Jonathan B. Martin, Yashwant Kurmi, Charlotte R. Sappoeess.IV cs.CV
Ultra-low-field MRI makes neonatal brain imaging deploy- able in low-resource settings, but its low SNR, lack of shielding, and long scan duration make it especially prone to acquisition artifacts, motivating automated quality control. We address the LISA 2026 Task 1a challenge: multi-label severity grading (0/1/2) of seven common image artifacts on ULF T2 weighted volumes. We identify that a number of backbones may be successfully paired with a classification MLP, but that no single backbone is uniformly best across artifacts. To improve performance, we evaluate routing complementary foundation model teachers through a per-artifact gate, as well as distilling the teachers into a single in-domain ViT-S student (LoFi RADIO) over an unlabeled low-field MRI corpus. Both of these strategies improve the weighted composite. The distilled backbone matches or exceeds the gate and has the added advantage of not requiring deployment of multiple large foundation models at infer- ence.
Dexter Wen Jie Teo, Nairouz Shehata, Herve Lombaerteess.IV cs.CV cs.LG
Cardiac cine-MRI serves as a direct visual indicator of cardiovascular hemodynamics by capturing the continuous wall motion of the aorta. Quantifying these dynamic structural changes across the cardiac cycle is essential for measuring aortic distensibility, a primary marker of arterial stiffness. However, standard 2D segmentation networks focus on each frame independently. Consequently, when rapid systolic flow temporarily obscures the aorta's boundaries, this lack of continuous context results in frame-to-frame tracking dropouts and boundary inconsistencies. Spatiotemporal ($2\text{D}+t$) networks can enforce temporal consistency across the sequence but suffer from a scarcity of expert annotations. To address this, we present a semi-supervised spatiotemporal ($2\text{D}$ to $2\text{D}+t$) knowledge distillation framework exploiting the cardiac cycle. The framework distills a spatial teacher's expertise into a spatiotemporal student network by executing a dynamic latent interception, pairing a recurrent spatiotemporal bottleneck with a residual spatial bypass. Our model selection strategy applies a baseline validation threshold ($\text{DSC} \ge 0.50$) prior to selecting the epoch that maximizes anatomical consistency. This strategy enables the spatiotemporal student model to achieve superior surface tracking accuracy ($\text{NSD@1mm} = 92.3\% \pm 0.2\%$) and high structural reliability ($\text{Frac}_{2\text{CC}} = 99.2\% \pm 0.6\%$), reducing population-wide structural anomalies by over 56\% compared to a 2D nnU-Net baseline.
Automated seizure detection from electroencephalography (EEG) is essential for continuous neurological monitoring, particularly for subclinical epileptic seizures that may exhibit only subtle electrographic changes. Existing time-series methods are often designed for fixed EEG channel configurations, thereby limiting their applicability to heterogeneous EEG recordings with irregular channel layouts. Although visual and language modeling offer promising alternatives, aligning heterogeneous EEG representations with clinical semantics remains challenging. We introduce ViTexSZ, a heterogeneous Vision-Text knowledge distillation framework for EEG seizure detection. ViTexSZ converts EEG recordings into structured waveform images and introduces a query-based multi-channel alignment module that maps source-dependent visual features into a unified token space. A heterogeneous teacher further integrates the aligned EEG representations with clinical prompts through a multimodal large language model, associating high-level clinical semantics with seizure-related evidence. Vision-text knowledge distillation then transfers the teacher representations to a lightweight student during detection. Experiments on four EEG seizure datasets demonstrate the generalizability of ViTexSZ across both subclinical and general seizure detection scenarios, achieving the highest accuracy on all datasets and relative improvements of up to 12.9% over the second-best baselines, showing its effectiveness.
Ramon Kaspar, Andrey Ignatov, Valentina Boevacs.CV
Many high-performing pathology tile encoders are now foundation models with hundreds of millions to over a billion parameters. Encoding and storing the thousands of tiles in each whole-slide image with such models is costly on commodity hardware, so compact encoders that retain useful downstream performance are a valuable alternative. We present DistillPath-KS16, which starts from the existing 22M kaiko ViT-S/16 encoder and improves it by distilling from released pathology encoders used as frozen teachers. The recipe reads only the teachers' final class and patch tokens and trains on 6,000 public slides, needing neither their DINO nor iBOT pretraining heads nor a billion-tile corpus, so it applies to any released encoder that exposes backbone tokens. We distill four teachers spanning 86M to 1.1B parameters into the same student. Every variant improves the kaiko baseline on all three benchmarks we use, EVA, HEST, and PLISM, and the strongest teacher is task-dependent. On the seven-task EVA mean, DistillPath-KS16-Virchow2 reaches $0.795$, within $0.015$ points of Virchow2, the top-scoring model in our evaluation, at about $29\times$ fewer parameters; it also scores above H0-mini and GPFM on this aggregate metric, though that advantage is task-concentrated rather than uniform. Because it remains a 22M ViT-S/16 with 384-dimensional features, DistillPath-KS16 runs more than $25\times$ faster than Virchow2. Code is available at https://github.com/RamonKaspar/DistillPath, and released model weights are available at https://huggingface.co/collections/RamonK/distillpath.
