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Deep learning has enabled great strides in abdominal multi-organ segmentation, even surpassing junior oncologists on common cases or organs. However, robustness on corner cases and complex organs remains a challenging open problem for clinical adoption. To investigate model robustness, we collected and annotated the RAOS dataset comprising 413 CT scans ($\sim$80k 2D images, $\sim$8k 3D organ annotations) from 413 patients each with 17 (female) or 19 (male) labelled organs, manually delineated by oncologists. We grouped scans based on clinical information into 1) diagnosis/radiotherapy (317 volumes), 2) partial excision without the whole organ missing (22 volumes), and 3) excision with the whole organ missing (74 volumes). RAOS provides a potential benchmark for evaluating model robustness including organ hallucination. It also includes some organs that can be very hard to access on public datasets like the rectum, colon, intestine, prostate and seminal vesicles. We benchmarked several state-of-the-art methods in these three clinical groups to evaluate performance and robustness. We also assessed cross-generalization between RAOS and three public datasets. This dataset and comprehen

Deep learning in medical imaging faces obstacles: limited data diversity, ethical issues, high acquisition costs, and the need for precise annotations. Bleeding detection and localization during surgery is especially challenging due to the scarcity of high-quality datasets that reflect real surgical scenarios. We propose orGAN, a GAN-based system for generating high-fidelity, annotated surgical images of bleeding. By leveraging small "mimicking organ" datasets, synthetic models that replicate tissue properties and bleeding, our approach reduces ethical concerns and data-collection costs. orGAN builds on StyleGAN with Relational Positional Learning to simulate bleeding events realistically and mark bleeding coordinates. A LaMa-based inpainting module then restores clean, pre-bleed visuals, enabling precise pixel-level annotations. In evaluations, a balanced dataset of orGAN and mimicking-organ images achieved 90% detection accuracy in surgical settings and up to 99% frame-level accuracy. While our development data lack diverse organ morphologies and contain intraoperative artifacts, orGAN markedly advances ethical, efficient, and cost-effective creation of realistic annotated bleedi

An organ shape atlas, which represents the shape and position of the organs and skeleton of a living body using a small number of parameters, is expected to have a wide range of clinical applications, including intraoperative guidance and radiotherapy. Because the shape and position of soft organs vary greatly among patients, it is difficult for linear models to reconstruct shapes that have large local variations. Because it is difficult for conventional nonlinear models to control and interpret the organ shapes obtained, deep learning has been attracting attention in three-dimensional shape representation. In this study, we propose an organ shape atlas based on a mesh variational autoencoder (MeshVAE) with hierarchical latent variables. To represent the complex shapes of biological organs and nonlinear shape differences between individuals, the proposed method maintains the performance of organ shape reconstruction by hierarchizing latent variables and enables shape representation using lower-dimensional latent variables. Additionally, templates that define vertex correspondence between different resolutions enable hierarchical representation in mesh data and control the global an

Although data generation is often straightforward, extracting information from data is more difficult. Object-centric representation learning can extract information from images in an unsupervised manner. It does so by segmenting an image into its subcomponents: the objects. Each object is then represented in a low-dimensional latent space that can be used for downstream processing. Object-centric representation learning is dominated by autoencoder architectures (AEs). Here, we present ORGAN, a novel approach for object-centric representation learning, which is based on cycle-consistent Generative Adversarial Networks instead. We show that it performs similarly to other state-of-the-art approaches on synthetic datasets, while at the same time being the only approach tested here capable of handling more challenging real-world datasets with many objects and low visual contrast. Complementing these results, ORGAN creates expressive latent space representations that allow for object manipulation. Finally, we show that ORGAN scales well both with respect to the number of objects and the size of the images, giving it a unique edge over current state-of-the-art approaches.

