Due to the high costs associated with collecting large quantities of medical data, base-to-novel few-shot learning has emerged as a critical area in computer-aided medical image analysis. Common approaches leverage a prototype network trained on abundant samples of common diseases (base class), requiring only a small number of samples from rare diseases (novel class) for accurate downstream tasks. Recently, CLIP has demonstrated exceptional capabilities in vision-language representation, particularly excelling in few-shot learning through efficient transfer learning techniques. However, adapting CLIP to medical tasks poses challenges, as conventional adapter methods based on feature projection are suboptimal due to the significant domain gap between medical and natural images. In this paper, we introduce MedDATP, an efficient transfer learning framework designed to adapt CLIP for few-shot medical image classification. To be specific, we first obtain a domain knowledge-enhanced encoder via contrastive learning on base class data. We then adapt this enhanced encoder and CLIP using efficient transfer learning, leveraging the few-shot support set from novel class data. To address substantial disparities in pixel distribution within the visual branch of CLIP, we design a residual domain adapter that introduces a learnable normalization layer for effective distribution mapping. Additionally, we introduce soft task prompts in the language branch to capture task-specific prompts for the medical domain. Extensive experiments on the BreakHis and ISIC2018 Skin Lesion datasets validate the effectiveness of MedDATP.

Pixel-level annotation remains a major bottleneck in medical image segmentation, making weak supervision an attractive yet under-constrained alternative. We propose OBBSeg, an intermediate supervision paradigm guided by Oriented Bounding Boxes (OBBs) that bridges the gap between full and weak supervision. By jointly encoding spatial extent and orientation, OBBs provide compact geometric supervision that better aligns with elongated or anisotropic lesions, reducing the ambiguity of coarse box annotations. To mitigate the inherent rectangular bias of OBBs, we introduce a Mask-to-OBB loss, a differentiable formulation that enforces geometric consistency between predicted masks and OBB regions. Furthermore, we incorporate prompt-driven semantic guidance through two complementary modules-PAFE and DBFE-which enhance foreground representation and suppress background interference. Extensive experiments on 13 datasets across 5 imaging modalities show that OBBSeg not only outperforms existing weakly supervised methods but also achieves performance comparable to fully supervised approaches, demonstrating its potential for efficient and scalable medical image segmentation. The code is available at https://github.com/StarLxc3/OBBSeg.

Pixel-level annotations for medical image segmentation are costly and labor-intensive, often requiring expert knowledge. Bounding box labels provide a more scalable alternative but introduce strong box-shaped bias that hampers segmentation quality. We propose WeakMed, a general-purpose weakly supervised segmentation framework that removes the dependence on pixel-level masks while overcoming the structural limitations of box supervision. WeakMed introduces two lightweight, plug-and-play training components: (1) a Mask-to-Box (M2B) transformation that aligns predicted masks with box annotations to reduce label mismatch and box-induced bias, and (2) a Scale Consistency (SC) loss that enforces multi-scale self-supervision to address the ambiguity and instability of weak labels. Both modules are used only during training and impose no inference overhead. Across 9 segmentation tasks, 10 datasets, and 6 imaging modalities, WeakMed consistently surpasses existing weakly supervised methods and achieves performance competitive with fully supervised baselines. These results demonstrate its practicality as a low-cost yet high-quality solution for medical image segmentation. Codes will be released.

Existing polyp segmentation models are limited by high labeling costs and the small size of datasets. Additionally, vast polyp datasets remain underutilized because these models typically rely on a single type of annotation. To address this dilemma, we introduce MARIO, a mixed supervision model designed to accommodate various annotation types, significantly expanding the range of usable data. MARIO learns from underutilized datasets by incorporating five forms of supervision: pixel-level, box-level, polygon-level, scribblelevel, and point-level. Each form of supervision is associated with a tailored loss that effectively leverages the supervision labels while minimizing the noise. This allows MARIO to move beyond the constraints of relying on a single annotation type. Furthermore, MARIO primarily utilizes dataset with weak and cheap annotations, reducing the dependence on large-scale, fully annotated ones. Experimental results across five benchmark datasets demonstrate that MARIO consistently outperforms existing methods, highlighting its efficacy in balancing trade-offs between different forms of supervision and maximizing polyp segmentation performance

