Foundational models are trained on extensive datasets to capture the general trends of a domain. However, in medical imaging, the scarcity of data makes pre-training for every domain, modality, or task challenging. Instead of building separate models, we propose MAFM3(Modular Adaptation of Foundation Models for Multi-Modal Medical AI), a framework that enables a single foundation model to expand into diverse domains, tasks, and modalities through lightweight modular components. These components serve as specialized skill sets that allow the system to flexibly activate the appropriate capability at the inference time, depending on the input type or clinical objective. Unlike conventional adaptation methods that treat each new task or modality in isolation, MAFM3provides a unified and expandable framework for efficient multitask and multimodality adaptation. Empirically, we validate our approach by adapting a chest CT foundation model initially trained for classification into prognosis and segmentation modules. Our results show improved performance on both tasks. Furthermore, by incorporating PET scans, MAFM3achieved an improvement in the Dice score 5% compared to the respective baselines. These findings establish that foundation models, when equipped with modular components, are not inherently constrained to their initial training scope but can evolve into multitask, multimodality systems for medical imaging. The code implementation of this work will be made available upon acceptance. The code implementation of this work can be found at Code

Deep learning for medical imaging is hampered by task-specific models that lack generalizability and prognostic capabilities, while existing ’universal’ approaches suffer from simplistic conditioning and poor medical semantic understanding. To address these limitations, we introduce DuPLUS, a deep learning framework for efficient multimodal medical image analysis. DuPLUS introduces a novel vision-language framework that leverages hierarchical semantic prompts for fine-grained control over the analysis task, a capability absent in prior universal models. To enable extensibility to other medical tasks, it includes a hierarchical, text-controlled architecture driven by a unique dual-prompt mechanism. For segmentation, DuPLUS is able to generalize across three imaging modalities, ten different anatomically various medical datasets, encompassing more than 30 organs and tumor types. It outperforms the state-of-the-art task-specific and universal models on 8 out of 10 datasets. We demonstrate extensibility of its text-controlled architecture by seamless integration of electronic health record (EHR) data for prognosis prediction, and on a head and neck cancer dataset, DuPLUS achieved a Concordance Index (CI) of 0.69. Parameter-efficient fine-tuning enables rapid adaptation to new tasks and modalities from varying centers, establishing DuPLUS as a versatile and clinically relevant solution for medical image analysis. The code for this work is made available at: Code

Medical data often exhibits distribution shifts, leading to performance degradation of deep learning models trained using standard supervised learning pipelines. Domain Generalization (DG) addresses this challenge, with Single-Domain Generalization (SDG) being notably relevant due to the privacy and logistical constraints often inherent in medical data. Existing disentanglement-based SDG methods heavily rely on structural information from segmentation masks, but classification labels do not offer similarly dense information. This work introduces a novel SDG method for medical image classification, utilizing channel-wise contrastive disentanglement. The method is further refined with reconstruction-based style regularization to ensure distinct style and structural feature representations are extracted. We evaluate our method on the complex tasks of multicenter histopathology image classification and Diabetic Retinopathy (DR) grading in fundus images, benchmarking it against state-of-the-art (SOTA) SDG baselines. Our results demonstrate that our method consistently outperforms the SOTA independently on the choice of the source domain while exhibiting greater performance stability. This study underscores the importance and challenges of exploring SDG frameworks for classification tasks. The code is publicly available at https://github.com/BioMedIA-MBZUAI/ConDiSR

International benchmarking competitions have become fundamental for the comparative performance assessment of image analysis methods. However, little attention has been given to investigating what can be learnt from these competitions. Do they really generate scientific progress? What are common and successful participation strategies? What makes a solution superior to a competing method? To address this gap in the literature, we performed a multicenter study with all 80 competitions that were conducted in the scope of IEEE ISBI 2021 and MICCAI 2021. Statistical analyses performed based on comprehensive descriptions of the submitted algorithms linked to their rank as well as the underlying participation strategies revealed common characteristics of winning solutions. These typically include the use of multi-task learning (63%) and/or multi-stage pipelines (61%), and a focus on augmentation (100%), image preprocessing (97%), data curation (79%), and post-processing (66%). The “typical” lead of a winning team is a computer scientist with a doctoral degree, five years of experience in biomedical image analysis, and four years of experience in deep learning. Two core general development strategies stood out for highly-ranked teams: the reflection of the metrics in the method design and the focus on analyzing and handling failure cases. According to the organizers, 43% of the winning algorithms exceeded the state of the art but only 11% completely solved the respective domain problem. The insights of our study could help researchers (1) improve algorithm development strategies when approaching new problems, and (2) focus on open research questions revealed by this work.

The number of studies on deep learning for medical diagnosis is expanding, and these systems are often claimed to outperform clinicians. However, only a few systems have shown medical efficacy. From this perspective, we examine a wide range of deep learning algorithms for the assessment of glioblastoma - a common brain tumor in older adults that is lethal. Surgery, chemotherapy, and radiation are the standard treatments for glioblastoma patients. The methylation status of the MGMT promoter, a specific genetic sequence found in the tumor, affects chemotherapy's effectiveness. MGMT promoter methylation improves chemotherapy response and survival in several cancers. MGMT promoter methylation is determined by a tumor tissue biopsy, which is then genetically tested. This lengthy and invasive procedure increases the risk of infection and other complications. Thus, researchers have used deep learning models to examine the tumor from brain MRI scans to determine the MGMT promoter's methylation state. We employ deep learning models and one of the largest public MRI datasets of 585 participants to predict the methylation status of the MGMT promoter in glioblastoma tumors using MRI scans. We test these models using Grad-CAM, occlusion sensitivity, feature visualizations, and training loss landscapes. Our results show no correlation between these two, indicating that external cohort data should be used to verify these models' performance to assure the accuracy and reliability of deep learning systems in cancer diagnosis.

Pulsed-Index Communication (PIC) is a novel technique for single-channel, high-data rate, low-power dynamic signaling that does not require any clock and data recovery. It is fully adapted to the simple yet robust communication needs of Internet of Things (IoT) devices and sensors. However, its error-free operation with maximum data rate requires a careful and judicious setting of PIC data packet and pulse timing parameters. In this paper, we present a new algorithm for automatically detecting and setting the PIC protocol parameters at the power-on phase while removing the restriction on the IoT devices in the PIC network to communicate at a baud rate. The hardware realization of the algorithm is power-efficient and uses closed-form formulas that assign suitable protocol parameters to both ends of the transmission link based on clock rate differences. This difference is determined by a preliminary exchange of clock pulse streams between the transmitter and the receiver. The automatic parameter setting remains operational even in the presence of variations between the local clock frequencies of the IoT devices communicating via PIC. The algorithm is illustrated in the case of several IoT devices with different local clock frequencies that are in need to synchronize their communication parameters with respect to the clock frequency of a master gateway node. A power-on PIC parameter configuration process is rigorously specified, and both an FPGA and an ASIC implementations are presented. In particular, we show that for an ASIC implementation in 65nm technology, the low-power operation of PIC is maintained, consuming only 4.35µW of power at a clock frequency of 25MHz. This architecture is experimentally verified and tested on a point-to-point communication link between two IoT devices connected via a single PIC channel in a master-slave mode.