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Learning Robust Visual Features in Computed Tomography Enables Efficient Transfer Learning for Clinical Tasks

arXiv:2604.04133v1 Announce Type: cross Abstract: There is substantial interest in developing artificial intelligence systems to support radiologists across tasks ranging from segmentation to report generation. Existing computed tomography (CT) foundation models have largely focused on building generalist vision-language systems capable of tasks such as question answering and report generation. However, training reliable vision-language systems requires paired image-text data at a scale that remains unavailable in CT. Moreover, adapting the underlying visual representations to downstream tasks typically requires partial or full backbone fine-tuning, a computationally demanding process inaccessible to many research groups. Instead, foundation models should prioritise learning robust visual representations that enable efficient transfer to new tasks with minimal labelled data and without backbone fine-tuning. We present VoxelFM, a 3D CT foundation model trained with self-distillation using the DINO framework, which learns semantically rich features without language supervision. We evaluated VoxelFM across seven categories of clinically relevant downstream tasks using frozen backbone representations with lightweight probes: classification, regression, survival analysis, instance retrieval, localisation, segmentation, and report generation. VoxelFM matched or outperformed four existing CT foundation models across all task categories. Despite receiving no language supervision during pre-training, VoxelFM surpassed models explicitly trained with language-alignment objectives, including on report generation. Our results indicate that current CT foundation models perform significantly better as feature extractors for lightweight probes rather than as vision encoders for vision-language models. Model weights and training code are publicly available.

From Noisy Labels to Intrinsic Structure: A Geometric-Structural Dual-Guided Framework for Noise-Robust Medical Image Segmentation

arXiv:2509.02419v2 Announce Type: replace-cross Abstract: The effectiveness of convolutional neural networks in medical image segmentation relies on large-scale, high-quality annotations, which are costly and time-consuming to obtain. Even expert-labeled datasets inevitably contain noise arising from subjectivity and coarse delineations, which disrupt feature learning and adversely impact model performance. To address these challenges, this study propose a Geometric-Structural Dual-Guided Network (GSD-Net), which integrates geometric and structural cues to improve robustness against noisy annotations. It incorporates a Geometric Distance-Aware module that dynamically adjusts pixel-level weights using geometric features, thereby strengthening supervision in reliable regions while suppressing noise. A Structure-Guided Label Refinement module further refines labels with structural priors, and a Knowledge Transfer module enriches supervision and improves sensitivity to local details. To comprehensively assess its effectiveness, we evaluated GSD-Net on six publicly available datasets: four containing three types of simulated label noise, and two with multi-expert annotations that reflect real-world subjectivity and labeling inconsistencies. Experimental results demonstrate that GSD-Net achieves state-of-the-art performance under noisy annotations, achieving improvements of 1.58% on Kvasir, 22.76% on Shenzhen, 8.87% on BU-SUC, and 1.77% on BraTS2020 under SR simulated noise. The codes of this study are available at https://github.com/ortonwang/GSD-Net.

3D Wavelet-Based Structural Priors for Controlled Diffusion in Whole-Body Low-Dose PET Denoising

arXiv:2601.07093v4 Announce Type: replace-cross Abstract: Low-dose Positron Emission Tomography (PET) imaging reduces patient radiation exposure but suffers from increased noise that degrades image quality and diagnostic reliability. Although diffusion models have demonstrated strong denoising capability, their stochastic nature makes it challenging to enforce anatomically consistent structures, particularly in low signal-to-noise regimes and volumetric whole-body imaging. We propose Wavelet-Conditioned ControlNet (WCC-Net), a fully 3D diffusion-based framework that introduces explicit frequency-domain structural priors via wavelet representations to guide volumetric PET denoising. By injecting wavelet-based structural guidance into a frozen pretrained diffusion backbone through a lightweight control branch, WCC-Net decouples anatomical structure from noise while preserving generative expressiveness and 3D structural continuity. Extensive experiments demonstrate that WCC-Net consistently outperforms CNN-, GAN-, and diffusion-based baselines. On the internal 1/20-dose test set, WCC-Net improves PSNR by +1.21 dB and SSIM by +0.008 over a strong diffusion baseline, while reducing structural distortion (GMSD) and intensity error (NMAE). Moreover, WCC-Net generalizes robustly to unseen dose levels (1/50 and 1/4), achieving superior quantitative performance and improved volumetric anatomical consistency.
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