Smartphone skin photographs are indispensable to teledermatology, yet assessing the diagnostic suitability of submitted cases (gradability) remains a critical bottleneck in mobile care workflows. Dermatologists routinely review multiple photographic views (regional, angled, and close-up) to identify consistent textural detail rather than relying on a single image. We present the Semantic Tri-view Pipeline, an interpretable architecture for automated teledermatology gradability screening that formalizes epidermal micro-relief as a computable biomarker of image quality. Using an expert-annotated subset of the public SCIN dataset, we train a lightweight DeepLabV3+ model to segment micro-relief fidelity. These spatial masks are then aggregated across up to three case views with a logistic regression classifier, leveraging viewpoint redundancy to support robustness under uncontrolled smartphone acquisition. This approach learns context-aware, clinically intelligible heuristics, such as penalizing high-fidelity texture in regional distance views. Evaluated at a predefined 90% sensitivity operating point, the system's apparent errors largely reflect subjective clinical variance on borderline cases where clinicians rely on non-visual metadata. On SCIN, performance improves from an AUC of 0.81 (80.6% PPV) on variance-heavy majority-consensus cases to 0.96 (97.7% PPV) on optically unambiguous unanimous cases. Overall, this work delivers an interpretable, privacy-by-design, edge-ready system that can provide real-time feedback during case submission to filter ungradable photo sets before review.
Clear cell renal cell carcinoma (CCRCC) grading is essential for treatment planning, yet existing approaches either analyze patch-level images directly or focus solely on nuclei-level classification, without linking to final tumor grading. We propose a semantic-guided multimodal preprocessing method that integrates nuclei classification maps from existing pre-trained models with RGB histopathology images for Vision Transformer (ViT)-based CCRCC grading. Our approach employs classification map channel concatenation and multiplicative modulation, with optimized overlays to leverage nuclei grading information, while preserving RGB textural features. Evaluation of multiple preprocessing strategies demonstrates that semantic-guided enhancement achieves 0.916 balanced accuracy, outperforming RGB-only baseline (0.707) and max-voting aggregation from prior studies (0.427). Sensitivity analysis reveals that this 21 percentage point improvement over baseline persists even under simulated perturbation at rates matching current state-of-the-art nuclei classification model error thresholds, suggesting both effective semantic utilization and practical robustness. These findings show that preprocessing-based multimodal fusion can leverage the diagnostic potential of existing imperfect nuclei classifiers, effectively bridging previously isolated fine-grained nuclear-level analysis with coarse-grained ViT-based patch classification. Per-class recall was consistent across grades (0.93, 0.91, 0.91), indicating that gains are not concentrated in the majority class. Because the sensitivity analysis perturbs ground-truth maps rather than predictions from an actual nuclei model, this result characterizes robustness under simulated error rather than deployment with a real upstream model, which remains for future work.
Julia Dietlmeier, Benjamin Greenberg, Wenxuan He +10cs.CV cs.AI
Objective: Cochlear implants (CIs) are bionic prostheses that restores hearing via electrical stimulation of the auditory nerve. Hybrid CIs, which use electroacoustic stimulation (EAS), combine residual low-frequency acoustic hearing with CI electrical stimulation. Intracochlear fibrosis, which forms in response to the presence of the implant, may impede residual hearing function and gradually reduce the efficacy of EAS. It is therefore a translational objective to study the formation of cochlear fibrosis in rodents, with the goal of reducing fibrotic burden and improving outcomes for CI patients. Methods: We generate and annotate a novel dataset of optical coherence tomography (OCT) images from chronically implanted guinea pigs as part of an ongoing study focused on implant induced fibrosis. Objectively assessing fibrotic burden in this model, with high resolution and repeatability, presents an obvious use case for computer vision methods. Results: We present the results of several state-of-the-art semantic segmentation models and compare their efficacy for identifying cochlear fibrosis and other relevant annotations, using a new library of manually segmented OCT images. Conclusions: We find that the best performance is achieved by using a modified version of the well-known UNET architecture (which we term 2D-OCT-UNET) that operates on the upscaled OCT input resolution. Significance: For the first time, we have successfully applied computer vision techniques to an OCT dataset of implanted cochleae with fibrosis. Using this deep learning model, the cochlear fibrotic burden calculation can be reliably carried out as we verify in our experimental section. The dataset and the project code are available at: https://github.com/juliadietlmeier/CF-OCT-segmentation