Dillan Imans, Phuoc-Nguyen Bui, Duc-Tai Le +1cs.CV eess.IV
Cross-modal knowledge distillation can transfer diagnostic knowledge from a strong but costly teacher modality to a cheaper and more deployable student modality. In medical image analysis, however, the two modalities are often unpaired: they are collected from different patient cohorts and occupy geometrically incompatible feature spaces. This makes instance-level distillation invalid and direct feature matching unreliable. To address these challenges, we propose Shared Semantic Codebook Distillation (SSCD), which compares teacher and student representations through a shared discrete codebook. Each image is represented as a distribution over a common, modality-agnostic vocabulary, and knowledge is transferred by aligning these distributions across modalities, both globally and class-conditionally, without requiring paired samples or directly comparable raw features. The codebook is evolved online by exponential moving average and kept diverse through entropy regularization and dead-code restart. At inference, all teacher-side and codebook modules are discarded, leaving only the student encoder and classifier. On two heterogeneous unpaired settings, OCT-to-fundus retinal disease classification and CT-to-chest-X-ray pneumonia classification, SSCD improves the student from 64.5 to 70.2 macro-F1 and from 73.8 to 76.3 macro-F1, respectively, outperforming all evaluated distillation baselines on both settings. Code and pretrained models are available at https://github.com/DillanImans/SSCD-unpaired-distillation
Youwan Mahé, Axel Plessis, Stéphanie Leplaideur +3cs.CV
Deep learning frameworks like nnU-Net achieve state-of-theart brain lesion segmentation performance but remain difficult to deploy in clinical research environments due to, among other reasons, software dependencies and computational requirements. We introduce StrokeSeg2, a lightweight, modular, cross-platform C++/Qt framework designed to adapt resource-intensive 3D stroke segmentation pipelines into portable and reproducible applications. To improve compatibility with standard clinical workstations, we investigate the combined effect of architectural compression through knowledge distillation and inference optimisation using ONNX Runtime with Float16 quantisation. Across heterogeneous hardware configurations (CPU, integrated GPU, and dedicated GPU) architectural distillation emerged as the primary contributor to efficiency gains, contributing to over 90% reduction in energy consumption and an average 84% reduction in inference time. Specifically, we identify a 0.84M-parameter student model as the most favourable trade-off, reducing the original 102.3M-parameter teacher architecture to a 2.1 MB disk footprint while preserving robust lesion localisation and competitive segmentation performance. This small footprint supports the development of a self-contained installer for clinical workstation targets. Finally, StrokeSeg2 packages these optimisations into standalone installers for Windows, macOS, and Linux. By providing both graphical and commandline interfaces without Docker or external environment dependencies, StrokeSeg2 facilitates deployment of high-performance segmentation workflows for routine clinical research pipelines.
Abu Mukaddim Rahi, Md Mithun Hossain, Md Zulficar Hasan Joy +2cs.CV
Accurate skin lesion classification can benefit from lesion segmentation masks, but requiring masks or an auxiliary segmentation model during inference reduces clinical practicality and increases computational complexity. This work introduces Privileged Lesion-Context Relational Distillation (PLCRD), a teacher-student framework that exploits lesion masks exclusively during training while preserving image-only inference. The privileged teacher jointly analyzes the original dermoscopic image and its mask-guided lesion region to learn lesion-specific and contextual diagnostic representations. An image-only student is then trained through complementary knowledge-transfer mechanisms that convey the teacher's diagnostic distribution, lesion-focused attention, inter-lesion relational geometry, and lesion-context structure. PLCRD decomposes deep representations into lesion and contextual embeddings and transfers their relational organization through inter-lesion similarity alignment, lesion-context affinity matching, separation regularization, and class-aware relational learning. This formulation avoids direct feature matching between heterogeneous teacher and student architectures and enables the student to internalize mask-informed diagnostic structure without accessing masks at deployment. The framework was evaluated on HAM10000 using lesion-disjoint data partitioning and externally validated on ISIC 2018 without retraining. PLCRD achieved a lesion-level macro-F1 of 0.773 +/- 0.018, balanced accuracy of 0.764 +/- 0.023, and macro-AUROC of 0.976 +/- 0.002 on HAM10000, together with a macro-F1 of 0.732 +/- 0.008 on ISIC 2018. The results indicate that privileged lesion annotations can be transformed into transferable relational knowledge, yielding a practical and interpretable approach to mask-free skin lesion classification.
