Central lumbar spinal stenosis, a prevalent degenerative spinal disorder, severely impacts the quality of life for those affected. Axial and sagittal MRI images offer diverse information on tissue structure and lesions, which is crucial for accurate diagnosis. However, MRI-based diagnostic approaches still have poor lesion localization, insufficient cross-view alignment, underutilization of multi-view MRI information, and limited generalization across patient variability. To address these problems, we proposed an Encompassing Lumbar Central Spinal Stenosis Grading Model via Multi-view MRI Image Fusion called ELSG-MF. ELSG-MF consists of three stages: the first stage utilizes the extraction of robust pseudo-labels through a contrast-driven consistency reinforcement technique to guide Med-SAM in localizing and segmenting spinal tissue components. The Sagittal-Axial Pairing (SAP) Algorithm was developed by stage2 to integrate the spatial anatomical relationship between the vertebral body and the intervertebral disc, facilitating the correlation pairing between sagittal and axial images. Stage3 subsequently innovated the multi-view Adaptive Fusion (M²AF) module, which enables adaptive dynamic fusion of anatomical features across views. M²AF enhances the extraction of contextual complementary information, and significantly improves the model’s capacity to detect subtle variations in the degree of narrowness. A series of studies show that our model achieves an overall accuracy of 0.8631, AUC of 0.96, and F1-score of 0.8614. These results indicate that our model substantially outperforms mainstream approaches, attaining superior segmentation and grading accuracy, exhibiting robust generalization and clinical application potential.

Medical Large Vision-Language Models (MLVLMs) show encouraging results in medical diagnostics but easily in-herit biases from pretraining data, leading to bias catastrophic inheritance, where data biases persist and distort predictions. In this work, we present the first systematic study of this issue in MLVLMs, revealing how inherited biases affect classification and free-text reasoning tasks. We propose Logit Fairness Adjustment (LFA), a training-free debiasing method that operates at the logits level to recalibrate biased predictions. LFA quantifies bias by computing logit margins between valid and invalid medical images, applying logit smoothing when the margin is small to reduce overconfidence and bias compensation when the margin is large to reinforce valid features. We introduce the Medical Multimodal Bias Benchmark to assess bias severity across binary classification, multi-class classification, and free-text reasoning. Experiments on LLaVA-Med, SkinGPT-4, and Qwen-VL-7B show that LFA effectively mitigates bias for MLVLMs.

Pancreatic cancer is characterized by insidious onset and extremely poor prognosis. Accurate segmentation of the pancreas and its tumors is crucial for achieving precision medicine. The pancreas presents as a small, low-contrast target, while pancreatic tumors appear even smaller with highly irregular shapes. Existing methods, such as Convolutional Neural Networks, are limited by their small receptive fields and thus struggle to model long-range dependencies. Meanwhile, the fixed computational path of Transformers presents challenges for their adaptation to 3D pancreas and tumor segmentation. This study proposes the Global Awareness and Local Refinement (GALR) model, which addresses the challenges of long-range dependencies and multi-scale modeling, achieving precise 3D segmentation of the pancreas and its tumor boundaries. The model consists of two core innovative modules: The Multi-scale Dual Attention Mamba (MDAM) module dynamically captures the key information of the remodeling sequence through the Selective State Space Model, and combines the dilated convolution multi-scale fusion to enhance the multi-scale object recognition ability. The module integrates the dual attention mechanism to capture the cross-regional anatomical correlation, strengthens the segmentation sensitivity of low contrast regions, and realizes global perception of precision medical image segmentation. The Lightweight Grouped Convolutional Enhancement (LGCE) module uses a parameter-efficient linkage structure to construct a feature refinement flow for small target boundaries in the decoding stage, which effectively suppresses the interference of noise such as artifacts on the target contour. This module significantly improves the localization accuracy through the Local Refinement mechanism, and achieves accurate boundary contour segmentation. Experimental results on two datasets, CT and MRI, show that GALR has the best performance in pancreas and tumor segmentation tasks. On dataset 1, our method achieves Dice coefficients of 80.27 % and 51.72 % in pancreas and tumor segmentation tasks, respectively, which are 0.46 % and 1.18 % higher than the previous best model. The performance of other indicators is also excellent. The experiment on dataset 2 also leads to the same conclusion. The experimental results indicate that GALR provides an efficient clinical solution for computeraided diagnosis of pancreatic diseases.