Understanding symptom-image associations is crucial for clinical reasoning. However, existing medical multimodal models often rely on simple one-to-one hard labeling, oversimplifying clinical reality where symptoms relate to multiple organs. In addition, they mainly use single-slice 2D features without incorporating 3D information, limiting their ability to capture full anatomical context. In this study, we propose Med-SORA, a framework for symptom-to-organ reasoning in abdominal CT images. Med-SORA introduces RAG-based dataset construction, soft labeling with learnable organ anchors to capture one-to-many symptom-organ relationships, and a 2D-3D cross-attention architecture to fuse local and global image features. To our knowledge, this is the first work to address symptom-to-organ reasoning in medical multimodal learning. Experimental results show that Med-SORA outperforms existing medical multimodal models and enables accurate 3D clinical reasoning.

In radiation therapy planning, inaccurate segmentations of organs at risk can result in suboptimal treatment delivery, if left undetected by the clinician. To address this challenge, we developed a denoising autoencoder-based method to detect inaccurate organ segmentations. We applied noise to ground truth organ segmentations, and the autoencoders were tasked to denoise them. Through the application of our method to organ segmentations generated on both MR and CT scans, we demonstrated that the method is independent of imaging modality. By providing reconstructions, our method offers visual information about inaccurate regions of the organ segmentations, leading to more explainable detection of suboptimal segmentations. We compared our method to existing approaches in the literature and demonstrated that it achieved superior performance for the majority of organs.

Radiotherapy often involves a prolonged treatment period. During this time, patients may experience organ motion due to breathing and other physiological factors. Predicting and modeling this motion before treatment is crucial for ensuring precise radiation delivery. However, existing pre-treatment organ motion prediction methods primarily rely on deformation analysis using principal component analysis (PCA), which is highly dependent on registration quality and struggles to capture periodic temporal dynamics for motion modeling.In this paper, we observe that organ motion prediction closely resembles an autoregressive process, a technique widely used in natural language processing (NLP). Autoregressive models predict the next token based on previous inputs, naturally aligning with our objective of predicting future organ motion phases. Building on this insight, we reformulate organ motion prediction as an autoregressive process to better capture patient-specific motion patterns. Specifically, we acquire 4D CT scans for each patient before treatment, with each sequence comprising multiple 3D CT phases. These phases are fed into the autoregressive model to predict future phases based

Augmented Reality (AR) holds the potential to revolutionize surgical procedures by allowing surgeons to visualize critical structures within the patient's body. This is achieved through superimposing preoperative organ models onto the actual anatomy. Challenges arise from dynamic deformations of organs during surgery, making preoperative models inadequate for faithfully representing intraoperative anatomy. To enable reliable navigation in augmented surgery, modeling of intraoperative deformation to obtain an accurate alignment of the preoperative organ model with the intraoperative anatomy is indispensable. Despite the existence of various methods proposed to model intraoperative organ deformation, there are still few literature reviews that systematically categorize and summarize these approaches. This review aims to fill this gap by providing a comprehensive and technical-oriented overview of modeling methods for intraoperative organ deformation in augmented reality in surgery. Through a systematic search and screening process, 112 closely relevant papers were included in this review. By presenting the current status of organ deformation modeling methods and their clinical applic

The wide range of research in deep learning-based medical image segmentation pushed the boundaries in a multitude of applications. A clinically relevant problem that received less attention is the handling of scans with irregular anatomy, e.g., after organ resection. State-of-the-art segmentation models often lead to organ hallucinations, i.e., false-positive predictions of organs, which cannot be alleviated by oversampling or post-processing. Motivated by the increasing need to develop robust deep learning models, we propose HALOS for abdominal organ segmentation in MR images that handles cases after organ resection surgery. To this end, we combine missing organ classification and multi-organ segmentation tasks into a multi-task model, yielding a classification-assisted segmentation pipeline. The segmentation network learns to incorporate knowledge about organ existence via feature fusion modules. Extensive experiments on a small labeled test set and large-scale UK Biobank data demonstrate the effectiveness of our approach in terms of higher segmentation Dice scores and near-to-zero false positive prediction rate.

