Medical image segmentation remains challenging due to the high cost of pixel-level annotations for training. In the context of weak supervision, clinician gaze data captures regions of diagnostic interest; however, its sparsity limits its use for segmentation. In contrast, vision-language models (VLMs) provide semantic context through textual descriptions but lack the explanation precision required. Recognizing that neither source alone suffices, we propose a teacher-student framework that integrates both gaze and language supervision, leveraging their complementary strengths. Our key insight is that gaze data indicates "where" clinicians focus during diagnosis, while VLMs explain "why" those regions are significant. To implement this, the teacher model first learns from gaze points enhanced by VLM-generated descriptions of lesion morphology, establishing a foundation for guiding the student model. The teacher then directs the student through three strategies: 1) Multi-scale feature alignment to fuse visual cues with textual semantics; 2) Confidence-weighted consistency constraints to focus on reliable predictions; 3) Adaptive masking to limit error propagation in uncertain areas. Experiments on the Kvasir-SEG, NCI-ISBI, and ISIC datasets show that our method achieves Dice scores of 80.78%, 80.53%, and 84.22%, respectively-improving 3-5% over gaze baselines without increasing the annotation burden. By preserving correlations among predictions, gaze data, and lesion descriptions, our framework also maintains clinical interpretability. This work illustrates how integrating human visual attention with AI-generated semantic context can effectively overcome the limitations of individual weak supervision signals, thereby advancing the development of deployable, annotation-efficient medical AI systems. Code is available at: https://github.com/jingkunchen/FGI.

Automatic coronary artery labeling is essential for accurate vascular identification and the diagnosis of coronary disease. The task requires delineating the full vasculature and classifying each segment; however, preserving global topology and local demarcation line precision is difficult due to complex anatomy and blurry contours. We propose a coarse-to-fine ensemble framework with two modules: a Coarse-to-fine Topology Extraction (CTE) network using topology priors for global continuity, and a Progressive Vessel Labeling (PVL) module with multibranch fusion for segmentation and classification. Experiments on the ARCADE dataset achieve a mean F1-score of 0.6028, outperforming state-of-the-art methods and enhancing topological integrity and labeling accuracy. Code: https://github.com/IPMINWU/PGSMODEL.

High-fidelity, patient-specific cardiac mesh reconstruction underpins diagnosis, surgical planning, and hemodynamic simulation. Accurate and topologically coherent reconstruction remains challenging due to large inter-individual anatomical variability and complex cardiac morphology. We propose a template-free framework, TFSG, that integrates an Adaptive Structural Point Generation (ASG) module and a Structural Consistency Constraint (SCC). ASG extracts patientspecific anatomical landmarks from a point-cloud representation to guide deformation, while SCC enforces multi-level consistency (point distance, normal alignment and structural-point relations) to suppress topological and structural errors. Experiments on the CARE2025 WHS dataset show TFSG improves segmentation and mesh reconstruction quality compared to prior methods. Code: https://github.com/IPMI-NWU/TFSG.

Tissue segmentation in histopathological images plays a crucial role in computational pathology, owing to its significant potential to indicate the prognosis of cancer patients. Presently, numerous Weakly Supervised Semantic Segmentation (WSSS) methods strive to utilize image-level labels to achieve pixel-level segmentation, aiming to minimize the need for detailed annotations. Most of these methods rely on Class Activation Maps (CAM) extracted from classification models, frequently leading to poor coverage of objects. The major cause is attributed to the strong inductive bias of the classification model, focusing primarily on discriminative feature of objects, rather than non-discriminative features. Inspired by this, we propose a simple yet effective method that introduces a self-supervised task by exploiting both the discriminative and non-discriminative features, and generate Unbiased Activation Maps (UAM) to encompass the whole object. Specifically, our method entails clustering all spatial features of an object class to derive semantic centers. Each center then works as a spatial filter that amplifies similar feature and suppresses dissimilar feature, and extract high-quality pseudo-labels (some noise at object boundaries). Moreover, we further propose a Noise-Reduced (NR) Learning method to train the segmentation network towards credible signals and lessen the impact of false predictions. Comprehensive experimental results on two public histopathology image datasets demonstrate the superior performance of our method over the state-of-the-art weakly supervised segmentation methods.