Vision Transformers (ViTs) suffer from high parameter complexity because they rely on Multi-layer Perceptrons (MLPs) for nonlinear representation. This issue is particularly challenging in medical image analysis, where labeled data is limited, leading to inadequate feature representation. Existing methods have attempted to optimize either the patch embedding stage or the non-embedding stage of ViTs. Still, they have struggled to balance effective modeling, parameter complexity, and data availability. Recently, the Kolmogorov-Arnold Network (KAN) was introduced as an alternative to MLPs, offering a potential solution to the large parameter issue in ViTs. However, KAN cannot be directly integrated into ViT due to challenges such as handling 2D structured data and dimensionality catastrophe. To solve this problem, we propose MedKAFormer, the first ViT model to incorporate the Kolmogorov-Arnold (KA) theorem for medical image representation. It includes a Dynamic Kolmogorov-Arnold Convolution (DKAC) layer for flexible nonlinear modeling in the patch embedding stage. Additionally, it introduces a Nonlinear Sparse Token Mixer (NSTM) and a Nonlinear Dynamic Filter (NDF) in the non-embedding stage. These components provide comprehensive nonlinear representation while reducing model overfitting. MedKAFormer reduces parameter complexity by 85.61% compared to ViT-Base and achieves competitive results on 14 medical datasets across various imaging modalities and structures.

Achieving accurate bladder wall and tumor segmentation from MRI is critical for diagnosing and treating bladder cancer. However, automated segmentation remains challenging due to factors such as comparable density distributions, intricate tumor morphologies, and unclear boundaries. Considering the attributes of bladder MRI images, we propose an efficient multiscale hierarchical hybrid attention with a transformer (MH2AFormer) for bladder cancer and wall segmentation. Specifically, a multiscale hybrid attention and transformer (MHAT) module in the encoder is designed to adaptively extract and aggregate multiscale hybrid feature representations from the input image. In the decoder stage, we devise a multiscale hybrid attention (MHA) module to generate high-quality segmentation results from multiscale hybrid features. Combining these modules enhances the feature representation and guides the model to focus on tumor and wall regions, which helps to solve bladder image segmentation challenges. Moreover, MHAT utilizes the Fast Fourier Transformer with a large kernel (e.g., 224 × 224) to model global feature relationships while reducing computational complexity in the encoding stage. The model performance was evaluated on two datasets. As a result, the model achieves relatively best results regarding the intersection over union (IoU) and dice similarity coefficient (DSC) on both datasets (Dataset A: IoU = 80.26%, DSC = 88.20%; Dataset B: IoU = 89.74%, DSC = 94.48%). These advantageous outcomes substantiate the practical utility of our approach, highlighting its potential to alleviate the workload of radiologists when applied in clinical settings.

Real-world face super-resolution (SR) is a highly ill-posed image restoration task. The fully-cycled Cycle-GAN architecture is widely employed to achieve promising performance on face SR, but is prone to produce artifacts upon challenging cases in real-world scenarios, since joint participation in the same degradation branch will impact final performance due to huge domain gap between real-world and synthetic LR ones obtained by generators. To better exploit the powerful generative capability of GAN for real-world face SR, in this paper, we establish two independent degradation branches in the forward and backward cycle-consistent reconstruction processes, respectively, while the two processes share the same restoration branch. Our Semi-Cycled Generative Adversarial Networks (SCGAN) is able to alleviate the adverse effects of the domain gap between the real-world LR face images and the synthetic LR ones, and to achieve accurate and robust face SR performance by the shared restoration branch regularized by both the forward and backward cycle-consistent learning processes. Experiments on two synthetic and two real-world datasets demonstrate that, our SCGAN outperforms the state-of-the-art methods on recovering the face structures/details and quantitative metrics for real-world face SR. The code will be publicly released at https://github.com/HaoHou-98/SCGAN.

Automated Screening of COVID-19 from chest CT is of emergency and importance during the outbreak of SARS-CoV-2 worldwide in 2020. However, accurate screening of COVID-19 is still a massive challenge due to the spatial complexity of 3D volumes, the labeling difficulty of infection areas, and the slight discrepancy between COVID-19 and other viral pneumonia in chest CT. While a few pioneering works have made significant progress, they are either demanding manual annotations of infection areas or lack of interpretability. In this paper, we report our attempt towards achieving highly accurate and interpretable screening of COVID-19 from chest CT with weak labels. We propose an attention-based deep 3D multiple instance learning (AD3D-MIL) where a patient-level label is assigned to a 3D chest CT that is viewed as a bag of instances. AD3D-MIL can semantically generate deep 3D instances following the possible infection area. AD3D-MIL further applies an attention-based pooling approach to 3D instances to provide insight into each instance's contribution to the bag label. AD3D-MIL finally learns Bernoulli distributions of the bag-level labels for more accessible learning. We collected 460 chest CT examples: 230 CT examples from 79 patients with COVID-19, 100 CT examples from 100 patients with common pneumonia, and 130 CT examples from 130 people without pneumonia. A series of empirical studies show that our algorithm achieves an overall accuracy of 97.9%, AUC of 99.0%, and Cohen kappa score of 95.7%. These advantages endow our algorithm as an efficient assisted tool in the screening of COVID-19.