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Xiahai Zhuang

Publications and source records attributed to Xiahai Zhuang.

At least 19 recordsLinked to original sources
arXiv2026

A generalizable structural brain MRI foundation model built through dual-priority federated pretraining

Foundation models hold promise for generalizable analysis of structural brain magnetic resonance imaging (MRI) across development, aging and disease. However, existing models are typically built through centralized pretraining on pooled data, despite privacy and governance constraints. Such pooling optimization can overemphasize cohort size and overlook complementary information from smaller, specialized cohorts. Here we present BrainFedFM, a structural brain MRI foundation model federatively pretrained on 164,707 three-dimensional scans drawn from diverse real-world data distributions and organized across 42 federated sites. BrainFedFM uses dual-priority federated pretraining, coupling spatial-priority masking at each site with site-priority aggregation at the server to emphasize informative anatomical regions locally and prioritize site contributions globally. Across 20 downstream datasets spanning 17 classification, regression and segmentation tasks, BrainFedFM achieved the state-of-the-art performance (mean rank 1.68, 50\% gain) across seven models, including four centralized foundation models, while showing particularly consistent advantages in classification and regression and robustness across underrepresented populations. These findings demonstrate the generalizability of BrainFedFM and highlight federated pretraining as a practical strategy for developing neuroimaging foundation models from distributed data without pooling raw images.

cs.CV↗
arXiv2026

H$^2$EDL: Hyper Evidential Deep Learning for Hierarchical Classification

Fine-grained recognition often involves hierarchical label spaces, where a model may be confident about a coarse semantic concept while remaining uncertain among its descendant classes. Such structured ambiguity requires uncertainty representations that capture both fine-grained classes and intermediate concepts. However, existing tools each capture only half of it: flat evidential classifiers quantify total ignorance with a single vacuity on the leaf frame, and hierarchical classifiers propagate point probabilities with no notion of evidence. Hyper-opinions would unify the two, but their general form is exponential in the label count, and existing hyper-evidential networks either require composite labels to be supplied in the training data or read them off an unstructured weight pattern, with no principled notion of which composites deserve mass. We observe that the taxonomy itself is the missing hyperdomain. Its subtrees and leaf singletons form a linear-size focal family, and one local Dirichlet opinion per branching node induces every composite mass in closed form. The resulting model, H$^2$EDL, can be interpreted in two complementary ways using the same set of parameters. From a prediction perspective, it functions as a hierarchical classifier that preserves consistency across different levels of the label tree. From a probabilistic perspective, it defines a valid tree-structured hyper-opinion, where the mass assigned to each node represents the belief that reaches that node but does not provide sufficient confidence to further specialize into its descendants. On FGVC-Aircraft and DERM12345, H$^2$EDL reduces calibration error by approximately half compared with cross-entropy baselines, with the improvement becoming more pronounced at deeper hierarchy levels and under larger training budgets.

cs.LG↗
arXiv2026

ReCBM: Uncertainty-Gated Relational Reasoning for Concept Bottleneck Models

Concept Bottleneck Models (CBMs) provide an interpretable framework by grounding predictions in human-understandable concepts, enabling semantic inspection and test-time intervention. Recent variants have improved CBMs through richer concept representations, uncertainty estimation, and dependency modeling. However, robust reasoning under unreliable concept states remains underexplored. Without such reasoning, misleading semantic evidence can propagate through the bottleneck, compromising both explanations and downstream predictions. To address this issue, we propose ReCBM, an uncertainty-gated relational reasoning framework for CBMs. ReCBM introduces semantically defined concept relations into the bottleneck and uses uncertainty to guide their refinement. By modeling co-occurrence, implication, and exclusion, ReCBM specifies how evidence is exchanged across concepts, while uncertainty modulates the contribution of each concept during this process. Experiments across diverse datasets showed that ReCBM improved concept and task recovery under missing and flipped concepts, supported uncertainty-aware intervention, and extracted compact task-relevant concept subsets without degrading downstream performance.

