Accurate liver and tumor segmentation on abdominal CT images is critical for reliable diagnosis and treatment planning, but remains challenging due to complex anatomical structures, variability in tumor appearance, and limited annotated data. To address these issues, we introduce Hyperbolic-convolutions Adaptive-temporal-attention with Neural-representation and Synaptic-plasticity Network (HANS-Net), a novel segmentation framework that synergistically combines hyperbolic convolutions for hierarchical geometric representation, a wavelet-inspired decomposition module for multi-scale texture learning, a biologically motivated synaptic plasticity mechanism for adaptive feature enhancement, and an implicit neural representation branch to model fine-grained and continuous anatomical boundaries. Additionally, we incorporate uncertainty-aware Monte Carlo dropout to quantify prediction confidence and lightweight temporal attention to improve inter-slice consistency without sacrificing efficiency. Extensive evaluations of the LiTS dataset demonstrate that HANS-Net achieves a mean Dice score of 93.26%, an IoU of 88.09%, an average symmetric surface distance (ASSD) of 0.72 mm, and a volume overlap error (VOE) of 11.91%. Furthermore, cross-dataset validation on the 3D-IRCADb-01 dataset obtains an average Dice of 87.45%, IoU of 80.30%, ASSD of 1.525 mm, and VOE of 19.71%, indicating strong generalization across different datasets. These results confirm the effectiveness and robustness of HANS-Net in providing anatomically consistent, accurate, and confident liver and tumor segmentation.
Breast ultrasound imaging is a valuable tool for early breast cancer detection, but automated tumor segmentation is challenging due to inherent noise, variations in scale of lesions, and fuzzy boundaries. To address these challenges, we propose a novel hybrid attention-based network for lesion segmentation. Our proposed architecture integrates a pre-trained DenseNet121 in the encoder part for robust feature extraction with a multi-branch attention-enhanced decoder tailored for breast ultrasound images. The bottleneck incorporates Global Spatial Attention (GSA), Position Encoding (PE), and Scaled Dot-Product Attention (SDPA) to learn global context, spatial relationships, and relative positional features. The Spatial Feature Enhancement Block (SFEB) is embedded at skip connections to refine and enhance spatial features, enabling the network to focus more effectively on tumor regions. A hybrid loss function combining Binary Cross-Entropy (BCE) and Jaccard Index loss optimizes both pixel-level accuracy and region-level overlap metrics, enhancing robustness to class imbalance and irregular tumor shapes. Experiments on public datasets demonstrate that our method outperforms existing approaches, highlighting its potential to assist radiologists in early and accurate breast cancer diagnosis.
Cancer is an abnormal growth with potential to invade locally and metastasize to distant organs. Accurate auto-segmentation of the tumor and surrounding normal tissues is required for radiotherapy treatment plan optimization. Recent AI-based segmentation models are generally trained on large public datasets, which lack the heterogeneity of local patient populations. While these studies advance AI-based medical image segmentation, research on local datasets is necessary to develop and integrate AI tumor segmentation models directly into hospital software for efficient and accurate oncology treatment planning and execution. This study enhances tumor segmentation using computationally efficient hybrid UNet-Transformer models on magnetic resonance imaging (MRI) datasets acquired from a local hospital under strict privacy protection. We developed a robust data pipeline for seamless DICOM extraction and preprocessing, followed by extensive image augmentation to ensure model generalization across diverse clinical settings, resulting in a total dataset of 6080 images for training. Our novel architecture integrates UNet-based convolutional neural networks with a transformer bottleneck and complementary attention modules, including efficient attention, Squeeze-and-Excitation (SE) blocks, Convolutional Block Attention Module (CBAM), and ResNeXt blocks. To accelerate convergence and reduce computational demands, we used a maximum batch size of 8 and initialized the encoder with pretrained ImageNet weights, training the model on dual NVIDIA T4 GPUs via checkpointing to overcome Kaggle's runtime limits. Quantitative evaluation on the local MRI dataset yielded a Dice similarity coefficient of 0.764 and an Intersection over Union (IoU) of 0.736, demonstrating competitive performance despite limited data and underscoring the importance of site-specific model development for clinical deployment.