Inertial sensors at multiple body locations can improve activity recognition, but requiring every sensor at inference increases the deployment burden. We study whether four synchronized IMUs available during training can improve a student that uses only the right-arm IMU during fitting and inference. A frozen four-IMU teacher provides logit and feature targets. Fixed-weight knowledge distillation applies each target with the same strength to every fitting sample, although the student may not benefit equally from them. We introduce dynamic influence weighting (DIW), which tests a one-step candidate update on separate fold-internal training participants. DIW then assigns separate sample-wise gates to the logit and feature losses. On WEAR, we evaluate 19 labels and 68,298 complete windows from 22 participants using subject-disjoint five-fold cross-validation. Pooled out-of-fold macro-F1 is 0.561820 for Supervised and 0.571623 for Fixed-weight KD. DIW reaches 0.638451, gains of 7.66 and 6.68 percentage points, respectively. It exceeds Supervised for 18 of 19 labels and 21 of 22 held-out participants. All three routes retain the same 80,915-parameter right-arm student at inference. Under this protocol, DIW converts training-only multi-position information into a stronger single-IMU model without changing deployed sensing or the student forward graph.
Multiple instance learning (MIL) has become the main paradigm for whole-slide image (WSI) analysis in computational pathology. However, existing MIL aggregators are still typically trained from scratch for each downstream task, relying on limited slide-level labels to learn both aggregation mechanisms and downstream discriminative representations simultaneously. As a result, they often suffer from unstable optimization, overfitting, and limited transferability. Similar to pretrained ResNet and Vision Transformer models in natural image learning, MIL also requires reusable pretrained initialization. However, high-quality slide-level pretraining data remain scarce, and MIL models are usually lightweight and weakly supervised, making large-scale pretraining difficult in practice. To address this challenge, we propose a distillation-based pretraining framework for MIL, which leverages two slide-level foundation models, TITAN and CARE, as teachers to transfer their representational knowledge into a diverse set of MIL architectures. To effectively balance supervision from different teachers, we further introduce an angular dispersion normalized distillation loss. The distilled weights are then used as initialization for downstream adaptation. We conduct systematic evaluations on 15 benchmark datasets under both linear probing and full-parameter fine-tuning, and further validate its advantages in few-shot scenarios. Experimental results show that pretraining generally improves MIL aggregators over from scratch training, especially in linear-probing and few-shot settings, while maintaining the computational efficiency of lightweight MIL models. Code is available at https://github.com/fu0201/MIL_Pretrained.
Accurate differentiation between gastric adenoma and carcinoma during endoscopy is critical for clinical decision-making. Yet, this task is highly challenging due to high inter-class similarity and ambiguous boundaries between the two classes. Existing ROI-based classification methods often suffer from detection/segmentation error propagation and loss of surrounding global context. In contrast, full-image classification lacks the necessary spatial focus. Furthermore, we observe that deep neural networks gravitate towards domain-specific texture biases(e.g. bleeding, lighting artifacts), often causing models to predict based on spurious correlations instead of intrinsic morphological features. To address these limitations, we propose a novel framework, Masked Achromatic Guidance Expert (MAGE). During training, we introduce an auxiliary local expert branch trained on masked achromatic views of the neoplasm. By suppressing background context and color, this branch is forced to learn highly discriminative, purely structural features. We then employ a dual-objective distillation strategy, transferring both classification logits and spatial attention maps to provide implicit spatial supervision to the main branch that receives full WLI as input. This dual-objective distillation forces the model to ground its predictions in morphology rather than relying on shortcuts, while still retaining clinically relevant color cues. At inference time, our deployable model operates on images without annotated masks, ensuring real-time deployability . Extensive experiments on a clinical gastric endoscopy dataset show that our method significantly outperforms existing detection-based methodologies (e.g. YOLO) and classification-based methodologies (e.g. Swin-Transformer), providing not only superior classification performance but also interpretable attention maps for clinical reliability.