The rapid adoption of Artificial Intelligence (AI) in medical imaging raises fairness and privacy concerns across demographic groups, especially in diagnosis and treatment decisions. While federated learning (FL) offers decentralized privacy preservation, current frameworks often prioritize collaboration fairness over group fairness, risking healthcare disparities. Here we present FlexFair, an innovative FL framework designed to address both fairness and privacy challenges. FlexFair incorporates a flexible regularization term to facilitate the integration of multiple fairness criteria, including equal accuracy, demographic parity, and equal opportunity. Evaluated across four clinical applications (polyp segmentation, fundus vascular segmentation, cervical cancer segmentation, and skin disease diagnosis), FlexFair outperforms state-of-the-art methods in both fairness and accuracy. Moreover, we curate a multi-center dataset for cervical cancer segmentation that includes 678 patients from four hospitals. This diverse dataset allows for a more comprehensive analysis of model performance across different population groups, ensuring the findings are applicable to a broader range of patients.

Semantic communication has emerged as a promising technology for enhancing communication efficiency. However, most existing research emphasizes single-task reconstruction, neglecting model adaptability and generalization across multi-task systems. In this paper, we propose a novel generative semantic communication system that supports both image reconstruction and segmentation tasks. Our approach builds upon semantic knowledge bases (KBs) at both the transmitter and receiver, with each semantic KB comprising a source KB and a task KB. The source KB at the transmitter leverages a hierarchical Swin-Transformer, a generative AI scheme, to extract multi-level features from the input image. Concurrently, the counterpart source KB at the receiver utilizes hierarchical residual blocks to generate task-specific knowledge. Furthermore, the task KBs adopt a semantic similarity model to map different task requirements into pre-defined task instructions, thereby facilitating the feature selection of the source KBs. Additionally, we develop a unified residual block-based joint source and channel (JSCC) encoder and two task-specific JSCC decoders to achieve the two image tasks. In particular, a generative diffusion model is adopted to construct the JSCC decoder for the image reconstruction task. Experimental results show that our multi-task generative semantic communication system outperforms previous single-task communication systems in terms of peak signal-to-noise ratio and segmentation accuracy.

Ultrasound imaging is widely used in clinical diagnosis due to its non-invasive nature and real-time capabilities. However, traditional ultrasound diagnostics relies heavily on physician expertise and is often hampered by suboptimal image quality, leading to potential diagnostic errors. While artificial intelligence (AI) offers a promising solution to enhance clinical diagnosis by detecting abnormalities across various imaging modalities, existing AI methods for ultrasound face two major challenges. First, they typically require vast amounts of labeled medical data, raising serious concerns regarding patient privacy. Second, most models are designed for specific tasks, which restricts their broader clinical utility. To overcome these challenges, we present UltraFedFM, an innovative privacy-preserving ultrasound foundation model. UltraFedFM is collaboratively pre-trained using federated learning across 16 distributed medical institutions in 9 countries, leveraging a dataset of over 1 million ultrasound images covering 19 organs and 10 ultrasound modalities. This extensive and diverse data, combined with a secure training framework, enables UltraFedFM to exhibit strong generalization and diagnostic capabilities. It achieves an average area under the receiver operating characteristic curve (AUROC) of 0.927 for disease diagnosis and a dice similarity coefficient (DSC) of 0.878 for lesion segmentation. Notably, UltraFedFM surpasses the diagnostic accuracy of mid-level ultrasonographers (4-8 years of experience) and matches the performance of expert-level sonographers (10+ years of experience) in the joint diagnosis of 8 common systemic diseases.c These findings indicate that UltraFedFM can significantly enhance clinical diagnostics while safeguarding patient privacy, marking a significant advancement in AI-driven ultrasound imaging for future clinical applications.