AI requires extensive datasets, while medical data is subject to high data protection. Anonymization is essential, but poses a challenge for some regions, such as the head, as identifying structures overlap with regions of clinical interest. Synthetic data offers a potential solution, but studies often lack rigorous evaluation of realism and utility. Therefore, we investigate to what extent synthetic data can replace real data in segmentation tasks. We employed head and neck cancer CT scans and brain glioma MRI scans from two large datasets. Synthetic data were generated using generative adversarial networks and diffusion models. We evaluated the quality of the synthetic data using MAE, MS-SSIM, Radiomics and a Visual Turing Test (VTT) performed by 5 radiologists and their usefulness in segmentation tasks using DSC. Radiomics indicates high fidelity of synthetic MRIs, but fall short in producing highly realistic CT tissue, with correlation coefficient of 0.8784 and 0.5461 for MRI and CT tumors, respectively. DSC results indicate limited utility of synthetic data: tumor segmentation achieved DSC=0.064 on CT and 0.834 on MRI, while bone segmentation a mean DSC=0.841. Relation between DSC and correlation is observed, but is limited by the complexity of the task. VTT results show synthetic CTs' utility, but with limited educational applications. Synthetic data can be used independently for the segmentation task, although limited by the complexity of the structures to segment. Advancing generative models to better tolerate heterogeneous inputs and learn subtle details is essential for enhancing their realism and expanding their application potential.
This work introduces a novel framework for brain tumor segmentation leveraging pre-trained GANs and Unet architectures. By combining a global anomaly detection module with a refined mask generation network, the proposed model accurately identifies tumor-sensitive regions and iteratively enhances segmentation precision using adversarial loss constraints. Multi-modal MRI data and synthetic image augmentation are employed to improve robustness and address the challenge of limited annotated datasets. Experimental results on the BraTS dataset demonstrate the effectiveness of the approach, achieving high sensitivity and accuracy in both lesion-wise Dice and HD95 metrics than the baseline. This scalable method minimizes the dependency on fully annotated data, paving the way for practical real-world applications in clinical settings.
Deep learning has demonstrated remarkable success in medical image segmentation and computer-aided diagnosis. In particular, numerous advanced methods have achieved state-of-the-art performance in brain tumor segmentation from MRI scans. While recent studies in other medical imaging domains have revealed that integrating textual reports with visual data can enhance segmentation accuracy, the field of brain tumor analysis lacks a comprehensive dataset that combines radiological images with corresponding textual annotations. This limitation has hindered the exploration of multimodal approaches that leverage both imaging and textual data. To bridge this critical gap, we introduce the TextBraTS dataset, the first publicly available volume-level multimodal dataset that contains paired MRI volumes and rich textual annotations, derived from the widely adopted BraTS2020 benchmark. Building upon this novel dataset, we propose a novel baseline framework and sequential cross-attention method for text-guided volumetric medical image segmentation. Through extensive experiments with various text-image fusion strategies and templated text formulations, our approach demonstrates significant improvements in brain tumor segmentation accuracy, offering valuable insights into effective multimodal integration techniques. Our dataset, implementation code, and pre-trained models are publicly available at https://github.com/Jupitern52/TextBraTS.