Yunhang Qian, Jiaquan Yu, Jiawei Liu +3cs.CV cs.AI
Medical Vision-Language Models (Med-VLMs) require reliable reasoning from fine-grained visual evidence, yet existing models can produce plausible clinical answers by relying on language priors or medical templates rather than truly attending to diagnosis-critical regions. On-Policy Distillation (OPD) offers dense token-level supervision on student-generated trajectories and provides a privacy-compatible means of capability transfer without requiring the redistribution of raw patient data. However, standard OPD uniformly distills all tokens, causing sparse evidence-dependent tokens to be diluted by abundant clinical narrative tokens. Inspired by the success of OPD in the large language model community, we propose \textbf{Med-OPD}, to our knowledge the first unified post-training framework that integrates on-policy distillation with medical evidence-aware supervision for Med-VLMs. We introduce \textbf{Medical Evidence Advantage} (MEA), a teacher-grounded counterfactual signal that uses an answer-aware hint to focus teacher scoring on evidence supporting the target diagnosis, and measures each token's dependence on medical visual evidence by comparing teacher likelihoods under the original and evidence-degraded imaging modalities. Based on MEA, Med-OPD redistributes the distillation signal at both the token and trajectory levels, emphasizing diagnosis-critical tokens and evidence-reliant rollouts. Experiments on OmniMedVQA subsets show that Med-OPD consistently outperforms SFT and standard OPD across CT, MRI, Disease Diagnosis, and Lesion Grading. These results demonstrate that evidence-aware distillation can better strengthen medical VLMs' reliance on key visual evidence and improve reliable multimodal medical reasoning. The source code and data is publicly available at: https://github.com/yunhang8658/MedOPD.git
Perineural invasion (PNI) is associated with poor postoperative outcomes in intrahepatic cholangiocarcinoma, but it is confirmed by surgical pathology. Existing preoperative imaging models often rely on radiologist-defined variables, contrast-enhanced imaging, or manual annotations. We propose an anatomy-privileged teacher--student framework for patient-level PNI prediction from T2-weighted MRI. During training, the teacher uses MRI with tumor and liver masks to learn dense token routing, and the student distills this guidance to retain and aggregate informative tokens under a fixed budget. Anatomical supervision is restricted to training, and the deployed model does not require masks at inference. In 155 patients, the proposed method achieved the highest mean AUROC of 0.750 among matched MRI-only baselines evaluated under the same protocol, with 1.43 GFLOPs and 8.02 ms per case on a Jetson Orin Nano Super Developer Kit.
Pathology Foundation Models (PFMs) offer powerful Whole Slide Image (WSI) representations but suffer from massive computational costs. While Knowledge Distillation (KD) can create efficient student models, existing multi-teacher methods often use suboptimal uniform weighting that ignores tissue heterogeneity. We propose LaGuadia (Language-Guided Adaptive DistillAtion), a framework that develops a compact pathology image encoder by dynamically integrating expertise from multiple PFMs under clinical linguistic guidance. Our approach utilizes a multi-stage pipeline: first, extracting visually observable clinical keywords from pathology reports; second, aligning visual features with these keywords via a Vision-Language meta-teacher (MedSigLIP) to provide dense semantic guidance; and finally, performing adaptive KD where teacher contributions are weighted based on their semantic alignment with the clinical narrative. Experiments on WSI captioning, visual question answering, and slide-level classification tasks demonstrate that an 87M parameter LaGuadia student model matches or exceeds foundation-scale models such as GigaPath and UNI, achieving strong factual consistency and robust generalization. These results highlight clinical language as an effective semantic anchor for building efficient and reliable digital pathology systems. Code is available at https://github.com/hvcl/LaGuadia.
Deploying deep learning models for automated electrocardiogram classification on resource-constrained wearable devices remains challenging due to high computational costs. To address this, we propose LSTrans, a lightweight hybrid model designed for efficient and sensitive ECG analysis. LSTrans introduces a specialized 1D convolutional backbone with an interleaved layer architecture to capture both macroscopic rhythmic trends and microscopic morphological variations. This backbone is cascaded with a Transformer encoder to model long-range temporal dependencies, incorporating Low-Rank Adaptation across critical layers to compress the model and reduce the trainable parameter space. We further employ homogeneous and heterogeneous knowledge distillation to transfer diagnostic expertise from high-capacity teacher models to the student. Experimental results on multiple benchmark datasets demonstrate that LSTrans achieves a competitive balance between diagnostic sensitivity and resource efficiency, substantially reducing peak memory footprints and training latency during downstream adaptation. The source code is available for review at https://github.com/zyee00128/LSTrans4BIBM.
