The recently emerging conditional diffusion models seem promising for mitigating the labor and expenses in building large 3D medical imaging datasets. However, previous studies on 3D CT generation primarily focus on specific organs characterized by a local structure and fixed contrast and have yet to fully capitalize on the benefits of both semantic and textual conditions. In this paper, we present GuideGen, a controllable framework based on easily-acquired text prompts to generate anatomical masks and corresponding CT volumes for the entire torso—from chest to pelvis. Our approach includes three core components: a text-conditional semantic synthesizer for creating realistic full-torso anatomies; an anatomy-aware high-dynamic-range (HDR) autoencoder for high-fidelity feature extraction across varying intensity levels; and a latent feature generator that ensures alignment between CT images, anatomical semantics and input prompts. Combined, these components enable data synthesis for segmentation tasks from only textual instructions. To train and evaluate GuideGen, we compile a multi-modality cancer imaging dataset with paired CT and clinical descriptions from 12 public TCIA datasets and one private real-world dataset. Comprehensive evaluations across generation quality, cross-modality alignment, and data usability on multi-organ and tumor segmentation tasks demonstrate GuideGen's superiority over existing CT generation methods.

Medical image re-identification (MedReID) is underexplored so far, despite its critical applications in personalized healthcare and privacy protection. In this paper, we introduce a thorough benchmark and a unified model for this problem. First, to handle various medical modalities, we propose a novel Continuous Modality-based Parameter Adapter (ComPA). ComPA condenses medical content into a continuous modality representation and dynamically adjusts the modality-agnostic model with modalityspecific parameters at runtime. This allows a single model to adaptively learn and process diverse modality data. Furthermore, we integrate medical priors into our model by aligning it with a bag of pre-trained medical foundation models, in terms of the differential features. Compared to single-image feature, modeling the inter-image difference better fits the re-identification problem, which involves discriminating multiple images. We evaluate the proposed model against 25 foundation models and 8 large multimodal language models across 11 image datasets, demonstrating consistently superior performance. Additionally, we deploy the proposed MedReID technique to two realworld applications, i.e., history-augmented personalized diagnosis and medical privacy protection. Codes and model is available at https://github.com/tianyuan168326/All-inOne-MedReID-Pytorch.

The long-tailed distribution problem in medical image analysis reflects a high prevalence of common conditions and a low prevalence of rare ones, which poses a significant challenge in developing a unified model capable of identifying rare or novel tumor categories not encountered during training. In this paper, we propose a new Zero-shot Pan-Tumor segmentation framework (ZePT) based on query-disentangling and self-prompting to segment unseen tumor categories beyond the training set. ZePT disentangles the object queries into two subsets and trains them in two stages. Initially, it learns a set of fundamental queries for organ segmentation through an object-aware feature grouping strategy, which gathers organ-level visual features. Subsequently, it refines the other set of advanced queries that focus on the auto-generated visual prompts for unseen tumor segmentation. Moreover, we introduce query-knowledge alignment at the feature level to enhance each query's discriminative representation and generalizability. Extensive experiments on various tumor segmentation tasks demonstrate the performance superiority of ZePT, which surpasses the previous counterparts and evidences the promising ability for zero-shot tumor segmentation in real-world settings.

Existing promptable segmentation methods in the medical imaging field primarily consider either textual or visual prompts to segment relevant objects, yet they often fall short when addressing anomalies in medical images, like tumors, which may vary greatly in shape, size, and appearance. Recognizing the complexity of medical scenarios and the limitations of textual or visual prompts, we propose a novel dual-prompt schema that leverages the complementary strengths of visual and textual prompts for segmenting various organs and tumors. Specifically, we introduce $\textbf{\textit{CAT}}$, an innovative model that $\textbf{C}$oordinates $\textbf{A}$natomical prompts derived from 3D cropped images with $\textbf{T}$extual prompts enriched by medical domain knowledge. The model architecture adopts a general query-based design, where prompt queries facilitate segmentation queries for mask prediction. To synergize two types of prompts within a unified framework, we implement a ShareRefiner, which refines both segmentation and prompt queries while disentangling the two types of prompts. Trained on a consortium of 10 public CT datasets, $\textbf{\textit{CAT}}$ demonstrates superior performance in multiple segmentation tasks. Further validation on a specialized in-house dataset reveals the remarkable capacity of segmenting tumors across multiple cancer stages. This approach confirms that coordinating multimodal prompts is a promising avenue for addressing complex scenarios in the medical domain.

Acute ischemic stroke is recognized as a common cerebral vascular disease in aging people. Accurate diagnosis and timely treatment can effectively improve the blood supply of the ischemic area and reduce the risk of disability or even death. Understanding the location and size of infarcts plays a critical role in the diagnosis decision. However, manual localization and quantification of stroke lesions are laborious and time-consuming. In this paper, we propose a novel automatic method to segment acute ischemic stroke from diffusion weighted images (DWIs) using deep 3-D convolutional neural networks (CNNs). Our method can efficiently utilize 3-D contextual information and automatically learn very discriminative features in an end-to-end and data-driven way. To relieve the difficulty of training very deep 3-D CNN, we equip our network with dense connectivity to enable the unimpeded propagation of information and gradients throughout the network. We train our model with Dice objective function to combat the severe class imbalance problem in data. A DWI data set containing 242 subjects (90 for training, 62 for validation, and 90 for testing) with various types of acute ischemic stroke was constructed to evaluate our method. Our model achieved high performance on various metrics (Dice similarity coefficient: 79.13%, lesionwise precision: 92.67%, and lesionwise F1 score: 89.25%), outperforming the other state-of-the-art CNN methods by a large margin. We also evaluated the model on ISLES2015-SSIS data set and achieved very competitive performance, which further demonstrated its generalization capacity. The proposed method is fast and accurate, demonstrating a good potential in clinical routines.