Accurate segmentation and classification of brain tumors from Magnetic Resonance Imaging (MRI) remain key challenges in medical image analysis, largely due to the lack of high-quality, balanced, and diverse datasets. In this work, we present a new curated MRI dataset designed specifically for brain tumor segmentation and classification tasks. The dataset comprises 6,000 contrast-enhanced T1-weighted MRI scans annotated by certified radiologists and physicians, spanning three major tumor types-glioma, meningioma, and pituitary-as well as non-tumorous cases. Each sample includes high-resolution labels and is categorized across axial, sagittal, and coronal imaging planes to facilitate robust model development and cross-view generalization. To demonstrate the utility of the dataset, we propose a transformer-based segmentation model and benchmark it against established baselines. Our method achieves the highest weighted mean Intersection-over-Union (IoU) of 82.3%, with improvements observed across all tumor categories. Importantly, this study serves primarily as an introduction to the dataset, establishing foundational benchmarks for future research. We envision this dataset as a valuable resource for advancing machine learning applications in neuro-oncology, supporting both academic research and clinical decision-support development. datasetlink: https://www.kaggle.com/datasets/briscdataset/brisc2025/
The Brain Tumor Segmentation (BraTS) cluster of challenges has significantly advanced brain tumor image analysis by providing large, curated datasets and addressing clinically relevant tasks. However, despite its success and popularity, algorithms and models developed through BraTS have seen limited adoption in both scientific and clinical communities. To accelerate their dissemination, we introduce BraTS orchestrator, an open-source Python package that provides seamless access to state-of-the-art segmentation and synthesis algorithms for diverse brain tumors from the BraTS challenge ecosystem. Available on GitHub (https://github.com/BrainLesion/BraTS), the package features intuitive tutorials designed for users with minimal programming experience, enabling both researchers and clinicians to easily deploy winning BraTS algorithms for inference. By abstracting the complexities of modern deep learning, BraTS orchestrator democratizes access to the specialized knowledge developed within the BraTS community, making these advances readily available to broader neuro-radiology and neuro-oncology audiences.
In this paper, we address the crucial task of brain tumor segmentation in medical imaging and propose innovative approaches to enhance its performance. The current state-of-the-art nnU-Net has shown promising results but suffers from extensive training requirements and underutilization of pre-trained weights. To overcome these limitations, we integrate Axial-Coronal-Sagittal convolutions and pre-trained weights from ImageNet into the nnU-Net framework, resulting in reduced training epochs, reduced trainable parameters, and improved efficiency. Two strategies for transferring 2D pre-trained weights to the 3D domain are presented, ensuring the preservation of learned relationships and feature representations critical for effective information propagation. Furthermore, we explore a joint classification and segmentation model that leverages pre-trained encoders from a brain glioma grade classification proxy task, leading to enhanced segmentation performance, especially for challenging tumor labels. Experimental results demonstrate that our proposed methods in the fast training settings achieve comparable or even outperform the ensemble of cross-validation models, a common practice in the brain tumor segmentation literature.
Precise segmentation of brain tumors, particularly contrast-enhancing regions visible in post-contrast MRI (areas highlighted by contrast agent injection), is crucial for accurate clinical diagnosis and treatment planning but remains challenging. However, current methods exhibit notable performance degradation in segmenting these enhancing brain tumor areas, largely due to insufficient consideration of MRI-specific tumor features such as complex textures and directional variations. To address this, we propose the Harmonized Frequency Fusion Network (HFF-Net), which rethinks brain tumor segmentation from a frequency-domain perspective. To comprehensively characterize tumor regions, we develop a Frequency Domain Decomposition (FDD) module that separates MRI images into low-frequency components, capturing smooth tumor contours and high-frequency components, highlighting detailed textures and directional edges. To further enhance sensitivity to tumor boundaries, we introduce an Adaptive Laplacian Convolution (ALC) module that adaptively emphasizes critical high-frequency details using dynamically updated convolution kernels. To effectively fuse tumor features across multiple scales, we design a Frequency Domain Cross-Attention (FDCA) integrating semantic, positional, and slice-specific information. We further validate and interpret frequency-domain improvements through visualization, theoretical reasoning, and experimental analyses. Extensive experiments on four public datasets demonstrate that HFF-Net achieves an average relative improvement of 4.48\% (ranging from 2.39\% to 7.72\%) in the mean Dice scores across the three major subregions, and an average relative improvement of 7.33% (ranging from 5.96% to 8.64%) in the segmentation of contrast-enhancing tumor regions, while maintaining favorable computational efficiency and clinical applicability. Code: https://github.com/VinyehShaw/HFF.