Computational pathology foundation models (PFMs) have advanced whole-slide image analysis. However, their size and inference cost hinder local deployment in pathology departments. We propose MuCoDi, a pretraining framework that distills frozen tile embeddings from multiple PFMs into compact edge-oriented encoders. Instead of regressing individual teacher features, MuCoDi trains lightweight MobileOne and RepViT students with a contrastive distillation objective adapted from MoCo v3, where cached Virchow2, UNI2, and H-Optimus-1 embeddings replace momentum-encoder keys. We pretrain students on 14.3M TCGA tiles from only 11.8K WSIs and evaluate frozen encoders on 23 clinically curated downstream classification tasks. RepViT-based MuCoEdge students retain near-teacher performance while reducing model size by orders of magnitude: MuCoEdge-R2.3 and MuCoEdge-R1.5 reach 71.0% external AUROC, within 0.8 percentage points of the best teacher (Virchow2, 71.8%), while MuCoEdge-R2.3 obtains the best external F1 and the second-best AUPRC (51.8% and 53.3%). MuCoEdge-R1.0 reaches 70.9% AUROC with only 6.4M parameters and 1.12 GFLOPs. On a Raspberry Pi 5, sub-million-parameter MobileOne students achieve up to 605-fold single-tile speedup over Virchow2 while retaining 66.5% to 66.9% external AUROC, demonstrating that PFM-quality pathology representations can be moved toward practical edge deployment. Code is available at https://anonymous.4open.science/r/mucodi-6243.
Accurate 3D medical segmentation is limited by anatomical variability and high computational costs. While knowledge distillation (KD) offers a route for model compression, conventional methods often fail to preserve complex structures and are overwhelmed by background noise. We propose Displacement-Preserving Relational Distillation (DPRD), which distills latent anatomical trajectories via vector based alignment to preserve the orientation and relative scale of the teacher's manifold, and prevents signal dilution by anchoring distillation in task-relevant structures. Integrated into nnU-Net, DPRD outperforms established baselines on ISLES 2022 and AMOS 2022 benchmarks. Notably, on the AMOS dataset, DPRD achieves a Dice score of 85.46%, edging out the high-capacity MedNeXt teacher while significantly reducing boundary errors. Despite utilizing only ~5% of the teacher's parameters and ~3% of its FLOPs, our approach maintains high structural consistency. This provides a robust, efficient solution for deploying high performance segmenters in resource-constrained clinical environments. Code: https://github.com/ClinicaAlpha/DPRD-3D-MedSeg
Yurui Liu, Xiao-Cong Zhong, Qisong Wang +3eess.SP cs.AI
Surface electromyography (sEMG)-based gesture recognition has emerged as a promising technology for natural human-computer interaction. However, its practical deployment remains challenging due to severe performance degradation caused by feature distribution discrepancies across different subjects and recording sessions. Although domain adaptation (DA) techniques are commonly employed to mitigate such discrepancies, conventional methods often struggle to effectively aligning sEMG features, primarily due to their inherent stochasticity and the scarcity of labeled data. To address these limitations, this paper proposes a novel Pressure-Guided Unsupervised Domain Adaptation (PGUDA) framework, which leverages the robustness and stability of pressure signals to introduce a cross-modal knowledge distillation strategy that transfers consistent physical semantics across modalities. Specifically, a teacher network trained on pressure signals guides an sEMG student network on unlabeled target domains, thereby regularizing the representation learning process with transferable and modality-invariant knowledge. Extensive experiments conducted on a self-collected multimodal dataset involving eleven subjects validate the effectiveness of the proposed PGUDA framework. The results demonstrate that our proposed PGUDA achieves leading performance in both cross-subject and cross-session classification tasks, achieving average accuracies of 58.08% and substantially outperforming existing DA approaches. Notably, PGUDA exhibits remarkable label efficiency: it attains classification accuracy comparable to fully supervised benchmarks while requiring only 5% of labeled data for teacher network training. This framework offers a robust and data-efficient solution that can significantly reduce the calibration burden in practical sEMG-based gesture recognition systems.
