arXiv subjects

Zdravko Marinov

Publications and source records attributed to Zdravko Marinov.

At least 19 recordsLinked to original sources

arXiv2026

Case2Flow: Bridging Patient Cases and Guideline Flowcharts through Multimodal Retrieval

Medical guidelines encode rich, evidence-based decision logic, yet the specific decision artifact a clinician needs is hard to locate within a guideline, let alone across guidelines covering plausible diseases and treatments. While guideline passages have supported end-to-end question answering, flowcharts remain largely underused in decision support despite their ability to encode actionable clinical pathways. We therefore introduce Case2Flow, a task designed to retrieve the most relevant guideline flowchart for a given patient case from a collection of guideline documents. To support it, we construct FlowAtlas, a curated corpus of 202 flowcharts extracted from 2,080 medical guidelines, together with a pipeline that synthesises 1,911 aligned case-flowchart pairs. Our evaluation of multimodal retrieval methods reveals systematic failure modes, including overreliance on keywords and spurious token-patch matches induced by uninformative background regions in flowcharts. Motivated by this, we propose CRISP, a training-free scoring method that sharpens late-interaction retrieval by suppressing uninformative patches, discounting ambiguous token matches, and incorporating bidirectional query-image alignment. CRISP improves Recall@1 by up to 18.71 percentage points, while a blinded physician assessment on published case narratives provides preliminary feasibility evidence beyond synthetic queries.

cs.CL↗

arXiv2026

OmniFall: From Staged Through Synthetic to Wild, A Unified Multi-Domain Dataset for Robust Fall Detection

Visual fall detection models are usually trained on small, staged datasets. Their real-world utility remains unclear; such data lacks diversity and evaluation protocols differ from paper to paper. We propose OmniFall, a unified benchmark of 15k videos (80 hours) with frame-level annotations in a single 16-class taxonomy. It spans three domains: OF-Staged unifies eight staged datasets with cross-subject and cross-view splits; OF-Synthetic adds 12k videos (17 h) with controlled demographic and environmental diversity; and OF-In-the-Wild provides a test-only set of genuine accident videos. We evaluate fine-tuned models as well as much larger zero-shot multimodal LLMs. On in-the-wild fall events, both do comparably well. The clinically critical fallen state is where they part: zero-shot models keep confusing fallen with lying, whereas models fine-tuned on synthetic data with explicit fallen-state scenes do substantially better. We release the unified annotations, the synthetic data, and the in-the-wild test set to foster the development of fall and fallen-state detectors for uncontrolled environments. Dataset: https://hf.co/datasets/simplexsigil2/omnifall

cs.CV↗

arXiv2026

Good Enough? An Investigation on the Impact of Label Quality in Large-Scale Medical Datasets

Manually refining radiological segmentation masks is highly resource-intensive. To determine when this expert commitment is truly justified for the training of segmentation models, we investigate the relationship between label quality and model performance. Expanding beyond models trained directly for inference, we conduct the first study isolating the impact of label quality in pre-training datasets. While high-quality labels remain essential for models proceeding directly to deployment, we find no evidence that strict label quality is crucial for pre-training efficacy. These results question the necessity of exhaustive human-in-the-loop refinement for massive corpora intended for pretraining and suggest that expert effort is more effectively invested in well-curated downstream target datasets.

cs.CV↗

arXiv2026

Quo Vadis, Visual In-Context Learning? A Unified Benchmark Across Domains and Tasks

Visual in-context learning has been proposed as a pathway towards dynamic models that can generate predictions based on a provided context and thereby can adapt to new vision tasks at test-time. Yet, the evaluation of the adaptation capabilities of these models has been limited to narrow setups that mainly mirror tasks or image domains from pre-training for which real adaptation is not required. We address this gap by constructing a broad Visual In-Context BEnchmark (VIBE) with a focus on diverse imaging domains and a wide range of tasks. With this, we are able to get a much clearer picture of the adaptive capabilities of visual in-context models when faced with new image- and task distributions. We stress test six models on $14$ datasets and $12$ tasks (in total, we explore $106$ dataset-task combinations) and compare them under a unified, reproducible evaluation protocol, in an one-shot setting. Our evaluation uncovers key insights on the state of visual in-context learning, including limitations, systematic failure modes and promising directions. To foster broader evaluation, we will openly release our VIBE toolkit.