Accurate 3D medical image segmentation demands architectures capable of reconciling global context modeling with spatial topology preservation. While State Space Models (SSMs) like Mamba show potential for sequence modeling, existing medical SSMs suffer from encoder-decoder incompatibility: the encoder's 1D sequence flattening compromises spatial structures, while conventional decoders fail to leverage Mamba's state propagation. We present DM-SegNet, a Dual-Mamba architecture integrating directional state transitions with anatomy-aware hierarchical decoding. The core innovations include a quadri-directional spatial Mamba module employing four-directional 3D scanning to maintain anatomical spatial coherence, a gated spatial convolution layer that enhances spatially sensitive feature representation prior to state modeling, and a Mamba-driven decoding framework enabling bidirectional state synchronization across scales. Extensive evaluation on two clinically significant benchmarks demonstrates the efficacy of DM-SegNet: achieving state-of-the-art Dice Similarity Coefficient (DSC) of 85.44% on the Synapse dataset for abdominal organ segmentation and 90.22% on the BraTS2023 dataset for brain tumor segmentation.
In medical image segmentation, limited external validity remains a critical obstacle when models are deployed across unseen datasets, an issue particularly pronounced in the ultrasound image domain. Existing solutions-such as domain adaptation and GAN-based style transfer-while promising, often fall short in the medical domain where datasets are typically small and diverse. This paper presents a novel application of principal component analysis (PCA) to address this limitation. PCA preprocessing reduces noise and emphasizes essential features by retaining approximately 90\% of the dataset variance. We evaluate our approach across six diverse breast tumor ultrasound datasets comprising 3,983 B-mode images and corresponding expert tumor segmentation masks. For each dataset, a corresponding dimensionality reduced PCA-dataset is created and U-Net-based segmentation models are trained on each of the twelve datasets. Each model trained on an original dataset was inferenced on the remaining five out-of-domain original datasets (baseline results), while each model trained on a PCA dataset was inferenced on five out-of-domain PCA datasets. Our experimental results indicate that using PCA reconstructed datasets, instead of original images, improves the model's recall and Dice scores, particularly for model-dataset pairs where baseline performance was lowest, achieving statistically significant gains in recall (0.57 $\pm$ 0.07 vs. 0.70 $\pm$ 0.05, $p = 0.0004$) and Dice scores (0.50 $\pm$ 0.06 vs. 0.58 $\pm$ 0.06, $p = 0.03$). Our method reduced the decline in recall values due to external validation by $33\%$. These findings underscore the potential of PCA reconstruction as a safeguard to mitigate declines in segmentation performance, especially in challenging cases, with implications for enhancing external validity in real-world medical applications.
Foundation models (FMs) such as CLIP and SAM have recently shown great promise in image segmentation tasks, yet their adaptation to 3D medical imaging-particularly for pathology detection and segmentation-remains underexplored. A critical challenge arises from the domain gap between natural images and medical volumes: existing FMs, pre-trained on 2D data, struggle to capture 3D anatomical context, limiting their utility in clinical applications like tumor segmentation. To address this, we propose an adaptation framework called TAGS: Tumor Adaptive Guidance for SAM, which unlocks 2D FMs for 3D medical tasks through multi-prompt fusion. By preserving most of the pre-trained weights, our approach enhances SAM's spatial feature extraction using CLIP's semantic insights and anatomy-specific prompts. Extensive experiments on three open-source tumor segmentation datasets prove that our model surpasses the state-of-the-art medical image segmentation models (+46.88% over nnUNet), interactive segmentation frameworks, and other established medical FMs, including SAM-Med2D, SAM-Med3D, SegVol, Universal, 3D-Adapter, and SAM-B (at least +13% over them). This highlights the robustness and adaptability of our proposed framework across diverse medical segmentation tasks.
