Publications by Kevin Marchesini

Accurate registration of Intraoral Scans (IOS) with Cone-Beam Computed Tomography (CBCT) enables integration of dental crown surfaces with the tooth roots and the surrounding alveolar bone. However, IOS-CBCT registration remains challenging because of limited anatomical overlap, cross-modal differences, and unreliable correspondences. Task 2 of the MICCAI STS 2026 Challenge formulates this setting as a semi-supervised rigid registration problem, in which IOS meshes must be aligned with their corresponding CBCT volumes. For this task, we propose a landmark-driven coarse-to-fine framework in which modality-specific networks predict corresponding dental landmarks from the IOS mesh and CBCT volume. A confidence-weighted RANSAC-Kabsch procedure estimates a robust initial transformation, later refined using point-to-plane Iterative Closest Point. On the challenge validation set, the method achieved a Mean Translation Error of 4.988 mm and a Mean Rotation Error of 1.421°, ranking first on the registration leaderboard at the time of evaluation. The code is available on GitHub: https://github.com/AImageLab-zip/L2L-Registration

Cone-beam computed tomography (CBCT) is widely used for dento-maxillofacial diagnostics and treatment planning, and comprehensive multi-structure segmentation remains time-consuming, limiting large-scale, reproducible research. In this article, we present ToothFairy2, a MICCAI 2024 challenge on multi-structure segmentation in maxillofacial CBCT. The accompanying dataset comprises 530 CBCT volumes (480 public training, 50 hidden test) with expert 3D annotations of 42 classes, including maxilla, mandible, crowns, bridges, implants, inferior alveolar canals, maxillary sinuses, pharynx, and teeth using the International Tooth Numbering System (FDI). 26 international teams participated in ToothFairy2, and their methods were run and evaluated for voxel-wise multi-class segmentation using a standardized protocol. This report extends the evaluation of teeth to also investigate the current capabilities of tooth detection and FDI numbering. Furthermore, ranking stability was analyzed to assess the robustness of the final challenge outcome. Overall, challenge participants achieved consistently high performance for large, high-contrast structures such as jawbones, pharynx, and most teeth, while maxillary sinuses, dental restorations, and fine structures remain challenging due to class imbalance and metal artifacts. Analysis of tooth-related metrics further revealed that assigning correct FDI numbers was more challenging than delineating individual teeth. By releasing CBCT data, 3D annotations, baseline models, and evaluation code, ToothFairy2 establishes a long-term benchmark to drive the development of automated methods for robust, clinically meaningful multi-structure segmentation in maxillofacial CBCT.

Large-scale benchmarks such as BraTS have driven progress in brain tumor segmentation, but they provide only masks with limited access to the clinical semantics found in radiology reports. We introduce ReportX, a paired resource of 257 clinical reports aligned to BraTS-GLI-2023 subjects, structured into a rich set of qualitative and quantitative attributes. Qualitative fields are curated by clinicians, while quantitative descriptors are automatically derived via atlas-based localization and geometric computations. We compare our annotation schema to existing report-augmented datasets and show that ReportX provides substantially broader coverage of clinically relevant factors. To exploit this supervision, we encode reports using biomedical language models and incorporate their embeddings as auxiliary semantic guidance for 3D tumor segmentation during training. Experimental results demonstrate that the proposed vision-text alignment improves segmentation performance on standard BraTS metrics, with clinically curated reports providing more consistent improvements than automatically generated or less-structured counterparts. We publicly release the dataset (https://ditto.ing.unimore.it/reportx) and the source code (https://github.com/AImageLab-zip/ReportX).

Reproducibility policies promise "checkable" medical-imaging science, yet many submissions still ship unverifiable artifacts. Our analysis of 3722 MICCAI papers shows code-linking rising from 51.8% (2021) to 72.5% (2025), but ~13% of linked repositories are inaccessible or empty. We present paper-snitch, a reviewer-facing decision-support tool that turns these signals into an evidence-grounded report. Paper-snitch parses PDFs, resolves and sanity-checks repositories, and applies policy-aware checklists aligned with MICCAI expectations, producing a review-time verifiability score decomposed into interpretable sub-scores plus criterion-linked excerpts and artifacts reviewers can inspect. It never executes untrusted code or attempts GPU-heavy reproduction, focusing instead on bounded, verifiable checks. We compare paper-snitch on 100 randomly sampled MICCAI 2025 papers with human annotators using shared evaluation criteria, indicating that automated, bounded checks can scale reproducibility screening while keeping final decisions with reviewers.

Model reuse offers a solution to the challenges of segmentation in biomedical imaging, where high data annotation costs remain a major bottleneck for deep learning. However, although many pre-trained models are released through challenges, model zoos, and repositories, selecting the most suitable model for a new dataset remains difficult due to the lack of reliable model ranking methods. We introduce the first black-box-compatible framework for unsupervised and source-free ranking of semantic and instance segmentation models based on the consistency of predictions under perturbations. While ranking methods have been studied for classification and a few segmentation-related approaches exist, most target-related tasks such as transferability estimation or model validation and typically rely on labelled data, feature-space access, or specific training assumptions. In contrast, our method directly addresses the repository setting and applies to both semantic and instance segmentation, for zero-shot reuse or after unsupervised domain adaptation. We evaluate the approach across a wide range of biomedical segmentation tasks in both 2D and 3D imaging, showing that our estimated rankings strongly correlate with true target-domain model performance rankings. Code is available on GitHub: https://github.com/kreshuklab/model_ranking.