cs.CV↗

arXiv2026

TriALS: Triphasic-Aided Liver Lesion Segmentation Benchmark in Non-Contrast CT

Automated segmentation of liver lesions on non-contrast computed tomography (NCCT) is clinically important but fundamentally challenging, particularly in low-resource settings across Africa and Asia where contrast agents are frequently unavailable. Progress has been limited by the absence of annotated NCCT benchmarks. Here we describe the TriALS challenge for automated liver lesion segmentation under contrast-limited conditions, supported by a multi-centre dataset of 150 cases with four-phase CT acquisitions (600 volumes) from Egyptian and Chinese institutions. Algorithms were evaluated on 70 cases from three institutions, including an independent external cohort. The top-performing method achieved a mean venous-phase Dice of 0.754, consistent with human-level performance, yet dropped to 0.57 on NCCT. On external validation, the leading method outperformed off-the-shelf models by up to 28% in Dice on NCCT. Algorithm performance was most strongly predicted by training data scale and pre-training strategy. A cross-year comparison exposed a persistent perceptual barrier on NCCT that scaling pre-training alone cannot overcome. Data, annotations, and code are available at https://github.com/xmed-lab/TriALS.

cs.CV↗

arXiv2026

IMPACT-HOI: Supervisory Control for Onset-Anchored Partial HOI Event Construction

We present IMPACT-HOI, a mixed-initiative framework for annotating egocentric procedural video by constructing structured event graphs for Human-Object Interactions (HOI), motivated by the need for high-quality structured supervision for learning robot manipulation from human demonstration. IMPACT-HOI frames this task as the incremental resolution of a partially specified, onset-anchored event state. A trust-calibrated controller selects among direct queries, human-confirmed suggestions, and conservative completions based on empirical annotator behavior and evidence quality. A risk-bounded execution protocol, utilizing atomic rollback, ensures that human-confirmed decisions are preserved against conflicting automated updates. A user study with 9 participants shows a 13.5% reduction in manual annotation actions, a 46.67% event match rate, and zero confirmed-field violations under the studied protocol. The code will be made publicly available at https://github.com/541741106/IMPACT_HOI.

cs.CV↗

arXiv2026

IMPACT-Scribe: Interactive Temporal Action Segmentation with Boundary Scribbles and Query Planning

Dense temporal annotation of procedural activity videos is vital for action understanding and embodied intelligence but remains labor-intensive due to reactive tools. Each correction is treated as an isolated edit, limiting reuse of information on annotator uncertainty and model reliability. We introduce IMPACT-Scribe, a correction-driven framework for dense labeling that uses each correction to improve future human-machine collaboration. IMPACT-Scribe combines uncertainty-aware boundary scribble supervision, local proposal modeling, cost-aware query planning, structured propagation, and correction-driven adaptation. Experiments and a human study show that this closed-loop design improves labeling quality per effort, enhances boundary accuracy, and fosters better human-machine interaction over time. The code will be made publicly available at https://github.com/BanzQians/IMPACT_AS.

cs.CV↗

arXiv2026

IMPACT-CYCLE: A Contract-Based Multi-Agent System for Claim-Level Supervisory Correction of Long-Video Semantic Memory

Correcting errors in long-video understanding is disproportionately costly: existing multimodal pipelines produce opaque, end-to-end outputs that expose no intermediate state for inspection, forcing annotators to revisit raw video and reconstruct temporal logic from scratch. The core bottleneck is not generation quality alone, but the absence of a supervisory interface through which human effort can be proportional to the scope of each error. We present IMPACT-CYCLE, a supervisory multi-agent system that reformulates long-video understanding as iterative claim-level maintenance of a shared semantic memory -- a structured, versioned state encoding typed claims, a claim dependency graph, and a provenance log. Role-specialized agents operating under explicit authority contracts decompose verification into local object-relation correctness, cross-temporal consistency, and global semantic coherence, with corrections confined to structurally dependent claims. When automated evidence is insufficient, the system escalates to human arbitration as the supervisory authority with final override rights; dependency-closure re-verification then ensures correction cost remains proportional to error scope. Experiments on VidOR show substantially improved downstream reasoning (VQA: 0.71 to 0.79) and a 4.8x reduction in human arbitration cost, with workload significantly lower than manual annotation. Code will be released at https://github.com/MKong17/IMPACT_CYCLE.

cs.CV↗

arXiv2026

Probing Intrinsic Medical Task Relationships: A Contrastive Learning Perspective

While much of the medical computer vision community has focused on advancing performance for specific tasks, the underlying relationships between tasks, i.e., how they relate, overlap, or differ on a representational level, remain largely unexplored. Our work explores these intrinsic relationships between medical vision tasks, specifically, we investigate 30 tasks, such as semantic tasks (e.g., segmentation and detection), image generative tasks (e.g., denoising, inpainting, or colorization), and image transformation tasks (e.g., geometric transformations). Our goal is to probe whether a data-driven representation space can capture an underlying structure of tasks across a variety of 39 datasets from wildly different medical imaging modalities, including computed tomography, magnetic resonance, electron microscopy, X-ray ultrasound and more. By revealing how tasks relate to one another, we aim to provide insights into their fundamental properties and interconnectedness. To this end, we introduce Task-Contrastive Learning (TaCo), a contrastive learning framework designed to embed tasks into a shared representation space. Through TaCo, we map these heterogeneous tasks from different modalities into a joint space and analyze their properties: identifying which tasks are distinctly represented, which blend together, and how iterative alterations to tasks are reflected in the embedding space. Our work provides a foundation for understanding the intrinsic structure of medical vision tasks, offering a deeper understanding of task similarities and their interconnected properties in embedding spaces.

cs.CV↗

arXiv2025

Is Visual in-Context Learning for Compositional Medical Tasks within Reach?

