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arXiv2024

Few-Shot Medical Image Segmentation with Large Kernel Attention

Medical image segmentation has witnessed significant advancements with the emergence of deep learning. However, the reliance of most neural network models on a substantial amount of annotated data remains a challenge for medical image segmentation. To address this issue, few-shot segmentation methods based on meta-learning have been employed. Presently, the methods primarily focus on aligning the support set and query set to enhance performance, but this approach hinders further improvement of the model's effectiveness. In this paper, our objective is to propose a few-shot medical segmentation model that acquire comprehensive feature representation capabilities, which will boost segmentation accuracy by capturing both local and long-range features. To achieve this, we introduce a plug-and-play attention module that dynamically enhances both query and support features, thereby improving the representativeness of the extracted features. Our model comprises four key modules: a dual-path feature extractor, an attention module, an adaptive prototype prediction module, and a multi-scale prediction fusion module. Specifically, the dual-path feature extractor acquires multi-scale features by obtaining features of 32{\times}32 size and 64{\times}64 size. The attention module follows the feature extractor and captures local and long-range information. The adaptive prototype prediction module automatically adjusts the anomaly score threshold to predict prototypes, while the multi-scale fusion prediction module integrates prediction masks of various scales to produce the final segmentation result. We conducted experiments on publicly available MRI datasets, namely CHAOS and CMR, and compared our method with other advanced techniques. The results demonstrate that our method achieves state-of-the-art performance.

cs.CV↗

arXiv2024

Learnable Weight Initialization for Volumetric Medical Image Segmentation

Hybrid volumetric medical image segmentation models, combining the advantages of local convolution and global attention, have recently received considerable attention. While mainly focusing on architectural modifications, most existing hybrid approaches still use conventional data-independent weight initialization schemes which restrict their performance due to ignoring the inherent volumetric nature of the medical data. To address this issue, we propose a learnable weight initialization approach that utilizes the available medical training data to effectively learn the contextual and structural cues via the proposed self-supervised objectives. Our approach is easy to integrate into any hybrid model and requires no external training data. Experiments on multi-organ and lung cancer segmentation tasks demonstrate the effectiveness of our approach, leading to state-of-the-art segmentation performance. Our proposed data-dependent initialization approach performs favorably as compared to the Swin-UNETR model pretrained using large-scale datasets on multi-organ segmentation task. Our source code and models are available at: https://github.com/ShahinaKK/LWI-VMS.

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arXiv2024

TransDAE: Dual Attention Mechanism in a Hierarchical Transformer for Efficient Medical Image Segmentation

In healthcare, medical image segmentation is crucial for accurate disease diagnosis and the development of effective treatment strategies. Early detection can significantly aid in managing diseases and potentially prevent their progression. Machine learning, particularly deep convolutional neural networks, has emerged as a promising approach to addressing segmentation challenges. Traditional methods like U-Net use encoding blocks for local representation modeling and decoding blocks to uncover semantic relationships. However, these models often struggle with multi-scale objects exhibiting significant variations in texture and shape, and they frequently fail to capture long-range dependencies in the input data. Transformers designed for sequence-to-sequence predictions have been proposed as alternatives, utilizing global self-attention mechanisms. Yet, they can sometimes lack precise localization due to insufficient granular details. To overcome these limitations, we introduce TransDAE: a novel approach that reimagines the self-attention mechanism to include both spatial and channel-wise associations across the entire feature space, while maintaining computational efficiency. Additionally, TransDAE enhances the skip connection pathway with an inter-scale interaction module, promoting feature reuse and improving localization accuracy. Remarkably, TransDAE outperforms existing state-of-the-art methods on the Synaps multi-organ dataset, even without relying on pre-trained weights.

cs.CV↗

arXiv2024

Shape Transformation Driven by Active Contour for Class-Imbalanced Semi-Supervised Medical Image Segmentation

