Segmenting 3D blood vessels is a critical yet challenging task in medical image analysis. This is due to significant imaging modality-specific variations in artifacts, vascular patterns and scales, signal-to-noise ratios, and background tissues. These variations, along with domain gaps arising from varying imaging protocols, limit the generalization of existing supervised learning-based methods, requiring tedious voxel-level annotations for each dataset separately. While foundation models promise to alleviate this limitation, they typically fail to generalize to the task of blood vessel segmentation, posing a unique, complex problem. In this work, we present vesselFM, a foundation model designed specifically for the broad task of 3D blood vessel segmentation. Unlike previous models, vesselFM can effortlessly generalize to unseen domains. To achieve zero-shot generalization, we train vesselFM on three heterogeneous data sources: a large, curated annotated dataset, data generated by a domain randomization scheme, and data sampled from a flow matching-based generative model. Extensive evaluations show that vesselFM outperforms state-of-the-art medical image segmentation foundation models across four (pre-)clinically relevant imaging modalities in zero-, one-, and few-shot scenarios, therefore providing a universal solution for 3D blood vessel segmentation.

Current state-of-the-art generative models map noise to data distributions by matching flows or scores. A key limitation of these models is their inability to readily integrate available partial observations and additional priors. In contrast, energy-based models (EBMs) address this by incorporating corresponding scalar energy terms. Here, we propose Energy Matching, a framework that endows flow-based approaches with the flexibility of EBMs. Far from the data manifold, samples move from noise to data along irrotational, optimal transport paths. As they approach the data manifold, an entropic energy term guides the system into a Boltzmann equilibrium distribution, explicitly capturing the underlying likelihood structure of the data. We parameterize these dynamics with a single time-independent scalar field, which serves as both a powerful generator and a flexible prior for effective regularization of inverse problems. The present method substantially outperforms existing EBMs on CIFAR-10 and ImageNet generation in terms of fidelity, while retaining simulation-free training of transport-based approaches away from the data manifold. Furthermore, we leverage the flexibility of the method to introduce an interaction energy that supports the exploration of diverse modes, which we demonstrate in a controlled protein generation setting. This approach learns a scalar potential energy, without time conditioning, auxiliary generators, or additional networks, marking a significant departure from recent EBM methods. We believe this simplified yet rigorous formulation significantly advances EBMs capabilities and paves the way for their wider adoption in generative modeling in diverse domains.

Physical models in the form of partial differential equations serve as important priors for many under-constrained problems. One such application is tumor treatment planning, which relies on accurately estimating the spatial distribution of tumor cells within a patient’s anatomy. While medical imaging can detect the bulk of a tumor, it cannot capture the full extent of its spread, as low-concentration tumor cells often remain undetectable, particularly in glioblastoma, the most common primary brain tumor. Machine learning approaches struggle to estimate the complete tumor cell distribution due to a lack of appropriate training data. Consequently, most existing methods rely on physics-based simulations to generate anatomically and physiologically plausible estimations. However, these approaches face challenges with complex and unknown initial conditions and are constrained by overly rigid physical models. In this work, we introduce a novel method that integrates data-driven and physics-based cost functions, akin to Physics-Informed Neural Networks (PINNs). However, our approach parametrizes the solution directly on a dynamic discrete mesh, allowing for the effective modeling of complex biomechanical behaviors. Specifically, we propose a unique discretization scheme that quantifies how well the learned spatiotemporal distributions of tumor and brain tissues adhere to their respective growth and elasticity equations. This quantification acts as a regularization term, offering greater flexibility and improved integration of patient data compared to existing models. We demonstrate enhanced coverage of tumor recurrence areas using real-world data from a patient cohort, highlighting the potential of our method to improve model-driven treatment planning for glioblastoma in clinical practice.

Statistical shape models are an essential tool for various tasks in medical image analysis, including shape generation, reconstruction and classification. Shape models are learned from a population of example shapes, which are typically obtained through segmentation of volumetric medical images. In clinical practice, highly anisotropic volumetric scans with large slice distances are prevalent, e.g., to reduce radiation exposure in CT or image acquisition time in MR imaging. For existing shape modeling approaches, the resolution of the emerging model is limited to the resolution of the training shapes. Therefore, any missing information between slices prohibits existing methods from learning a high-resolution shape prior. We propose a novel shape modeling approach that can be trained on sparse, binary segmentation masks with large slice distances. This is achieved through employing continuous shape representations based on neural implicit functions. After training, our model can reconstruct shapes from various sparse inputs at high target resolutions beyond the resolution of individual training examples. We successfully reconstruct high-resolution shapes from as few as three orthogonal slices. Furthermore, our shape model allows us to embed various sparse segmentation masks into a common, low-dimensional latent space - independent of the acquisition direction, resolution, spacing, and field of view. We show that the emerging latent representation discriminates between healthy and pathological shapes, even when provided with sparse segmentation masks. Lastly, we qualitatively demonstrate that the emerging latent space is smooth and captures characteristic modes of shape variation. We evaluate our shape model on two anatomical structures: the lumbar vertebra and the distal femur, both from publicly available datasets.