Decoupling Language Guidance from Backbones for Text-Guided Medical Segmentation

Text-guided medical image segmentation leverages clinical semantics to improve lesion delineation, yet many existing models bind cross-modal fusion, supervision, and decoder design into a task-specific architecture. Such tight coupling makes it difficult to reuse language guidance modules across heterogeneous vision and text backbones, and often requires redesigning the network when the encoder pair changes. This paper presents BTHA, a backbone-transferable hierarchical adapter framework for text-guided medical image segmentation. BTHA is built around a stable feature-level interface: given multi-scale visual features and a text representation, it injects semantic guidance through shape-preserving adapters while maintaining the decoder-side tensor contract. To make this interface effective, we introduce a Hierarchical Coarse-to-Fine Supervision Strategy that decomposes learning into global image-text alignment, multi-scale auxiliary localization, and boundary-aware final mask refinement. We further design a Scale-Adaptive Gated Semantic Guidance (SAGSG) adapter, where resolution-specific gates adaptively control textual injection and channel recalibration suppresses redundant cross-modal responses. Evaluations across diverse vision and text backbones show that the same adapter and supervision design remains effective across convolutional and transformer-based visual encoders as well as different language encoders. Experiments on four public datasets further demonstrate that BTHA improves strong text-guided baselines with modest computational overhead.

Learning to Unify Deformable Shape and Texture Representations for Cardiac Video Classification

Deformable shape representations have proven to be robust complements to texture features in cardiac image classification, offering geometric priors that are invariant to imaging artifacts and intensity variations. However, existing deep networks perform simple concatenation to combine these distinct feature representations, which neither fully exploits their complementary nature nor learns cross-modal feature dependencies. Furthermore, this results in uniform attention across all timepoints; hence ignoring the varying diagnostic importance across the cardiac phases. In this paper, we propose a novel cardiac video classification model that, for the first time, learns temporal features in an integrated space of deformable shape and image texture representations. In particular, we design a bi-directional cross-attention in the latent space to fuse latent deformable shape and image features, allowing each modality to adaptively weight the other based on spatio-temporal correspondence. In contrast to current methods that apply uniform weighting across all the cardiac phases, our approach learns to dynamically adjust the contributions of shape and texture representations, derived from images, over time. We demonstrate state-of-the-art classification performance on a cine cardiac magnetic resonance (CMR) video dataset, achieving improved interpretability from attention mechanisms that identify diagnostically critical cardiac phases and modality contributions.

Cross-Modal Fusion of OCT and OCT angiography enface for Improved Diagnostics of Diabetic Retinopathy

Diabetic retinopathy (DR) is a leading cause of vision impairment worldwide, highlighting the need for accurate and accessible screening tools. Optical Coherence Tomography (OCT) provides high-resolution structural information of the retina, whereas OCT angiography (OCTA) offers complementary vascular information that is highly relevant for DR diagnosis. In this study, we propose a cross-modal fusion of OCT B-scans with single-channel en face OCTA using a bidirectional cross-modal attention network for automated DR classification. Two independent datasets, OCT500 and UIC, comprising 730 subjects in total, were utilized to evaluate performance under within-dataset, combined-dataset, and cross-dataset generalization settings. A ConvNeXt V2 model trained solely on OCT images served as the unimodal baseline. In addition to ground-truth (GT) OCTA, we explored the use of translated (TR) OCTA generated from OCT scans, eliminating the requirement for dedicated OCTA hardware. Experimental results demonstrate that cross-modal fusion consistently outperforms unimodal OCT classification across all evaluation scenarios. Fusion with GT OCTA improved classification accuracy and discriminative performance, while TR OCTA achieved comparable or superior results in most settings. Furthermore, TR OCTA improved sensitivity and cross-dataset generalization, indicating enhanced robustness to domain shifts. These findings demonstrate that attention-based OCT-OCTA en face fusion provides clinically meaningful improvements for DR detection and suggest that computationally generated OCTA can serve as a practical, low-cost alternative to hardware-acquired OCTA, enabling broader deployment of high-performance retinal screening systems in resource-limited clinical environments.

Token-Level Cross-Modal Transformer with Contrastive Multi-Task Learning for Breast Cancer Subtype Classification and Survival Prediction

Integrating heterogeneous genomic and clinical modalities for joint cancer subtype classification and survival prediction remains a key challenge in precision oncology. Existing approaches suffer from three limitations: (1) they treat each modality as a monolithic feature vector, precluding fine-grained token-level interactions across modalities; (2) cross-modal fusion is typically performed through linear weighting or late averaging rather than structured token exchange; and (3) survival and classification objectives are optimized independently, missing a joint regularization signal.