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RDTE-UNet: A Boundary and Detail Aware UNet for Precise Medical Image Segmentation

Medical image segmentation is essential for computer-assisted diagnosis and treatment planning, yet substantial anatomical variability and boundary ambiguity hinder reliable delineation of fine structures. We propose RDTE-UNet, a segmentation network that unifies local modeling with global context to strengthen boundary delineation and detail preservation. RDTE-UNet employs a hybrid ResBlock detail-aware Transformer backbone and three modules: ASBE for adaptive boundary enhancement, HVDA for fine-grained feature modeling, and EulerFF for fusion weighting guided by Euler's formula. Together, these components improve structural consistency and boundary accuracy across morphology, orientation, and scale. On Synapse and BUSI dataset, RDTE-UNet has achieved a comparable level in terms of segmentation accuracy and boundary quality.

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TM-UNet: Token-Memory Enhanced Sequential Modeling for Efficient Medical Image Segmentation

Medical image segmentation is essential for clinical diagnosis and treatment planning. Although transformer-based methods have achieved remarkable results, their high computational cost hinders clinical deployment. To address this issue, we propose TM-UNet, a novel lightweight framework that integrates token sequence modeling with an efficient memory mechanism for efficient medical segmentation. Specifically, we introduce a multi-scale token-memory (MSTM) block that transforms 2D spatial features into token sequences through strategic spatial scanning, leveraging matrix memory cells to selectively retain and propagate discriminative contextual information across tokens. This novel token-memory mechanism acts as a dynamic knowledge store that captures long-range dependencies with linear complexity, enabling efficient global reasoning without redundant computation. Our MSTM block further incorporates exponential gating to identify token effectiveness and multi-scale contextual extraction via parallel pooling operations, enabling hierarchical representation learning without computational overhead. Extensive experiments demonstrate that TM-UNet outperforms state-of-the-art methods across diverse medical segmentation tasks with substantially reduced computation cost. The code is available at https://github.com/xq141839/TM-UNet.

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SAM-Fed: SAM-Guided Federated Semi-Supervised Learning for Medical Image Segmentation

Medical image segmentation is clinically important, yet data privacy and the cost of expert annotation limit the availability of labeled data. Federated semi-supervised learning (FSSL) offers a solution but faces two challenges: pseudo-label reliability depends on the strength of local models, and client devices often require compact or heterogeneous architectures due to limited computational resources. These constraints reduce the quality and stability of pseudo-labels, while large models, though more accurate, cannot be trained or used for routine inference on client devices. We propose SAM-Fed, a federated semi-supervised framework that leverages a high-capacity segmentation foundation model to guide lightweight clients during training. SAM-Fed combines dual knowledge distillation with an adaptive agreement mechanism to refine pixel-level supervision. Experiments on skin lesion and polyp segmentation across homogeneous and heterogeneous settings show that SAM-Fed consistently outperforms state-of-the-art FSSL methods.

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MaskMed: Decoupled Mask and Class Prediction for Medical Image Segmentation

Medical image segmentation typically adopts a point-wise convolutional segmentation head to predict dense labels, where each output channel is heuristically tied to a specific class. This rigid design limits both feature sharing and semantic generalization. In this work, we propose a unified decoupled segmentation head that separates multi-class prediction into class-agnostic mask prediction and class label prediction using shared object queries. Furthermore, we introduce a Full-Scale Aware Deformable Transformer module that enables low-resolution encoder features to attend across full-resolution encoder features via deformable attention, achieving memory-efficient and spatially aligned full-scale fusion. Our proposed method, named MaskMed, achieves state-of-the-art performance, surpassing nnUNet by +2.0% Dice on AMOS 2022 and +6.9% Dice on BTCV.

