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Research · AI field

Clinical reasoning

Found by the topic model: clinical reasoning, radiology report generation, electroencephalography eeg.

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138papers this week−34.6% vs last week809 this month

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All fields1899Multimodal317Frontier LLMs234Recursive self improvement223Agents & indirect prompt injection175Inference & serving170Neural operators147Clinical reasoning138Robotics119Forecasting time75Linear bandits50AI safety45Voice AI41Character recognition OCR30Molecular property prediction27Federated learning18All 23 fields
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Papers

Open problems in Clinical reasoning

  • Lack of domain-specific benchmarks for clinical reasoning2 papers raise it · 1 addresses it

    General benchmarks fail to capture critical domain requirements like safety, personalization, and actionable quality, risking harm in real-world use.

    • MoveBench: A Rubric-Based Benchmark for Evaluating Large Language Models in Sports and Health Coachingraises · addresses
    • Clinician use of language models diverges from how the models are evaluatedraises
  • Handling incidental information in clinical documentation1 paper raises it · 0 address it

    LLMs may misattribute or use irrelevant small-talk or background noise in clinical notes, leading to errors or contamination.

    • Large language models are vulnerable to incidental information in clinical documentation and reasoningraises
  • Temporal modeling of multimodal clinical trajectories1 paper raises it · 1 addresses it

    Existing multimodal approaches often overlook irregular, time-dependent clinical events, limiting risk prediction accuracy.

    • TRACE: Tracking Multimodal Clinical Trajectories for Inpatient Risk Predictionraises · addresses
  • Privacy-preserving learning from deployment experience2 papers raise it · 2 address it

    Frozen models cannot adapt to new clinical evidence or guidelines without retraining, which is often impractical or private.

    • Frozen Models, Evolving Expertise: Model-Agnostic Learning from Deployment Experience for Multimodal Medical AIraises · addresses
    • Agentic discovery of blood biomarker from distilled private health recordsraises · addresses
  • Tool-augmented reasoning with evidence grounding1 paper raises it · 2 address it

    Medical agents lack mechanisms to decide when to use auxiliary evidence and how to prevent invalid data from affecting reasoning.

    • X-Ragent: Tool-Augmented Reinforcement Learning for Evidence-Grounded Chest X-Ray Reasoningraises · addresses
    • MMedAgent-Plus: Scaling Multimodal Medical Agents across Modalities, Tasks and Workflowsaddresses

Named by an AI from these papers' abstracts.

Rising research topics

  • Spiking neural networks7+40.0%
  • Diffusion priors16+14.3%
  • Algorithmic fairness9+12.5%
  • Channel state information8−20.0%
  • Quantum machine learning14−22.2%
  • Character recognition OCR30−28.6%
  • Linear bandits50−31.5%
  • Molecular property prediction27−32.5%

Papers

  • arXiv cs.CLOct 29

    Testimony from Timelines: Evidence-Grounded Significance Testing of Temporal Clinical Hypotheses

    Chengyang He, Wenlong Zhang, Koduvayur Subbalakshmi, Ping Wang

    Ask a language model whether sales tend to dip after a product recall, or whether one side effect tends to follow another after a vaccine, and it answers in a fluent sentence that reads like a finding, with no test behind it. Assertions about how events unfold across many cases fill the Web, and each is a temporal hypothesis that only a significance test over the right records can settle. The verifier must specify the null, select the test and decide which records bear on the hypothesis, and any of these choices can go wrong while the conclusion still comes out right. Yet benchmarks for language-model data analysis grade only the conclusion, with the relevant data handed over. We study the problem in health, where a wrong verdict is costly, and present STRATA, a benchmark that grades every decision on the way to a verdict: 8,735 hypotheses over the clinical timelines of vaccine adverse-event reports, with gold plans, evidence sets, p-values and verdicts derived under a released codebook and reproduced by a deterministic oracle. We also propose ART (articulate, retrieve, test), a staged paradigm that exposes each decision as an inspectable output. Extensive experiments with five…