Annotating 3D medical images demands expert knowledge and is time-consuming. As a result, semi-supervised learning (SSL) approaches have gained significant interest in 3D medical image segmentation. The significant size differences among various organs in the human body lead to imbalanced class distribution, which is a major challenge in the real-world application of these SSL approaches. To address this issue, we develop a novel Shape Transformation driven by Active Contour (STAC), that enlarges smaller organs to alleviate imbalanced class distribution across different organs. Inspired by curve evolution theory in active contour methods, STAC employs a signed distance function (SDF) as the level set function, to implicitly represent the shape of organs, and deforms voxels in the direction of the steepest descent of SDF (i.e., the normal vector). To ensure that the voxels far from expansion organs remain unchanged, we design an SDF-based weight function to control the degree of deformation for each voxel. We then use STAC as a data-augmentation process during the training stage. Experimental results on two benchmark datasets demonstrate that the proposed method significantly outperforms some state-of-the-art methods. Source code is publicly available at https://github.com/GuGuLL123/STAC.

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arXiv2026

Prior-Guided Residual Diffusion: Calibrated and Efficient Medical Image Segmentation

Ambiguity in medical image segmentation calls for models that capture full conditional distributions rather than a single point estimate. We present Prior-Guided Residual Diffusion (PGRD), a diffusion-based framework that learns voxel-wise distributions while maintaining strong calibration and practical sampling efficiency. PGRD embeds discrete labels as one-hot targets in a continuous space to align segmentation with diffusion modeling. A coarse prior predictor provides step-wise guidance; the diffusion network then learns the residual to the prior, accelerating convergence and improving calibration. A deep diffusion supervision scheme further stabilizes training by supervising intermediate time steps. Evaluated on representative MRI and CT datasets, PGRD achieves higher Dice scores and lower NLL/ECE values than Bayesian, ensemble, Probabilistic U-Net, and vanilla diffusion baselines, while requiring fewer sampling steps to reach strong performance.

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arXiv2026

ReCo-KD: Region- and Context-Aware Knowledge Distillation for Efficient 3D Medical Image Segmentation

Accurate 3D medical image segmentation is vital for diagnosis and treatment planning, but state-of-the-art models are often too large for clinics with limited computing resources. Lightweight architectures typically suffer significant performance loss. To address these deployment and speed constraints, we propose Region- and Context-aware Knowledge Distillation (ReCo-KD), a training-only framework that transfers both fine-grained anatomical detail and long-range contextual information from a high-capacity teacher to a compact student network. The framework integrates Multi-Scale Structure-Aware Region Distillation (MS-SARD), which applies class-aware masks and scale-normalized weighting to emphasize small but clinically important regions, and Multi-Scale Context Alignment (MS-CA), which aligns teacher-student affinity patterns across feature levels. Implemented on nnU-Net in a backbone-agnostic manner, ReCo-KD requires no custom student design and is easily adapted to other architectures. Experiments on multiple public 3D medical segmentation datasets and a challenging aggregated dataset show that the distilled lightweight model attains accuracy close to the teacher while markedly reducing parameters and inference latency, underscoring its practicality for clinical deployment.

cs.CV↗

arXiv2026

Pareto-Guided Optimization for Uncertainty-Aware Medical Image Segmentation

Uncertainty in medical image segmentation is inherently non-uniform, with boundary regions exhibiting substantially higher ambiguity than interior areas. Conventional training treats all pixels equally, leading to unstable optimization during early epochs when predictions are unreliable. We argue that this instability hinders convergence toward Pareto-optimal solutions and propose a region-wise curriculum strategy that prioritizes learning from certain regions and gradually incorporates uncertain ones, reducing gradient variance. Methodologically, we introduce a Pareto-consistent loss that balances trade-offs between regional uncertainties by adaptively reshaping the loss landscape and constraining convergence dynamics between interior and boundary regions; this guides the model toward Pareto-approximate solutions. To address boundary ambiguity, we further develop a fuzzy labeling mechanism that maintains binary confidence in non-boundary areas while enabling smooth transitions near boundaries, stabilizing gradients, and expanding flat regions in the loss surface. Experiments on brain metastasis and non-metastatic tumor segmentation show consistent improvements across multiple configurations, with our method outperforming traditional crisp-set approaches in all tumor subregions.

cs.CV↗

arXiv2026

Volumetric Directional Diffusion: Anchoring Uncertainty Quantification in Anatomical Consensus for Ambiguous Medical Image Segmentation