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DAUNet: A Lightweight UNet Variant with Deformable Convolutions and Parameter-Free Attention for Medical Image Segmentation

Medical image segmentation plays a pivotal role in automated diagnostic and treatment planning systems. In this work, we present DAUNet, a novel lightweight UNet variant that integrates Deformable V2 Convolutions and Parameter-Free Attention (SimAM) to improve spatial adaptability and context-aware feature fusion without increasing model complexity. DAUNet's bottleneck employs dynamic deformable kernels to handle geometric variations, while the decoder and skip pathways are enhanced using SimAM attention modules for saliency-aware refinement. Extensive evaluations on two challenging datasets, FH-PS-AoP (fetal head and pubic symphysis ultrasound) and FUMPE (CT-based pulmonary embolism detection), demonstrate that DAUNet outperforms state-of-the-art models in Dice score, HD95, and ASD, while maintaining superior parameter efficiency. Ablation studies highlight the individual contributions of deformable convolutions and SimAM attention. DAUNet's robustness to missing context and low-contrast regions establishes its suitability for deployment in real-time and resource-constrained clinical environments.

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SegReg: Latent Space Regularization for Improved Medical Image Segmentation

Medical image segmentation models are typically optimised with voxel-wise losses that constrain predictions only in the output space. This leaves latent feature representations largely unconstrained, potentially limiting generalisation. We propose {SegReg}, a latent-space regularisation framework that operates on feature maps of U-Net models to encourage structured embeddings while remaining fully compatible with standard segmentation losses. Integrated with the nnU-Net framework, we evaluate SegReg on prostate, cardiac, and hippocampus segmentation and demonstrate consistent improvements in domain generalisation. Furthermore, we show that explicit latent regularisation improves continual learning by reducing task drift and enhancing forward transfer across sequential tasks without adding memory or any extra parameters. These results highlight latent-space regularisation as a practical approach for building more generalisable and continual-learning-ready models.

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Semantic Class Distribution Learning for Debiasing Semi-Supervised Medical Image Segmentation

Medical image segmentation is critical for computer-aided diagnosis. However, dense pixel-level annotation is time-consuming and costly, and medical datasets often exhibit severe class imbalance. Such an imbalance causes minority structures to be overwhelmed by dominant classes in feature representations, hindering the learning of discriminative features and making reliable segmentation particularly challenging. To address this, we propose the Semantic Class Distribution Learning (SCDL) framework, a plug-and-play module that mitigates supervision and representation biases by learning structured class-conditional feature distributions. SCDL integrates Class Distribution Bidirectional Alignment (CDBA) to align embeddings with learnable class proxies and leverages Semantic Anchor Constraints (SAC) to guide proxies using labeled data. Experiments on the Synapse and AMOS datasets demonstrate that SCDL largely improves segmentation performance across both overall and class-level metrics, with particularly notable gains for several low-frequency organs. Our anonymous code is released at https://anonymous.4open.science/r/SCDL.

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TALENT: Target-aware Efficient Tuning for Referring Image Segmentation

Referring image segmentation aims to segment specific targets based on a natural text expression. Recently, parameter-efficient tuning (PET) has emerged as a promising paradigm. However, existing PET-based methods often suffer from the fact that visual features can't emphasize the text-referred target instance but activate co-category yet unrelated objects. We analyze and quantify this problem, terming it the `non-target activation' (NTA) issue. To address this, we propose a novel framework, TALENT, which utilizes target-aware efficient tuning for PET-based RIS. Specifically, we first propose a Rectified Cost Aggregator (RCA) to efficiently aggregate text-referred features. Then, to calibrate `NTA' into accurate target activation, we adopt a Target-aware Learning Mechanism (TLM), including contextual pairwise consistency learning and target-centric contrastive learning. The former uses the sentence-level text feature to achieve a holistic understanding of the referent and constructs a text-referred affinity map to optimize the semantic association of visual features. The latter further enhances target localization to discover the distinct instance while suppressing associations with other unrelated ones. The two objectives work in concert and address `NTA' effectively. Extensive evaluations show that TALENT outperforms existing methods across various metrics (e.g., 2.5\% mIoU gains on G-Ref val set). Our codes will be released at: https://github.com/Kimsure/TALENT.