Dong Yeong Kim, JunGyu Lee, Jaewon Choi +5cs.CV cs.AI
Real-time video segmentation of the prostate in Transrectal Ultrasound (TRUS) is essential for image-guided interventions. While conventional 2D methods suffer from inter-frame inconsistencies by disregarding temporal context, 3D architectures incur prohibitive latency. To resolve this dilemma, we present a Temporally Consistent Learning Framework that distills temporal coherence into a 2D network during training, preserving single-frame inference efficiency. Our design is driven by a key clinical observation: the prostate exhibits geometric stability, whereas the surrounding acoustic environment fluctuates due to physiological motion and transducer pressure. Because conventional temporal constraints propagate erroneous gradients from these unstable regions, we introduce a Confidence-Weighted Temporal Consistency objective derived from optical flow warping residuals, selectively attenuating contributions from unreliable regions. Complementing this pixel-wise constraint, a Dual-scale Prototype Alignment Module enforces semantic coherence through contrastive optimization of local boundary and global semantic features. Furthermore, to eliminate the need for dense per-frame video annotations, we employ geometric equivariance-based pseudo-labeling with knowledge distillation from a pretrained teacher. Extensive experiments on SUN-SEG and our newly introduced TRUS-V benchmark (2,679 frames) demonstrate state-of-the-art accuracy and temporal consistency at real-time speed. Code and dataset are available at https://github.com/DYDevelop/DTC-TRUS.
We present APRIL-MedSeg, a YAML-driven modular framework for 2D medical image segmentation. It provides a unified and extensible ecosystem that decomposes segmentation networks into reusable components. Also, the framework integrates a broad spectrum of advanced paradigms, including semi-supervised learning, domain adaptation, knowledge distillation, weakly supervised learning, and text-guided segmentation as well as foundation model support. A registry-based configuration system with inheritance enables flexible and reproducible experiment management, supporting seamless switching across models, datasets, and training strategies. In addition, the framework provides a unified interface for medical datasets, augmentation pipelines, deployment utilities and model ensembling. Overall, APRIL-MedSeg is designed as a general-purpose research and development platform that bridges algorithmic innovation and practical deployment, while also serving as a structured ecosystem for systematically organizing and reproducing advances in medical image segmentation. The code is available at https://github.com/juntaoJianggavin/APRIL-MedSeg under an Apache 2.0 license.
Binh Nguyen, Colleen Josephson, Mircea Teodorescu +2cs.NE cs.AI cs.LG eess.SY
Neuromorphic and edge computing research has focused on reducing the inference cost of neural network controllers, yet in physical closed-loop systems the actuator can rival or exceed an efficient controller in energy. An efficient controller is therefore necessary but not sufficient, because the actuator becomes the cost worth reducing once inference no longer dominates it. Here, we introduce energy-aware learning, an approach that incorporates actuator energy directly into the reinforcement learning reward, and demonstrate it in closed-loop deep brain stimulation (DBS) for Parkinson's disease. A deep spiking Q-network, trained in a biophysical cortico-basal ganglia-thalamic circuit model, learns to suppress pathological alpha-beta oscillations by 45.2% while reducing stimulation charge by 80.0% relative to continuous DBS. Sparsity-constrained knowledge distillation compresses the policy onto the SynSense XyloAudio 3 neuromorphic processor at 0.52 mW inference power, yielding 28.1x lower energy per inference than an equivalent artificial neural network on conventional edge hardware. By co-optimizing stimulation energy and inference efficiency, the framework addresses both major power demands in implantable neuromodulation.
Cross-domain diagnosis remains a major challenge in cervical cell pathology due to pronounced domain shifts across institutions and the subtle visual differences among disease stages, which jointly impair model generalization. To address these issues, this paper proposes a two-stage framework for cross-domain cervical cell detection. In the first stage, we propose the Spatially-Continuous Unpaired Neural Schrödinger Bridge (SC-UNSB), which constructs a synthetic intermediate domain to mitigate cross-domain distribution shifts by modeling image translation as an entropy-regularized optimal transport process. In the second stage, we propose a dual-level feature alignment strategy within a knowledge distillation, which progressively aligns shallow structural features and deep semantic representations to facilitate the transfer of domain-invariant knowledge from the source to the target model. Experimental results demonstrate that the proposed method effectively mitigates domain shift and category ambiguity, improving the cross-domain detection performance.
Type 1 Diabetes (T1D) is a chronic, life-threatening autoimmune condition characterized by the complete destruction of insulin-producing pancreatic beta cells. While Artificial Pancreas Systems (APS) powered by Reinforcement Learning (RL) have shown promise in automating insulin delivery, their ``black-box'' nature makes it hard for patients and doctors to trust them fully. This paper presents LLM-T1D, a promising approach that combines the precision of RL with the clear, human-like reasoning of Large Language Models (LLMs) to create a more transparent and reliable insulin pump controller. By training an expert RL system and distilling its knowledge into fine-tuned LLaMA 3.1 8B and Qwen3 8B models, we developed a controller that not only surpasses the RL system's performance but also explains its decisions in plain, understandable language. Tested on the FDA-approved UVA/Padova T1D simulator, the LLM controllers deliver excellent blood sugar control (73.5% Time in Range) while maintaining strict formal safety verification against hallucinations.
