Cardiac anatomy segmentation is essential for clinical assessment of cardiac function and disease diagnosis to inform treatment and intervention. Deep learning (DL) has improved cardiac anatomy segmentation accuracy, especially when information on cardiac motion dynamics is integrated into the networks. Several methods for incorporating motion information have been proposed; however, existing methods are not yet optimal: adding the time dimension to input data causes high computational costs, and incorporating registration into the segmentation network remains computationally costly and can be affected by errors of registration, especially with non-DL registration. While attention-based motion modeling is promising, suboptimal design constrains its capacity to learn the complex and coherent temporal interactions inherent in cardiac image sequences. Here, we propose a novel approach to incorporating motion information in the DL segmentation networks: a computationally efficient yet robust Temporal Attention Module (TAM), modeled as a small, multi-headed, cross-temporal attention module, which can be plug-and-play inserted into a broad range of segmentation networks (CNN, transformer, or hybrid) without a drastic architecture modification. Extensive experiments on multiple cardiac imaging datasets, such as 2D echocardiography (CAMUS and EchoNet-Dynamic), 3D echocardiography (MITEA), and 3D cardiac MRI (ACDC), confirm that TAM consistently improves segmentation performance across datasets when added to a range of networks, including UNet, FCN8s, UNetR, SwinUNetR, and the recent I2UNet and DT-VNet. Integrating TAM into SAM yields a temporal SAM that reduces Hausdorff distance (HD) from 3.99 mm to 3.51 mm on the CAMUS dataset, while integrating TAM into a pre-trained MedSAM reduces HD from 3.04 to 2.06 pixels after fine-tuning on the EchoNet-Dynamic dataset. On the ACDC 3D dataset, our TAM-UNet and TAM-DT-VNet achieve substantial reductions in HD, from 7.97 mm to 4.23 mm and 6.87 mm to 4.74 mm, respectively. Additionally, TAM's training does not require segmentation of ground truths from all time frames and can be achieved with sparse temporal annotation. TAM is thus a robust, generalizable, and adaptable solution for motion-awareness enhancement that is easily scaled from 2D to 3D. The code is available at https://github.com/kamruleee51/TAM.

High-quality 3D reconstruction of pulmonary segments plays a crucial role in segmentectomy and surgical planning for the treatment of lung cancer. Due to the resolution requirement of the target reconstruction, conventional deep learning-based methods often suffer from computational resource constraints or limited granularity. Conversely, implicit modeling is favored due to its computational efficiency and continuous representation at any resolution. We propose a neural implicit function-based method to learn a 3D surface to achieve anatomy-aware, precise pulmonary segment reconstruction, represented as a shape by deforming a learnable template. Additionally, we introduce two clinically relevant evaluation metrics to comprehensively assess the quality of the reconstruction. Furthermore, to address the lack of publicly available shape datasets for benchmarking reconstruction algorithms, we developed a shape dataset named Lung3D, which includes the 3D models of 800 labeled pulmonary segments and their corresponding airways, arteries, veins, and intersegmental veins. We demonstrate that the proposed approach outperforms existing methods, providing a new perspective for pulmonary segment reconstruction. Code and data will be available at https://github.com/HINTLab/ImPulSe.

Esophageal varices (EV) represent a critical complication of portal hypertension, affecting approximately 60% of cirrhosis patients with a significant bleeding risk of ∼ 30%. While traditionally diagnosed through invasive endoscopy, non-contrast computed tomography (NCCT) presents a potential non-invasive alternative that has yet to be fully utilized in clinical practice. We present Multi-Organ-COhesion Network++ (MOON++), a novel multimodal framework that enhances EV assessment through comprehensive analysis of NCCT scans. Inspired by clinical evidence correlating organ volumetric relationships with liver disease severity, MOON++ synthesizes imaging characteristics of the esophagus, liver, and spleen through multimodal learning. We evaluated our approach using 1631 patients, those with endoscopically confirmed EV were classified into four severity grades. Validation in 239 patient cases and independent testing in 289 cases demonstrate superior performance compared to conventional single organ methods, achieving an AUC of 0.894 versus 0.803 for the severe grade EV classification (G3 versus < G3) and 0.921 versus 0.793 for the differentiation of moderate to severe grades ( ≥ G2 versus < G2). We conducted a reader study involving experienced radiologists to further validate the performance of MOON++. To our knowledge, MOON++ represents the first comprehensive multi-organ NCCT analysis framework incorporating clinical knowledge priors for EV assessment, potentially offering a promising non-invasive diagnostic alternative. Code is available at https://github.com/StevenHaojc/MOON.