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CiUNet: A Hybrid Swin-CNN UNet for Medical Image Segmentation

Medical image segmentation requires high accuracy and robustness, yet practical commercial deployment also demands privacy preservation and computational efficiency. In this context, the U-Net architecture, which can be inherently decoupled into independent encoder and decoder components, serves as a natural commercial choice. However, pure Transformer-based variants like Swin-UNet often suffer from insufficient local detail capture and limited interpretability. In this paper, we propose a lightweight hybrid architecture built upon the Swin-UNet framework. Our model integrates a parallel CNN encoder to complement the shallow layer reasoning of Swin Transformers with local texture features. To bridge the semantic gap and enhance fine-grained spatial detail recovery, we design an asymmetric feature fusion strategy and introduce cross-layer skip (XSkip) connections that explicitly propagate shallow CNN features into the decoder. We further incorporate novel loss functions and an auxiliary supervision head (Aux-Head) to strengthen training stability, boundary delineation, and intermediate feature interpretability. Extensive experiments on the Synapse multi-organ segmentation dataset demonstrate that our approach achieves state-of-the-art competitive Dice scores and Hausdorff distances, offering an accurate, efficient, and interpretable solution for clinical deployment.

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LM-Net: A Light-weight and Multi-scale Network for Medical Image Segmentation

Current medical image segmentation approaches have limitations in deeply exploring multi-scale information and effectively combining local detail textures with global contextual semantic information. This results in over-segmentation, under-segmentation, and blurred segmentation boundaries. To tackle these challenges, we explore multi-scale feature representations from different perspectives, proposing a novel, lightweight, and multi-scale architecture (LM-Net) that integrates advantages of both Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs) to enhance segmentation accuracy. LM-Net employs a lightweight multi-branch module to capture multi-scale features at the same level. Furthermore, we introduce two modules to concurrently capture local detail textures and global semantics with multi-scale features at different levels: the Local Feature Transformer (LFT) and Global Feature Transformer (GFT). The LFT integrates local window self-attention to capture local detail textures, while the GFT leverages global self-attention to capture global contextual semantics. By combining these modules, our model achieves complementarity between local and global representations, alleviating the problem of blurred segmentation boundaries in medical image segmentation. To evaluate the feasibility of LM-Net, extensive experiments have been conducted on three publicly available datasets with different modalities. Our proposed model achieves state-of-the-art results, surpassing previous methods, while only requiring 4.66G FLOPs and 5.4M parameters. These state-of-the-art results on three datasets with different modalities demonstrate the effectiveness and adaptability of our proposed LM-Net for various medical image segmentation tasks.

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Mix-modal Federated Learning for MRI Image Segmentation

Magnetic resonance imaging (MRI) image segmentation is crucial in diagnosing and treating many diseases, such as brain tumors. Existing MRI image segmentation methods mainly fall into a centralized multimodal paradigm, which is inapplicable in engineering non-centralized mix-modal medical scenarios. In this situation, each distributed client (hospital) processes multiple mixed MRI modalities, and the modality set and image data for each client are diverse, suffering from extensive client-wise modality heterogeneity and data heterogeneity. In this paper, we first formulate non-centralized mix-modal MRI image segmentation as a new paradigm for federated learning (FL) that involves multiple modalities, called mix-modal federated learning (MixMFL). It distinguishes from existing multimodal federating learning (MulMFL) and cross-modal federating learning (CroMFL) paradigms. Then, we proposed a novel modality decoupling and memorizing mix-modal federated learning framework (MDM-MixMFL) for MRI image segmentation, which is characterized by a modality decoupling strategy and a modality memorizing mechanism. Specifically, the modality decoupling strategy disentangles each modality into modality-tailored and modality-shared information. During mix-modal federated updating, corresponding modality encoders undergo tailored and shared updating, respectively. It facilitates stable and adaptive federating aggregation of heterogeneous data and modalities from distributed clients. Besides, the modality memorizing mechanism stores client-shared modality prototypes dynamically refreshed from every modality-tailored encoder to compensate for incomplete modalities in each local client.

