#01Nov 5, 2026
cs.CV
OraRefer: Segmentation-Guided Multi-Photograph Fusion for Oral Cancer Screening with Guaranteed Patient-Level Sensitivity
Rupam Mukherjee, Mehakdeep Singh, Shirin Dasgupta and 1 more
Oral cancer and the oral potentially malignant disorders (OPMD) that can precede it are visible on the oral mucosa, which makes smartphone photographs a promising tool for screening. Deep learning models for this task classify individual photographs. However, screening refers patients, not photographs: a patient is usually photographed several times, and the referral decision must miss no more than a set share of patients with disease. We propose OraRefer, a patient-level screening model that reads each photograph with a segmentation-guided foundation model that conditions its class decision on the predicted lesion, combines all photographs of a patient with risk factors, and refers through a threshold with a finite-sample sensitivity guarantee. The model localizes the mouth itself, so inference needs no annotation. On 3000 photographs of 714 patients, patient-level fusion reaches an AUROC of 0.919 and outperforms attention-based multiple-instance learning. At a 90% sensitivity target, OraRefer detects 95% of patients with OPMD or cancer and misses 3 of 61 patients with cancer, at a specificity of 0.610. Because the threshold is calibrated without retraining, each clinic can set its own guaranteed operating point on a local calibration sample.
#02Nov 5, 2026
cs.CV
USB Gym: A Gymnasium Testbed for Closed-Loop Ultrasound View Matching
Thanapong Intharah, Zhichao Gao, Yiliang Liu and 1 more
Background and Objective: Our main goal is ultrasound guidance: moving a probe until its image matches a target view. Published methods for each part of a guide are evaluated in separate simulators. We asked whether these methods, combined into one guide, are good enough. Methods: We built USB Gym, a testbed whose standard engine simulates ultrasound from public patient CT, with a network drawing organ textures from CT labels. Its guide has three replaceable parts (slots), an organ segmenter, a controller and a reward, which received 20 published methods, each run on the same 60 episodes of six held-out patients. In each slot, a published method replaced ours only if detectably better on these patients. The better of this combination and our original guide on 20 new CTs is the benchmark baseline. A pose oracle, reading the exact probe pose available only in simulation, set the reference. The results below are exploratory. Results: On these CTs, the probe started on average 16.0 mm from the target view; the pose oracle brought it to 1.5 mm. Of the results known when the combination was fixed, only an image-similarity reward (SSIM) was slightly but detectably better, so the combination was our guide with that reward. This combination was the benchmark baseline, ending at 13.7 mm (16% of the oracle's progress). Conclusions: Combining untuned published methods with ours did not guide the probe near the target view; the task remains under-explored. The testbed accepts new methods; no guide was tested on hardware.
#03Nov 5, 2026
cs.LG
FewStepRL: Fine-tuning Few-step Diffusion Models with Reinforcement Learning
Haitao Lin, Minsi Ren, Yang Li and 4 more
Reinforcement learning (RL) has become a standard post-training method for diffusion models, but most RL objectives roll out the current policy at every iteration, and with a many-step sampler these rollouts typically dominate the cost of training. Few-step models cut this cost, yet they model an average velocity over an interval, whereas existing RL objectives are built for an instantaneous velocity with a many-step sampler. We adapt RL objectives to few-step models systematically in three phases, namely a transformation, a decomposition and an adaptation. The transformation to $x$-space expresses each objective we consider through a common policy prediction, at the clean end by default and at an explicitly marked level for transition or flow-map objectives, so that objectives stated over densities, velocities or rewards become comparable. The decomposition writes the gradient of each of these objectives as the sum of a self-regression toward a reference and a reward augmentation, so that a method reduces, at the gradient level, to a choice of anchors and weights. The adaptation computes each anchor from a few-step model at the end of its transport or along its tangent, with the instantaneous velocity recovered from the network itself or from an auxiliary network. This yields few-step versions of FlowGRPO, AWM, DiffusionNFT, DiffusionOPSD and ReFL in one modular codebase. In our experiments, reward-gradient-based methods are the most effective when the reward is differentiable and its gradient is affordable; otherwise DiffusionNFT-style methods generally reach high rewards in relatively few iterations despite a sometimes higher per-iteration cost. Extra inference steps show no systematic aggregate benefit in our experiments, although selected outputs visibly improve with two to four times as many sampling steps as in training.
#04Nov 5, 2026
cs.LG
Interpretable Multimodal MRI-Clinical Fusion for Functional Outcome Prediction After Acute Ischemic Stroke
Sina Raeisadigh, Henning Müller, Abderrahmane Hedjoudje
This study evaluates the added prognostic value of day-1 multimodal MRI for predicting three-month functional outcome after acute ischemic stroke (AIS). Sixty-six AIS patients with ADC, DWI, FLAIR, and clinical data were analyzed. Three-dimensional pretrained ResNet embeddings were extracted from each MRI modality, reduced using fold-isolated principal component analysis, and combined with structured clinical variables and ADC-derived lesion biomarkers. Linear support vector machines were evaluated using eight-fold stratified group cross-validation across MRI modality combinations. Clinical-only modeling achieved strong performance (AUC = $0.899 \pm 0.151$), while MRI-only models showed limited discrimination (AUC $\approx$ $0.67$-$0.73$). Among multimodal configurations, FLAIR-clinical fusion achieved the highest mean cross-validated performance (AUC = $0.948 \pm 0.061$), followed by ADC-clinical fusion (AUC = $0.941 \pm 0.094$). Full ADC-DWI-FLAIR fusion did not consistently outperform single-modality clinical fusion. Feature-importance analysis identified age, NIHSS subscores, ADC lesion burden, and learned FLAIR representations as key contributors, while qualitative FLAIR activation maps showed responses over lesion-like regions. These findings suggest that compact day-1 FLAIR and ADC representations provide complementary prognostic information beyond clinical variables and support interpretable, data-efficient outcome prediction in AIS.
#05Nov 5, 2026
cs.CV
Multimodal Hierarchical Mixture-of-Experts for 3D Medical Vision-Language Modeling
Gizem Mert, Szymon Płotka, Pedro R. A. S. Bassi and 5 more
Medical 3D scans and reports are inherently hierarchical, with diagnostic cues concentrated in specific anatomical regions across multiple levels of organization. Yet, most medical vision-language models ignore this structure and fail to focus on clinically relevant anatomy. We introduce MedHiVE, which combines hierarchical vision-language Soft Mixture-of-Experts (SMoE) with contrastive learning to jointly model fine-grained anatomy and global scan context. To our knowledge, MedHiVE is the first framework to route both vision and text tokens through a two-level SMoE hierarchy organized by anatomical scale, coupling this with report-derived anatomy-level contrastive alignment for 3D medical imaging. This replaces the direct region-text alignment of statically pooled features and vision-only hierarchical routing of prior work with dynamic, slot-based cross-modal information flow across anatomical scales. MedHiVE operates via a two-level, learnable token-routing mechanism, where local image and text features are first routed through a local SMoE and then fused by a global SMoE into unified multimodal representations. Contrastive learning aligns both anatomy-level and global vision-language representations in a unified space. Pre-trained on 25,000+ CT scans with anatomical supervision, MedHiVE consistently surpasses 11 state-of-the-art methods across 6 datasets on 3 tasks: segmentation, classification, and detection, demonstrating the importance of hierarchical modeling. The code for MedHiVE is at github.com/szczurek-lab/MedHiVE.