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  • arXiv cs.CVOct 29

    Beyond Ground Truth: A Heuristic Unsupervised Quality Assurance Engine for Diagnosing Calibrational Blindness in Dental Segmentation

    Fatematuj Johura Mim

    In real-world clinical settings, dental X-ray segmentation using deep learning methods suffers from reliability issues. Even when the segmentation quality is bad, deep learning models show high confidence in their predictions (calibrational blindness). Moreover, in real use, doctors do not have ground-truth masks to check their accuracy. To address this problem, we introduce a simple quality-checking engine called HUS-QA with three stages. We train it on the PRAD (Periapical Dental X-ray) dataset to build our SimCLR self-supervised ResNet-18 U-Net model, which generates the segmentation mask and then evaluates its quality. Our HUS-QA checks the segmentation mask quality without a ground-truth mask. Prediction confidence, edge sharpness, shape connectivity, and area-size penalty are the simple indicators considered in this research. Results show that standard confidence methods fail (r = -0.1394, p = 1.7864e-3, ROC AUC = 0.4275). By contrast, our HUS-QA shows a positive correlation with actual Dice scores (r = 0.4647, p = 3.7510e-28) and achieves a strong ROC-AUC of 0.8405. Therefore, HUS-QA serves as a practical tool for clinical quality control.

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  • arXiv cs.AIOct 29

    Advancing Clinical Genomic Analysis with a Skill-Centred Agent

    Qiaoyu Zheng, Weike Zhao, Yanjie Fan, Ye Cao, Mengqi Jiang +8

    Clinical genomic analysis requires experts to integrate evolving guidelines, databases, and computational evidence. As sequencing has become increasingly accessible, this complex and labor-intensive process has become a major bottleneck to the timely use of genomic information in clinical decision-making. To fill this gap, we developed ClinGeX, a large-language-model agent that composes 105 curated executable skills through task-specific retrieval and dependency-aware orchestration. On 223 temporally held-out benchmark cases, ClinGeX achieved 71.7\% macro-averaged task-level concordance with expert reference classifications, compared with 45.7\% for the strongest comparator. In a three-condition, counterbalanced human-AI collaboration study, 45 clinical genomic professionals assessed 135 clinically derived cases under routine (no AI assistance), DeepSeek-assisted and ClinGeX-assisted conditions. ClinGeX assistance increased raw case-level concordance across criterion-level variant analysis, genomic interpretation in rare disease and molecular oncology decision-making (51.1\%, 57.8\%, 64.4\% versus 15.6\%, 31.1\%, 20.0\% in comparator conditions) and reduced reported…

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  • arXiv cs.CEOct 29

    TRACER, a time-to-event EHR foundation model for disease detection across health systems

    Mara Pleasure, Ekaterina Redekop, Vedrana Ivezic, Rushikesh Kulkarni, Aaron Chin +2

    Foundation models trained on longitudinal electronic health records (EHRs) can predict clinical diagnoses years in the future, making them a potential tool for disease screening. We developed TRACER (Temporal Risk Assessment with Clinical EHR Representations), a decoder-based foundation model pretrained on data from over 4.5 million patients from four health systems, and evaluated it on 16 incident diseases at 1-, 2-, and 5-year horizons in more than 2 million patients from two health systems excluded from model development. In contrast to typical evaluations that focus on global metrics (e.g., AUROC), we measured performance at the low false-positive rates that are realistic for screening. We found that TRACER retained its discrimination in external health systems, and at 95% specificity, the patients it flagged were up to eight times more likely to be diagnosed within a year than unselected patients. Evaluating at this operating point also revealed what global metrics alone did not: detection and false-alert burden varied across diseases and health systems, even when discrimination appeared stable. Our results illustrate the potential of foundation models for screening and…

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  • arXiv cs.CVOct 29

    Accurate MRI-free PET Quantification and Reliability Assessment via CT-to-MRI Synthesis and Conformal Prediction