Endorectal ultrasound (ERUS) is an important imaging modality that provides high reliability for diagnosing the depth and boundary of invasion in colorectal cancer. However, the lack of a large-scale ERUS dataset with high-quality annotations hinders the development of automatic ultrasound diagnostics. In this paper, we collected and annotated the first benchmark dataset that covers diverse ERUS scenarios, i.e. colorectal cancer segmentation, detection, and infiltration depth staging. Our ERUS-10K dataset comprises 77 videos and 10,000 high-resolution annotated frames. Based on this dataset, we further introduce a benchmark model for colorectal cancer segmentation, named the Adaptive Sparse-context TRansformer (ASTR). ASTR is designed based on three considerations: scanning mode discrepancy, temporal information, and low computational complexity. For generalizing to different scanning modes, the adaptive scanning-mode augmentation is proposed to convert between raw sector images and linear scan ones. For mining temporal information, the sparse-context transformer is incorporated to integrate inter-frame local and global features. For reducing computational complexity, the sparse-context block is introduced to extract contextual features from auxiliary frames. Finally, on the benchmark dataset, the proposed ASTR model achieves a 77.6% Dice score in rectal cancer segmentation, largely outperforming previous state-of-the-art methods.

Point cloud salient object detection (PCSOD) is a newly proposed task in 3D dense segmentation. However, the acquisition of accurate 3D dense annotations comes at a high cost, severely limiting the progress of PCSOD. To address this issue, we propose the first weakly supervised PCSOD (named WeakPCSOD) model, which relies solely on cheap 3D bounding box annotations. In WeakPCSOD, we extract noise-free supervision from coarse 3D bounding boxes while mitigating shape biases inherent in box annotations. To achieve this, we introduce a novel mask-to-box (M2B) transformation and a color consistency (CC) loss. The M2B transformation, from a shape perspective, disentangles predictions from labels, enabling the extraction of noiseless supervision from labels while preserving object shapes independently of the box bias. From an appearance perspective, we further introduce the CC loss to provide dense supervision, which mitigates the non-unique predictions stemming from weak supervision and substantially reduces prediction variability. Furthermore, we employ a self-training (ST) strategy to enhance performance by utilizing high-confidence pseudo labels. Notably, the M2B transformation, CC loss, and ST strategy are seamlessly integrated into any model and incur no computational costs for inference. Extensive experiments demonstrate the effectiveness of our WeakPCSOD model, even comparable to fully supervised models utilizing dense annotations.

AI-assisted lesion detection models play a crucial role in the early screening of cancer. However, previous image-based models ignore the inter-frame contextual information present in videos. On the other hand, video-based models capture the inter-frame context but are computationally expensive. To mitigate this contradiction, we delve into Video-to-Image knowledge distillation leveraging DEtection TRansformer (V2I-DETR) for the task of medical video lesion detection. V2I-DETR adopts a teacher-student network paradigm. The teacher network aims at extracting temporal contexts from multiple frames and transferring them to the student network, and the student network is an image-based model dedicated to fast prediction in inference. By distilling multi-frame contexts into a single frame, the proposed V2I-DETR combines the advantages of utilizing temporal contexts from video-based models and the inference speed of image-based models. Through extensive experiments, V2I-DETR outperforms previous state-of-the-art methods by a large margin while achieving the real-time inference speed (30 FPS) as the image-based model.

Limited by the expensive labeling, polyp segmentation models are plagued by data shortages. To tackle this, we propose the mixed supervised polyp segmentation paradigm (MixPolyp). Unlike traditional models relying on a single type of annotation, MixPolyp combines diverse annotation types (mask, box, and scribble) within a single model, thereby expanding the range of available data and reducing labeling costs. To achieve this, MixPolyp introduces three novel supervision losses to handle various annotations: Subspace Projection loss (LSP), Binary Minimum Entropy loss (LBME), and Linear Regularization loss (LLR). For box annotations, LSP eliminates shape inconsistencies between the prediction and the supervision. For scribble annotations, LBME provides supervision for unlabeled pixels through minimum entropy constraint, thereby alleviating supervision sparsity. Furthermore, LLR provides dense supervision by enforcing consistency among the predictions, thus reducing the non-uniqueness. These losses are independent of the model structure, making them generally applicable. They are used only during training, adding no computational cost during inference. Extensive experiments on five datasets demonstrate MixPolyp's effectiveness.