Ambiguous 3D medical image segmentation often involves boundaries where different expert delineations are non-identical yet clinically plausible. Modeling such inter-observer variability requires a careful balance between diversity and anatomical fidelity: deterministic models preserve coherent volumetric structures but collapse expert disagreement into a single mask, while stochastic generative models can produce diverse samples but may introduce disconnected components or slice-to-slice inconsistency when generating full 3D masks from unstructured noise. We propose Volumetric Directional Diffusion (VDD), a prior-anchored diffusion framework that shifts stochastic generation from full-mask synthesis to residual boundary exploration. VDD uses a coarse consensus prediction as an anatomical anchor and learns a directional diffusion process to generate plausible boundary variations around ambiguous regions while preserving stable volumetric topology. Experiments on three multi-rater datasets, including LIDC-IDRI, KiTS21, and ISBI 2015, show that VDD improves uncertainty distribution alignment while maintaining competitive segmentation accuracy and 3D structural consistency. These results suggest that prior-anchored residual diffusion can model clinically plausible expert disagreement without sacrificing anatomical fidelity.

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arXiv2026

BiSegMamba: Efficient Bidirectional Tri-Oriented Mamba for 3D Medical Image Segmentation

Accurate 3D medical image segmentation requires both fine spatial detail and long-range volumetric context. Although Mamba provides efficient long-sequence modeling, volumetric formulations remain sensitive to spatial serialization order, repeated multi-orientation processing, and fixed aggregation of orientation-specific representations. We propose BiSegMamba, an efficient bidirectional tri-oriented Mamba framework that follows a compact-to-detail and local-to-global processing strategy. A progressive compacting stem shifts semantic reasoning to compact representations while retaining shallow high-resolution features for reconstruction, and a multi-scale spatial mixer captures local anatomical patterns. For global context modeling, volumetric features are serialized along three anatomical orientations and their reversed directions, the resulting six sequences are processed jointly by a shared Mamba operator, and reconciled using learned channel-wise forward-backward weighting. The restored orientation-specific features are subsequently integrated through input-dependent directional fusion. Experiments on an in-house carotid dataset and ACDC, BraTS2023, and AMOS-CT achieve Dice scores of 96.3%, 91.63%, 92.57%, and 89.03%, respectively. Compared with SegMamba-V2 under standardized $128^3$ profiling, BiSegMamba reduces the parameter count by 65.9% (138.77M$\rightarrow$47.38M) and inference latency by 53.6% (129.08$\rightarrow$59.86 ms), while increasing throughput by 115.7% (7.75$\rightarrow$16.71 samples/s). These results demonstrate a favorable accuracy--efficiency trade-off among volumetric Mamba-based segmentation models.

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arXiv2026

DiCoR: Decoupled Referent Disambiguation and Contour Recalibration for Efficient Referring Remote Sensing Image Segmentation

Referring remote sensing image segmentation (RRSIS) aims to delineate targets specified by natural language expressions in remote sensing imagery. Existing methods mainly follow joint fusion segmentation (JFS) or decoupled prompt segmentation (DPS). JFS is efficient but often suffers from limited accuracy because referent localization and mask delineation are optimized under a unified objective, whereas DPS separates localization from mask generation using spatial prompts and foundation segmenters at the cost of higher memory consumption and inference latency. To bridge this gap, we propose DiCoR, a decoupled referent disambiguation and contour recalibration framework built on an efficient JFS pipeline. DiCoR addresses two key challenges: distinguishing the correct referent from ambiguous candidates and refining coarse masks after localization. A disambiguation-aware localization guidance strategy ranks salient candidate regions with adaptive linguistic cues and injects the resulting localization prior into fused features. A lightweight contour recalibration module further predicts residual corrections to coarse logits under localized contour supervision, improving mask quality with limited computational overhead. Experiments on RefSegRS, RRSIS-D, and RISBench show that DiCoR achieves the best segmentation accuracy across all three benchmarks. On RefSegRS, it improves mIoU and gIoU by 4.90% and 2.16% over a competitive JFS method while running 2.4-6.5 times faster than the evaluated DPS method, demonstrating a favorable accuracy-efficiency trade-off. Code is available at https://github.com/zyGao1126/DiCoR.