    Jungwoo Seo, Seung Yun Choi, Kun Ho Lee, Seun Jeon, Byoung Seok Ye +1

    Standardized uptake value ratio (SUVR) quantification of amyloid PET commonly relies on a subject-specific T1-weighted MRI, yet a usable MRI is not always available. We therefore combined CT-to-MRI synthesis with conformal prediction for MRI-free PET quantification with reliability assessment. A slice-consistent Brownian Bridge Diffusion Model was strengthened with multi-dataset training and data-source conditioning to enrich the anatomical prior learned from MRI, and with expanded multi-slice CT context to exploit the through-plane continuity of subject-specific anatomy in CT. Synthetic MRI was used for FreeSurfer-based anatomical parcellation and PET quantification, while deep-ensemble uncertainty was calibrated with conformal prediction to estimate a plausible range for the corresponding real MRI-based SUVR. On $^{11}$C-PiB PET from OASIS-3, the proposed method achieved the highest synthesis and parcellation fidelity among the compared methods. Mean cortical SUVR from the proposed synthetic MRI agreed closely with the real MRI-based reference (MAE $0.016 \pm 0.015$, Pearson $r = 0.9987$) and yielded the same amyloid-positivity classification as the real MRI in all 87 test…

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  • arXiv cs.AIOct 29

    Training language models in simulation for psychiatric intake

    Samuel Schmidgall, Tim Strother, Alex Bijamov, Min Woo Sun, Anil Palepu +51

    In psychiatric practice, the clinical intake interview remains a primary diagnostic instrument, requiring the clinician to establish rapport while disentangling complex, overlapping presentations. Here, we show that multi-turn reinforcement learning (RL) in simulation environments improves language model performance on structured text-based psychiatric intake, spanning history-taking, differential diagnosis, and initial management planning. In a randomized, double-blind crossover study ($N = 60$ matched scenario pairs, 120 encounters) comparing the RL-trained agent against its identically prompted base model, 32 board-certified psychiatrists role-played standardized patients while a separate panel of 15 independent, board-certified psychiatrists scored the de-identified transcripts. The trained agent outperformed the base model in 76.7% of matched scenario pairs ($p < 0.0001$), with gains on an adapted clinical-examination rubric ($d_z = 0.77$, $p < 0.0001$), patient-centered communication (82.0% vs. 65.2%, $p < 0.001$), and differential diagnosis appropriateness (68.3% vs. 33.3%, $p < 0.001$). Across 127 psychiatrist-validated simulated intake scenarios, the trained agent nearly…

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  • arXiv cs.LGOct 29

    NECA: Neighbor Event Curve Augmentation for Multi-Horizon ICU Deterioration Prediction

    Chenyang Wang, Jiawei Theresa Tang, Xinran Liu, Xinyu Lu, Xulei Yang

    Early prediction of ICU organ dysfunction events supports timely clinical monitoring and intervention, but estimating short-term organ-specific risk from early ICU records remains challenging due to irregular measurements, heterogeneous clinical variables, and the need to predict risk across multiple future horizons. Existing supervised models usually treat each patient as an isolated sample and do not explicitly use the observed event timing of similar historical patients. We propose Neighbor Event-Curve Augmentation (NECA), a model-agnostic method that retrieves training-set patients with similar early-window profiles and converts their subsequent organ dysfunction event onset times into cumulative event-curve features over 6h, 12h, 24h, and 42h. These features are concatenated with the original patient representation and used by standard downstream predictors. On PhysioNet 2012 and a 4,000-stay MIMIC-IV subset, NECA improves average PR-AUC and ROC-AUC across four organ dysfunction event tasks and seven supervised learners. The largest gain appears for neurological dysfunction events, where task-level average PR-AUC increases from 0.461 to 0.557 on PhysioNet 2012. Ablations…

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  • arXiv q-bio.QMOct 29

    Agentic LLM reasoning in pediatric diabetes outcome prediction from multimodal medical records

