FALCON: Few-Shot Adversarial Learning for Cross-Domain Medical Image Segmentation

Precise delineation of anatomical and pathological structures within 3D medical volumes is crucial for accurate diagnosis, effective surgical planning, and longitudinal disease monitoring. Despite advancements in AI, clinically viable segmentation is often hindered by the scarcity of 3D annotations, patient-specific variability, data privacy concerns, and substantial computational overhead. In this work, we propose FALCON, a cross-domain few-shot segmentation framework that achieves high-precision 3D volume segmentation by processing data as 2D slices. The framework is first meta-trained on natural images to learn-to-learn generalizable segmentation priors, then transferred to the medical domain via adversarial fine-tuning and boundary-aware learning. Task-aware inference, conditioned on support cues, allows FALCON to adapt dynamically to patient-specific anatomical variations across slices. Experiments on four benchmarks demonstrate that FALCON consistently achieves the lowest Hausdorff Distance scores, indicating superior boundary accuracy while maintaining a Dice Similarity Coefficient comparable to the state-of-the-art models. Notably, these results are achieved with significantly less labeled data, no data augmentation, and substantially lower computational overhead.

Predictive uncertainty estimation in deep learning for lung carcinoma classification in digital pathology under real dataset shifts

Deep learning has shown tremendous progress in a wide range of digital pathology and medical image classification tasks. Its integration into safe clinical decision-making support requires robust and reliable models. However, real-world data comes with diversities that often lie outside the intended source distribution. Moreover, when test samples are dramatically different, clinical decision-making is greatly affected. Quantifying predictive uncertainty in models is crucial for well-calibrated predictions and determining when (or not) to trust a model. Unfortunately, many works have overlooked the importance of predictive uncertainty estimation. This paper evaluates whether predictive uncertainty estimation adds robustness to deep learning-based diagnostic decision-making systems. We investigate the effect of various carcinoma distribution shift scenarios on predictive performance and calibration. We first systematically investigate three popular methods for improving predictive uncertainty: Monte Carlo dropout, deep ensemble, and few-shot learning on lung adenocarcinoma classification as a primary disease in whole slide images. Secondly, we compare the effectiveness of the methods in terms of performance and calibration under clinically relevant distribution shifts such as in-distribution shifts comprising primary disease sub-types and other characterization analysis data; out-of-distribution shifts comprising well-differentiated cases, different organ origin, and imaging modality shifts. While studies on uncertainty estimation exist, to our best knowledge, no rigorous large-scale benchmark compares predictive uncertainty estimation including these dataset shifts for lung carcinoma classification.