cs.CV↗

arXiv2022

Comprehensive Multi-Modal Interactions for Referring Image Segmentation

We investigate Referring Image Segmentation (RIS), which outputs a segmentation map corresponding to the natural language description. Addressing RIS efficiently requires considering the interactions happening across visual and linguistic modalities and the interactions within each modality. Existing methods are limited because they either compute different forms of interactions sequentially (leading to error propagation) or ignore intramodal interactions. We address this limitation by performing all three interactions simultaneously through a Synchronous Multi-Modal Fusion Module (SFM). Moreover, to produce refined segmentation masks, we propose a novel Hierarchical Cross-Modal Aggregation Module (HCAM), where linguistic features facilitate the exchange of contextual information across the visual hierarchy. We present thorough ablation studies and validate our approach's performance on four benchmark datasets, showing considerable performance gains over the existing state-of-the-art (SOTA) methods.

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arXiv2015

Inverse Renormalization Group Transformation in Bayesian Image Segmentations

A new Bayesian image segmentation algorithm is proposed by combining a loopy belief propagation with an inverse real space renormalization group transformation to reduce the computational time. In results of our experiment, we observe that the proposed method can reduce the computational time to less than one-tenth of that taken by conventional Bayesian approaches.

cs.CV↗

arXiv2024

VM-UNET-V2 Rethinking Vision Mamba UNet for Medical Image Segmentation

In the field of medical image segmentation, models based on both CNN and Transformer have been thoroughly investigated. However, CNNs have limited modeling capabilities for long-range dependencies, making it challenging to exploit the semantic information within images fully. On the other hand, the quadratic computational complexity poses a challenge for Transformers. Recently, State Space Models (SSMs), such as Mamba, have been recognized as a promising method. They not only demonstrate superior performance in modeling long-range interactions, but also preserve a linear computational complexity. Inspired by the Mamba architecture, We proposed Vison Mamba-UNetV2, the Visual State Space (VSS) Block is introduced to capture extensive contextual information, the Semantics and Detail Infusion (SDI) is introduced to augment the infusion of low-level and high-level features. We conduct comprehensive experiments on the ISIC17, ISIC18, CVC-300, CVC-ClinicDB, Kvasir, CVC-ColonDB and ETIS-LaribPolypDB public datasets. The results indicate that VM-UNetV2 exhibits competitive performance in medical image segmentation tasks. Our code is available at https://github.com/nobodyplayer1/VM-UNetV2.

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arXiv2026

Efficient Search of Implantable Adaptive Cells for Medical Image Segmentation

Purpose: Adaptive skip modules can improve medical image segmentation, but searching for them is computationally costly. Implantable Adaptive Cells (IACs) are compact NAS modules inserted into U-Net skip connections, reducing the search space compared with full-network NAS. However, the original IAC framework still requires a 200-epoch differentiable search for each backbone and dataset. Methods: We analyzed the temporal behavior of operations and edges within IAC cells during differentiable search on public medical image segmentation benchmarks. We found that operations selected in the final discrete cell typically emerge among the strongest candidates early in training, and their architecture parameters stabilize well before the final epoch. Based on this, we propose a Jensen--Shannon-divergence-based stability criterion that tracks per-edge operation-importance distributions and progressively prunes low-importance operations during search. The accelerated framework is called IAC-LTH. Results: Across four public benchmarks (ACDC, BraTS, KiTS, AMOS), several 2-D U-Net backbones, and a 2-D nnU-Net pipeline, IAC-LTH discovers IAC cells whose patient-level segmentation performance matches and sometimes slightly exceeds that of cells found by the original full-length search, while reducing wall-clock NAS cost by 3.7x to 16x across datasets and backbones. These results are consistent across architectures, benchmarks, and both non-augmented and augmented training settings, while preserving the gains of IAC-equipped U-Nets over strong attention-based and dense-skip baselines. Conclusion: Competitive IAC architectures can be identified from early-stabilizing operations without running the full search, making adaptive skip-module design more practical for medical image segmentation under realistic computational constraints.

cs.CV↗

arXiv2023

Rethinking Semi-Supervised Medical Image Segmentation: A Variance-Reduction Perspective