Modern deep learning architectures have demonstrated strong performance in dental CBCT segmentation. One remaining crucial challenge is accurate tooth labeling in cases with missing or malpositioned teeth, which are highly relevant for dental practice. Transformer-based architectures should in theory be able to resolve such ambiguities using global anatomical context. However, due to the high resolution of CBCT volumes and the wide spatial distribution of teeth within volumes, dense patch-based volumetric processing faces an inherent trade-off. Computational costs limit the number of patches that can be used in self-attention and thus, one can either increase the extent of the context captured in self-attention or capture fine-grained structural details by using small patches, but not both. In this work, we present Teeth2Point, an efficient point-based transformer framework for dental CBCT semantic segmentation that can avoid this trade-off. Teeth2Point first localizes volumetric regions of interest (ROIs) surrounding teeth using a convolutional model, then converts ROIs into point tokens using adaptive sampling. A transformer model predicts accurate segmentations using the point tokens, which allow capturing global context while retaining high resolution. The transformer is first pretrained using self-supervised learning (SSL), in the style of DINO but using domain-specific augmentation strategies, followed by supervised finetuning. The SSL pretraining, which includes random token masking, provides robustness to complex anatomical variations. Compared with the strongest two-stage baseline, Teeth2Point improves abnormal-case performance by 1.44 DSC points on average across four datasets; relative to the first-stage nnU-Net, the gain is 1.9 points.
Niccolò Tallone, Francesca Salis, Pio Raffaele Fina +13eess.IV cs.CV
Ovarian cancer is the deadliest gynecological malignancy; accurate and objective segmentation of adnexal masses and functional ovaries in ultrasound (US) remains challenging due to operator variability and morphological complexity. We present OvAi Focus (SynDiag s.r.l., Italy), a stand-alone AI software medical device that performs multi-class semantic segmentation of functional ovaries and adnexal masses, distinguishing cystic from solid components. The system was trained and independently validated on a multicenter dataset of 1,081 adult women from 6 centers across Italy and Israel. Segmentation achieved DICE scores of 0.87 (complete lesion), 0.85 (cystic), 0.68 (solid), and 0.62 (functional ovary), in line with or superior to state-of-the-art approaches across heterogeneous acquisition settings.
While echocardiography is essential for cardiovascular diagnosis, inherent speckle noise and low signal-to-noise ratio often lead to ambiguous semantic features and fragmented boundaries. These limitations significantly hinder the segmentation accuracy of deep learning models in complex clinical cases. Moreover, temporal motion of the heart plays a critical role in recognizing anatomical structures. To address these challenges, we designed a STLSF module which comprises a window-matching-based semantic correction component and a semantics-guided texture enhancement component. By leveraging local transition probability correlations to correct semantics and employing semantics-guided texture enhancement, the STLSF module effectively mitigates texture instability and ambiguous semantic interpretations caused by disadvantaged echocardiography quality. Additionally, to facilitate the encoder's adaptation to the intrinsic priors of ultrasound-specific imaging patterns, we propose a frequency-aware denoising pre-training method. The entire work builds a convolution-based network with locality inductive bias and long-range dependencies. Extensive experiments confirm our SOTA performance, achieving 93.87\% Dice on CAMUS and 92.62\% on EchoNet-Dynamic, with respective HD95 values of 3.29mm and 2.73mm.
