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

Accurate segmentation of cervical structures in transvaginal ultrasound (TVS) is critical for assessing the risk of spontaneous preterm birth (PTB), yet the scarcity of labeled data limits the performance of supervised learning approaches. This paper introduces the Fetal Ultrasound Grand Challenge (FUGC), the first benchmark for semi-supervised learning in cervical segmentation, hosted at ISBI 2025. FUGC provides a dataset of 890 TVS images, including 500 training images, 90 validation images, and 300 test images. Methods were evaluated using the Dice Similarity Coefficient (DSC), Hausdorff Distance (HD), and runtime (RT), with a weighted combination of 0.4/0.4/0.2. The challenge attracted 10 teams with 82 participants submitting innovative solutions. The best-performing methods for each individual metric achieved 90.26% mDSC, 38.88 mHD, and 32.85 ms RT, respectively. FUGC establishes a standardized benchmark for cervical segmentation, demonstrates the efficacy of semi-supervised methods with limited labeled data, and provides a foundation for AI-assisted clinical PTB risk assessment.

We introduce DiMPLe (Disentangled Multi-Modal Prompt Learning), a novel approach to disentangle invariant and spurious features across vision and language modalities in multi-modal learning. Spurious correlations in visual data often hinder out-of-distribution (OOD) performance. Unlike prior methods focusing solely on image features, DiMPLe disentangles features within and across modalities while maintaining consistent alignment, enabling better generalization to novel classes and robustness to distribution shifts. Our method combines three key objectives: (1) mutual information minimization between invariant and spurious features, (2) spurious feature regularization, and (3) contrastive learning on invariant features. Extensive experiments demonstrate DiMPLe demonstrates superior performance compared to CoOp-OOD, when averaged across 11 diverse datasets, and achieves absolute gains of 15.27 in base class accuracy and 44.31 in novel class accuracy.

The success of Deep Neural Network (DNN) models significantly depends on the quality of provided annotations. In medical image segmentation, for example, having multiple expert annotations for each data point is standard to minimize subjective annotation bias. Then, the goal of estimation is to filter out the label noise and recover the ground-truth masks, which are not explicitly given. This paper proposes a probabilistic model for noisy observations that allows us to build confident classification and segmentation models. We explicitly model label noise to accomplish this and introduce a new information-based regularization that pushes the network to recover the ground-truth labels. In addition, we adjust the loss function for the segmentation task by prioritizing learning in high-confidence regions where all the annotators agree on labeling. We evaluate the proposed method on a series of classification tasks such as noisy versions of MNIST, CIFAR-10, and Fashion-MNIST datasets, as well as CIFAR-10N, a real-world dataset with noisy human annotations. Additionally, for the segmentation task, we consider several medical imaging datasets, such as LIDC and RIGA, that reflect real-world inter-variability among multiple annotators. Our experiments show that our algorithm outperforms state-of-the-art solutions for the considered classification and segmentation problems.

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

Nuclear detection, segmentation and morphometric profiling are essential in helping us further understand the relationship between histology and patient outcome. To drive innovation in this area, we setup a community-wide challenge using the largest available dataset of its kind to assess nuclear segmentation and cellular composition. Our challenge, named CoNIC, stimulated the development of reproducible algorithms for cellular recognition with real-time result inspection on public leaderboards. We conducted an extensive post-challenge analysis based on the top-performing models using 1,658 whole-slide images of colon tissue. With around 700 million detected nuclei per model, associated features were used for dysplasia grading and survival analysis, where we demonstrated that the challenge's improvement over the previous state-of-the-art led to significant boosts in downstream performance. Our findings also suggest that eosinophils and neutrophils play an important role in the tumour microevironment. We release challenge models and WSI-level results to foster the development of further methods for biomarker discovery.

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.

Flower classification is a challenging task due to the wide range of flower species, which have a similar shape, appearance or surrounding objects such as leaves and grass. In this study, the authors propose a novel two‐step deep learning classifier to distinguish flowers of a wide range of species. First, the flower region is automatically segmented to allow localisation of the minimum bounding box around it. The proposed flower segmentation approach is modelled as a binary classifier in a fully convolutional network framework. Second, they build a robust convolutional neural network classifier to distinguish the different flower types. They propose novel steps during the training stage to ensure robust, accurate and real‐time classification. They evaluate their method on three well known flower datasets. Their classification results exceed 97% on all datasets, which are better than the state‐of‐the‐art in this domain.

