Deformable image registration (DIR) is critical for accurate clinical diagnosis and effective treatment planning. However, patient movement, significant intensity differences, and large breathing deformations hinder accurate anatomical alignment in multi-modal image registration. These factors exacerbate the entanglement of anatomical and modality-specific style information, thereby severely limiting the performance of multi-modal registration. To address this, we propose a novel LAtent Diffusion-based Domain-Adaptive feature disentangling (LADDA) framework for unsupervised multi-modal medical image registration, which explicitly addresses the representation disentanglement. First, LADDA extracts reliable anatomical priors from the Latent Diffusion Model (LDM), facilitating downstream content-style disentangled learning. A Domain-Adaptive Feature Disentangling (DAFD) module is proposed to promote anatomical structure alignment further. This module disentangles image features into content and style information, boosting the network to focus on cross-modal content information. Next, a Neighborhood-Preserving Hashing (NPH) is constructed to further perceive and integrate hierarchical content information through local neighbourhood encoding, thereby maintaining cross-modal structural consistency. Furthermore, a Unilateral-Query-Frozen Attention (UQFA) module is proposed to enhance the coupling between upstream prior and downstream content information. The feature interaction within intra-domain consistent structures improves the fine recovery of detailed textures. The proposed framework is extensively evaluated on large-scale multi-center datasets, demonstrating superior performance across diverse clinical scenarios and strong generalization on out-of-distribution (OOD) data.

Cone-beam CT is extensively used in medical diagnosis and treatment. Despite its large longitudinal field of view (FoV), the horizontal FoV of CBCT systems is severely limited due to the detector width. Certain commercial CBCT systems increase the horizontal FoV by employing the offset detector method. However, this method necessitates 360° full circular scanning trajectory which increases the scanning time and is not compatible with specific CBCT system models. In this paper, we investigate the feasibility of large FoV imaging under short scan trajectories with an additional X-ray source. A dual-source CBCT geometry is proposed as well as two corresponding image reconstruction algorithms. The first one is based on cone-parallel rebinning and the subsequent employs a modified Parker weighting scheme. Theoretical calculations demonstrate that the proposed geometry achieves a wider horizontal FoV than the ${90}\%$ detector offset geometry (radius of ${214}.{83}\textit {mm}$ vs. ${198}.{99}\textit {mm}$ ) with a significantly reduced rotation angle (less than 230° vs. 360°). As demonstrated by experiments, the proposed geometry and reconstruction algorithms obtain comparable imaging qualities within the FoV to conventional CBCT imaging techniques. Implementing the proposed geometry is straightforward and does not substantially increase development expenses. It possesses the capacity to expand CBCT applications even further.

Cone beam computed tomography (CBCT) is an important imaging technology widely used in medical scenarios, such as diagnosis and preoperative planning. Using fewer projection views to reconstruct CT, also known as sparse-view reconstruction, can reduce ionizing radiation and further benefit interventional radiology. Compared with sparse-view reconstruction for traditional parallel/fan-beam CT, CBCT reconstruction is more challenging due to the increased dimensionality caused by the measurement process based on cone-shaped X-ray beams. As a 2D-to-3D reconstruction problem, although implicit neural representations have been introduced to enable efficient training, only local features are considered and different views are processed equally in previous works, resulting in spatial inconsistency and poor performance on complicated anatomies. To this end, we propose C2RV by leveraging explicit multi-scale volumetric representations to enable cross-regional learning in the 3D space. Additionally, the scale-view cross-attention module is introduced to adaptively aggregate multi-scale and multi-view features. Extensive experiments demonstrate that our C2RV achieves consistent and significant improvement over previous state-of-the-art methods on datasets with diverse anatomy. Code is available at https://github.com/xmed-lab/C2RV-CBCT.

Surgical phase recognition is a fundamental task in computer-assisted surgery systems. Most existing works are under the supervision of expensive and time-consuming full annotations, which require the surgeons to repeat watching videos to find the precise start and end time for a surgical phase. In this paper, we introduce timestamp supervision for surgical phase recognition to train the models with timestamp annotations, where the surgeons are asked to identify only a single timestamp within the temporal boundary of a phase. This annotation can significantly reduce the manual annotation cost compared to the full annotations. To make full use of such timestamp supervisions, we propose a novel method called uncertainty-aware temporal diffusion (UATD) to generate trustworthy pseudo labels for training. Our proposed UATD is motivated by the property of surgical videos, i.e., the phases are long events consisting of consecutive frames. To be specific, UATD diffuses the single labelled timestamp to its corresponding high confident (i.e., low uncertainty) neighbour frames in an iterative way. Our study uncovers unique insights of surgical phase recognition with timestamp supervision: 1) timestamp annotation can reduce 74% annotation time compared with the full annotation, and surgeons tend to annotate those timestamps near the middle of phases; 2) extensive experiments demonstrate that our method can achieve competitive results compared with full supervision methods, while reducing manual annotation costs; 3) less is more in surgical phase recognition, i.e., less but discriminative pseudo labels outperform full but containing ambiguous frames; 4) the proposed UATD can be used as a plug-and-play method to clean ambiguous labels near boundaries between phases, and improve the performance of the current surgical phase recognition methods. Code and annotations obtained from surgeons are available at https://github.com/xmed-lab/TimeStamp-Surgical.

The automatic diagnosis of various conventional ophthalmic diseases from fundus images is important in clinical practice. However, developing such automatic solutions is challenging due to the requirement of a large amount of training data and the expensive annotations for medical images. This paper presents a novel self-supervised learning framework for retinal disease diagnosis to reduce the annotation efforts by learning the visual features from the unlabeled images. To achieve this, we present a rotation-oriented collaborative method that explores rotation-related and rotation-invariant features, which capture discriminative structures from fundus images and also explore the invariant property used for retinal disease classification. We evaluate the proposed method on two public benchmark datasets for retinal disease classification. The experimental results demonstrate that our method outperforms other self-supervised feature learning methods (around 4.2% area under the curve (AUC)). With a large amount of unlabeled data available, our method can surpass the supervised baseline for pathologic myopia (PM) and is very close to the supervised baseline for age-related macular degeneration (AMD), showing the potential benefit of our method in clinical practice.