    Daniel Palacios, Guantong Qi, Anna Kadi, Natali Borrego, Sukru Aras +6

    Large language model (LLM) agents are proposed for clinical prediction but are untested in pediatrics, where cohorts are small and outcomes are uncommon. Using records from 2,489 youth with type 2 diabetes (T2D) and 4,018 with type 1 diabetes (T1D), spanning structured data, note-derived social determinants and, in T1D, continuous glucose monitoring data, we predicted seven T2D outcomes, four also in T1D, at 24 months from 18 months of follow-up. CEDAR (Clinical Evidence-Driven Agent for Risk-prediction), an evidence-citing, self-auditing LLM pipeline, outperformed trained machine learning in both cohorts (pooled area under the receiver operating characteristic curve 0.815 versus 0.656 to 0.700 in T2D and 0.756 versus 0.603 to 0.631 in T1D), most on the sparsely screened outcomes. Only 4 of 70,246 values it cited did not match the chart. Reading only the evidence and reasoning cited by CEDAR, two pediatric endocrinologists reached the same prediction as CEDAR in about nine of ten cases, agreeing with each other on 90.5%.

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  • arXiv cs.ROOct 29

    The Athlete as a Scientist of One: Agentic Bayesian Experimental Design for Individualized Physiology from Consumer Wearables

    Behnam Moradi

    Large language model (LLM) agents for personal health read wearable data and recommend, but do not learn about the individual in a way that can be audited or falsified. We present EpiCoach, an agentic system that treats one athlete, a cross-country mountain biker, as the subject of accountable N-of-1 science. Claims about the athlete live in an evidence-gated hypothesis registry: each must issue a probabilistic prediction about a future session before it occurs, and its belief moves only through computed evidence from a logged statistical fit. Predictions come from a mechanistic digital twin inferred from heart rate, GPS and barometric altitude: a lagged heart-rate response model, a fitness-fatigue model with learned time constants, and a latent technical-descending skill state, measured on discovered trail segments. The agent prescribes the next training week as a constrained experiment maximizing information gain subject to load and safety constraints, around two instrument rides. We evaluate the system two ways over eighteen months of data. A rolling-origin replay benchmark shows the twin beats standard forecasters on heart rate but not segment time, and the agentic loop…

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  • arXiv cs.CVOct 29

    Radiology Guideline-derived Decision Graph for Efficient Clinical Decision Support

    Xuewen Zhou, Zhen Chen

    Radiological risk stratification and management planning are essential downstream tasks in medical imaging. Automating these tasks is challenging because clinical guideline criteria are distributed across prose, tables, and cross-referenced definitions. We present Guideline-derived Decision Graph (GDGraph), a framework that decouples guideline compilation from case evaluation. During compilation, a large language model partitions guidelines into section-based chunks, extracts local decision subgraphs with linked definitions, and aggregates related branches into an executable decision graph. During inference, a fast System One model answers localized clinical questions while deterministic traversal resolves Boolean logic, turning opaque single-pass predictions into a traceable decision path without task-specific training. Across 347 cases spanning renal cyst, adnexal mass, and thyroid nodule guidelines, GDGraph improves System One accuracy from 57.3% to 90.8%, outperforming retrieval-augmented GPT-4o (80.1%) and graph-guided GPT-4o with chain-of-thought (82.7%) at substantially lower latency and cost. The source code will be available.

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  • arXiv cs.CLOct 29

    Decision and System One models in rheumatology: accuracy and calibration on specialty-training examination questions and diagnostic case vignettes

    Alfredo Madrid-García, Diego Benavent, Fabian Lechner, Phillip Kremer, Johannes Knitza +1

