One-shot federated learning (OSFL) reduces the communication cost and privacy risks of iterative federated learning by constructing a global model with a single round of communication. However, most existing methods struggle to achieve robust performance on real-world domains such as medical imaging, or are inefficient when handling non-IID (Independent and Identically Distributed) data. To address these limitations, we introduce FALCON, a novel framework that enhances the effectiveness of OSFL over non-IID image data. The core idea of FALCON is to leverage the feature-aware hierarchical token sequences generation and knowledge distillation into OSFL. First, each client leverages a pretrained visual encoder with hierarchical scale encoding to compress images into hierarchical token sequences, which capture multi-scale semantics. Second, a multi-scale autoregressive transformer generator is used to model the distribution of these token sequences and generate the synthetic sequences. Third, clients upload the synthetic sequences along with the local classifier trained on the real token sequences to the server. Finally, the server incorporates knowledge distillation into global training to reduce reliance on precise distribution modeling. Experiments on medical and natural image datasets validate the effectiveness of FALCON in diverse non-IID scenarios, outperforming the best OSFL baselines by 9.58\% in average accuracy.

Foundation Models (FMs) have demonstrated strong generalization across diverse vision tasks. However, their deployment in federated settings is hindered by high computational demands, substantial communication overhead, and significant inference costs. We propose DSFedMed, a dual-scale federated framework that enables mutual knowledge distillation between a centralized foundation model and lightweight client models for medical image segmentation. To support knowledge distillation, a set of high-quality medical images is generated to replace real public datasets, and a learnability-guided sample selection strategy is proposed to enhance efficiency and effectiveness in dual-scale distillation. This mutual distillation enables the foundation model to transfer general knowledge to lightweight clients, while also incorporating client-specific insights to refine the foundation model. Evaluations on five medical imaging segmentation datasets show that DSFedMed achieves an average 2 percent improvement in Dice score while reducing communication costs and inference time by nearly 90 percent compared to existing federated foundation model baselines. These results demonstrate significant efficiency gains and scalability for resource-limited federated deployments.

In multi-center scenarios, One-Shot Federated Learning (OSFL) has attracted increasing attention due to its low communication overhead, requiring only a single round of transmission. However, existing generative model-based OSFL methods suffer from low training efficiency and potential privacy leakage in the healthcare domain. Additionally, achieving convergence within a single round of model aggregation is challenging under non-Independent and Identically Distributed (non-IID) data. To address these challenges, in this paper a modified OSFL framework is proposed, in which a new Feature-Guided Rectified Flow Model (FG-RF) and Dual-Layer Knowledge Distillation (DLKD) aggregation method are developed. FG-RF on the client side accelerates generative modeling in medical imaging scenarios while preserving privacy by synthesizing feature-level images rather than pixel-level images. To handle non-IID distributions, DLKD enables the global student model to simultaneously mimic the output logits and align the intermediate-layer features of client-side teacher models during aggregation. Experimental results on three non-IID medical imaging datasets show that our new framework and method outperform multi-round federated learning approaches, achieving up to 21.73% improvement, and exceed the baseline FedISCA by an average of 21.75%. Furthermore, our experiments demonstrate that feature-level synthetic images significantly reduce privacy leakage risks compared to pixel-level synthetic images. The code is available at https://github.com/LMIAPC/one-shot-fl-medical.

Learning from multi-center medical datasets to obtain a high-performance global model is challenging due to the privacy protection and data heterogeneity in healthcare systems. Current federated learning approaches are not efficient enough to learn Non-Independent and Identically Distributed (Non-IID) data and require high communication costs. In this work, a practical privacy computing framework is proposed to train a Non-IID medical image segmentation model under various multi-center setting in low communication cost. Specifically, an efficient cascaded diffusion model is trained to generate image-mask pairs that have similar distribution to the training data of clients, providing rich labeled data on client side to mitigate heterogeneity. Also, a label construction module is developed to improve the quality of generated image-mask pairs. Moreover, a set of aggregation methods is proposed to achieve global model from data generated from Cascaded Diffusion model for diverse scenarios: CD-Syn, CD-Ens and its extension CD-KD. CD-Syn is a one-shot method that trains segmentation model solely on public generated datasets while CD-Ens and CD-KD maximize the utilization of local original data by an extra communication round of ensemble or knowledge distillation. In this way, the setting of our proposed framework is highly practical, providing multiple aggregation methods which can flexibly adapt to varying demands for efficiency, privacy, and accuracy. We systematically evaluated the effectiveness of our proposed framework on five Non-IID medical datasets and observe 5.38% improvement in Dice score compared with baseline method (FednnU-Net) on average.