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MIST: A Simple and Scalable End-To-End 3D Medical Imaging Segmentation Framework

Medical imaging segmentation is a highly active area of research, with deep learning-based methods achieving state-of-the-art results in several benchmarks. However, the lack of standardized tools for training, testing, and evaluating new methods makes the comparison of methods difficult. To address this, we introduce the Medical Imaging Segmentation Toolkit (MIST), a simple, modular, and end-to-end medical imaging segmentation framework designed to facilitate consistent training, testing, and evaluation of deep learning-based medical imaging segmentation methods. MIST standardizes data analysis, preprocessing, and evaluation pipelines, accommodating multiple architectures and loss functions. This standardization ensures reproducible and fair comparisons across different methods. We detail MIST's data format requirements, pipelines, and auxiliary features and demonstrate its efficacy using the BraTS Adult Glioma Post-Treatment Challenge dataset. Our results highlight MIST's ability to produce accurate segmentation masks and its scalability across multiple GPUs, showcasing its potential as a powerful tool for future medical imaging research and development.

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CoSAM: Self-Correcting SAM for Domain Generalization in 2D Medical Image Segmentation

Medical images often exhibit distribution shifts due to variations in imaging protocols and scanners across different medical centers. Domain Generalization (DG) methods aim to train models on source domains that can generalize to unseen target domains. Recently, the segment anything model (SAM) has demonstrated strong generalization capabilities due to its prompt-based design, and has gained significant attention in image segmentation tasks. Existing SAM-based approaches attempt to address the need for manual prompts by introducing prompt generators that automatically generate these prompts. However, we argue that auto-generated prompts may not be sufficiently accurate under distribution shifts, potentially leading to incorrect predictions that still require manual verification and correction by clinicians. To address this challenge, we propose a method for 2D medical image segmentation called Self-Correcting SAM (CoSAM). Our approach begins by generating coarse masks using SAM in a prompt-free manner, providing prior prompts for the subsequent stages, and eliminating the need for prompt generators. To automatically refine these coarse masks, we introduce a generalized error decoder that simulates the correction process typically performed by clinicians. Furthermore, we generate diverse prompts as feedback based on the corrected masks, which are used to iteratively refine the predictions within a self-correcting loop, enhancing the generalization performance of our model. Extensive experiments on two medical image segmentation benchmarks across multiple scenarios demonstrate the superiority of CoSAM over state-of-the-art SAM-based methods.

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Synthetic Instance Segmentation from Semantic Image Segmentation Masks

In recent years, instance segmentation has garnered significant attention across various applications. However, training a fully-supervised instance segmentation model requires costly both instance-level and pixel-level annotations. In contrast, weakly-supervised instance segmentation methods, such as those using image-level class labels or point labels, often struggle to satisfy the accuracy and recall requirements of practical scenarios. In this paper, we propose a novel paradigm called Synthetic Instance Segmentation (SISeg). SISeg achieves instance segmentation results by leveraging image masks generated by existing semantic segmentation models, and it is highly efficient as we do not require additional training for semantic segmentation or the use of instance-level image annotations. In other words, the proposed model does not need extra manpower or higher computational expenses. Specifically, we first obtain a semantic segmentation mask of the input image via an existent semantic segmentation model. Then, we calculate a displacement field vector for each pixel based on the segmentation mask, which can indicate representations belonging to the same class but different instances, i.e., obtaining the instance-level object information. Finally, the instance segmentation results are refined by a learnable category-agnostic object boundary branch. Extensive experimental results on two challenging datasets highlight the effectiveness of SISeg in achieving competitive results when compared to state-of-the-art methods, especially fully-supervised methods. The code will be released at: SISeg

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M$^{2}$SNet: Multi-scale in Multi-scale Subtraction Network for Medical Image Segmentation

Accurate medical image segmentation is critical for early medical diagnosis. Most existing methods are based on U-shape structure and use element-wise addition or concatenation to fuse different level features progressively in decoder. However, both the two operations easily generate plenty of redundant information, which will weaken the complementarity between different level features, resulting in inaccurate localization and blurred edges of lesions. To address this challenge, we propose a general multi-scale in multi-scale subtraction network (M$^{2}$SNet) to finish diverse segmentation from medical image. Specifically, we first design a basic subtraction unit (SU) to produce the difference features between adjacent levels in encoder. Next, we expand the single-scale SU to the intra-layer multi-scale SU, which can provide the decoder with both pixel-level and structure-level difference information. Then, we pyramidally equip the multi-scale SUs at different levels with varying receptive fields, thereby achieving the inter-layer multi-scale feature aggregation and obtaining rich multi-scale difference information. In addition, we build a training-free network ``LossNet'' to comprehensively supervise the task-aware features from bottom layer to top layer, which drives our multi-scale subtraction network to capture the detailed and structural cues simultaneously. Without bells and whistles, our method performs favorably against most state-of-the-art methods under different evaluation metrics on eleven datasets of four different medical image segmentation tasks of diverse image modalities, including color colonoscopy imaging, ultrasound imaging, computed tomography (CT), and optical coherence tomography (OCT). The source code can be available at https://github.com/Xiaoqi-Zhao-DLUT/MSNet.