    Objectives: To evaluate the accuracy and calibration of Decision and System One models on rheumatology examination questions and diagnostic vignettes. Methods: Two benchmarks were analysed: 172 rheumatology questions from Spanish specialty-training examinations (expanded RheumaMIR dataset) in Spanish and English, and 70 English diagnostic vignettes from RheumBench with 5-18 candidate diagnoses, 52 of which included the reference diagnosis. Four System One models (Jev 1.13, Clef, Microsoft-Decision-1, Laya) and GPT-6 Luna (OpenAI Decisions API) were compared with GPT-6 Sol and two local generative models. The primary outcome was accuracy; secondary outcomes included calibration, discrimination, accuracy of answers with probability >=0.90 and language differences. Results: In RheumaMIR, Jev's accuracy was 93.0% in Spanish and 91.9% in English, below GPT-6 Sol (99.4%; Holm-adjusted P<=0.005); GPT-6 Luna reached 97.7%, Clef 91.9-93.0% and Microsoft-Decision-1 86.0-87.8%, without detectable language differences. Jev's answers with probability >=0.90 (76-77% of answers) were 98.5% correct. In RheumBench, accuracy was lower: GPT-6 Sol 76.9%, GPT-6 Luna 63.5%, Clef 59.6%, Jev 50.0% and…

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  • arXiv cs.CVOct 29

    Self-training for cross-centre coronary vessel segmentation in X-ray angiography using pre-contrast frame subtraction

    Danial Moafi, Aida Moafi, Mostafa Aryafar, Ashkan Sami, Maryam Aryafar

    Deep learning models for coronary vessel segmentation in X-ray angiography often perform poorly on data from centres that were not represented in training. Apart from differences in equipment, the labels of the largest public dataset (ARCADE) are incomplete, as only the segments defined in the SYNTAX score are annotated. In this study, we evaluated whether self-training with pseudo-labels can improve performance on external data without additional manual annotation. Pseudo-labels were generated from two sources, namely the predictions of an nnU-Net model trained on ARCADE and a contrast map obtained by subtracting a pre-contrast frame from the same sequence. The nnU-Net predictions were extended along the contrast map, and pixels detected only in the subtraction image were assigned an ignore label and excluded from the loss. Six models were trained and tested on ARCADE and on two external datasets (XCAD and XACV). All first-round models initialised with the baseline predictions performed better than both the baseline and a control model fine-tuned for the same number of epochs. The model trained on the XCAD pool improved the macro-averaged Dice score by 2.7 points (95% CI…

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  • arXiv cs.CVOct 29

    LoRe-MIM: Lost-or-Replaced Masked Image Modeling for Self-Supervised Representation Learning in Whole-Body PET/CT

    Amartya Bhattacharya, Bashirul Azam Biswas, Biratal Raj Wagle, Michael S. Leapman, Matthew E. Maeder +2

    Deep learning models for whole-body positron emission tomography/computed tomography (PET/CT) hold significant clinical potential for disease detection, treatment planning, and response assessment. However, the time and cost associated with expert annotations remain major bottlenecks in developing robust and generalizable models. Although self-supervised learning (SSL) has emerged as a promising approach to mitigating annotation scarcity, its application to whole-body PET/CT remains relatively underexplored due to the limited availability of large-scale datasets and the challenges associated with learning complementary cross-modal representations. To address these limitations, we curate a heterogeneous, multi-tracer, multi-institutional cohort comprising 6,531 whole-body PET/CT scans and propose LoRe-MIM (Lost-Or-Replaced Masked Image Modelling), a novel self-supervised framework designed to learn multimodal representations through masked image reconstruction. Specifically, LoRe-MIM introduces a masking strategy in which image regions are either replaced with zeros (Lost) or substituted with corresponding complementary imaging modality (Replaced), encouraging the model to capture…

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  • arXiv cs.LGOct 29

    Latent Prediction Yields Cross-Subject Alignable Representations in Sensory-Evoked fMRI