Vishal Jain, Giorgio Buzzanca, Sarah Cechnicka +6cs.CV
Foreground segmentation is the critical first step of every computational pathology pipeline, yet existing methods rely on hand-tuned heuristics or supervised models that overfit to narrow stain and scanner distributions, failing silently on specialised stains such as Jones silver or Elastica van Gieson. We propose a coarse-to-fine approach that recasts foreground segmentation as a visual perception task and leverages general-purpose vision-language models (VLMs) as zero-annotation oracles. Our key insight is that tissue-versus-background discrimination is a natural-image recognition problem, not a histopathological one, so VLMs trained on internet-scale corpora generalise where domain-specific models cannot. We introduce Leica-75, a benchmark of 75 renal transplant whole-slide images spanning three stain families. On Leica-75, our method achieves the highest segmentation quality on out-of-distribution stains (Dice 0.858 +/- 0.027 on Jones, 0.853 +/- 0.041 on EVG) with 7x lower cross-stain variance than the best supervised baseline, while remaining competitive on in-distribution H&E. Few-shot prompting with automatically curated exemplars (Auto-context) rescues hard cases on Stress-32 (n=32), a curated stress-test subset (Dice 0.470 to 0.819 for the 2B model). VLM-based annotation review matches human expert consensus (kappa=0.989 for blur detection; mean precision/recall grading accuracy 0.708 vs. human 0.646 for segmentation mask review). The resulting pseudo-labels are used to distil lightweight student models that are as performant as the teacher model while running for a fraction of the cost. Our framework provides a principled, scalable solution to a persistent infrastructure bottleneck in digital pathology.
Multiple instance learning (MIL) has become a standard paradigm for whole slide image (WSI) analysis in digital pathology, as it enables slide-level prediction without dense annotations. Existing MIL methods typically rely on exhaustive extraction and encoding of high-resolution patches. However, this practice suffers from two critical limitations in real-world clinical settings: it struggles to capture global visual cues at lower magnifications, and incurs substantial computational overhead due to the massive number of high-resolution patches per slide. To address these limitations, we propose an efficient low-resolution multiple instance learning (LRMIL) framework that transfers high-resolution knowledge to low-resolution representations. LRMIL adopts a two-stage distillation strategy. First, patch-level cross-resolution distillation aligns low-resolution patch embeddings with high-resolution representations. Second, slide-level knowledge distillation trains a low-resolution student MIL model under both slide-level supervision and teacher guidance. At inference time, LRMIL operates exclusively on low-resolution patches, substantially reducing data preprocessing and computational cost. Extensive experiments on multiple WSI benchmarks demonstrate that LRMIL consistently outperforms state-of-the-art MIL methods while achieving more efficient inference. These results highlight LRMIL as a practical and scalable solution for WSI analysis in clinical pathology.
Current prompt-based and adapter-based tuning of vision-language models (VLMs) is attractive for medical imaging, where clinical data sensitivity favors frozen backbones and annotations are limited. However, these methods typically optimize only the ground-truth class, treating all other classes as equally incorrect, ignoring clinically meaningful class relations and yielding unstable decision boundaries in limited-supervision settings. We propose Omni-Geometry Knowledge Distillation (OGKD), a new framework that injects class-relation structure into the teacher to produce directional targets that preserve the ground truth while respecting inter-class geometry. Using these targets, we develop two distillation losses: Global Geometry-Aware Distillation (GAD) operates on the global image token, and Label-Guided Geometry Distillation (LGD) applies the same geometry to attentive patch tokens to improve fine-grained alignment. Across comprehensive experiments and analyses on 11 widely-used medical datasets for base-to-novel and few-shot evaluations, our OGKD achieves substantially better performance, consistently improving accuracy by an average absolute gain of 1.7%-2.8% over all prior state-of-the-art VLM adaptation counterparts. It also robustly generalizes to unseen classes and yields more reliable predictions than other approaches. Our code is available at https://github.com/tientrandinh/OGKD.