The parasagittal (PS) plane is a 2-D diagnostic plane used routinely in cranial ultrasonography of the neonatal brain. This paper develops a novel approach to find the PS plane in a 3-D fetal ultrasound scan to allow image-based biomarkers to be tracked from prebirth through the first weeks of postbirth life. We propose an accurate plane-finding solution based on regression forests (RF). The method initially localizes the fetal brain and its midline automatically. The midline on several axial slices is used to detect the midsagittal plane, which is used as a constraint in the proposed RF framework to detect the PS plane. The proposed learning algorithm guides the RF learning method in a novel way by: 1) using informative voxels and voxel informative strength as a weighting within the training stage objective function, and 2) introducing regularization of the RF by proposing a geometrical feature within the training stage. Results on clinical data indicate that the new automated method is more reproducible than manual plane finding obtained by two clinicians.

We propose an automated framework for predicting gestational age (GA) and neurodevelopmental maturation of a fetus based on 3D ultrasound (US) brain image appearance. Our method capitalizes on age-related sonographic image patterns in conjunction with clinical measurements to develop, for the first time, a predictive age model which improves on the GA-prediction potential of US images. The framework benefits from a manifold surface representation of the fetal head which delineates the inner skull boundary and serves as a common coordinate system based on cranial position. This allows for fast and efficient sampling of anatomically-corresponding brain regions to achieve like-for-like structural comparison of different developmental stages. We develop bespoke features which capture neurosonographic patterns in 3D images, and using a regression forest classifier, we characterize structural brain development both spatially and temporally to capture the natural variation existing in a healthy population (N=447) over an age range of active brain maturation (18-34weeks). On a routine clinical dataset (N=187) our age prediction results strongly correlate with true GA (r=0.98,accurate within±6.10days), confirming the link between maturational progression and neurosonographic activity observable across gestation. Our model also outperforms current clinical methods by ±4.57 days in the third trimester-a period complicated by biological variations in the fetal population. Through feature selection, the model successfully identified the most age-discriminating anatomies over this age range as being the Sylvian fissure, cingulate, and callosal sulci.

This paper presents the evaluation results of the methods submitted to Challenge US: Biometric Measurements from Fetal Ultrasound Images, a segmentation challenge held at the IEEE International Symposium on Biomedical Imaging 2012. The challenge was set to compare and evaluate current fetal ultrasound image segmentation methods. It consisted of automatically segmenting fetal anatomical structures to measure standard obstetric biometric parameters, from 2D fetal ultrasound images taken on fetuses at different gestational ages (21 weeks, 28 weeks, and 33 weeks) and with varying image quality to reflect data encountered in real clinical environments. Four independent sub-challenges were proposed, according to the objects of interest measured in clinical practice: abdomen, head, femur, and whole fetus. Five teams participated in the head sub-challenge and two teams in the femur sub-challenge, including one team who tackled both. Nobody attempted the abdomen and whole fetus sub-challenges. The challenge goals were two-fold and the participants were asked to submit the segmentation results as well as the measurements derived from the segmented objects. Extensive quantitative (region-based, distance-based, and Bland-Altman measurements) and qualitative evaluation was performed to compare the results from a representative selection of current methods submitted to the challenge. Several experts (three for the head sub-challenge and two for the femur sub-challenge), with different degrees of expertise, manually delineated the objects of interest to define the ground truth used within the evaluation framework. For the head sub-challenge, several groups produced results that could be potentially used in clinical settings, with comparable performance to manual delineations. The femur sub-challenge had inferior performance to the head sub-challenge due to the fact that it is a harder segmentation problem and that the techniques presented relied more on the femur's appearance.

This paper describes a novel 3-D segmentation technique posed within the Random Forests (RF) classification framework. Two improvements over the traditional RF framework are considered. Motivated by the high redundancy of feature selection in the traditional RF framework, the first contribution develops methods to improve voxel classification by selecting relatively "strong" features and neglecting "weak" ones. The second contribution involves weighting each tree in the forest during the testing stage, to provide an unbiased and more accurate decision than provided by the traditional RF. To demonstrate the improvement achieved by these enhancements, experimental validation is performed on adult brain MRI and 3-D fetal femoral ultrasound datasets. In a comparison of the new method with a traditional Random Forest, the new method showed a notable improvement in segmentation accuracy. We also compared the new method with other state-of-the-art techniques to place it in context of the current 3-D medical image segmentation literature.