Text-guided image editing has advanced rapidly with the rise of diffusion models. While flow-based inversion-free methods offer high efficiency by avoiding latent inversion, they often fail to effectively integrate source information, leading to poor background preservation, spatial inconsistencies, and over-editing due to the lack of effective integration of source information. In this paper, we present FIA-Edit, a novel inversion-free framework that achieves high-fidelity and semantically precise edits through a Frequency-Interactive Attention. Specifically, we design two key components: (1) a Frequency Representation Interaction (FRI) module that enhances cross-domain alignment by exchanging frequency components between source and target features within self-attention, and (2) a Feature Injection (FIJ) module that explicitly incorporates source-side queries, keys, values, and text embeddings into the target branch's cross-attention to preserve structure and semantics. Comprehensive and extensive experiments demonstrate that FIA-Edit supports high-fidelity editing at low computational cost (~6s per 512 * 512 image on an RTX 4090) and consistently outperforms existing methods across diverse tasks in visual quality, background fidelity, and controllability. Furthermore, we are the first to extend text-guided image editing to clinical applications. By synthesizing anatomically coherent hemorrhage variations in surgical images, FIA-Edit opens new opportunities for medical data augmentation and delivers significant gains in downstream bleeding classification.

Dual-view mammography, including craniocaudal (CC) and mediolateral oblique (MLO) projections, offers complementary anatomical views crucial for breast cancer diagnosis. However, in real-world clinical workflows, one view may be missing, corrupted, or degraded due to acquisition errors or compression artifacts, limiting the effectiveness of downstream analysis. View-to-view translation can help recover missing views and improve lesion alignment. Unlike natural images, this task in mammography is highly challenging due to large non-rigid deformations and severe tissue overlap in X-ray projections, which obscure pixel-level correspondences. In this paper, we propose Column-Aware and Implicit 3D Diffusion (CA3D-Diff), a novel bidirectional mammogram view translation framework based on conditional diffusion model. To address cross-view structural misalignment, we first design a column-aware Cross-Attention mechanism that leverages the geometric property that anatomically corresponding regions tend to lie in similar column positions across views. Furthermore, we introduce an implicit 3D structure reconstruction module that back-projects noisy 2D latents into a coarse 3D feature volume based on breast-view projection geometry. Extensive experiments demonstrate that CA3D-Diff achieves superior performance in bidirectional tasks, outperforming state-of-the-art methods in visual fidelity and structural consistency. Furthermore, the synthesized views effectively improve single-view malignancy classification in screening settings, demonstrating the practical value of our method in realworld diagnostics. Our code is available at https://github.com/lixinHUST/CA3D-Diff.

Surgical phase recognition has become a crucial requirement in laparoscopic surgery, enabling various clinical applications like surgical risk forecasting. Current methods typically identify the surgical phase using individual frame-wise embeddings as the fundamental unit for time modeling. However, this approach is overly sensitive to current observations, often resulting in discontinuous and erroneous predictions within a complete surgical phase. In this paper, we propose DACAT, a novel dual-stream model that adaptively learns clip-aware context information to enhance the temporal relationship. In one stream, DACAT pretrains a frame encoder, caching all historical frame-wise features. In the other stream, DACAT fine-tunes a new frame encoder to extract the frame-wise feature at the current moment. Additionally, a max clip-response read-out (Max-R) module is introduced to bridge the two streams by using the current frame-wise feature to adaptively fetch the most relevant past clip from the feature cache. The clip-aware context feature is then encoded via cross-attention between the current frame and its fetched adaptive clip, and further utilized to enhance the time modeling for accurate online surgical phase recognition. The benchmark results on three public datasets, i.e., Cholec80, M2CAI16, and AutoLaparo, demonstrate the superiority of our proposed DACAT over existing state-of-the-art methods, with improvements in Jaccard scores of at least 4.5%, 4.6%, and 2.7%, respectively. Our code and models have been released at https://github.com/kk42yy/DACAT.