cs.AI↗
arXiv2026

A Self-Evolving Agent for Longitudinal Personal Health Management

Personal health management unfolds over repeated encounters, yet most health AI systems treat each request in isolation. We developed HealthClaw, an open-source agent architecture that updates support as a person's routines, preferences, measurements and risks change. It separates shared safety rules and medical knowledge from private longitudinal memory containing profile facts, reusable procedures and episodic traces. After each episode, induction determines what should update the profile, revise a procedure, remain episodic or be excluded. We evaluated HealthClaw with a synthetic year-long benchmark and nine 200-case biomedical tasks. Across 900 longitudinal support probes, answer accuracy increased from 0.2% with current-query prompting to 45.7% with HealthClaw, while prompt-side context exposure was 71.7% lower than with full-history prompting. In 100 privacy probes, HealthClaw produced higher privacy-aware answer quality and fewer unsafe disclosures than both baselines. Across the biomedical tasks, the mean absolute gain in the task-specific primary metric was 27.0 percentage points, and seven gains remained significant after false-discovery-rate correction. These offline benchmarks support governed, self-evolving memory for longitudinal personal health agents, although clinical effectiveness requires prospective evaluation. HealthClaw is publicly available at https://github.com/HC-Guo/HealthClaw.

cs.AI↗
arXiv2026

3D Consistency Optimization for Self-Supervised Monocular Video Depth Estimation

Reliable monocular video depth estimation is crucial for downstream 3D reasoning and embodied AI in endoscopic navigation. However, existing self-supervised approaches typically treat video frames independently or rely on weak temporal regularization. These methods, lacking a holistic perception of the underlying 3D scene, inevitably suffer from geometrically inconsistent predictions and severe cross-frame drift. To address these limitations, we introduce a new paradigm that recasts sequential video depth estimation as an unconstrained multi-view 3D reconstruction problem, enabling full exploitation of the powerful geometric priors embedded in recent 3D foundation models. The core of our approach is a 3D consistency optimization framework driven by three constraints: image-level photometric rendering, explicit world-coordinate geometric alignment, and multi-scale temporal gradient consistency. Such unified optimization elegantly anchors isolated frames to a globally coherent 3D structure. Our method has been validated in both the self-supervised training scenarios and challenging zero-shot clinical environments. Results show that the proposed approach achieves state-of-the-art spatial accuracy, outperforming the frame-based, video-based depth estimators and the multi-view 3D reconstruction baselines.

cs.CV↗
arXiv2026

How Far Has AI Come in Liver Fibrosis Staging? A Large-Scale Real-World Dataset and Benchmark

Despite years of methodological progress, how far AI has come in liver fibrosis staging has never been systematically evaluated under the heterogeneous, multi-center conditions that define clinical practice. To address this gap, we introduce LiFS, a large-scale dataset and benchmark derived from the MICCAI 2025 CARE-Liver challenge, comprising 610 patients across multiple centers and scanners with multi-sequence MRI. To the best of our knowledge, LiFS is the first benchmark providing complete gadoxetic acid-enhanced sequences with histopathology-confirmed annotations from diverse real-world scanners. Through systematic evaluation of 9 independently developed methods selected from 96 registered teams against in-cohort radiologist reference results, our findings address how far current AI has progressed toward clinical-level liver fibrosis staging from three complementary perspectives. First, against radiologists, the best AI methods were broadly comparable to the senior radiologist and significantly exceeded the junior radiologist in selected settings, while median AI performance generally approached junior-radiologist levels. Second, from a data perspective, cross-center heterogeneity, label imbalance, and contrast-enhanced sequence variability emerge as the dominant challenges for AI methods. Third, from a technical perspective, methodological design choices, including spatial registration, input dimensionality, multi-modal fusion strategy, and backbone architecture, appear to modulate cross-center robustness, although no single choice alone closes the gap. Overall, LiFS provides a rigorous real-world benchmark for positioning the current state of AI in liver fibrosis staging and for enabling future research on the key challenges that limit clinically reliable deployment.

cs.CV↗
arXiv2026

Generalized Evidential Deep Learning: From a Bayesian Perspective

Evidential Deep Learning (EDL) has emerged as an efficient, sampling-free strategy for uncertainty estimation. A series of EDL variants have been proposed to address specific limitations of the original framework, achieving notable success. However, the underlying theoretical structure of EDL and the relationships among these variants have received limited systematic investigation. In this work, we establish a principled theoretical foundation for EDL by interpreting it within a generalized Bayesian framework that includes prior specification, posterior update, and training objective. We further characterize evidential uncertainty from a Bayesian distributional uncertainty viewpoint, established via asymptotic analysis. Building on this perspective, we further propose Generalized Evidential Deep Learning (GEDL), a unified and extensible framework that explicitly disentangles the roles of individual components and systematically relates GEDL to existing variants. Extensive experiments demonstrate that GEDL yields comparable results on classification, uncertainty estimation and OOD detections, with theoretical grounding.