Automatic polyp segmentation models play a pivotal role in the clinical diagnosis of gastrointestinal diseases. In previous studies, most methods relied on fully supervised approaches, necessitating pixel-level annotations for model training. However, the creation of pixel-level annotations is both expensive and time-consuming, impeding the development of model generalization. In response to this challenge, we introduce ScribblePolyp, a novel scribble-supervised polyp segmentation framework. Unlike fully-supervised models, ScribblePolyp only requires the annotation of two lines (scribble labels) for each image, significantly reducing the labeling cost. Despite the coarse nature of scribble labels, which leave a substantial portion of pixels unlabeled, we propose a two-branch consistency alignment approach to provide supervision for these unlabeled pixels. The first branch employs transformation consistency alignment to narrow the gap between predictions under different transformations of the same input image. The second branch leverages affinity propagation to refine predictions into a soft version, extending additional supervision to unlabeled pixels. In summary, ScribblePolyp is an efficient model that does not rely on teacher models or moving average pseudo labels during training. Extensive experiments on the SUN-SEG dataset underscore the effectiveness of ScribblePolyp, achieving a Dice score of 0.8155, with the potential for a 1.8% improvement in the Dice score through a straightforward self-training strategy.

Limited by expensive pixel-level labels, polyp segmentation models are plagued by data shortage and suffer from impaired generalization. In contrast, polyp bounding box annotations are much cheaper and more accessible. Thus, to reduce labeling cost, we propose to learn a weakly supervised polyp segmentation model (i.e., WeakPolyp) completely based on bounding box annotations. However, coarse bounding boxes contain too much noise. To avoid interference, we introduce the mask-to-box (M2B) transformation. By supervising the outer box mask of the prediction instead of the prediction itself, M2B greatly mitigates the mismatch between the coarse label and the precise prediction. But, M2B only provides sparse supervision, leading to non-unique predictions. Therefore, we further propose a scale consistency (SC) loss for dense supervision. By explicitly aligning predictions across the same image at different scales, the SC loss largely reduces the variation of predictions. Note that our WeakPolyp is a plug-and-play model, which can be easily ported to other appealing backbones. Besides, the proposed modules are only used during training, bringing no computation cost to inference. Extensive experiments demonstrate the effectiveness of our proposed WeakPolyp, which surprisingly achieves a comparable performance with a fully supervised model, requiring no mask annotations at all.

MOTIVATION:Protein secondary structure prediction (PSSP) is one of the fundamental and challenging problems in the field of computational biology. Accurate PSSP relies on sufficient homologous protein sequences to build the multiple sequence alignment (MSA). Unfortunately, many proteins lack homologous sequences, which results in the low quality of MSA and poor performance. In this article, we propose the novel dynamic scoring matrix (DSM)-Distil to tackle this issue, which takes advantage of the pretrained BERT and exploits the knowledge distillation on the newly designed DSM features. Specifically, we propose the DSM to replace the widely used profile and PSSM (position-specific scoring matrix) features. DSM could automatically dig for the suitable feature for each residue, based on the original profile. Namely, DSM-Distil not only could adapt to the low homologous proteins but also is compatible with high homologous ones. Thanks to the dynamic property, DSM could adapt to the input data much better and achieve higher performance. Moreover, to compensate for low-quality MSA, we propose to generate the pseudo-DSM from a pretrained BERT model and aggregate it with the original DSM by adaptive residue-wise fusion, which helps to build richer and more complete input features. In addition, we propose to supervise the learning of low-quality DSM features using high-quality ones. To achieve this, a novel teacher-student model is designed to distill the knowledge from proteins with high homologous sequences to that of low ones. Combining all the proposed methods, our model achieves the new state-of-the-art performance for low homologous proteins. RESULTS:Compared with the previous state-of-the-art method 'Bagging', DSM-Distil achieves an improvement about 5% and 7.3% improvement for proteins with MSA count ≤30 and extremely low homologous cases, respectively. We also compare DSM-Distil with Alphafold2 which is a state-of-the-art framework for protein structure prediction. DSM-Distil outperforms Alphafold2 by 4.1% on extremely low-quality MSA on 8-state secondary structure prediction. Moreover, we release a large-scale up-to-date test dataset BC40 for low-quality MSA structure prediction evaluation. AVAILABILITY AND IMPLEMENTATION:BC40 dataset: https://drive.google.com/drive/folders/15vwRoOjAkhhwfjDk6-YoKGf4JzZXIMC. HardCase dataset: https://drive.google.com/drive/folders/1BvduOr2b7cObUHy6GuEWk-aUkKJgzTUv. Code: https://github.com/qinwang-ai/DSM-Distil.

