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Feb 3

RAIL: Region-Aware Instructive Learning for Semi-Supervised Tooth Segmentation in CBCT

Semi-supervised learning has become a compelling approach for 3D tooth segmentation from CBCT scans, where labeled data is minimal. However, existing methods still face two persistent challenges: limited corrective supervision in structurally ambiguous or mislabeled regions during supervised training and performance degradation caused by unreliable pseudo-labels on unlabeled data. To address these problems, we propose Region-Aware Instructive Learning (RAIL), a dual-group dual-student, semi-supervised framework. Each group contains two student models guided by a shared teacher network. By alternating training between the two groups, RAIL promotes intergroup knowledge transfer and collaborative region-aware instruction while reducing overfitting to the characteristics of any single model. Specifically, RAIL introduces two instructive mechanisms. Disagreement-Focused Supervision (DFS) Controller improves supervised learning by instructing predictions only within areas where student outputs diverge from both ground truth and the best student, thereby concentrating supervision on structurally ambiguous or mislabeled areas. In the unsupervised phase, Confidence-Aware Learning (CAL) Modulator reinforces agreement in regions with high model certainty while reducing the effect of low-confidence predictions during training. This helps prevent our model from learning unstable patterns and improves the overall reliability of pseudo-labels. Extensive experiments on four CBCT tooth segmentation datasets show that RAIL surpasses state-of-the-art methods under limited annotation. Our code will be available at https://github.com/Tournesol-Saturday/RAIL.

  • 7 authors
·
May 6, 2025 1

FerKD: Surgical Label Adaptation for Efficient Distillation

We present FerKD, a novel efficient knowledge distillation framework that incorporates partial soft-hard label adaptation coupled with a region-calibration mechanism. Our approach stems from the observation and intuition that standard data augmentations, such as RandomResizedCrop, tend to transform inputs into diverse conditions: easy positives, hard positives, or hard negatives. In traditional distillation frameworks, these transformed samples are utilized equally through their predictive probabilities derived from pretrained teacher models. However, merely relying on prediction values from a pretrained teacher, a common practice in prior studies, neglects the reliability of these soft label predictions. To address this, we propose a new scheme that calibrates the less-confident regions to be the context using softened hard groundtruth labels. Our approach involves the processes of hard regions mining + calibration. We demonstrate empirically that this method can dramatically improve the convergence speed and final accuracy. Additionally, we find that a consistent mixing strategy can stabilize the distributions of soft supervision, taking advantage of the soft labels. As a result, we introduce a stabilized SelfMix augmentation that weakens the variation of the mixed images and corresponding soft labels through mixing similar regions within the same image. FerKD is an intuitive and well-designed learning system that eliminates several heuristics and hyperparameters in former FKD solution. More importantly, it achieves remarkable improvement on ImageNet-1K and downstream tasks. For instance, FerKD achieves 81.2% on ImageNet-1K with ResNet-50, outperforming FKD and FunMatch by remarkable margins. Leveraging better pre-trained weights and larger architectures, our finetuned ViT-G14 even achieves 89.9%. Our code is available at https://github.com/szq0214/FKD/tree/main/FerKD.

  • 1 authors
·
Dec 29, 2023

V-Warper: Appearance-Consistent Video Diffusion Personalization via Value Warping

Video personalization aims to generate videos that faithfully reflect a user-provided subject while following a text prompt. However, existing approaches often rely on heavy video-based finetuning or large-scale video datasets, which impose substantial computational cost and are difficult to scale. Furthermore, they still struggle to maintain fine-grained appearance consistency across frames. To address these limitations, we introduce V-Warper, a training-free coarse-to-fine personalization framework for transformer-based video diffusion models. The framework enhances fine-grained identity fidelity without requiring any additional video training. (1) A lightweight coarse appearance adaptation stage leverages only a small set of reference images, which are already required for the task. This step encodes global subject identity through image-only LoRA and subject-embedding adaptation. (2) A inference-time fine appearance injection stage refines visual fidelity by computing semantic correspondences from RoPE-free mid-layer query--key features. These correspondences guide the warping of appearance-rich value representations into semantically aligned regions of the generation process, with masking ensuring spatial reliability. V-Warper significantly improves appearance fidelity while preserving prompt alignment and motion dynamics, and it achieves these gains efficiently without large-scale video finetuning.