Accurate segmentation of prostate tumors from multi-modal magnetic resonance (MR) images is crucial for diagnosis and treatment of prostate cancer. However, the robustness of existing segmentation methods is limited, mainly because these methods 1) fail to adaptively assess subject-specific information of each MR modality for accurate tumor delineation, and 2) lack effective utilization of inter-slice information across thick slices in MR images to segment tumor as a whole 3D volume. In this work, we propose a two-stage neighbor-aware multi-modal adaptive learning network (NaMa) for accurate prostate tumor segmentation from multi-modal anisotropic MR images. In particular, in the first stage, we apply subject-specific multi-modal fusion in each slice by developing a novel modality-informativeness adaptive learning (MIAL) module for selecting and adaptively fusing informative representation of each modality based on inter-modality correlations. In the second stage, we exploit inter-slice feature correlations to derive volumetric tumor segmentation. Specifically, we first use a Unet variant with sequence layers to coarsely capture slice relationship at a global scale, and further generate an activation map for each slice. Then, we introduce an activation mapping guidance (AMG) module to refine slice-wise representation (via information from adjacent slices) for consistent tumor segmentation across neighboring slices. Besides, during the network training, we further apply a random mask strategy to each MR modality to improve feature representation efficiency. Experiments on both in-house and public (PICAI) multi-modal prostate tumor datasets show that our proposed NaMa performs better than state-of-the-art methods.

Coronary artery segmentation is critical for coronary artery disease diagnosis but challenging due to its tortuous course with numerous small branches and inter-subject variations. Most existing studies ignore important anatomical information and vascular topologies, leading to less desirable segmentation performance that usually cannot satisfy clinical demands. To deal with these challenges, in this paper we propose an anatomy- and topology-preserving two-stage framework for coronary artery segmentation. The proposed framework consists of an anatomical dependency encoding (ADE) module and a hierarchical topology learning (HTL) module for coarse-to-fine segmentation, respectively. Specifically, the ADE module segments four heart chambers and aorta, and thus five distance field maps are obtained to encode distance between chamber surfaces and coarsely segmented coronary artery. Meanwhile, ADE also performs coronary artery detection to crop region-of-interest and eliminate foreground-background imbalance. The follow-up HTL module performs fine segmentation by exploiting three hierarchical vascular topologies, i.e., key points, centerlines, and neighbor connectivity using a multi-task learning scheme. In addition, we adopt a bottom-up attention interaction (BAI) module to integrate the feature representations extracted across hierarchical topologies. Extensive experiments on public and in-house datasets show that the proposed framework achieves state-of-the-art performance for coronary artery segmentation.

Anatomical labeling of head and neck vessels is a vital step for cerebrovascular disease diagnosis. However, it remains challenging to automatically and accurately label vessels in computed tomography angiography (CTA) since head and neck vessels are tortuous, branched, and often spatially close to nearby vasculature. To address these challenges, we propose a novel topology-aware graph network (TaG-Net) for vessel labeling. It combines the advantages of volumetric image segmentation in the voxel space and centerline labeling in the line space, wherein the voxel space provides detailed local appearance information, and line space offers high-level anatomical and topological information of vessels through the vascular graph constructed from centerlines. First, we extract centerlines from the initial vessel segmentation and construct a vascular graph from them. Then, we conduct vascular graph labeling using TaG-Net, in which techniques of topology-preserving sampling, topology-aware feature grouping, and multi-scale vascular graph are designed. After that, the labeled vascular graph is utilized to improve volumetric segmentation via vessel completion. Finally, the head and neck vessels of 18 segments are labeled by assigning centerline labels to the refined segmentation. We have conducted experiments on CTA images of 401 subjects, and experimental results show superior vessel segmentation and labeling of our method compared to other state-of-the-art methods.