Weakly supervised object localization (WSOL) aims at detecting objects through only image-level labels. Class activation maps (CAMs) are the commonly used features for WSOL. However, existing CAM-based methods tend to excessively pursue discriminative features for object recognition and hence ignore the feature similarities among different categories, thereby leading to CAMs incomplete for object localization. In addition, CAMs are sensitive to background noise due to over-dependence on the holistic classification. In this paper, we propose a simple but effective WSOL model (named ISIC) through Inter-class feature Similarity and Intra-class appearance Consistency. In practice, our ISIC model first proposes the inter-class feature similarity (ICFS) loss against the original cross entropy loss. Such an ICFS loss sufficiently leverages the shared features together with the discriminative features between different categories, which significantly reduces the model over-fitting risk to background noise and brings more complete object masks. Besides, instead of CAMs, a non-negative matrix factorization mask module is applied to extract object masks from multiple intraclass images. Thanks to intra-class appearance consistency, the achieved pseudo masks are more complete and robust. As a result, extensive experiments confirm that our ISIC model achieves state-of-the-art on both CUB-200 and ImageNet-1K benchmarks i.e., 97.3% and 70.0% GTKnown localization accuracy, respectively.

Accurate polyp segmentation is of great importance for colorectal cancer diagnosis and treatment. However, due to the high cost of producing accurate mask annotations, existing polyp segmentation methods suffer from severe data shortage and impaired model generalization. Reversely, coarse polyp bounding box annotations are more accessible. Thus, in this paper, we propose a boosted BoxPolyp model to make full use of both accurate mask and extra coarse box annotations. In practice, box annotations are applied to alleviate the over-fitting issue of previous polyp segmentation models, which generate fine-grained polyp area through the iterative boosted segmentation model. To achieve this goal, a fusion filter sampling (FFS) module is firstly proposed to generate pixel-wise pseudo labels from box annotations with less noise, leading to significant performance improvements. Besides, considering the appearance consistency of the same polyp, an image consistency (IC) loss is designed. Such IC loss explicitly narrows the distance between features extracted by two different networks, which improves the robustness of the model. Note that our BoxPolyp is a plug-and-play model, which can be merged into any appealing backbone. Quantitative and qualitative experimental results on five challenging benchmarks confirm that our proposed model outperforms previous state-of-the-art methods by a large margin.

Protein secondary structure prediction (PSSP) is essential for protein function analysis. However, for low homologous proteins, the PSSP suffers from insufficient input features. In this paper, we explicitly import external self-supervised knowledge for low homologous PSSP under the guidance of residue-wise (amino acid wise) profile fusion. In practice, we firstly demonstrate the superiority of profile over Position-Specific Scoring Matrix (PSSM) for low homologous PSSP. Based on this observation, we introduce the novel self-supervised BERT features as the pseudo profile, which implicitly involves the residue distribution in all native discovered sequences as the complementary features. Furthermore, a novel residue-wise attention is specially designed to adaptively fuse different features (i.e., original low-quality profile, BERT based pseudo profile), which not only takes full advantage of each feature but also avoids noise disturbance. Besides, the feature consistency loss is proposed to accelerate the model learning from multiple semantic levels. Extensive experiments confirm that our method outperforms state-of-the-arts (i.e., 4.7% for extremely low homologous cases on BC40 dataset).