As hematoxylin & eosin (H&E) staining constitutes the primary entry point in routine diagnostic workflows, computer-aided diagnosis from whole-slide H&E images is of particular clinical relevance. However, substantial variability in specimen preparation, staining protocols, and scanning conditions, together with inherent uncertainty in expert pixel-level annotations, makes automated analysis of H&E-stained images challenging. In this study, we propose a semantic segmentation-based framework for image-level diagnosis, grounded in the clinically motivated assumption that each histopathological image corresponds to a single cancer type. Image-level predictions are obtained by assigning the class of the dominant pixel-level label in the segmentation output. To ensure clinical relevance, we adopt the nnU-Net architecture and train it on a publicly available dataset collected in our study with pixel-level annotations for three liver cancer types: hepatocellular cacrcinoma (HCC; 55 images from 30 patients), cholangiocellular carcinoma (CCA; 55 images from 29 patients), and colorectal metastatic adenocarcinoma (CMA; 60 images from 30 patients). Annotations were independently provided by four pathologist. We hypothesize that the combination of stain normalization and semantic segmentation mitigates domain shift and reduces sensitivity to annotation noise. Five-fold cross-validation yielded balanced accuracy of 0.975 (HCC), 0.950 (CCA), and 1.000 (CMA), comparable to results obtained with immunohosthochemical staining and superior to several deep learning models trained on patch-level annotations. The proposed framework has the potential to support pathologists in prioritizing immunohistochemical marker selection, thereby reducing diagnostic costs and turnaround time. Integration with immunohistochemical findings improve overall diagnostic reliability.
Ronald L. P. D. de Jong, Tim J. M. Jaspers, Raf A. H. Vervoort +9cs.CV
Accurate recognition of anatomical structures is essential for safe and effective minimally invasive surgery (MIS), yet it remains underexplored in surgical computer vision due to limited annotated data and methods tailored primarily to natural scenes. In this work, we present a combined dataset and model framework to advance anatomy-aware perception in MIS. First, we introduce ATLAS-120k, a large-scale clip-level semantic segmentation dataset comprising over 120,000 annotated frames from 100 surgical videos spanning 14 procedures and multiple modalities, including laparoscopic and robot-assisted surgery. The dataset captures substantial procedural variability and was created using a scalable annotation pipeline that integrates expert manual labeling, automated propagation, iterative refinement, and surgeon verification to ensure high-quality annotations. Second, we propose ATLAS (Anatomy Recognition with Context Learning using Foundation Representations), a video semantic segmentation model specifically designed for surgical anatomy recognition. Unlike conventional approaches that emphasize object tracking, ATLAS leverages foundation-model embeddings together with lightweight temporal reasoning to incorporate contextual cues such as procedure type, surgical phase, and short-term visual memory. This design enables temporally consistent and accurate predictions while maintaining real-time feasibility. Together, the dataset and model establish a practical foundation for robust surgical scene understanding and support the development of clinically applicable guidance systems for minimally invasive surgery. The models, dataset annotations and annotation platform are publicly available at: https://github.com/TimJaspers0801/ATLAS.
Yangping Li, Thomas Pinetz, Michael Hölzel +2eess.IV cs.CV cs.LG
In pathology, the spatial distribution and proportions of tissue types are key indicators of disease progression, and are more readily available than fine-grained annotations. However, these assessments are rarely mapped to pixel-wise segmentation. The task is fundamentally underdetermined, as many spatially distinct segmentations can satisfy the same global proportions in the absence of pixel-wise constraints. To address this, we introduce Variational Segmentation from Label Proportions (VSLP), a two-stage framework that infers dense segmentations from global label proportions, without any pixel-level annotations. This framework first leverages a pre-trained transformer model with test-time augmentation to produce a pixel-wise confidence estimate. In the second stage, these estimates are fused by solving a variational optimization problem that incorporates a Wasserstein data fidelity term alongside a learned regularizer. Unlike end-to-end networks, our variational method can visualize the fidelity-regularization energy, resulting in more interpretable segmentation. We validate our approach on two public datasets, achieving superior performance over existing weakly supervised and unsupervised methods. For one of these datasets, proportions have been estimated by an experienced pathologist to provide a realistic benchmark to the community. Furthermore, the method scales to an in-house dataset with noisy pathologist labels, severely outperforming state-of-the-art methods, thereby demonstrating practical applicability. The code and data will be made publicly available upon acceptance at https://github.com/xiaoliangpi/VSLP.