Existing methods for multimodal MRI segmentation with missing modalities typically assume that all MRI modalities are available during training. However, in clinical practice, some modalities may be missing due to the sequential nature of MRI acquisition, leading to performance degradation. Furthermore, retraining models to accommodate newly available modalities can be inefficient and may cause overfitting, potentially compromising previously learned knowledge. To address these challenges, we propose Replay-based Hypergraph Domain Incremental Learning (ReHyDIL) for brain tumor segmentation with missing modalities. ReHyDIL leverages Domain Incremental Learning (DIL) to enable the segmentation model to learn from newly acquired MRI modalities without forgetting previously learned information. To enhance segmentation performance across diverse patient scenarios, we introduce the Cross-Patient Hypergraph Segmentation Network (CHSNet), which utilizes hypergraphs to capture high-order associations between patients. Additionally, we incorporate Tversky-Aware Contrastive (TAC) loss to effectively mitigate information imbalance both across and within different modalities. Extensive experiments on the BraTS2019 dataset demonstrate that ReHyDIL outperforms state-of-the-art methods, achieving an improvement of over 2% in the Dice Similarity Coefficient across various tumor regions. Our code is available at https://github.com/reeive/ReHyDIL.
Accurate segmentation of brain images typically requires the integration of complementary information from multiple image modalities. However, clinical data for all modalities may not be available for every patient, creating a significant challenge. To address this, previous studies encode multiple modalities into a shared latent space. While somewhat effective, it remains suboptimal, as each modality contains distinct and valuable information. In this study, we propose DC-Seg (Disentangled Contrastive Learning for Segmentation), a new method that explicitly disentangles images into modality-invariant anatomical representation and modality-specific representation, by using anatomical contrastive learning and modality contrastive learning respectively. This solution improves the separation of anatomical and modality-specific features by considering the modality gaps, leading to more robust representations. Furthermore, we introduce a segmentation-based regularizer that enhances the model's robustness to missing modalities. Extensive experiments on the BraTS 2020 and a private white matter hyperintensity(WMH) segmentation dataset demonstrate that DC-Seg outperforms state-of-the-art methods in handling incomplete multimodal brain tumor segmentation tasks with varying missing modalities, while also demonstrate strong generalizability in WMH segmentation. The code is available at https://github.com/CuCl-2/DC-Seg.
Self-supervised pretrain techniques have been widely used to improve the downstream tasks' performance. However, real-world magnetic resonance (MR) studies usually consist of different sets of contrasts due to different acquisition protocols, which poses challenges for the current deep learning methods on large-scale pretrain and different downstream tasks with different input requirements, since these methods typically require a fixed set of input modalities or, contrasts. To address this challenge, we propose variable-input ViT (VIViT), a transformer-based framework designed for self-supervised pretraining and segmentation finetuning for variable contrasts in each study. With this ability, our approach can maximize the data availability in pretrain, and can transfer the learned knowledge from pretrain to downstream tasks despite variations in input requirements. We validate our method on brain infarct and brain tumor segmentation, where our method outperforms current CNN and ViT-based models with a mean Dice score of 0.624 and 0.883 respectively. These results highlight the efficacy of our design for better adaptability and performance on tasks with real-world heterogeneous MR data.
Accurate lung tumor segmentation is crucial for improving diagnosis, treatment planning, and patient outcomes in oncology. However, the complexity of tumor morphology, size, and location poses significant challenges for automated segmentation. This study presents a comprehensive benchmarking analysis of deep learning-based segmentation models, comparing traditional architectures such as U-Net and DeepLabV3, self-configuring models like nnUNet, and foundation models like MedSAM, and MedSAM~2. Evaluating performance across two lung tumor segmentation datasets, we assess segmentation accuracy and computational efficiency under various learning paradigms, including few-shot learning and fine-tuning. The results reveal that while traditional models struggle with tumor delineation, foundation models, particularly MedSAM~2, outperform them in both accuracy and computational efficiency. These findings underscore the potential of foundation models for lung tumor segmentation, highlighting their applicability in improving clinical workflows and patient outcomes.
