Recently, Test-Time Adaptation (TTA) has gained increasing attention in medical imaging due to its ability to improve model generalization under domain shifts without retraining. In particular, directly applying a well-trained model across various medical centers faces significant performance degradation caused by variations in equipment, operators, imaging conditions, and scanning skill levels of sonographers. Existing TTA methods either rely on parameter adaptation that increases computational cost or apply simple prediction fusion that ignores anatomical structure knowledge. To address these limitations, we propose a novel backward-free Topology-aware TTA framework named T^3 that integrates Structural Perception Modeling (SPM) and Box Regression Adaptation (BRA). SPM is implemented through an organ space heatmap generated via Gaussian kernel superposition. This heatmap encodes anatomical topology without requiring additional training or source data. BRA further improves localization and classification by fusing detection outputs based on the contribution of detected results to anatomically meaningful peak points from the heatmaps. Extensive experiments were conducted across six cross-domain scenarios, and the results demonstrate that our method achieves state-of-the-art cross-domain detection performance while maintaining high efficiency, offering a practical and robust solution for real-world medical diagnostic applications.

Echocardiography and vascular ultrasound are essential for comprehensive cardiovascular assessment, yet manual evaluation and writing reports are labor-intensive, time-consuming, and require expertise from both cardiology and vascular surgery departments. Current automated report generation systems mainly focus on X-ray or CT, often neglecting echocardiographic modalities and critical quantitative parameters like aortic diameter and main pulmonary artery diameter, limiting their clinical utility. Moreover, the interdependence between cardiac and peripheral vascular health necessitates cross-departmental insights, which existing methods fail to incorporate. To address these limitations, we first propose the vision-language framework named the Echo-Cardiac-Vascular (ECV), for joint cardiac and vascular ultrasound report generation and parameter measurements. ECV introduces a Mixture-of-Experts vision encoder tailored for distinct ultrasound subtypes, a structured parameter measurement module for accurate quantification, and task-specific decoders that generate interpretable, multimodal diagnostic reports. Our framework, trained on 10K+ paired records, achieves high accuracy, improving diagnostic efficiency, consistency, and cross-disciplinary clinical applicability.

Deep learning has made remarkable progress in medical image analysis, yet its black-box nature still limits interpretability and clinician trust. Concept-based modeling offers a promising direction for explainable AI by integrating human-understandable concepts. However, existing approaches typically rely on global concept annotations and infer diagnosis based solely on the presence or absence of individual concepts. This oversimplified paradigm ignores the rich relationships among concepts and their causal influence on disease outcomes. To overcome these limitations, we propose the Concept Relationship Embedding Model (CREM) for interpretable medical diagnosis. CREM mirrors coarse-to-fine clinical reasoning by first extracting fine-grained subregional concepts, then explicitly encoding their relationships as a concept interaction graph, and finally performing causal inference between concepts and diagnoses to enable reliable and transparent diagnostic predictions. We evaluate CREM on four public medical imaging benchmarks, where it achieves state-of-the-art performance on both concept recognition and disease classification tasks, while exhibiting improved robustness, label efficiency, and interpretability. Furthermore, we deploy CREM as an interactive web-based demo that allows clinicians to visualize concept activations, trace diagnostic reasoning paths, and iteratively refine concept cues, facilitating effective human-in-the-loop decision-making.

Source-free unsupervised domain adaptation aims to eliminate domain shifts when data from the source domain and annotation from the target domain are not available. The multi-object detection tasks in medical image analysis are constrained by patient privacy and extremely huge annotation consumption. Hence, Source-free UDA is considered a more practical approach for eliminating the domain gap. However, relevant research that explores this topic is a dearth. In this paper, we design an Anatomy-aware Alignment Teacher-Student learning method using topological consistency based on a mean-teacher framework for Source-free UDA in multiple medical object detection named AATS, including Unsupervised Structure Refinement (USR) and Graph-aware Morphology Alignment (GMA). To match the student and teacher at the low-level and visual features, we propose the USR via an unsupervised clustering algorithm to group organs in ultrasound images. Based on USR, we obtain a graph with organ relations on the teacher branch. While in the student branch, we acquire visual features to construct graphical space and optimize the model with graph propagation. Finally, to match the student and teacher, GMA is designed to align the teacher and student based on both topology and morphology information that is derived from prior medical knowledge. Four groups of adaptation experiments were conducted on available medical datasets, and the outcomes demonstrate that our approach not only achieves state-of-the-art performance but also provides substantial advantages over existing methods.