cs.LG↗
arXiv2026

Towards 3D heart mesh generation using contactless radar imaging and physics-informed neural network

Cardiac function evaluation necessitates continuous, non-invasive monitoring, a capability limited in MRI. Millimeter-wave (mmWave) radar and its Synthetic Aperture Radar (SAR) mode offer a privacy-preserving and portable point-of-care clinical applications. However, reconstructing high-fidelity 3D cardiac geometry from SAR remains an open challenge. Traditional radar methods generate sparse point clouds that lack continuous surface topology. Meanwhile, direct application of optical reconstruction networks performs poorly due to the severe speckle noise and ambiguous boundaries inherent in SAR images. To bridge this gap, we propose SAR2Mesh, a novel framework that reformulates the task as a coarse-to-fine mesh deformation process. By initializing with a topological template, our approach explicitly preserves anatomical connectivity through progressive mesh deformation.We introduce a geometry-aware feature projection module to extract multi-view features via 3D-to-2D sampling, and a physics-informed radar loss to enforce consistency between the predicted geometry and raw radar echoes. Furthermore, we present Cardiac Mesh-SAR, the first large-scale paired SAR-mesh dataset. Extensive experiments demonstrate that SAR2Mesh significantly outperforms existing image-based baselines, achieving accurate and physically consistent cardiac reconstructions.

cs.CV↗
arXiv2026

X-Edit: Exact, Explicit, and Explainable Null-Space Editing for Medical Vision Transformers

Pre-trained Vision Transformers (ViTs) are increasingly deployed for medical image classification. However, correcting their inevitable failure cases in dynamic clinical scenarios poses a critical challenge. Conventional fine-tuning approaches inherently suffer from catastrophic forgetting, severely degrading previously acquired diagnostic capabilities. Such instability fundamentally compromises clinical safety. Addressing this vulnerability requires an active, controllable, and reliable intervention mechanism that is both theoretically grounded and inherently interpretable. To this end, we propose X-Edit (eXact, eXplicit, and eXplainable Editing), an efficient null-space model editing framework. X-Edit transitions the editing process from iterative gradient-based optimization to a theoretically grounded, closed-form solution. Specifically, we first explicitly localize the influential layers via causal tracing governing the erroneous prediction. Subsequently, we construct an orthogonal null-space projection matrix from a curated anchor set. By geometrically constraining the exact parameter update strictly within this null space, we provide mathematical guarantees that the intervention rectifies targeted errors without perturbing established diagnostic representations. Extensive evaluations on six medical imaging benchmarks demonstrate that X-Edit comprehensively suppresses catastrophic forgetting while achieving superior edit success rates. Our code is available at https://github.com/HenryLau7/X-Edit.

cs.CV↗
arXiv2026

Principle-Guided Supervision for Interpretable Uncertainty in Medical Image Segmentation

Uncertainty quantification complements model predictions by characterizing their reliability, which is essential for high-stakes decision making such as medical image segmentation. However, most existing methods reduce uncertainty to a scalar confidence estimate, leaving its spatial distribution semantically underconstrained. In this work, we focus on uncertainty interpretability, namely, whether estimated uncertainty behaves in a human-understandable manner with respect to sources of ambiguity. We identify three perception-aligned principles requiring the spatial distribution of uncertainty to reflect: (1) image contrast between structures, (2) severity of image corruption, and (3) geometric complexity in anatomical structures. Accordingly, we develop a principle-guided uncertainty supervision framework (PriUS) based on evidential learning, in which the corresponding supervision objectives are explicitly enforced during training. We further introduce quantitative metrics to measure the consistency between predicted uncertainty and image attributes that induce ambiguity. Experiments on ACDC, ISIC, and WHS datasets showed that, compared with state-of-the-art methods, PriUS produced more consistent uncertainty estimates while maintaining competitive segmentation performance.

cs.CV↗
arXiv2026

Beyond Forgetting in Continual Medical Image Segmentation: A Comprehensive Benchmark Study