    Serwan Jassim, Victoria Bosch, Daniel Anthes, Elia Bruni, Tim Kietzmann

    Decoding sensory-evoked functional magnetic resonance imaging (fMRI) data is a central analytical tool in cognitive neuroscience. Here we ask whether self-supervised learning (SSL), which has been scarcely explored in this domain, can yield representations that support strong downstream performance. To do so, we adapt a joint embedding predictive architecture (JEPA) to train participant-specific encoders on brain data alone. The encoders never see the stimulus images or any representation derived from them. Applied to the Natural Scenes Dataset (NSD), we evaluate our learned brain embeddings on the downstream tasks of brain captioning and image reconstruction, as well as cross-participant generalization. Our self-supervised approach achieves competitive performance with parameter-rich supervised pipelines that are trained end-to-end with access to image and language data. We further find that encoders trained independently for different participants can be aligned fully unsupervised, using neither images nor stimuli shared between them. After alignment, a neural decoding head trained on one participant can be applied to another without fine-tuning and retains most of its…

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  • arXiv stat.MEOct 29

    Conformal Annotation with Randomized Expert Review: Application to Online Cell-Type Labeling

    Xuhe Zhang, Zhi Huang, Ying Jin

    Artificial intelligence (AI) models can accelerate cell-type annotation in digital pathology, but safely scaling their use requires determining, with error control, which model-generated labels can be accepted without expert review. This is challenging in evolving workflows because cell morphology and type composition may change across tissue regions and slides, making one-time calibration unreliable. We propose Conformal Annotation with Randomized Expert review under Distribution shift (CARED), a distribution-free framework that leverages randomized expert audit to achieve long-run error control for AI-assisted annotation under distribution shift. For each incoming batch, CARED uniformly selects a subset of cases for expert review and uses the acquired labels to calibrate later decisions. Among unreviewed cases, CARED determines a subset of them to safely skip expert labeling, while suggesting candidate labels for the others for downstream resolution. We prove that this workflow provides long-run control of cumulative error over both the full stream and the cells outside of the audit sample, without stationarity or exchangeability assumptions. We further enhance the framework by…

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  • arXiv stat.MLOct 29

    Fisher Contrastive Learning to Mitigate Feature Suppression: A Case Study in Acute Promyelocytic Leukemia Diagnosis

    Shushan Wu, Yongkai Chen, Xilin Gong, Yufang Liu, Wenxuan Zhong +1

    Self-supervised contrastive learning (SSCL) learns representations by contrasting augmented views of the same sample, but it can exhibit feature suppression, where dominant or easy-to-learn factors suppress other class-relevant signals, degrading the performance of representations, particularly in high-dimensional data with heterogeneous features. We introduce Fisher Contrastive Learning (FCL), which uses a regularized Fisher trace criterion to address feature suppression. FCL learns embeddings by maximizing the discriminative strength of Fisher discriminant functions, producing representations that preserve class-relevant information implied by the augmentation process. We prove that the representations learned by FCL could alleviate the feature suppression effects. We demonstrate FCL on simulated benchmarks designed to induce feature suppression and on a real-world biomedical application, pretraining on large white blood cell microscopy image dataset and transfer learning for diagnosis of acute promyelocytic leukemia in an external cohort. In all experiments, FCL outperforms the self-supervised baselines and yields more robust and discriminative representations.

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  • arXiv cs.CVOct 29

    Learning a Motion Manifold to Constrain Ambiguity in Unsupervised 4D Medical Image Interpolation

    Haojin Li, Huazhu Fu, Heng Li, Jiang Liu

    Unsupervised 4D medical image interpolation reconstructs intermediate anatomical states from temporally sparse observations without intermediate supervision. Distinct motion fields may attain comparable endpoint agreement while producing different intermediate anatomy, giving rise to motion ambiguity. This ambiguity is difficult to constrain when many independently adjustable motion variables must be estimated from the observed endpoints. We develop a framework that learns a motion manifold to restrict candidate motion fields while retaining sample-specific variation. Cross-Sample Spectral Basis Learning extracts recurring motion structure from endpoint-derived dense estimates and encodes it in a shared spectral basis. Sample-Conditioned Cayley Basis Reorientation uses predicted motion coordinates to rotate the effective motion directions for each endpoint pair without increasing the number of independent coordinates. Their composition defines a nonlinear family of complete velocity fields across endpoint pairs, accommodating anatomical and motion-state differences within a restricted representation. Integrating each predicted field supports bidirectional reconstruction at…