Cardiovascular disease diagnosis via ultrasound screening relies on manually measured metrics and the experience level of human experts, which is time-consuming and may overlook subtle cross-anatomical pathological patterns. Recent vision-language models offer end-to-end diagnostic potential but lack mechanisms to handle heterogeneous multi-modal, multiview ultrasound data while preserving modality-specific semantics. To fill this gap, we propose an end-to-end framework called MMVL that directly fuses raw ultrasound sequences from diverse anatomical regions, bypassing intermediate measurements, and enabling direct diagnosis. We design lightweight adapters for domain-specific multi-modal feature fusion and refinement, a gating mechanism that dynamically reweights modality importance based on global context, and disease-aware prompt-guided classification. MMVL ensures robust performance across both common and rare conditions. The proposed multi-view, multimodal vision-language framework enables end-to-end cardiovascular disease diagnosis with a 10.9% accuracy gain, and opens a new avenue for automated and generalizable diagnostic solutions.

Despite domain generalization (DG) has significantly addressed the performance degradation of pre-trained models caused by domain shifts, it often falls short in real-world deployment. Test-time adaptation (TTA), which adjusts a learned model using unlabeled test data, presents a promising solution. However, most existing TTA methods struggle to deliver strong performance in medical image segmentation, primarily because they overlook the crucial prior knowledge inherent to medical images. To address this challenge, we incorporate morphological information and propose a framework based on multi-graph matching. Specifically, we introduce learnable universe embeddings that integrate morphological priors during multi-source training, along with novel unsupervised test-time paradigms for domain adaptation. This approach guarantees cycle-consistency in multi-matching while enabling the model to more effectively capture the invariant priors of unseen data, significantly mitigating the effects of domain shifts. Extensive experiments demonstrate that our method outperforms other state-of-the-art approaches on two medical image segmentation benchmarks for both multi-source and single-source domain generalization tasks. The source code is available at https://github.com/Yore0/TTDG-MGM.

Accurate anatomical structure detection is a critical preliminary step for diagnosing diseases characterized by structural abnormalities. In clinical practice, medical experts frequently adjust the zoom level of medical images to obtain comprehensive views for diagnosis. This common interaction results in significant variations in the apparent scale of anatomical structures across different images or fields of view. However, the information embedded in these zoom-induced scale changes is often overlooked by existing detection algorithms. In addition, human organs possess a priori, fixed topological knowledge. To overcome this limitation, we propose ZR-DETR, a zoom-aware probabilistic framework tailored for medical object detection. ZR-DETR uniquely incorporates scale-sensitive zoom embeddings, anatomical relation constraints, and a Gaussian Process-based detection head. This architecture enables the framework to jointly model semantic context, enforce anatomical plausibility, and quantify detection uncertainty. Empirical validation across three diverse medical imaging benchmarks demonstrates that ZR-DETR consistently outperforms strong baselines in both single-domain and unsupervised domain adaptation scenarios.

The widespread use of cloud-based face recognition technology raises privacy concerns, as unauthorized access to face images can expose personal information or be exploited for fraudulent purposes. In response, privacy-preserving face recognition (PPFR) schemes have emerged to hide visual information and thwart unauthorized access. However, the validation methods employed by these schemes often rely on unrealistic assumptions, leaving doubts about their true effectiveness in safeguarding facial privacy. In this paper, we introduce a new approach to pri-vacy validation called Minimum Assumption Privacy Protection Validation (Map2 V). This is the first exploration of formulating a privacy validation method utilizing deep image priors and zeroth-order gradient estimation, with the potential to serve as a general framework for PPFR eval-uation. Building upon Map2v, we comprehensively vali-date the privacy-preserving capability of PPFRs through a combination of human and machine vision. The exper-iment results and analysis demonstrate the effectiveness and generalizability of the proposed Map2v, showcasing its superiority over native privacy validation methods from PPFR works of literature. Additionally, this work exposes privacy vulnerabilities in evaluated state-of-the-art P P FR schemes, laying the foundation for the subsequent effective proposal of countermeasures. The source code is available at https://github.com/Beauty9882/MAP2V.

Models trained on ultrasound images from one institution typically experience a decline in effectiveness when transferred directly to other institutions. Moreover, unlike natural images, dense and overlapped structures exist in fetus ultrasound images, making the detection of structures more challenging. Thus, to tackle this problem, we propose a new Unsupervised Domain Adaptation (UDA) method named ToMo-UDA for fetus structure detection, which consists of the Topology Knowledge Transfer (TKT) and the Morphology Knowledge Transfer (MKT) module. The TKT leverages prior knowledge of the medical anatomy of fetal as topological information, reconstructing and aligning anatomy features across source and target domains. Then, the MKT formulates a more consistent and independent morphological representation for each substructure of an organ. To evaluate the proposed ToMo-UDA for ultrasound fetal anatomical structure detection, we introduce FUSH$^2$, a new Fetal UltraSound benchmark, comprises Heart and Head images collected from Two health centers, with 16 annotated regions. Our experiments show that utilizing topological and morphological anatomy information in ToMo-UDA can greatly improve organ structure detection. This expands the potential for structure detection tasks in medical image analysis.