Large foundation models have emerged in the last years and are pushing performance boundaries for a variety of tasks. Training or even finetuning such models demands vast datasets and computational resources, which are often scarce and costly. Adaptation methods provide a computationally efficient solution to address these limitations by allowing such models to be finetuned on small amounts of data and computing power. This is achieved by appending new trainable modules to frozen backbones with only a fraction of the trainable parameters and fitting only these modules on novel tasks. Recently, the VeRA adapter was shown to excel in parameter-efficient adaptations by utilizing a pair of frozen random low-rank matrices shared across all layers. In this paper, we propose PVeRA, a probabilistic version of the VeRA adapter, which modifies the low-rank matrices of VeRA in a probabilistic manner. This modification naturally allows handling inherent ambiguities in the input and allows for different sampling configurations during training and testing. A comprehensive evaluation was performed on the VTAB-1k benchmark and seven adapters, with PVeRA outperforming VeRA and other adapters. Our code for training models with PVeRA and benchmarking all adapters is available here.

Assessing the quality of automatic image segmentation is crucial in clinical practice, but often very challenging due to the limited availability of ground truth annotations. Reverse Classification Accuracy (RCA) is an approach that estimates the quality of new predictions on unseen samples by training a segmenter on those predictions, and then evaluating it against existing annotated images. In this work we introduce ConfIC-RCA (Conformal In-Context RCA), a novel method for automatically estimating segmentation quality with statistical guarantees in the absence of ground-truth annotations, which consists of two main innovations. First, In-Context RCA, which leverages recent in-context learning models for image segmentation and incorporates retrieval-augmentation techniques to select the most relevant reference images. This approach enables efficient quality estimation with minimal reference data while avoiding the need of training additional models. Second, we introduce Conformal RCA, which extends both the original RCA framework and In-Context RCA to go beyond point estimation. Using tools from split conformal prediction, Conformal RCA produces prediction intervals for segmentation quality providing statistical guarantees that the true score lies within the estimated interval with a user-specified probability. Validated across 10 different medical imaging tasks in various organs and modalities, our methods demonstrate robust performance and computational efficiency, offering a promising solution for automated quality control in clinical workflows, where fast and reliable segmentation assessment is essential. The code is available at https://github.com/mcosarinsky/Conformal-In-Context-RCA.

Shivalika Singh, Angelika Romanou, Clémentine Fourrier, David Ifeoluwa Adelani, Jian Gang Ngui, Daniel Vila-Suero, Peerat Limkonchotiwat, Kelly Marchisio, Wei Qi Leong, Yosephine Susanto, Raymond Ng, Shayne Longpre, Sebastian Ruder, Wei-Yin Ko, Antoine Bosselut, Alice Oh, Andre Martins, Leshem Choshen, Daphne Ippolito, Enzo Ferrante, Marzieh Fadaee, Beyza Ermis, Sara Hooker. Proceedings of the 63rd Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers). 2025.

Learning-based image reconstruction models, such as those based on the U-Net, require a large set of labeled images if good generalization is to be guaranteed. In some imaging domains, however, labeled data with pixel- or voxel-level label accuracy are scarce due to the cost of acquiring them. This problem is exacerbated further in domains like medical imaging, where there is no single ground truth label, resulting in large amounts of repeat variability in the labels. Therefore, training reconstruction networks to generalize better by learning from both labeled and unlabeled examples (called semi-supervised learning) is problem of practical and theoretical interest. However, traditional semi-supervised learning methods for image reconstruction often necessitate handcrafting a differentiable regularizer specific to some given imaging problem, which can be extremely time-consuming. In this work, we propose "supervision by denoising" (SUD), a framework to supervise reconstruction models using their own denoised output as labels. SUD unifies stochastic averaging and spatial denoising techniques under a spatio-temporal denoising framework and alternates denoising and model weight update steps in an optimization framework for semi-supervision. As example applications, we apply SUD to two problems from biomedical imaging-anatomical brain reconstruction (3D) and cortical parcellation (2D)-to demonstrate a significant improvement in reconstruction over supervised-only and ensembling baselines.

