VesselSAM: Leveraging SAM for Aortic Vessel Segmentation with LoRA and Atrous Attention

Medical image segmentation is crucial for clinical diagnosis and treatment planning, particularly for complex anatomical structures like vessels. In this work, we propose VesselSAM, a modified version of the Segmentation Anything Model (SAM), specifically designed for aortic vessel segmentation. VesselSAM incorporates AtrousLoRA, a novel module that combines Atrous Attention with Low-Rank Adaptation (LoRA), to improve segmentation performance. Atrous Attention enables the model to capture multi-scale contextual information, preserving both fine local details and broader global context. At the same time, LoRA facilitates efficient fine-tuning of the frozen SAM image encoder, reducing the number of trainable parameters and ensuring computational efficiency. We evaluate VesselSAM on two challenging datasets: the Aortic Vessel Tree (AVT) dataset and the Type-B Aortic Dissection (TBAD) dataset. VesselSAM achieves state-of-the-art performance with DSC scores of 93.50\%, 93.25\%, 93.02\%, and 93.26\% across multiple medical centers. Our results demonstrate that VesselSAM delivers high segmentation accuracy while significantly reducing computational overhead compared to existing large-scale models. This development paves the way for enhanced AI-based aortic vessel segmentation in clinical environments. The code and models will be released at https://github.com/Adnan-CAS/AtrousLora.

ClinKD: Cross-Modal Clinic Knowledge Distiller For Multi-Task Medical Images

Med-VQA (Medical Visual Question Answering) is a crucial subtask within the broader VQA (Visual Question Answering) domain. This task requires a visual question answering system to analyze the provided image and corresponding question,offering reasonable analysis and suggestions to assist medical professionals in making pathological diagnoses, or ideally, enabling the system to independently provide correct diagnoses. Furthermore, more advanced Med-VQA tasks involve Referring and Grounding, which not only require the system to accurately comprehend medical images but also to pinpoint specific biological locations within those images. While many large pre-trained models have demonstrated substantial VQA capabilities,challenges persist in the medical imaging domain. The intricacy of biological features in medical images and the scarcity of high-quality medical image datasets, combined with the fact that current models are not tailored for the medical field in terms of architecture and training paradigms, hinder the full exploitation of model generalization. This results in issues such as hallucination in Visual Grounding. In this paper, we introduce the ClinKD model, which incorporates modifications to model position encoding and a diversified training process. Initially, we enhance the model's ability to perceive image and modality variations by using Med-CLIP Guided Rotary Position Embedding. Subsequently, we leverage distillation to provide prior knowledge to the model before using complete training data. Additionally, the feedback-based training process during the formal training phase further enhances data utilization. Notably, under unchanged evaluation protocols, we achieve a new state-of-the-art performance on the Med-GRIT-270k dataset, and the Med-CLIP Guided Rotary Position Embedding approach presents potential for generalizing to universal model position encoding.

ASSNet: Adaptive Semantic Segmentation Network for Microtumors and Multi-Organ Segmentation

Medical image segmentation, a crucial task in computer vision, facilitates the automated delineation of anatomical structures and pathologies, supporting clinicians in diagnosis, treatment planning, and disease monitoring. Notably, transformers employing shifted window-based self-attention have demonstrated exceptional performance. However, their reliance on local window attention limits the fusion of local and global contextual information, crucial for segmenting microtumors and miniature organs. To address this limitation, we propose the Adaptive Semantic Segmentation Network (ASSNet), a transformer architecture that effectively integrates local and global features for precise medical image segmentation. ASSNet comprises a transformer-based U-shaped encoder-decoder network. The encoder utilizes shifted window self-attention across five resolutions to extract multi-scale features, which are then propagated to the decoder through skip connections. We introduce an augmented multi-layer perceptron within the encoder to explicitly model long-range dependencies during feature extraction. Recognizing the constraints of conventional symmetrical encoder-decoder designs, we propose an Adaptive Feature Fusion (AFF) decoder to complement our encoder. This decoder incorporates three key components: the Long Range Dependencies (LRD) block, the Multi-Scale Feature Fusion (MFF) block, and the Adaptive Semantic Center (ASC) block. These components synergistically facilitate the effective fusion of multi-scale features extracted by the decoder while capturing long-range dependencies and refining object boundaries. Comprehensive experiments on diverse medical image segmentation tasks, including multi-organ, liver tumor, and bladder tumor segmentation, demonstrate that ASSNet achieves state-of-the-art results. Code and models are available at: \url{https://github.com/lzeeorno/ASSNet}.

