Papers for
clinical imaging specialists
Papers whose findings have a practical use for this group, as judged from the abstract. Open a paper to read what it means in practice.
Multimodal models show mixed accuracy classifying breast ultrasound images
Can Multimodal Decision Models Classify Breast Ultrasound Images? Benchmarking CLEF and CLEF-Flash Across Prompts and Datasets
Abstract: Multimodal decision models return probabilities over predefined alternatives, offering a structured interface for image classification. This study benchmarks inference with CLEF and CLEF-Flash on 2818 breast ultrasound images from Dataset B, BUSI, and BUS-BRA. Dataset B and BUS-BRA use binary benign-malignant classification, whereas BUSI includes normal, benign, and malignant categories. Model parameters remain unchanged, and original images are submitted without user-defined preprocessing. Three prompts provide minimal labels, an explicit classification task, or sonographic criteria. We report accuracy, macro F1, balanced accuracy, macro precision, throughput, and latency. CLEF-Flash with the clinical prompt achieves the highest accuracy on all three datasets: 74.85% on Dataset B, 66.28% on BUSI, and 51.63% on BUS-BRA. On BUSI, however, CLEF with the task-guided prompt achieves the highest macro F1 (64.51%) and balanced accuracy (68.72%). CLEF-Flash has lower latency in every matched comparison. Clinical instructions improve CLEF-Flash accuracy relative to the minimal prompt but reduce CLEF accuracy on all datasets. Confusion matrices reveal frequent benign-to-malignant errors, particularly on BUS-BRA, where all configurations fall below the 67.63% accuracy of a majority-class predictor. These findings demonstrate dataset-and prompt-dependent performance and motivate class-specific evaluation before applying multimodal decision models to breast ultrasound analysis.
Iterative uncertainty gating improves medical image registration accuracy
Recursive Uncertainty-Gated Image Registration for Learning-based Algorithms
Abstract: Conventional image registration algorithms are robust to domain shifts and achieve low errors, but they are slow and computationally expensive. Deep-learning methods are efficient at inference-time, but face challenges in out-of-domain samples. We propose Recursive Uncertainty-Gated Image Registration (RUGI), an algorithm for iteratively refining deformation fields predicted by learning-based registration models. At each iteration, the registration model predicts an incremental deformation, and a gating map modulates the update. Refinements are hence concentrated in regions that remain difficult to register. We explore two gating strategies: a learned uncertainty-based approach and an image residual error approach. We evaluate RUGI on cardiac MRI and echocardiography datasets and show consistent improvements over single-step inference. Ablation experiments demonstrate that iterative refinement alone improves registration, but informative spatial gating provides a significant additional benefit. The error-gated variant of RUGI can also be applied directly to existing pretrained models; applied to VoxelMorph, TransMorph, and CycleMorph, it yields MSE reductions of 27-37% with no modification to the original training procedure. The improvements in registration performance are reflected in decreased errors in ejection fraction estimation relative to ground truths. These results demonstrate that spatially selective iterative refinement provides an effective strategy to improve registration accuracy at inference-time.