We review the literature on individual patient organ acceptance decision making by presenting a Markov Decision Process (MDP) model to formulate the organ acceptance decision process as a stochastic control problem. Under the umbrella of the MDP framework, we classify and summarize the major research streams and contributions. In particular, we focus on control limit-type policies, which are shown to be optimal under certain conditions and easy to implement in practice. Finally, we briefly discuss open problems and directions for future research.

Automatic lung organ segmentation on CT images is crucial for lung disease diagnosis. However, the unlimited voxel values and class imbalance of lung organs can lead to false-negative/positive and leakage issues in advanced methods. Additionally, some slender lung organs are easily lost during the recycled down/up-sample procedure, e.g., bronchioles & arterioles, causing severe discontinuity issue. Inspired by these, this paper introduces an effective lung organ segmentation method called Fuzzy Attention-based Border Rendering (FABR) network. Since fuzzy logic can handle the uncertainty in feature extraction, hence the fusion of deep networks and fuzzy sets should be a viable solution for better performance. Meanwhile, unlike prior top-tier methods that operate on all regular dense points, our FABR depicts lung organ regions as cube-trees, focusing only on recycle-sampled border vulnerable points, rendering the severely discontinuous, false-negative/positive organ regions with a novel Global-Local Cube-tree Fusion (GLCF) module. All experimental results, on four challenging datasets of airway & artery, demonstrate that our method can achieve the favorable performance signif

Automated patient positioning is a crucial step in streamlining MRI workflows and enhancing patient throughput. RGB-D camera-based systems offer a promising approach to automate this process by leveraging depth information to estimate internal organ positions. This paper investigates the feasibility of a learning-based framework to infer approximate internal organ positions from the body surface. Our approach utilizes a large-scale dataset of MRI scans to train a deep learning model capable of accurately predicting organ positions and shapes from depth images alone. We demonstrate the effectiveness of our method in localization of multiple internal organs, including bones and soft tissues. Our findings suggest that RGB-D camera-based systems integrated into MRI workflows have the potential to streamline scanning procedures and improve patient experience by enabling accurate and automated patient positioning.

We consider a stopping problem and its application to the decision-making process regarding the optimal timing of organ transplantation for individual patients. At each decision period, the patient state is inspected and a decision is made whether to transplant. If the organ is transplanted, the process terminates; otherwise, the process continues until a transplant happens or the patient dies. Under suitable conditions, we show that there exists a control limit optimal policy. We propose a smoothed perturbation analysis (SPA) estimator for the gradient of the total expected discounted reward with respect to the control limit. Moreover, we show that the SPA estimator is asymptotically unbiased.

Objective and Impact Statement: Accurate organ segmentation is critical for many clinical applications at different clinical sites, which may have their specific application requirements that concern different organs. Introduction: However, learning high-quality, site-specific organ segmentation models is challenging as it often needs on-site curation of a large number of annotated images. Security concerns further complicate the matter. Methods: The paper aims to tackle these challenges via a two-phase aggregation-then-adaptation approach. The first phase of federated aggregation learns a single multi-organ segmentation model by leveraging the strength of 'bigger data', which are formed by (i) aggregating together datasets from multiple sites that with different organ labels to provide partial supervision, and (ii) conducting partially supervised learning without data breach. The second phase of site adaptation is to transfer the federated multi-organ segmentation model to site-specific organ segmentation models, one model per site, in order to further improve the performance of each site's organ segmentation task. Furthermore, improved marginal loss and exclusion loss functions a

Accurate localization of organ boundaries is critical in medical imaging for segmentation, registration, surgical planning, and radiotherapy. While deep convolutional networks (ConvNets) have advanced general-purpose edge detection to near-human performance on natural images, their outputs often lack precise localization, a limitation that is particularly harmful in medical applications where millimeter-level accuracy is required. Building on a systematic analysis of ConvNet edge outputs, we propose a medically focused crisp edge detector that adapts a novel top-down backward refinement architecture to medical images (2D and volumetric). Our method progressively upsamples and fuses high-level semantic features with fine-grained low-level cues through a backward refinement pathway, producing high-resolution, well-localized organ boundaries. We further extend the design to handle anisotropic volumes by combining 2D slice-wise refinement with light 3D context aggregation to retain computational efficiency. Evaluations on several CT and MRI organ datasets demonstrate substantially improved boundary localization under strict criteria (boundary F-measure, Hausdorff distance) compared to