Anticipating and recognizing surgical workflows are critical for intelligent surgical assistance systems. However, existing methods rely on deterministic decision-making, struggling to generalize across the large anatomical and procedural variations inherent in real-world surgeries.In this paper, we introduce an innovative framework that incorporates stochastic modeling through a denoising diffusion probabilistic model (DDPM) into conventional deterministic learning for surgical workflow analysis. At the heart of our approach is a collaborative co-training paradigm: the DDPM branch captures procedural uncertainties to enrich feature representations, while the task branch focuses on predicting surgical phases and instrument usage.Theoretically, we demonstrate that this mutual refinement mechanism benefits both branches: the DDPM reduces prediction errors in uncertain scenarios, and the task branch directs the DDPM toward clinically meaningful representations. Notably, the DDPM branch is discarded during inference, enabling real-time predictions without sacrificing accuracy.Experiments on the Cholec80 dataset show that for the anticipation task, our method achieves a 16% reduction in eMAE compared to state-of-the-art approaches, and for phase recognition, it improves the Jaccard score by 1.0%. Additionally, on the AutoLaparo dataset, our method achieves a 1.5% improvement in the Jaccard score for phase recognition, while also exhibiting robust generalization to patient-specific variations. Our code and weight are available at https://github.com/kk42yy/CoStoDet-DDPM.

Mammography is the most commonly used imaging modality for breast cancer screening, driving an increasing demand for deep-learning techniques to support large-scale analysis. However, the development of accurate and robust methods is often limited by insufficient data availability and a lack of diversity in lesion characteristics. While generative models offer a promising solution for data synthesis, current approaches often fail to adequately emphasize lesion-specific features and their relationships with surrounding tissues. In this paper, we propose Gated Conditional Diffusion Model (GCDM), a novel framework designed to jointly synthesize holistic mammogram images and localized lesions. GCDM is built upon a latent denoising diffusion framework, where the noised latent image is concatenated with a soft mask embedding that represents breast, lesion, and their transitional regions, ensuring anatomical coherence between them during the denoising process. To further emphasize lesion-specific features, GCDM incorporates a gated conditioning branch that guides the denoising process by dynamically selecting and fusing the most relevant radiomic and geometric properties of lesions, effectively capturing their interplay. Experimental results demonstrate that GCDM achieves precise control over small lesion areas while enhancing the realism and diversity of synthesized mammograms. These advancements position GCDM as a promising tool for clinical applications in mammogram synthesis. Our code is available at https://github.com/lixinHUST/Gated-Conditional-Diffusion-Model/

Multi-modal brain tumor segmentation typically involves four magnetic resonance imaging (MRI) modalities, while incomplete modalities significantly degrade performance. Existing solutions employ explicit or implicit modality adaptation, aligning features across modalities or learning a fused feature robust to modality incompleteness. They share a common goal of encouraging each modality to express both itself and the others. However, the two expression abilities are entangled as a whole in a seamless feature space, resulting in prohibitive learning burdens. In this paper, we propose DeMoSeg to enhance the modality adaptation by Decoupling the task of representing the ego and other Modalities for robust incomplete multi-modal Segmentation. The decoupling is super lightweight by simply using two convolutions to map each modality onto four feature sub-spaces. The first sub-space expresses itself (Self-feature), while the remaining sub-spaces substitute for other modalities (Mutual-features). The Self- and Mutual-features interactively guide each other through a carefully-designed Channel-wised Sparse Self-Attention (CSSA). After that, a Radiologist-mimic Cross-modality expression Relationships (RCR) is introduced to have available modalities provide Self-feature and also ‘lend’ their Mutual-features to compensate for the absent ones by exploiting the clinical prior knowledge. The benchmark results on BraTS2020, BraTS2018 and BraTS2015 verify the DeMoSeg’s superiority thanks to the alleviated modality adaptation difficulty. Concretely, for BraTS2020, DeMoSeg increases Dice by at least 0.92%, 2.95% and 4.95% on whole tumor, tumor core and enhanced tumor regions, respectively, compared to other state-of-the-arts. Codes are at https://github.com/kk42yy/DeMoSeg.