In this paper, we explore the potential of visual in-context learning to enable a single model to handle multiple tasks and adapt to new tasks during test time without re-training. Unlike previous approaches, our focus is on training in-context learners to adapt to sequences of tasks, rather than individual tasks. Our goal is to solve complex tasks that involve multiple intermediate steps using a single model, allowing users to define entire vision pipelines flexibly at test time. To achieve this, we first examine the properties and limitations of visual in-context learning architectures, with a particular focus on the role of codebooks. We then introduce a novel method for training in-context learners using a synthetic compositional task generation engine. This engine bootstraps task sequences from arbitrary segmentation datasets, enabling the training of visual in-context learners for compositional tasks. Additionally, we investigate different masking-based training objectives to gather insights into how to train models better for solving complex, compositional tasks. Our exploration not only provides important insights especially for multi-modal medical task sequences but also highlights challenges that need to be addressed.

cs.CV↗

arXiv2024

Efficient MedSAMs: Segment Anything in Medical Images on Laptop

Promptable segmentation foundation models have emerged as a transformative approach to addressing the diverse needs in medical images, but most existing models require expensive computing, posing a big barrier to their adoption in clinical practice. In this work, we organized the first international competition dedicated to promptable medical image segmentation, featuring a large-scale dataset spanning nine common imaging modalities from over 20 different institutions. The top teams developed lightweight segmentation foundation models and implemented an efficient inference pipeline that substantially reduced computational requirements while maintaining state-of-the-art segmentation accuracy. Moreover, the post-challenge phase advanced the algorithms through the design of performance booster and reproducibility tasks, resulting in improved algorithms and validated reproducibility of the winning solution. Furthermore, the best-performing algorithms have been incorporated into the open-source software with a user-friendly interface to facilitate clinical adoption. The data and code are publicly available to foster the further development of medical image segmentation foundation models and pave the way for impactful real-world applications.

eess.IV↗

arXiv2024

Every Component Counts: Rethinking the Measure of Success for Medical Semantic Segmentation in Multi-Instance Segmentation Tasks

We present Connected-Component~(CC)-Metrics, a novel semantic segmentation evaluation protocol, targeted to align existing semantic segmentation metrics to a multi-instance detection scenario in which each connected component matters. We motivate this setup in the common medical scenario of semantic metastases segmentation in a full-body PET/CT. We show how existing semantic segmentation metrics suffer from a bias towards larger connected components contradicting the clinical assessment of scans in which tumor size and clinical relevance are uncorrelated. To rebalance existing segmentation metrics, we propose to evaluate them on a per-component basis thus giving each tumor the same weight irrespective of its size. To match predictions to ground-truth segments, we employ a proximity-based matching criterion, evaluating common metrics locally at the component of interest. Using this approach, we break free of biases introduced by large metastasis for overlap-based metrics such as Dice or Surface Dice. CC-Metrics also improves distance-based metrics such as Hausdorff Distances which are uninformative for small changes that do not influence the maximum or 95th percentile, and avoids pitfalls introduced by directly combining counting-based metrics with overlap-based metrics as it is done in Panoptic Quality.

cs.CV↗

arXiv2024

LIMIS: Towards Language-based Interactive Medical Image Segmentation

Within this work, we introduce LIMIS: The first purely language-based interactive medical image segmentation model. We achieve this by adapting Grounded SAM to the medical domain and designing a language-based model interaction strategy that allows radiologists to incorporate their knowledge into the segmentation process. LIMIS produces high-quality initial segmentation masks by leveraging medical foundation models and allows users to adapt segmentation masks using only language, opening up interactive segmentation to scenarios where physicians require using their hands for other tasks. We evaluate LIMIS on three publicly available medical datasets in terms of performance and usability with experts from the medical domain confirming its high-quality segmentation masks and its interactive usability.

cs.CV↗

arXiv2024

Rethinking Annotator Simulation: Realistic Evaluation of Whole-Body PET Lesion Interactive Segmentation Methods

