation remains constrained by the scarcity of expert-annotated data and by the spatial sparsity of coronary pathology, which occupies only a small fraction of each scan. Widely used label-free pretraining strategies, such as masked image modeling and contrastive learning, optimize for global anatomical reconstruction and tend to under-represent these tiny localized pathological features. Here we present CORA, an annotation-efficient model for comprehensive coronary artery disease assessment. Rather than reconstructing background anatomy, CORA learns from volumetric CCTA through a synthesis-driven self-supervised strategy: an anatomy-guided engine inserts diverse synthetic calcified and non-calcified lesions into unlabeled scans, reframing pretraining as an abnormality-detection task that biases representation learning toward clinically relevant disease features. We pretrained CORA on 10,138 unlabeled CCTA volumes and evaluated it across datasets from nine independent hospitals. Across plaque characterization, stenosis detection, and coronary artery segmentation, CORA consistently outperformed strong self-supervised pretraining baselines, with the largest gains on external multi-center data, indicating robust generalization under distributional shift. Coupling the imaging encoder with structured clinical variables further enabled near-term major adverse cardiac event (MACE) risk stratification. Our results show that pathology-centric, synthesis-driven pretraining is an effective and scalable strategy for annotation-efficient coronary artery disease assessment from CCTA.

cs.CV

Who Gets Missed in the Tail? Thresholded Subgroup Underdiagnosis in Long-Tailed Chest X-ray Classification

In chest X-ray (CXR) classification, acceptable ranking performance can still leave rare-positive patients below threshold, especially within subgroups. We study this pre-deployment fairness problem as an audit question: after a long-tailed multi-label CXR model is converted from scores into decisions, who is missed? Across VinDr-CXR and MIMIC-CXR/CXR-LT, we use a diagnostic ladder to separate class-level long-tail losses, subgroup-aware weighting, group robustness, and threshold selection. On VinDr-CXR, group-tail weighting followed by tail-aware thresholding reduces tail FNR from 0.665 to 0.269, sex worst-group FNR from 0.705 to 0.157, and age worst-group FNR from 0.822 to 0.133, while macro-mAP increases from 0.611 to 0.635. On MIMIC-CXR/CXR-LT, the same score-to-threshold comparison reduces tail FNR from 0.866 to 0.741 and lowers worst-group FNR across sex, age, race, and insurance; residual missed-positive rates nevertheless remain high. Paired bootstrap contrasts on VinDr support the thresholded FNR reductions, and GroupDRO reference runs indicate that aggregate group robustness alone does not remove rare subgroup misses in this setting. The study supports a narrow audit claim: rare-label fairness in CXR depends jointly on the finding, subgroup, and operating threshold, not on label frequency or ranking metrics alone.

cs.LG

ESC: Emotional Self-Correction for Reliable Vision-Language Models

Vision-language models (VLMs) have achieved strong performance across diverse multimodal tasks, yet they remain vulnerable to unreliable reasoning. Existing self-correction methods mitigate these issues but typically rely on post-training or carefully engineered feedback, incurring high computational cost. In this work, we revisit this challenge through the lens of emotional cues, asking whether they can activate latent self-correction behaviors in VLMs without additional training. \textbf{We find that emotional signals serve as an effective trigger for self-correction, encouraging more cautious and reflective reasoning}. Motivated by this finding, we propose \escabstract (\textbf{\underline{E}}motional \textbf{\underline{S}}elf-\textbf{\underline{C}}orrection), a training-free self-correction framework. ESC introduces an external verifier that detects potentially incorrect initial responses and injects emotional feedback to encourage model to reflect, and produce a better revised response without additional training. Extensive experiments across safety, hallucination, vision-centric perception, and multimodal reasoning benchmarks show that ESC consistently improves reliability while preserving overall model utility. These results suggest that emotion can function not only as an ability to be recognized, but also as a practical control signal for scalable self-correction in VLMs. \textbf{We therefore believe that ESC provides a strong foundation for a new reliable human-like, emotion-integrated research direction.} Our project is publicly available at \textcolor{red}{https://genai4e.github.io/ESC/}.

cs.CV