Accurate polyp segmentation is of great importance for colorectal cancer diagnosis. However, even with a powerful deep neural network, there still exists three big challenges that impede the development of polyp segmentation. (i) Samples collected under different conditions show inconsistent colors, causing the feature distribution gap and overfitting issue; (ii) Due to repeated feature downsampling, small polyps are easily degraded; (iii) Foreground and background pixels are imbalanced, leading to a biased training. To address the above issues, we propose the Shallow Attention Network (SANet) for polyp segmentation. Specifically, to eliminate the effects of color, we design the color exchange operation to decouple the image contents and colors, and force the model to focus more on the target shape and structure. Furthermore, to enhance the segmentation quality of small polyps, we propose the shallow attention module to filter out the background noise of shallow features. Thanks to the high resolution of shallow features, small polyps can be preserved correctly. In addition, to ease the severe pixel imbalance for small polyps, we propose a probability correction strategy (PCS) during the inference phase. Note that even though PCS is not involved in the training phase, it can still work well on a biased model and consistently improve the segmentation performance. Quantitative and qualitative experimental results on five challenging benchmarks confirm that our proposed SANet outperforms previous state-of-the-art methods by a large margin and achieves a speed about 72FPS.

Weakly supervised object localization (WSOL) aims to localize objects by only utilizing image-level labels. Class activation maps (CAMs) are the commonly used features to achieve WSOL. However, previous CAM-based methods did not take full advantage of the shallow features, despite their importance for WSOL. Because shallow features are easily buried in background noise through conventional fusion. In this paper, we propose a simple but effective Shallow feature-aware Pseudo supervised Object Localization (SPOL) model for accurate WSOL, which makes the utmost of low-level features embedded in shallow layers. In practice, our SPOL model first generates the CAMs through a novel element-wise multiplication of shallow and deep feature maps, which filters the background noise and generates sharper boundaries robustly. Besides, we further propose a general class-agnostic segmentation model to achieve the accurate object mask, by only using the initial CAMs as the pseudo label without any extra annotation. Eventually, a bounding box extractor is applied to the object mask to locate the target. Experiments verify that our SPOL outperforms the state-of-the-art on both CUB- 200 and ImageNet-1K benchmarks, achieving 93.44% and 67.15% (i.e., 3.93% and 2.13% improvement) Top-5 localization accuracy, respectively.

Most of existing salient object detection models have achieved great progress by aggregating multi-level features extracted from convolutional neural networks. However, because of the different receptive fields of different convolutional layers, there exists big differences between features generated by these layers. Common feature fusion strategies (addition or concatenation) ignore these differences and may cause suboptimal solutions. In this paper, we propose the F3Net to solve above problem, which mainly consists of cross feature module (CFM) and cascaded feedback decoder (CFD) trained by minimizing a new pixel position aware loss (PPA). Specifically, CFM aims to selectively aggregate multi-level features. Different from addition and concatenation, CFM adaptively selects complementary components from input features before fusion, which can effectively avoid introducing too much redundant information that may destroy the original features. Besides, CFD adopts a multi-stage feedback mechanism, where features closed to supervision will be introduced to the output of previous layers to supplement them and eliminate the differences between features. These refined features will go through multiple similar iterations before generating the final saliency maps. Furthermore, different from binary cross entropy, the proposed PPA loss doesn't treat pixels equally, which can synthesize the local structure information of a pixel to guide the network to focus more on local details. Hard pixels from boundaries or error-prone parts will be given more attention to emphasize their importance. F3Net is able to segment salient object regions accurately and provide clear local details. Comprehensive experiments on five benchmark datasets demonstrate that F3Net outperforms state-of-the-art approaches on six evaluation metrics. Code will be released at https://github.com/weijun88/F3Net.