Anatomical segmentation is a fundamental task in medical image computing, generally tackled with fully convolutional neural networks which produce dense segmentation masks. These models are often trained with loss functions such as cross-entropy or Dice, which assume pixels to be independent of each other, thus ignoring topological errors and anatomical inconsistencies. We address this limitation by moving from pixel-level to graph representations, which allow to naturally incorporate anatomical constraints by construction. To this end, we introduce HybridGNet, an encoder-decoder neural architecture that leverages standard convolutions for image feature encoding and graph convolutional neural networks (GCNNs) to decode plausible representations of anatomical structures. We also propose a novel image-to-graph skip connection layer which allows localized features to flow from standard convolutional blocks to GCNN blocks, and show that it improves segmentation accuracy. The proposed architecture is extensively evaluated in a variety of domain shift and image occlusion scenarios, and audited considering different types of demographic domain shift. Our comprehensive experimental setup compares HybridGNet with other landmark and pixel-based models for anatomical segmentation in chest x-ray images, and shows that it produces anatomically plausible results in challenging scenarios where other models tend to fail.

In real-life applications, machine learning models often face scenarios where there is a change in data distribution between training and test domains. When the aim is to make predictions on distributions different from those seen at training, we incur in a domain generalization problem. Methods to address this issue learn a model using data from multiple source domains, and then apply this model to the unseen target domain. Our hypothesis is that when training with multiple domains, conflicting gradients within each mini-batch contain information specific to the individual domains which is irrelevant to the others, including the test domain. If left untouched, such disagreement may degrade generalization performance. In this work, we characterize the conflicting gradients emerging in domain shift scenarios and devise novel gradient agreement strategies based on gradient surgery to alleviate their effect. We validate our approach in image classification tasks with three multi-domain datasets, showing the value of the proposed agreement strategy in enhancing the generalization capability of deep learning models in domain shift scenarios.

In this work we address the problem of landmark-based segmentation for anatomical structures. We propose HybridGNet, an encoder-decoder neural architecture which combines standard convolutions for image feature encoding, with graph convolutional neural networks to decode plausible representations of anatomical structures. We benchmark the proposed architecture considering other standard landmark and pixel-based models for anatomical segmentation in chest x-ray images, and found that HybridGNet is more robust to image occlusions. We also show that it can be used to construct landmark-based segmentations from pixel level annotations. Our experimental results suggest that HybridGNet produces accurate and anatomically plausible landmark-based segmentations, by naturally incorporating shape constraints within the decoding process via spectral convolutions.

Automatic quantification of the left ventricle (LV) from cardiac magnetic resonance (CMR) images plays an important role in making the diagnosis procedure efficient, reliable, and alleviating the laborious reading work for physicians. Considerable efforts have been devoted to LV quantification using different strategies that include segmentation-based (SG) methods and the recent direct regression (DR) methods. Although both SG and DR methods have obtained great success for the task, a systematic platform to benchmark them remains absent because of differences in label information during model learning. In this paper, we conducted an unbiased evaluation and comparison of cardiac LV quantification methods that were submitted to the Left Ventricle Quantification (LVQuan) challenge, which was held in conjunction with the Statistical Atlases and Computational Modeling of the Heart (STACOM) workshop at the MICCAI 2018. The challenge was targeted at the quantification of 1) areas of LV cavity and myocardium, 2) dimensions of the LV cavity, 3) regional wall thicknesses (RWT), and 4) the cardiac phase, from mid-ventricle short-axis CMR images. First, we constructed a public quantification dataset Cardiac-DIG with ground truth labels for both the myocardium mask and these quantification targets across the entire cardiac cycle. Then, the key techniques employed by each submission were described. Next, quantitative validation of these submissions were conducted with the constructed dataset. The evaluation results revealed that both SG and DR methods can offer good LV quantification performance, even though DR methods do not require densely labeled masks for supervision. Among the 12 submissions, the DR method LDAMT offered the best performance, with a mean estimation error of 301 mm2for the two areas, 2.15 mm for the cavity dimensions, 2.03 mm for RWTs, and a 9.5% error rate for the cardiac phase classification. Three of the SG methods also delivered comparable performances. Finally, we discussed the advantages and disadvantages of SG and DR methods, as well as the unsolved problems in automatic cardiac quantification for clinical practice applications.

The aim of this paper is to provide a comprehensive overview of the MICCAI 2020 AutoImplant Challenge. The approaches and publications submitted and accepted within the challenge will be summarized and reported, highlighting common algorithmic trends and algorithmic diversity. Furthermore, the evaluation results will be presented, compared and discussed in regard to the challenge aim: seeking for low cost, fast and fully automated solutions for cranial implant design. Based on feedback from collaborating neurosurgeons, this paper concludes by stating open issues and post-challenge requirements for intra-operative use. The codes can be found at https://github.com/Jianningli/tmi.