Integrating transcriptomics and histopathology can improve cancer risk modelling, yet practical use is constrained by the limited availability of RNA profiling in routine settings. Here we introduce Mixture of Pathway Experts (MoPE), a knowledge-distillation framework that reframes multimodal learning as privileged distillation for histology-only inference. MoPE is motivated by the partial observability between RNA profiles and whole-slide images: histology can capture morphology-linked consequences of certain molecular programmes, but cannot be expected to reconstruct the full transcriptomic state. MoPE encodes RNA-derived pathways and transfers the molecular supervision to pathway-indexed pathology experts through memory-usage alignment. Across diverse public benchmarks and two independent breast cancer cohorts, MoPE consistently improved WSI-only inference performance relative to baseline methods. Pathway-usage analyses and human-audited visual inspection provide bounded inspection of model behaviour and candidate morphology-linked readouts. These results support pathway-structured privileged distillation as a promising route to using molecular information during training while preserving RNA-free inference.
Practical non-invasive Brain-Computer Interface (BCI) systems require EEG decoders with strong cross-subject generalization and minimal calibration. However, inter-subject variability and signal non-stationarity often entangle motor semantics with subject-specific noise, limiting subject-independent decoding. Recent multimodal approaches use text as a semantic anchor, yet text provides sparse and static supervision for inherently dynamic motor processes. To address this issue, we propose EVA-Net, a two-stage framework that uses action videos as semantic priors for subject-independent EEG motor decoding. In the first stage, EEG and video features are aligned in a shared space using cross-modal and supervised contrastive objectives to reduce subject-specific variation. In the second stage, video category prototypes and knowledge distillation transfer video-derived priors to an EEG-only classifier without adding inference overhead. Experiments on two public datasets show that EVA-Net achieves strong subject-independent decoding performance, including an 8.66% LOSO accuracy gain on EEGMMI. Ablation results further suggest that video provides a more effective semantic anchor than the text baseline considered in this work.
Canyu Lei, David Repaske, Jianxin Xiecs.LG cs.AI eess.SY
Effective diabetes management requires continuous monitoring of glycemic levels. Clinically, glycemic control is assessed using metrics such as Time in Range (TIR), Time Below Range (TBR), and Time Above Range (TAR), typically derived from continuous glucose monitoring (CGM). However, many patients rely on self-monitoring of blood glucose (SMBG) due to the high cost and limited accessibility of CGM. Unlike CGM, SMBG provides sparse and irregular measurements, making accurate estimation of these metrics challenging. Conventional supervised learning approaches struggle under such sparsity, leading to poor generalization and unstable performance. To address this, we propose PACD-Net, a self-supervised contrastive knowledge distillation framework for estimating glycemic control from SMBG. Pseudo-SMBG samples with richer temporal coverage are used as teacher signals to guide learning from sparse observations. In addition, multi-view contrastive learning enforces representation consistency across diverse sampling patterns. The model adopts a hybrid Swin Transformer-CNN backbone to capture temporal dependencies in sparse SMBG sequences. Experimental results demonstrate that PACD-Net consistently outperforms existing methods in estimating TAR, TIR, and TBR from real-world SMBG data, achieving improved accuracy as well as enhanced stability and generalization under extremely sparse observation settings. The proposed framework provides a practical tool for clinical SMBG interpretation and offers a generalizable approach for learning from sparse and irregularly sampled sensor data in broader applications.
Medical foundation models pre-trained on large-scale datasets have shown powerful versatile performance. However, when adapting medical foundation models for specific medical scenarios, it remains the inevitable challenge due to the gap induced by the discrepancy between pre-training and downstream tasks, the real-world computation, and speed constraints. Relevant techniques that probably handle this challenge more or less suffer from some intrinsic limitations. For example, knowledge distillation (KD) assumes that teacher and student models share the same task, training strategy, and model structure family, while prevalent parameter-efficient fine-tuning (PEFT) fails to achieve personalized and lightweight deployment. Even the combination of PEFT and KD still struggles to resolve model structures and training strategies inconsistencies between teacher and student models, leading to inefficient knowledge transfer. In this study, we propose a novel framework called Deep Reprogramming Distillation (DRD) to combat the general adaptation challenge. Specifically, DRD introduces the novel reprogramming module that on the one side overcomes the domain and task discrepancy between pretraining and downstream scenarios, and on the other side builds the student-friendly efficient distillation from foundation models to lightweight downstream models. Furthermore, to mitigate variability under different training conditions, we design a centered kernel alignment (CKA) distillation method to promote robust knowledge transfer. Empirical results show that DRD surpasses previous PEFT and KD methods across 18 medical downstream tasks under different foundation models, covering various scenarios including 2D/3D classification and 2D/3D segmentation.