Continual learning (CL) is essential for deploying medical image segmentation models in clinical environments where imaging domains, anatomical targets, and diagnostic tasks evolve over time. However, continual segmentation still faces three main challenges. First, the scenarios for this task remain insufficiently standardized for real-world clinical settings. Second, existing research has been primarily focused on mitigating forgetting, overlooking the other essential properties such as plasticity. Third, a benchmark work with comprehensive evaluation on existing methods is stll desirable. To address these gaps, we present such benchmark study of continual medical image segmentation. We first define three clinically motivated scenarios, namely Domain-CL, Class-CL, and Organ-CL, to respectively capture the cross-center domain shift, the incremental anatomical structure segmentation, and the cross-organ segmentation. We then introduce an evaluation framework that measures not only general performance and forgetting, but also plasticity, forward generalizability, parameter efficiency, and replay burden. The results, from extensive experiments with representative CL methods, showed that it was still challenging to develop a model that could satisfy all the requirements simultaneously. Nevertheless, these studies also suggested that the replay-based methods achieve the best overall balance between stability and plasticity, the parameter-isolation methods should be effective at reducing forgetting, though at the cost of increased model size, and the forward generalizability remain a significantly understudied aspect of this research field. Finally, we discuss related learning paradigms and outline future directions for continual medical image segmentation.

cs.CV↗
arXiv2026

ZScribbleSeg: A comprehensive segmentation framework with modeling of efficient annotation and maximization of scribble supervision

Curating fully annotated datasets for medical image segmentation is labour-intensive and expertise-demanding. To alleviate this problem, prior studies have explored scribble annotations for weakly supervised segmentation. Existing solutions mainly compute losses on annotated areas and generate pseudo labels by propagating annotations to adjacent regions. However, these methods often suffer from inaccurate and unrealistic segmentations due to insufficient supervision and incomplete shape information. In contrast, we first investigate the principle of good scribble annotations, which leads to efficient scribble forms via supervision maximization and randomness simulation. We further introduce regularization terms to encode the spatial relationship and the shape constraints, where the EM algorithm is utilized to estimate the mixture ratios of label classes. These ratios are critical in identifying the unlabeled pixels for each class and correcting erroneous predictions, thus the accurate estimation lays the foundation for the incorporation of spatial prior. Finally, we integrate the efficient scribble supervision with the prior into a framework, referred to as ZScribbleSeg, and apply it to multiple scenarios. Leveraging only scribble annotations, ZScribbleSeg achieves competitive performance on six segmentation tasks including ACDC, MSCMRseg, BTCV, MyoPS, Decathlon-BrainTumor and Decathlon-Prostate. Our code will be released via https://github.com/DLwbm123/ZScribbleSeg.

cs.CV↗
arXiv2026

Few-Shot Video Object Segmentation in X-Ray Angiography Using Local Matching and Spatio-Temporal Consistency Loss

We introduce a novel FSVOS model that employs a local matching strategy to restrict the search space to the most relevant neighboring pixels. Rather than relying on inefficient standard im2col-like implementations (e.g., spatial convolutions, depthwise convolutions and feature-shifting mechanisms) or hardware-specific CUDA kernels (e.g., deformable and neighborhood attention), which often suffer from limited portability across non-CUDA devices, we reorganize the local sampling process through a direction-based sampling perspective. Specifically, we implement a non-parametric sampling mechanism that enables dynamically varying sampling regions. This approach provides the flexibility to adapt to diverse spatial structures without the computational costs of parametric layers and the need for model retraining. To further enhance feature coherence across frames, we design a supervised spatio-temporal contrastive learning scheme that enforces consistency in feature representations. In addition, we introduce a publicly available benchmark dataset for multi-object segmentation in X-ray angiography videos (MOSXAV), featuring detailed, manually labeled segmentation ground truth. Extensive experiments on the CADICA, XACV, and MOSXAV datasets show that our proposed FSVOS method outperforms current state-of-the-art video segmentation methods in terms of segmentation accuracy and generalization capability (i.e., seen and unseen categories). This work offers enhanced flexibility and potential for a wide range of clinical applications. Code is available at https://github.com/xilin-x/XRAVOS

cs.CV↗
arXiv2026

Open World MRI Reconstruction with Bias-Calibrated Adaptation

Real-world MRI reconstruction systems face the open-world challenge: test data from unseen imaging centers, anatomical structures, or acquisition protocols can differ drastically from training data, causing severe performance degradation. Existing methods struggle with this challenge. To address this, we propose BiasRecon, a bias-calibrated adaptation framework grounded in the minimal intervention principle: preserve what transfers, calibrate what does not. Concretely, BiasRecon formulates open-world adaptation as an alternating optimization framework that jointly optimizes three components: (1) frequency-guided prior calibration that introduces layer-wise calibration variables to selectively modulate frequency-specific features of the pre-trained score network via self-supervised k-space signals, (2) score-based denoising that leverages the calibrated generative prior for high-fidelity image reconstruction, and (3) adaptive regularization that employs Stein's Unbiased Risk Estimator to dynamically balance the prior-measurement trade-off, matching test-time noise characteristics without requiring ground truth. By intervening minimally and precisely through this alternating scheme, BiasRecon achieves robust adaptation with fewer than 100 tunable parameters. Extensive experiments across four datasets demonstrate state-of-the-art performance on open-world reconstruction tasks.