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  • arXiv cs.CVOct 29

    RepConTUR: A Report-Conditioned Volumetric Multimodal Model for Abdominal Tumor Segmentation

    Seunghwan Lee, Sangjoon Park, Jongmin Lee, Yoon Jo Kim, Wonyoung Cho +2

    Tumor delineation is required for radiotherapy planning, yet automatic segmentation is limited by errors, predominantly false positives, that distort dose and increase editing time. The radiology report accompanies the scan and localizes disease at the suborgan level, but existing text-promptable models condition on short referring phrases, and most operate in 2D. We present RepConTUR, a single native-3D early-fusion multimodal model that conditions volumetric abdominal tumor segmentation on the narrative report. We extend AbdomenAtlas 3.0 to a suborgan-level promptable segmentation dataset and generate report-based VQA pairs, yielding four report-derived tasks on the same annotations: referring segmentation (RES), report-grounded segmentation (GSEG), report generation (RRG), and visual question answering (VQA). We train RepConTUR, comprising a 3D CT encoder, an early-fusion language model, and a native-3D segmentation module, jointly on the four tasks. Across liver, kidney and pancreas, RepConTUR attains the highest Dice similarity coefficient (DSC), instance-wise precision, and detection F1 among the text-promptable baselines, and adding the report raises mean precision while…

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  • arXiv cs.CVOct 29

    Morphology-Aware Channel-Decoupled Mamba Network for Medical Image Segmentation

    Chenchen Wang, You Zhou

    Accurate multi-organ segmentation in computed tomography (CT) is essential for computer-aided diagnosis, treatment planning, and disease monitoring. However, substantial variations in organ shape and size, together with low tissue contrast and ambiguous boundaries, complicate the modeling of heterogeneous anatomical structures. To address these challenges, we propose a Morphology-Aware Channel-Decoupled Mamba Network (MCDNet), which integrates adaptive local structural enhancement with channel-decoupled long-range modeling. Specifically, we introduce a Morphology-Aware Channel-Decoupled State-Space (MCSS) block that divides feature channels into separate processing groups, allowing differentiated structural representations to be learned within an efficient state-space framework. Within each group, a Morphology-Aware Enhancement Module (MAEM) combines deformable convolutions with channel attention to adapt local feature extraction to anatomical shape variations. Group-wise state-space modeling then captures long-range spatial dependencies, and channel gating adaptively integrates the resulting features. Experiments on the Synapse abdominal CT dataset demonstrate the effectiveness…

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  • arXiv cs.CVOct 29

    Uncertainty-aware Coarse-to-Fine Main Pancreatic Duct Segmentation for Width Measurement in 3D MRCP

    Zipei Zhang, Jaakko Sahlsten, Mikko Saukkoriipi, Johanna Ronkainen, Mona Lehto +3

    Assessment of the main pancreatic duct (MPD) from volumetric magnetic resonance cholangiopancreatography (MRCP) scans is an essential task for ductal dilatation diagnosis and pancreatic cancer analysis. However, manual assessment is affected by reader variability in which automated analysis may assist. Nevertheless, fully automated and uncertainty-aware MPD analysis from volumetric MRCP remains underexplored area of research. In this study, we propose an automatic and uncertainty-aware deep learning-based pipeline for MPD segmentation and maximum-width analysis from MRCP scans. A coarse localisation model first identifies the ductal region-of-interest, followed by a fine model that segments the MPD within the region. The dataset consists of 256 MPD-segmented MRCP scans from 69 patients. A randomly selected holdout test subset of 14 patients with 55 MRCP volumes was used for evaluation. We employed a five-model cross-validation ensemble for improved performance and uncertainty estimation. The best MPD segmentation performance was 0.634 DSC, 0.744 precision, and 0.593 recall. The mean absolute error for maximum MPD width prediction was 0.355~mm and dilated MPD ($\geq 5$~mm) was…

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