Lagrange Duality and Compound Multi-Attention Transformer for Semi-Supervised Medical Image Segmentation

Medical image segmentation, a critical application of semantic segmentation in healthcare, has seen significant advancements through specialized computer vision techniques. While deep learning-based medical image segmentation is essential for assisting in medical diagnosis, the lack of diverse training data causes the long-tail problem. Moreover, most previous hybrid CNN-ViT architectures have limited ability to combine various attentions in different layers of the Convolutional Neural Network. To address these issues, we propose a Lagrange Duality Consistency (LDC) Loss, integrated with Boundary-Aware Contrastive Loss, as the overall training objective for semi-supervised learning to mitigate the long-tail problem. Additionally, we introduce CMAformer, a novel network that synergizes the strengths of ResUNet and Transformer. The cross-attention block in CMAformer effectively integrates spatial attention and channel attention for multi-scale feature fusion. Overall, our results indicate that CMAformer, combined with the feature fusion framework and the new consistency loss, demonstrates strong complementarity in semi-supervised learning ensembles. We achieve state-of-the-art results on multiple public medical image datasets. Example code are available at: \url{https://github.com/lzeeorno/Lagrange-Duality-and-CMAformer}.

SpineMamba: Enhancing 3D Spinal Segmentation in Clinical Imaging through Residual Visual Mamba Layers and Shape Priors

Accurate segmentation of 3D clinical medical images is critical in the diagnosis and treatment of spinal diseases. However, the inherent complexity of spinal anatomy and uncertainty inherent in current imaging technologies, poses significant challenges for semantic segmentation of spinal images. Although convolutional neural networks (CNNs) and Transformer-based models have made some progress in spinal segmentation, their limitations in handling long-range dependencies hinder further improvements in segmentation accuracy.To address these challenges, we introduce a residual visual Mamba layer to effectively capture and model the deep semantic features and long-range spatial dependencies of 3D spinal data. To further enhance the structural semantic understanding of the vertebrae, we also propose a novel spinal shape prior module that captures specific anatomical information of the spine from medical images, significantly enhancing the model's ability to extract structural semantic information of the vertebrae. Comparative and ablation experiments on two datasets demonstrate that SpineMamba outperforms existing state-of-the-art models. On the CT dataset, the average Dice similarity coefficient for segmentation reaches as high as 94.40, while on the MR dataset, it reaches 86.95. Notably, compared to the renowned nnU-Net, SpineMamba achieves superior segmentation performance, exceeding it by up to 2 percentage points. This underscores its accuracy, robustness, and excellent generalization capabilities.

Introducing Shape Prior Module in Diffusion Model for Medical Image Segmentation

Medical image segmentation is critical for diagnosing and treating spinal disorders. However, the presence of high noise, ambiguity, and uncertainty makes this task highly challenging. Factors such as unclear anatomical boundaries, inter-class similarities, and irrational annotations contribute to this challenge. Achieving both accurate and diverse segmentation templates is essential to support radiologists in clinical practice. In recent years, denoising diffusion probabilistic modeling (DDPM) has emerged as a prominent research topic in computer vision. It has demonstrated effectiveness in various vision tasks, including image deblurring, super-resolution, anomaly detection, and even semantic representation generation at the pixel level. Despite the robustness of existing diffusion models in visual generation tasks, they still struggle with discrete masks and their various effects. To address the need for accurate and diverse spine medical image segmentation templates, we propose an end-to-end framework called VerseDiff-UNet, which leverages the denoising diffusion probabilistic model (DDPM). Our approach integrates the diffusion model into a standard U-shaped architecture. At each step, we combine the noise-added image with the labeled mask to guide the diffusion direction accurately towards the target region. Furthermore, to capture specific anatomical a priori information in medical images, we incorporate a shape a priori module. This module efficiently extracts structural semantic information from the input spine images. We evaluate our method on a single dataset of spine images acquired through X-ray imaging. Our results demonstrate that VerseDiff-UNet significantly outperforms other state-of-the-art methods in terms of accuracy while preserving the natural features and variations of anatomy.