  • 7 authors
·
Dec 13, 2025

Seeing Isn't Always Believing: Analysis of Grad-CAM Faithfulness and Localization Reliability in Lung Cancer CT Classification

Explainable Artificial Intelligence (XAI) techniques, such as Gradient-weighted Class Activation Mapping (Grad-CAM), have become indispensable for visualizing the reasoning process of deep neural networks in medical image analysis. Despite their popularity, the faithfulness and reliability of these heatmap-based explanations remain under scrutiny. This study critically investigates whether Grad-CAM truly represents the internal decision-making of deep models trained for lung cancer image classification. Using the publicly available IQ-OTH/NCCD dataset, we evaluate five representative architectures: ResNet-50, ResNet-101, DenseNet-161, EfficientNet-B0, and ViT-Base-Patch16-224, to explore model-dependent variations in Grad-CAM interpretability. We introduce a quantitative evaluation framework that combines localization accuracy, perturbation-based faithfulness, and explanation consistency to assess Grad-CAM reliability across architectures. Experimental findings reveal that while Grad-CAM effectively highlights salient tumor regions in most convolutional networks, its interpretive fidelity significantly degrades for Vision Transformer models due to non-local attention behavior. Furthermore, cross-model comparisons indicate substantial variability in saliency localization, implying that Grad-CAM explanations may not always correspond to the true diagnostic evidence used by the networks. This work exposes critical limitations of current saliency-based XAI approaches in medical imaging and emphasizes the need for model-aware interpretability methods that are both computationally sound and clinically meaningful. Our findings aim to inspire a more cautious and rigorous adoption of visual explanation tools in medical AI, urging the community to rethink what it truly means to "trust" a model's explanation.

  • 1 authors
·
Jan 19

RegionE: Adaptive Region-Aware Generation for Efficient Image Editing

Recently, instruction-based image editing (IIE) has received widespread attention. In practice, IIE often modifies only specific regions of an image, while the remaining areas largely remain unchanged. Although these two types of regions differ significantly in generation difficulty and computational redundancy, existing IIE models do not account for this distinction, instead applying a uniform generation process across the entire image. This motivates us to propose RegionE, an adaptive, region-aware generation framework that accelerates IIE tasks without additional training. Specifically, the RegionE framework consists of three main components: 1) Adaptive Region Partition. We observed that the trajectory of unedited regions is straight, allowing for multi-step denoised predictions to be inferred in a single step. Therefore, in the early denoising stages, we partition the image into edited and unedited regions based on the difference between the final estimated result and the reference image. 2) Region-Aware Generation. After distinguishing the regions, we replace multi-step denoising with one-step prediction for unedited areas. For edited regions, the trajectory is curved, requiring local iterative denoising. To improve the efficiency and quality of local iterative generation, we propose the Region-Instruction KV Cache, which reduces computational cost while incorporating global information. 3) Adaptive Velocity Decay Cache. Observing that adjacent timesteps in edited regions exhibit strong velocity similarity, we further propose an adaptive velocity decay cache to accelerate the local denoising process. We applied RegionE to state-of-the-art IIE base models, including Step1X-Edit, FLUX.1 Kontext, and Qwen-Image-Edit. RegionE achieved acceleration factors of 2.57, 2.41, and 2.06. Evaluations by GPT-4o confirmed that semantic and perceptual fidelity were well preserved.

  • 10 authors
·
Oct 29, 2025 1

Segmentation variability and radiomics stability for predicting Triple-Negative Breast Cancer subtype using Magnetic Resonance Imaging

Most papers caution against using predictive models for disease stratification based on unselected radiomic features, as these features are affected by contouring variability. Instead, they advocate for the use of the Intraclass Correlation Coefficient (ICC) as a measure of stability for feature selection. However, the direct effect of segmentation variability on the predictive models is rarely studied. This study investigates the impact of segmentation variability on feature stability and predictive performance in radiomics-based prediction of Triple-Negative Breast Cancer (TNBC) subtype using Magnetic Resonance Imaging. A total of 244 images from the Duke dataset were used, with segmentation variability introduced through modifications of manual segmentations. For each mask, explainable radiomic features were selected using the Shapley Additive exPlanations method and used to train logistic regression models. Feature stability across segmentations was assessed via ICC, Pearson's correlation, and reliability scores quantifying the relationship between feature stability and segmentation variability. Results indicate that segmentation accuracy does not significantly impact predictive performance. While incorporating peritumoral information may reduce feature reproducibility, it does not diminish feature predictive capability. Moreover, feature selection in predictive models is not inherently tied to feature stability with respect to segmentation, suggesting that an overreliance on ICC or reliability scores for feature selection might exclude valuable predictive features.