We explore Generalizable Tumor Segmentation, aiming to train a single model for zero-shot tumor segmentation across diverse anatomical regions. Existing methods face limitations related to segmentation quality, scalability, and the range of applicable imaging modalities. In this paper, we uncover the potential of the internal representations within frozen medical foundation diffusion models as highly efficient zero-shot learners for tumor segmentation by introducing a novel framework named DiffuGTS. DiffuGTS creates anomaly-aware open-vocabulary attention maps based on text prompts to enable generalizable anomaly segmentation without being restricted by a predefined training category list. To further improve and refine anomaly segmentation masks, DiffuGTS leverages the diffusion model, transforming pathological regions into high-quality pseudo-healthy counterparts through latent space inpainting, and applies a novel pixel-level and feature-level residual learning approach, resulting in segmentation masks with significantly enhanced quality and generalization. Comprehensive experiments on four datasets and seven tumor categories demonstrate the superior performance of our method, surpassing current state-of-the-art models across multiple zero-shot settings. Codes are available at https://github.com/Yankai96/DiffuGTS.
Background: Brain tumor segmentation has a significant impact on the diagnosis and treatment of brain tumors. Accurate brain tumor segmentation remains challenging due to their irregular shapes, vague boundaries, and high variability. Objective: We propose a brain tumor segmentation method that combines deep learning with prior knowledge derived from a region-growing algorithm. Methods: The proposed method utilizes a multi-scale feature fusion (MSFF) module and adaptive attention mechanisms (AAM) to extract multi-scale features and capture global contextual information. To enhance the model's robustness in low-confidence regions, the Monte Carlo Dropout (MC Dropout) strategy is employed for uncertainty estimation. Results: Extensive experiments demonstrate that the proposed method achieves superior performance on Brain Tumor Segmentation (BraTS) datasets, significantly outperforming various state-of-the-art methods. On the BraTS2021 dataset, the test Dice scores are 89.18% for Enhancing Tumor (ET) segmentation, 93.67% for Whole Tumor (WT) segmentation, and 91.23% for Tumor Core (TC) segmentation. On the BraTS2019 validation set, the validation Dice scores are 87.43%, 90.92%, and 90.40% for ET, WT, and TC segmentation, respectively. Ablation studies further confirmed the contribution of each module to segmentation accuracy, indicating that each component played a vital role in overall performance improvement. Conclusion: This study proposed a novel 3D brain tumor segmentation network based on the U-Net architecture. By incorporating the prior knowledge and employing the uncertainty estimation method, the robustness and performance were improved. The code for the proposed method is available at https://github.com/chenzhao2023/UPMAD_Net_BrainSeg.
Cancer remains one of the leading causes of mortality worldwide, and among its many forms, brain tumors are particularly notorious due to their aggressive nature and the critical challenges involved in early diagnosis. Recent advances in artificial intelligence have shown great promise in assisting medical professionals with precise tumor segmentation, a key step in timely diagnosis and treatment planning. However, many state-of-the-art segmentation methods require extensive computational resources and prolonged training times, limiting their practical application in resource-constrained settings. In this work, we present a novel dual-decoder U-Net architecture enhanced with attention-gated skip connections, designed specifically for brain tumor segmentation from MRI scans. Our approach balances efficiency and accuracy by achieving competitive segmentation performance while significantly reducing training demands. Evaluated on the BraTS 2020 dataset, the proposed model achieved Dice scores of 85.06% for Whole Tumor (WT), 80.61% for Tumor Core (TC), and 71.26% for Enhancing Tumor (ET) in only 50 epochs, surpassing several commonly used U-Net variants. Our model demonstrates that high-quality brain tumor segmentation is attainable even under limited computational resources, thereby offering a viable solution for researchers and clinicians operating with modest hardware. This resource-efficient model has the potential to improve early detection and diagnosis of brain tumors, ultimately contributing to better patient outcomes