We introduce Neural Organ Transplantation (NOT), a modular adaptation framework that enables trained transformer layers to function as reusable transferable checkpoints for domain adaptation. Unlike conventional fine-tuning approaches that tightly couple trained parameters to specific model instances and training data, NOT extracts contiguous layer subsets ("donor organs") from pre-trained models, trains them independently on domain-specific data, and saves them as standalone checkpoint files that can be transplanted into compatible recipient models without access to the original training data. Through experiments on three decoder-only transformer architectures spanning 124M to 20B parameters (GPT-2, TinyLlama, and GPT-OSS), we demonstrate that donor transplantation substantially outperforms existing adaptation methods, achieving an order-of-magnitude improvement in perplexity over LoRA while training significantly faster. The method exhibits position dependence, with early insertion positions yielding optimal results. Cross-domain transfer at billion-parameter scale reveals unexpected regularization benefits. These findings demonstrate that transformer middle layers can support ef

There exists a large number of datasets for organ segmentation, which are partially annotated and sequentially constructed. A typical dataset is constructed at a certain time by curating medical images and annotating the organs of interest. In other words, new datasets with annotations of new organ categories are built over time. To unleash the potential behind these partially labeled, sequentially-constructed datasets, we propose to incrementally learn a multi-organ segmentation model. In each incremental learning (IL) stage, we lose the access to previous data and annotations, whose knowledge is assumingly captured by the current model, and gain the access to a new dataset with annotations of new organ categories, from which we learn to update the organ segmentation model to include the new organs. While IL is notorious for its `catastrophic forgetting' weakness in the context of natural image analysis, we experimentally discover that such a weakness mostly disappears for CT multi-organ segmentation. To further stabilize the model performance across the IL stages, we introduce a light memory module and some loss functions to restrain the representation of different categories in

Organ transplantation, which is the utilization of codes directly related to some specific functionalities to complete ones own program, provides more convenience for developers than traditional component reuse. However, recent techniques are challenged with the lack of organs for transplantation. Hence, we conduct an empirical study on extracting organs from GitHub repository to explore transplantation based on large-scale dataset. We analyze statistics from 12 representative GitHub projects and get the conclusion that 1) there are abundant practical organs existing in commits with add as a key word in the comments; 2) organs in this repository mainly possess four kinds of contents; 3) approximately 70% of the organs are easy-to-transplant. Implementing our transplantation strategy for different kinds of organs, we manually extract 30 organs in three different programming languages, namely Java, Python, and C, and make unit tests for them utilizing four testing tools (two for Java, one for Python, and one for C). At last, we transplant three Java organs into a specific platform for a performance check to verify whether they can work well in the new system. All the 30 organs extrac

Annotating multiple organs in 3D medical images is time-consuming and costly. Meanwhile, there exist many single-organ datasets with one specific organ annotated. This paper investigates how to learn a multi-organ segmentation model leveraging a set of binary-labeled datasets. A novel Multi-teacher Single-student Knowledge Distillation (MS-KD) framework is proposed, where the teacher models are pre-trained single-organ segmentation networks, and the student model is a multi-organ segmentation network. Considering that each teacher focuses on different organs, a region-based supervision method, consisting of logits-wise supervision and feature-wise supervision, is proposed. Each teacher supervises the student in two regions, the organ region where the teacher is considered as an expert and the background region where all teachers agree. Extensive experiments on three public single-organ datasets and a multi-organ dataset have demonstrated the effectiveness of the proposed MS-KD framework.