Interactive segmentation plays a crucial role in accelerating the annotation, particularly in domains requiring specialized expertise such as nuclear medicine. For example, annotating lesions in whole-body Positron Emission Tomography (PET) images can require over an hour per volume. While previous works evaluate interactive segmentation models through either real user studies or simulated annotators, both approaches present challenges. Real user studies are expensive and often limited in scale, while simulated annotators, also known as robot users, tend to overestimate model performance due to their idealized nature. To address these limitations, we introduce four evaluation metrics that quantify the user shift between real and simulated annotators. In an initial user study involving four annotators, we assess existing robot users using our proposed metrics and find that robot users significantly deviate in performance and annotation behavior compared to real annotators. Based on these findings, we propose a more realistic robot user that reduces the user shift by incorporating human factors such as click variation and inter-annotator disagreement. We validate our robot user in a second user study, involving four other annotators, and show it consistently reduces the simulated-to-real user shift compared to traditional robot users. By employing our robot user, we can conduct more large-scale and cost-efficient evaluations of interactive segmentation models, while preserving the fidelity of real user studies. Our implementation is based on MONAI Label and will be made publicly available.

eess.IV↗

arXiv2024

Deep Interactive Segmentation of Medical Images: A Systematic Review and Taxonomy

Interactive segmentation is a crucial research area in medical image analysis aiming to boost the efficiency of costly annotations by incorporating human feedback. This feedback takes the form of clicks, scribbles, or masks and allows for iterative refinement of the model output so as to efficiently guide the system towards the desired behavior. In recent years, deep learning-based approaches have propelled results to a new level causing a rapid growth in the field with 121 methods proposed in the medical imaging domain alone. In this review, we provide a structured overview of this emerging field featuring a comprehensive taxonomy, a systematic review of existing methods, and an in-depth analysis of current practices. Based on these contributions, we discuss the challenges and opportunities in the field. For instance, we find that there is a severe lack of comparison across methods which needs to be tackled by standardized baselines and benchmarks.

eess.IV↗

arXiv2023

Sliding Window FastEdit: A Framework for Lesion Annotation in Whole-body PET Images

Deep learning has revolutionized the accurate segmentation of diseases in medical imaging. However, achieving such results requires training with numerous manual voxel annotations. This requirement presents a challenge for whole-body Positron Emission Tomography (PET) imaging, where lesions are scattered throughout the body. To tackle this problem, we introduce SW-FastEdit - an interactive segmentation framework that accelerates the labeling by utilizing only a few user clicks instead of voxelwise annotations. While prior interactive models crop or resize PET volumes due to memory constraints, we use the complete volume with our sliding window-based interactive scheme. Our model outperforms existing non-sliding window interactive models on the AutoPET dataset and generalizes to the previously unseen HECKTOR dataset. A user study revealed that annotators achieve high-quality predictions with only 10 click iterations and a low perceived NASA-TLX workload. Our framework is implemented using MONAI Label and is available: https://github.com/matt3o/AutoPET2-Submission/

eess.IV↗

arXiv2023

Quantized Distillation: Optimizing Driver Activity Recognition Models for Resource-Constrained Environments

Deep learning-based models are at the forefront of most driver observation benchmarks due to their remarkable accuracies but are also associated with high computational costs. This is challenging, as resources are often limited in real-world driving scenarios. This paper introduces a lightweight framework for resource-efficient driver activity recognition. The framework enhances 3D MobileNet, a neural architecture optimized for speed in video classification, by incorporating knowledge distillation and model quantization to balance model accuracy and computational efficiency. Knowledge distillation helps maintain accuracy while reducing the model size by leveraging soft labels from a larger teacher model (I3D), instead of relying solely on original ground truth data. Model quantization significantly lowers memory and computation demands by using lower precision integers for model weights and activations. Extensive testing on a public dataset for in-vehicle monitoring during autonomous driving demonstrates that this new framework achieves a threefold reduction in model size and a 1.4-fold improvement in inference time, compared to an already optimized architecture. The code for this study is available at https://github.com/calvintanama/qd-driver-activity-reco.

cs.CV↗

arXiv2023

AutoPET Challenge 2023: Sliding Window-based Optimization of U-Net

Tumor segmentation in medical imaging is crucial and relies on precise delineation. Fluorodeoxyglucose Positron-Emission Tomography (FDG-PET) is widely used in clinical practice to detect metabolically active tumors. However, FDG-PET scans may misinterpret irregular glucose consumption in healthy or benign tissues as cancer. Combining PET with Computed Tomography (CT) can enhance tumor segmentation by integrating metabolic and anatomic information. FDG-PET/CT scans are pivotal for cancer staging and reassessment, utilizing radiolabeled fluorodeoxyglucose to highlight metabolically active regions. Accurately distinguishing tumor-specific uptake from physiological uptake in normal tissues is a challenging aspect of precise tumor segmentation. The AutoPET challenge addresses this by providing a dataset of 1014 FDG-PET/CT studies, encouraging advancements in accurate tumor segmentation and analysis within the FDG-PET/CT domain. Code: https://github.com/matt3o/AutoPET2-Submission/

eess.IV↗