CNNs and Transformer-based architectures are recently dominating the field of 3D medical segmentation. While CNNs face limitations in the local receptive field, Transformers require significant memory and data, making them less suitable for analyzing large 3D medical volumes. Consequently, fully convolutional network models like U-Net are still leading the 3D segmentation scenario. Although efforts have been made to reduce the Transformers computational complexity, such optimized models still struggle with content-based reasoning. This paper examines Mamba, a Recurrent Neural Network (RNN) based on State Space Models (SSMs), which achieves linear complexity and has outperformed Transformers in long-sequence tasks. Specifically, we assess Mamba’s performance in 3D medical segmentation using three widely recognized and commonly employed datasets and propose architectural enhancements to improve its segmentation effectiveness by mitigating the primary shortcomings of existing Mamba-based solutions.

Testicular ultrasound imaging is vital for assessing male infertility, with testicular inhomogeneity serving as a key biomarker. However, subjective interpretation and the scarcity of publicly available datasets pose challenges to automated classification. In this study, we explore supervised and unsupervised pretraining strategies using a ResNet-based architecture, supplemented by diffusion-based generative models to synthesize realistic ultrasound images. Our results demonstrate that pretraining significantly enhances classification performance compared to training from scratch, and synthetic data can effectively substitute real images in the pretraining process, alleviating data-sharing constraints. These methods offer promising advancements toward robust, clinically valuable automated analysis of male infertility. The source code is publicly available at https://github.com/AImageLab-zip/TesticulUS/.

Brain tumor segmentation is a crucial task in medical imaging that involves the integrated modeling of four distinct imaging modalities to identify tumor regions accurately. Unfortunately, in real-life scenarios, the full availability of such four modalities is often violated due to scanning cost, time, and patient condition. Consequently, several deep learning models have been developed to address the challenge of brain tumor segmentation under conditions of missing imaging modalities. However, the majority of these models have been evaluated using the 2018 version of the BraTS dataset, which comprises only $285$ volumes. In this study, we reproduce and extensively analyze the most relevant models using BraTS2023, which includes 1,250 volumes, thereby providing a more comprehensive and reliable comparison of their performance. Furthermore, we propose and evaluate the adoption of Mamba as an alternative fusion mechanism for brain tumor segmentation in the presence of missing modalities. Experimental results demonstrate that transformer-based architectures achieve leading performance on BraTS2023, outperforming purely convolutional models that were instead superior in BraTS2018. Meanwhile, the proposed Mamba-based architecture exhibits promising performance in comparison to state-of-the-art models, competing and even outperforming transformers. The source code of the proposed approach is publicly released alongside the benchmark developed for the evaluation: https://github.com/AImageLab-zip/IM-Fuse.

Convolutional Neural Networks (CNNs) have been broadly employed in dermoscopic image analysis, mainly due to the large amount of data gathered by the International Skin Imaging Collaboration (ISIC). But where do neural networks look? Several authors have claimed that the ISIC dataset is affected by strong biases, i.e. spurious correlations between samples that machine learning models unfairly exploit while discarding the useful patterns they are expected to learn. These strong claims have been supported by showing that deep learning models maintain excellent performance even when "no information about the lesion remains" in the debased input images. With this paper, we explore the interpretability of CNNs in dermoscopic image analysis by analyzing which characteristics are considered by autonomous classification algorithms. Starting from a standard setting, experiments presented in this paper gradually conceal well-known crucial dermoscopic features and thoroughly investigate how CNNs performance subsequently evolves. Experimental results carried out on two well-known CNNs, EfficientNet-B3, and ResNet-152, demonstrate that neural networks autonomously learn to extract features that are notoriously important for melanoma detection. Even when some of such features are removed, the others are still enough to achieve satisfactory classification performance. Obtained results demonstrate that literature claims on biases are not supported by carried-out experiments. Finally, to demonstrate the generalization capabilities of state-of-the-art CNN models for skin lesion classification, a large private dataset has been employed as an additional test set.

The synthesis of missing MRI modalities has emerged as a critical solution to address incomplete multi-parametric imaging in brain tumor diagnosis and treatment planning. While recent advances in generative models, especially GANs and diffusion-based approaches, have demonstrated promising results in cross-modality MRI generation, challenges remain in preserving anatomical fidelity and minimizing synthesis artifacts. In this work, we build upon the Hybrid Fusion GAN (\hfgan) framework, introducing several enhancements aimed at improving synthesis quality and generalization across tumor types. Specifically, we incorporate z-score normalization, optimize network components for faster and more stable training, and extend the pipeline to support multi-view generation across various brain tumor categories, including gliomas, metastases, and meningiomas. Our approach focuses on refining 2D slice-based generation to ensure intra-slice coherence and reduce intensity inconsistencies, ultimately supporting more accurate and robust tumor segmentation in scenarios with missing imaging modalities. Our source code is available at https://github.com/AImageLab-zip/BraSyn25.