For medical image segmentation, contrastive learning is the dominant practice to improve the quality of visual representations by contrasting semantically similar and dissimilar pairs of samples. This is enabled by the observation that without accessing ground truth labels, negative examples with truly dissimilar anatomical features, if sampled, can significantly improve the performance. In reality, however, these samples may come from similar anatomical regions and the models may struggle to distinguish the minority tail-class samples, making the tail classes more prone to misclassification, both of which typically lead to model collapse. In this paper, we propose ARCO, a semi-supervised contrastive learning (CL) framework with stratified group theory for medical image segmentation. In particular, we first propose building ARCO through the concept of variance-reduced estimation and show that certain variance-reduction techniques are particularly beneficial in pixel/voxel-level segmentation tasks with extremely limited labels. Furthermore, we theoretically prove these sampling techniques are universal in variance reduction. Finally, we experimentally validate our approaches on eight benchmarks, i.e., five 2D/3D medical and three semantic segmentation datasets, with different label settings, and our methods consistently outperform state-of-the-art semi-supervised methods. Additionally, we augment the CL frameworks with these sampling techniques and demonstrate significant gains over previous methods. We believe our work is an important step towards semi-supervised medical image segmentation by quantifying the limitation of current self-supervision objectives for accomplishing such challenging safety-critical tasks.

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arXiv2019

Mumford-Shah Loss Functional for Image Segmentation with Deep Learning

Recent state-of-the-art image segmentation algorithms are mostly based on deep neural networks, thanks to their high performance and fast computation time. However, these methods are usually trained in a supervised manner, which requires large number of high quality ground-truth segmentation masks. On the other hand, classical image segmentation approaches such as level-set methods are formulated in a self-supervised manner by minimizing energy functions such as Mumford-Shah functional, so they are still useful to help generation of segmentation masks without labels. Unfortunately, these algorithms are usually computationally expensive and often have limitation in semantic segmentation. In this paper, we propose a novel loss function based on Mumford-Shah functional that can be used in deep-learning based image segmentation without or with small labeled data. This loss function is based on the observation that the softmax layer of deep neural networks has striking similarity to the characteristic function in the Mumford-Shah functional. We show that the new loss function enables semi-supervised and unsupervised segmentation. In addition, our loss function can be also used as a regularized function to enhance supervised semantic segmentation algorithms. Experimental results on multiple datasets demonstrate the effectiveness of the proposed method.

cs.CV↗

arXiv2025

SynthFM: Training Modality-agnostic Foundation Models for Medical Image Segmentation without Real Medical Data

Foundation models like the Segment Anything Model (SAM) excel in zero-shot segmentation for natural images but struggle with medical image segmentation due to differences in texture, contrast, and noise. Annotating medical images is costly and requires domain expertise, limiting large-scale annotated data availability. To address this, we propose SynthFM, a synthetic data generation framework that mimics the complexities of medical images, enabling foundation models to adapt without real medical data. Using SAM's pretrained encoder and training the decoder from scratch on SynthFM's dataset, we evaluated our method on 11 anatomical structures across 9 datasets (CT, MRI, and Ultrasound). SynthFM outperformed zero-shot baselines like SAM and MedSAM, achieving superior results under different prompt settings and on out-of-distribution datasets.

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arXiv2010

A Q-Ising model application for linear-time image segmentation

A computational method is presented which efficiently segments digital grayscale images by directly applying the Q-state Ising (or Potts) model. Since the Potts model was first proposed in 1952, physicists have studied lattice models to gain deep insights into magnetism and other disordered systems. For some time, researchers have realized that digital images may be modeled in much the same way as these physical systems (i.e., as a square lattice of numerical values). A major drawback in using Potts model methods for image segmentation is that, with conventional methods, it processes in exponential time. Advances have been made via certain approximations to reduce the segmentation process to power-law time. However, in many applications (such as for sonar imagery), real-time processing requires much greater efficiency. This article contains a description of an energy minimization technique that applies four Potts (Q-Ising) models directly to the image and processes in linear time. The result is analogous to partitioning the system into regions of four classes of magnetism. This direct Potts segmentation technique is demonstrated on photographic, medical, and acoustic images.

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