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原文摘要

DeepLearning (DL)-based Computer-Aided Diagnostic (CAD) systems have shown great promise in supporting clinicians, but their performance heavily depends on the availability of large, well-annotated datasets. In medical lesion detection, the scarcity of comprehensive, stan dardized annotations and the heterogeneity of existing datasets limit the development of robust foundation models. In this work, we introduce a novel approach to building a multi-domain foundation model for le sion detection by integrating diverse medical image datasets annotated for both anatomical structures and abnormalities. We first propose a student-teacher training strategy to effectively combine datasets with heterogeneous label spaces, mitigating catastrophic forgetting, and im proving feature learning. In addition, building on our previously pro posed example-based EM-DETR framework, we adapt it to jointly learn from multiple domain-specific datasets, enabling fine-grained, example driven detection across modalities. Our model achieves state-of-the-art (SOTA) results, with image-level AUC scores exceeding previous SOTA by 1% point on four key findings in CXRs. We achieve a leading mAP50 in CXRs and mammography, surpassing EM-DETR trained on a single dataset by 2-3% points. This approach paves the way for scalable foundation models in medical imaging that leverage heterogeneous data while maintaining robust and generalizable performance.