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Medical Image Segmentation on MRI Images with Missing Modalities: A Review

Dealing with missing modalities in Magnetic Resonance Imaging (MRI) and overcoming their negative repercussions is considered a hurdle in biomedical imaging. The combination of a specified set of modalities, which is selected depending on the scenario and anatomical part being scanned, will provide medical practitioners with full information about the region of interest in the human body, hence the missing MRI sequences should be reimbursed. The compensation of the adverse impact of losing useful information owing to the lack of one or more modalities is a well-known challenge in the field of computer vision, particularly for medical image processing tasks including tumour segmentation, tissue classification, and image generation. Various approaches have been developed over time to mitigate this problem's negative implications and this literature review goes through a significant number of the networks that seek to do so. The approaches reviewed in this work are reviewed in detail, including earlier techniques such as synthesis methods as well as later approaches that deploy deep learning, such as common latent space models, knowledge distillation networks, mutual information maximization, and generative adversarial networks (GANs). This work discusses the most important approaches that have been offered at the time of this writing, examining the novelty, strength, and weakness of each one. Furthermore, the most commonly used MRI datasets are highlighted and described. The main goal of this research is to offer a performance evaluation of missing modality compensating networks, as well as to outline future strategies for dealing with this issue.

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Automatic Image Segmentation by Dynamic Region Merging

This paper addresses the automatic image segmentation problem in a region merging style. With an initially over-segmented image, in which the many regions (or super-pixels) with homogeneous color are detected, image segmentation is performed by iteratively merging the regions according to a statistical test. There are two essential issues in a region merging algorithm: order of merging and the stopping criterion. In the proposed algorithm, these two issues are solved by a novel predicate, which is defined by the sequential probability ratio test (SPRT) and the maximum likelihood criterion. Starting from an over-segmented image, neighboring regions are progressively merged if there is an evidence for merging according to this predicate. We show that the merging order follows the principle of dynamic programming. This formulates image segmentation as an inference problem, where the final segmentation is established based on the observed image. We also prove that the produced segmentation satisfies certain global properties. In addition, a faster algorithm is developed to accelerate the region merging process, which maintains a nearest neighbor graph in each iteration. Experiments on real natural images are conducted to demonstrate the performance of the proposed dynamic region merging algorithm.

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Unsupervised Universal Image Segmentation

Several unsupervised image segmentation approaches have been proposed which eliminate the need for dense manually-annotated segmentation masks; current models separately handle either semantic segmentation (e.g., STEGO) or class-agnostic instance segmentation (e.g., CutLER), but not both (i.e., panoptic segmentation). We propose an Unsupervised Universal Segmentation model (U2Seg) adept at performing various image segmentation tasks -- instance, semantic and panoptic -- using a novel unified framework. U2Seg generates pseudo semantic labels for these segmentation tasks via leveraging self-supervised models followed by clustering; each cluster represents different semantic and/or instance membership of pixels. We then self-train the model on these pseudo semantic labels, yielding substantial performance gains over specialized methods tailored to each task: a +2.6 AP$^{\text{box}}$ boost vs. CutLER in unsupervised instance segmentation on COCO and a +7.0 PixelAcc increase (vs. STEGO) in unsupervised semantic segmentation on COCOStuff. Moreover, our method sets up a new baseline for unsupervised panoptic segmentation, which has not been previously explored. U2Seg is also a strong pretrained model for few-shot segmentation, surpassing CutLER by +5.0 AP$^{\text{mask}}$ when trained on a low-data regime, e.g., only 1% COCO labels. We hope our simple yet effective method can inspire more research on unsupervised universal image segmentation.

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