eess.IV↗
arXiv2025

Liver Fibrosis Quantification and Analysis: The LiQA Dataset and Baseline Method

Liver fibrosis represents a significant global health burden, necessitating accurate staging for effective clinical management. This report introduces the LiQA (Liver Fibrosis Quantification and Analysis) dataset, established as part of the CARE 2024 challenge. Comprising $440$ patients with multi-phase, multi-center MRI scans, the dataset is curated to benchmark algorithms for Liver Segmentation (LiSeg) and Liver Fibrosis Staging (LiFS) under complex real-world conditions, including domain shifts, missing modalities, and spatial misalignment. We further describe the challenge's top-performing methodology, which integrates a semi-supervised learning framework with external data for robust segmentation, and utilizes a multi-view consensus approach with Class Activation Map (CAM)-based regularization for staging. Evaluation of this baseline demonstrates that leveraging multi-source data and anatomical constraints significantly enhances model robustness in clinical settings.

cs.CV↗
arXiv2025

Towards Modality- and Sampling-Universal Learning Strategies for Accelerating Cardiovascular Imaging: Summary of the CMRxRecon2024 Challenge

Cardiovascular health is vital to human well-being, and cardiac magnetic resonance (CMR) imaging is considered the {clinical reference standard} for diagnosing cardiovascular disease. However, its adoption is hindered by long scan times, complex contrasts, and inconsistent quality. While deep learning methods perform well on specific CMR imaging {sequences}, they often fail to generalize across modalities and sampling schemes. The lack of benchmarks for high-quality, fast CMR image reconstruction further limits technology comparison and adoption. The CMRxRecon2024 challenge, attracting over 200 teams from 18 countries, addressed these issues with two tasks: generalization to unseen {modalities} and robustness to diverse undersampling patterns. We introduced the largest public multi-{modality} CMR raw dataset, an open benchmarking platform, and shared code. Analysis of the best-performing solutions revealed that prompt-based adaptation and enhanced physics-driven consistency enabled strong cross-scenario performance. These findings establish principles for generalizable reconstruction models and advance clinically translatable AI in cardiovascular imaging.

eess.IV↗
arXiv2025

Uncertainty-Supervised Interpretable and Robust Evidential Segmentation

Uncertainty estimation has been widely studied in medical image segmentation as a tool to provide reliability, particularly in deep learning approaches. However, previous methods generally lack effective supervision in uncertainty estimation, leading to low interpretability and robustness of the predictions. In this work, we propose a self-supervised approach to guide the learning of uncertainty. Specifically, we introduce three principles about the relationships between the uncertainty and the image gradients around boundaries and noise. Based on these principles, two uncertainty supervision losses are designed. These losses enhance the alignment between model predictions and human interpretation. Accordingly, we introduce novel quantitative metrics for evaluating the interpretability and robustness of uncertainty. Experimental results demonstrate that compared to state-of-the-art approaches, the proposed method can achieve competitive segmentation performance and superior results in out-of-distribution (OOD) scenarios while significantly improving the interpretability and robustness of uncertainty estimation. Code is available via https://github.com/suiannaius/SURE.

cs.CV↗
arXiv2025

Evaluating Foundation Models with Pathological Concept Learning for Kidney Cancer

To evaluate the translational capabilities of foundation models, we develop a pathological concept learning approach focused on kidney cancer. By leveraging TNM staging guidelines and pathology reports, we build comprehensive pathological concepts for kidney cancer. Then, we extract deep features from whole slide images using foundation models, construct pathological graphs to capture spatial correlations, and trained graph neural networks to identify these concepts. Finally, we demonstrate the effectiveness of this approach in kidney cancer survival analysis, highlighting its explainability and fairness in identifying low- and high-risk patients. The source code has been released by https://github.com/shangqigao/RadioPath.

cs.AI↗