Shuchang Xu

Shu Yang, Zhiyuan Cai, Luyang Luo et al.

Capitalizing on image-level pre-trained models for various downstream tasks has recently emerged with promising performance. However, the paradigm of "image pre-training followed by video fine-tuning" for high-dimensional video data inevitably poses significant performance bottlenecks. Furthermore, in the medical domain, many surgical video tasks encounter additional challenges posed by the limited availability of video data and the necessity for comprehensive spatial-temporal modeling. Recently, Parameter-Efficient Image-to-Video Transfer Learning has emerged as an efficient and effective paradigm for video action recognition tasks, which employs image-level pre-trained models with promising feature transferability and involves cross-modality temporal modeling with minimal fine-tuning. Nevertheless, the effectiveness and generalizability of this paradigm within intricate surgical domain remain unexplored. In this paper, we delve into a novel problem of efficiently adapting image-level pre-trained models to specialize in fine-grained surgical phase recognition, termed as Parameter-Efficient Image-to-Surgical-Video Transfer Learning. Firstly, we develop a parameter-efficient transfer learning benchmark SurgPETL for surgical phase recognition, and conduct extensive experiments with three advanced methods based on ViTs of two distinct scales pre-trained on five large-scale natural and medical datasets. Then, we introduce the Spatial-Temporal Adaptation module, integrating a standard spatial adapter with a novel temporal adapter to capture detailed spatial features and establish connections across temporal sequences for robust spatial-temporal modeling. Extensive experiments on three challenging datasets spanning various surgical procedures demonstrate the effectiveness of SurgPETL with STA.

Shu Yang, Fengtao Zhou, Leon Mayer et al.

Computer-Assisted Intervention (CAI) has the potential to revolutionize modern surgery, with surgical scene understanding serving as a critical component in supporting decision-making, improving procedural efficacy, and ensuring intraoperative safety. While existing AI-driven approaches alleviate annotation burdens via self-supervised spatial representation learning, their lack of explicit temporal modeling during pre-training fundamentally restricts the capture of dynamic surgical contexts, resulting in incomplete spatiotemporal understanding. In this work, we introduce the first video-level surgical pre-training framework that enables joint spatiotemporal representation learning from large-scale surgical video data. To achieve this, we constructed a large-scale surgical video dataset comprising 3,650 videos and approximately 3.55 million frames, spanning more than 20 surgical procedures and over 10 anatomical structures. Building upon this dataset, we propose SurgVISTA (Surgical Video-level Spatial-Temporal Architecture), a reconstruction-based pre-training method that captures intricate spatial structures and temporal dynamics through joint spatiotemporal modeling. Additionally, SurgVISTA incorporates image-level knowledge distillation guided by a surgery-specific expert to enhance the learning of fine-grained anatomical and semantic features. To validate its effectiveness, we established a comprehensive benchmark comprising 13 video-level datasets spanning six surgical procedures across four tasks. Extensive experiments demonstrate that SurgVISTA consistently outperforms both natural- and surgical-domain pre-trained models, demonstrating strong potential to advance intelligent surgical systems in clinically meaningful scenarios.

Wenshuo Zhang, Leixian Shen, Shuchang Xu et al.

Conversational LLMs have been widely adopted by domain users with limited programming experience to solve domain problems. However, these users often face misalignment between their intent and generated code, resulting in frustration and rounds of clarification. This work first investigates the cause of this misalignment, which dues to bidirectional ambiguity: both user intents and coding tasks are inherently nonlinear, yet must be expressed and interpreted through linear prompts and code sequences. To address this, we propose direct intent-task matching, a new human-LLM interaction paradigm that externalizes and enables direct manipulation of the LLM understanding, i.e., the coding tasks and their relationships inferred by the LLM prior to code generation. As a proof-of-concept, this paradigm is then implemented in NeuroSync, which employs a knowledge distillation pipeline to extract LLM understanding, user intents, and their mappings, and enhances the alignment by allowing users to intuitively inspect and edit them via visualizations. We evaluate the algorithmic components of NeuroSync via technical experiments, and assess its overall usability and effectiveness via a user study (N=12). The results show that it enhances intent-task alignment, lowers cognitive effort, and improves coding efficiency.

Yikun Ma, Bo Li, Ying Chen et al.

The early detection of esophagogastric junction adenocarcinoma (EGJA) is crucial for improving patient prognosis, yet its current diagnosis is highly operator-dependent. This paper aims to make the first attempt to develop an artificial intelligence (AI) foundation model-based method for both screening and staging diagnosis of EGJA using endoscopic images. In this cohort and learning study, we conducted a multicentre study across seven Chinese hospitals between December 28, 2016 and December 30, 2024. It comprises 12,302 images from 1,546 patients; 8,249 of them were employed for model training, while the remaining were divided into the held-out (112 patients, 914 images), external (230 patients, 1,539 images), and prospective (198 patients, 1,600 images) test sets for evaluation. The proposed model employs DINOv2 (a vision foundation model) and ResNet50 (a convolutional neural network) to extract features of global appearance and local details of endoscopic images for EGJA staging diagnosis. Our model demonstrates satisfactory performance for EGJA staging diagnosis across three test sets, achieving an accuracy of 0.9256, 0.8895, and 0.8956, respectively. In contrast, among representative AI models, the best one (ResNet50) achieves an accuracy of 0.9125, 0.8382, and 0.8519 on the three test sets, respectively; the expert endoscopists achieve an accuracy of 0.8147 on the held-out test set. Moreover, with the assistance of our model, the overall accuracy for the trainee, competent, and expert endoscopists improves from 0.7035, 0.7350, and 0.8147 to 0.8497, 0.8521, and 0.8696, respectively. To our knowledge, our model is the first application of foundation models for EGJA staging diagnosis and demonstrates great potential in both diagnostic accuracy and efficiency.