  • 7 authors
·
Apr 2, 2025

Offline Guarded Safe Reinforcement Learning for Medical Treatment Optimization Strategies

When applying offline reinforcement learning (RL) in healthcare scenarios, the out-of-distribution (OOD) issues pose significant risks, as inappropriate generalization beyond clinical expertise can result in potentially harmful recommendations. While existing methods like conservative Q-learning (CQL) attempt to address the OOD issue, their effectiveness is limited by only constraining action selection by suppressing uncertain actions. This action-only regularization imitates clinician actions that prioritize short-term rewards, but it fails to regulate downstream state trajectories, thereby limiting the discovery of improved long-term treatment strategies. To safely improve policy beyond clinician recommendations while ensuring that state-action trajectories remain in-distribution, we propose Offline Guarded Safe Reinforcement Learning (OGSRL), a theoretically grounded model-based offline RL framework. OGSRL introduces a novel dual constraint mechanism for improving policy with reliability and safety. First, the OOD guardian is established to specify clinically validated regions for safe policy exploration. By constraining optimization within these regions, it enables the reliable exploration of treatment strategies that outperform clinician behavior by leveraging the full patient state history, without drifting into unsupported state-action trajectories. Second, we introduce a safety cost constraint that encodes medical knowledge about physiological safety boundaries, providing domain-specific safeguards even in areas where training data might contain potentially unsafe interventions. Notably, we provide theoretical guarantees on safety and near-optimality: policies that satisfy these constraints remain in safe and reliable regions and achieve performance close to the best possible policy supported by the data.

  • 6 authors
·
May 22, 2025

MedRegion-CT: Region-Focused Multimodal LLM for Comprehensive 3D CT Report Generation

The recent release of RadGenome-Chest CT has significantly advanced CT-based report generation. However, existing methods primarily focus on global features, making it challenging to capture region-specific details, which may cause certain abnormalities to go unnoticed. To address this, we propose MedRegion-CT, a region-focused Multi-Modal Large Language Model (MLLM) framework, featuring three key innovations. First, we introduce Region Representative (R^2) Token Pooling, which utilizes a 2D-wise pretrained vision model to efficiently extract 3D CT features. This approach generates global tokens representing overall slice features and region tokens highlighting target areas, enabling the MLLM to process comprehensive information effectively. Second, a universal segmentation model generates pseudo-masks, which are then processed by a mask encoder to extract region-centric features. This allows the MLLM to focus on clinically relevant regions, using six predefined region masks. Third, we leverage segmentation results to extract patient-specific attributions, including organ size, diameter, and locations. These are converted into text prompts, enriching the MLLM's understanding of patient-specific contexts. To ensure rigorous evaluation, we conducted benchmark experiments on report generation using the RadGenome-Chest CT. MedRegion-CT achieved state-of-the-art performance, outperforming existing methods in natural language generation quality and clinical relevance while maintaining interpretability. The code for our framework is publicly available.

  • 10 authors
·
Jun 29, 2025

Region Attention Transformer for Medical Image Restoration

Transformer-based methods have demonstrated impressive results in medical image restoration, attributed to the multi-head self-attention (MSA) mechanism in the spatial dimension. However, the majority of existing Transformers conduct attention within fixed and coarsely partitioned regions (e.g. the entire image or fixed patches), resulting in interference from irrelevant regions and fragmentation of continuous image content. To overcome these challenges, we introduce a novel Region Attention Transformer (RAT) that utilizes a region-based multi-head self-attention mechanism (R-MSA). The R-MSA dynamically partitions the input image into non-overlapping semantic regions using the robust Segment Anything Model (SAM) and then performs self-attention within these regions. This region partitioning is more flexible and interpretable, ensuring that only pixels from similar semantic regions complement each other, thereby eliminating interference from irrelevant regions. Moreover, we introduce a focal region loss to guide our model to adaptively focus on recovering high-difficulty regions. Extensive experiments demonstrate the effectiveness of RAT in various medical image restoration tasks, including PET image synthesis, CT image denoising, and pathological image super-resolution. Code is available at https://github.com/Yaziwel/Region-Attention-Transformer-for-Medical-Image-Restoration.git{https://github.com/RAT}.

  • 8 authors
·
Jul 12, 2024