We introduce Post-DAE, a post-processing method based on denoising autoencoders (DAE) to improve the anatomical plausibility of arbitrary biomedical image segmentation algorithms. Some of the most popular segmentation methods (e.g. based on convolutional neural networks or random forest classifiers) incorporate additional post-processing steps to ensure that the resulting masks fulfill expected connectivity constraints. These methods operate under the hypothesis that contiguous pixels with similar aspect should belong to the same class. Even if valid in general, this assumption does not consider more complex priors like topological restrictions or convexity, which cannot be easily incorporated into these methods. Post-DAE leverages the latest developments in manifold learning via denoising autoencoders. First, we learn a compact and non-linear embedding that represents the space of anatomically plausible segmentations. Then, given a segmentation mask obtained with an arbitrary method, we reconstruct its anatomically plausible version by projecting it onto the learnt manifold. The proposed method is trained using unpaired segmentation mask, what makes it independent of intensity information and image modality. We performed experiments in binary and multi-label segmentation of chest X-ray and cardiac magnetic resonance images. We show how erroneous and noisy segmentation masks can be improved using Post-DAE. With almost no additional computation cost, our method brings erroneous segmentations back to a feasible space.

Deep convolutional neural networks (CNN) proved to be highly accurate to perform anatomical segmentation of medical images. However, some of the most popular CNN architectures for image segmentation still rely on post-processing strategies (e.g. Conditional Random Fields) to incorporate connectivity constraints into the resulting masks. These post-processing steps are based on the assumption that objects are usually continuous and therefore nearby pixels should be assigned the same object label. Even if it is a valid assumption in general, these methods do not offer a straightforward way to incorporate more complex priors like convexity or arbitrary shape restrictions. In this work we propose Post-DAE, a post-processing method based on denoising autoencoders (DAE) trained using only segmentation masks. We learn a low-dimensional space of anatomically plausible segmentations, and use it as a post-processing step to impose shape constraints on the resulting masks obtained with arbitrary segmentation methods. Our approach is independent of image modality and intensity information since it employs only segmentation masks for training. This enables the use of anatomical segmentations that do not need to be paired with intensity images, making the approach very flexible. Our experimental results on anatomical segmentation of X-ray images show that Post-DAE can improve the quality of noisy and incorrect segmentation masks obtained with a variety of standard methods, by bringing them back to a feasible space, with almost no extra computational time.

Deformable registration has been one of the pillars of biomedical image computing. Conventional approaches refer to the definition of a similarity criterion that, once endowed with a deformation model and a smoothness constraint, determines the optimal transformation to align two given images. The definition of this metric function is among the most critical aspects of the registration process. We argue that incorporating semantic information (in the form of anatomical segmentation maps) into the registration process will further improve the accuracy of the results. In this paper, we propose a novel weakly supervised approach to learn domain-specific aggregations of conventional metrics using anatomical segmentations. This combination is learned using latent structured support vector machines. The learned matching criterion is integrated within a metric-free optimization framework based on graphical models, resulting in a multi-metric algorithm endowed with a spatially varying similarity metric function conditioned on the anatomical structures. We provide extensive evaluation on three different datasets of CT and MRI images, showing that learned multi-metric registration outperforms single-metric approaches based on conventional similarity measures.

Incorporation of prior knowledge about organ shape and location is key to improve performance of image analysis approaches. In particular, priors can be useful in cases where images are corrupted and contain artefacts due to limitations in image acquisition. The highly constrained nature of anatomical objects can be well captured with learning-based techniques. However, in most recent and promising techniques such as CNN-based segmentation it is not obvious how to incorporate such prior knowledge. State-of-the-art methods operate as pixel-wise classifiers where the training objectives do not incorporate the structure and inter-dependencies of the output. To overcome this limitation, we propose a generic training strategy that incorporates anatomical prior knowledge into CNNs through a new regularisation model, which is trained end-to-end. The new framework encourages models to follow the global anatomical properties of the underlying anatomy (e.g. shape, label structure) via learnt non-linear representations of the shape. We show that the proposed approach can be easily adapted to different analysis tasks (e.g. image enhancement, segmentation) and improve the prediction accuracy of the state-of-the-art models. The applicability of our approach is shown on multi-modal cardiac data sets and public benchmarks. In addition, we demonstrate how the learnt deep models of 3-D shapes can be interpreted and used as biomarkers for classification of cardiac pathologies.