Disease grading is a crucial task in medical image analysis. Due to the continuous progression of diseases, i.e., the variability within the same level and the similarity between adjacent stages, accurate grading is highly challenging.Furthermore, in real-world scenarios, models trained on limited source domain datasets should also be capable of handling data from unseen target domains.Due to the cross-domain variants, the feature distribution between source and unseen target domains can be dramatically different, leading to a substantial decrease in model performance.To address these challenges in cross-domain disease grading, we propose a Severity-aware Recurrent Modeling (Samba) method in this paper.As the core objective of most staging tasks is to identify the most severe lesions, which may only occupy a small portion of the image, we propose to encode image patches in a sequential and recurrent manner.Specifically, a state space model is tailored to store and transport the severity information by hidden states.Moreover, to mitigate the impact of cross-domain variants, an Expectation-Maximization (EM) based state recalibration mechanism is designed to map the patch embeddings into a more compact space.We model the feature distributions of different lesions through the Gaussian Mixture Model (GMM) and reconstruct the intermediate features based on learnable severity bases.Extensive experiments show the proposed Samba outperforms the VMamba baseline by an average accuracy of 23.5\%, 5.6\% and 4.1\% on the cross-domain grading of fatigue fracture, breast cancer and diabetic retinopathy, respectively. Source code is available at \url{https://github.com/BiQiWHU/Samba}.

Diabetic Retinopathy (DR) affects individuals with long-term diabetes. Without early diagnosis, DR can lead to vision loss. Fundus photography captures the structure of the retina along with abnormalities indicative of the stage of the disease. Artificial Intelligence (AI) can support clinicians in identifying these lesions, reducing manual workload, but models require high-quality annotated datasets. Due to the complexity of retinal structures, errors in image acquisition and lesion interpretation of manual annotators can occur. We proposed a quality-control framework, ensuring only high-standard data is used for evaluation and AI training. First, an explainable feature-based classifier is used to filter inadequate images. The features are extracted both using image processing and contrastive learning. Then, the images are enhanced and put subject to annotation, using deep-learning-based assistance. Lastly, the agreement between annotators calculated using derived formulas determines the usability of the annotations.

Coronary angiography is the main tool for assessing coronary artery disease, but visual grading of stenosis is variable and only moderately related to ischaemia. Wire based fractional flow reserve (FFR) improves lesion selection but is not used systematically. Angiography derived indices such as quantitative flow ratio (QFR) offer wire free physiology, yet many tools are workflow intensive and separate from automated anatomy analysis and virtual PCI planning. We developed AngioAI-QFR, an end to end angiography only pipeline combining deep learning stenosis detection, lumen segmentation, centreline and diameter extraction, per millimetre Relative Flow Capacity profiling, and virtual stenting with automatic recomputation of angiography derived QFR. The system was evaluated in 100 consecutive vessels with invasive FFR as reference. Primary endpoints were agreement with FFR (correlation, mean absolute error) and diagnostic performance for FFR <= 0.80. On held out frames, stenosis detection achieved precision 0.97 and lumen segmentation Dice 0.78. Across 100 vessels, AngioAI-QFR correlated strongly with FFR (r = 0.89, MAE 0.045). The AUC for detecting FFR <= 0.80 was 0.93, with sensitivity 0.88 and specificity 0.86. The pipeline completed fully automatically in 93 percent of vessels, with median time to result 41 s. RFC profiling distinguished focal from diffuse capacity loss, and virtual stenting predicted larger QFR gain in focal than in diffuse disease. AngioAI-QFR provides a practical, near real time pipeline that unifies computer vision, functional profiling, and virtual PCI with automated angiography derived physiology.

In the field of healthcare, precise skin lesion segmentation is crucial for the early detection and accurate diagnosis of skin diseases. Despite significant advances in deep learning for image processing, existing methods have yet to effectively address the challenges of irregular lesion shapes and low contrast. To address these issues, this paper proposes an innovative encoder-decoder network architecture based on multi-scale residual structures, capable of extracting rich feature information from different receptive fields to effectively identify lesion areas. By introducing a Multi-Resolution Multi-Channel Fusion (MRCF) module, our method captures cross-scale features, enhancing the clarity and accuracy of the extracted information. Furthermore, we propose a Cross-Mix Attention Module (CMAM), which redefines the attention scope and dynamically calculates weights across multiple contexts, thus improving the flexibility and depth of feature capture and enabling deeper exploration of subtle features. To overcome the information loss caused by skip connections in traditional U-Net, an External Attention Bridge (EAB) is introduced, facilitating the effective utilization of information in the decoder and compensating for the loss during upsampling. Extensive experimental evaluations on several skin lesion segmentation datasets demonstrate that the proposed model significantly outperforms existing transformer and convolutional neural network-based models, showcasing exceptional segmentation accuracy and robustness.

Accurate segmentation of vertebral metastasis in CT is clinically important yet difficult to scale, as voxel-level annotations are scarce and both lytic and blastic lesions often resemble benign degenerative changes. We introduce a weakly supervised method trained solely on vertebra-level healthy/malignant labels, without any lesion masks. The method combines a Diffusion Autoencoder (DAE) that produces a classifier-guided healthy edit of each vertebra with pixel-wise difference maps that propose candidate lesion regions. To determine which regions truly reflect malignancy, we introduce Hide-and-Seek Attribution: each candidate is revealed in turn while all others are hidden, the edited image is projected back to the data manifold by the DAE, and a latent-space classifier quantifies the isolated malignant contribution of that component. High-scoring regions form the final lytic or blastic segmentation. On held-out radiologist annotations, we achieve strong blastic/lytic performance despite no mask supervision (F1: 0.91/0.85; Dice: 0.87/0.78), exceeding baselines (F1: 0.79/0.67; Dice: 0.74/0.55). These results show that vertebra-level labels can be transformed into reliable lesion masks, demonstrating that generative editing combined with selective occlusion supports accurate weakly supervised segmentation in CT.