Hsin-Yu Wu

Cheng-Yi Li, Kao-Jung Chang, Cheng-Fu Yang et al.

Multi-modal large language models (MLLMs) have been given free rein to explore exciting medical applications with a primary focus on radiology report generation. Nevertheless, the preliminary success in 2D radiology captioning is incompetent to reflect the real-world diagnostic challenge in the volumetric 3D anatomy. To mitigate three crucial limitation aspects in the existing literature, including (1) data complexity, (2) model capacity, and (3) evaluation metric fidelity, we collected an 18,885 text-scan pairs 3D-BrainCT dataset and applied clinical visual instruction tuning (CVIT) to train BrainGPT models to generate radiology-adherent 3D brain CT reports. Statistically, our BrainGPT scored BLEU-1 = 44.35, BLEU-4 = 20.38, METEOR = 30.13, ROUGE-L = 47.6, and CIDEr-R = 211.77 during internal testing and demonstrated an accuracy of 0.91 in captioning midline shifts on the external validation CQ500 dataset. By further inspecting the captioned report, we reported that the traditional metrics appeared to measure only the surface text similarity and failed to gauge the information density of the diagnostic purpose. To close this gap, we proposed a novel Feature-Oriented Radiology Task Evaluation (FORTE) to estimate the report's clinical relevance (lesion feature and landmarks). Notably, the BrainGPT model scored an average FORTE F1-score of 0.71 (degree=0.661; landmark=0.706; feature=0.693; impression=0.779). To demonstrate that BrainGPT models possess objective readiness to generate human-like radiology reports, we conducted a Turing test that enrolled 11 physician evaluators, and around 74% of the BrainGPT-generated captions were indistinguishable from those written by humans. Our work embodies a holistic framework that showcased the first-hand experience of curating a 3D brain CT dataset, fine-tuning anatomy-sensible language models, and proposing robust radiology evaluation metrics.

Meidan Ding, Jipeng Zhang, Wenxuan Wang et al.

Multimodal large language models (MLLMs) hold significant potential in medical applications, including disease diagnosis and clinical decision-making. However, these tasks require highly accurate, context-sensitive, and professionally aligned responses, making reliable reward models and judges critical. Despite their importance, medical reward models (MRMs) and judges remain underexplored, with no dedicated benchmarks addressing clinical requirements. Existing benchmarks focus on general MLLM capabilities or evaluate models as solvers, neglecting essential evaluation dimensions like diagnostic accuracy and clinical relevance. To address this, we introduce Med-RewardBench, the first benchmark specifically designed to evaluate MRMs and judges in medical scenarios. Med-RewardBench features a multimodal dataset spanning 13 organ systems and 8 clinical departments, with 1,026 expert-annotated cases. A rigorous three-step process ensures high-quality evaluation data across six clinically critical dimensions. We evaluate 32 state-of-the-art MLLMs, including open-source, proprietary, and medical-specific models, revealing substantial challenges in aligning outputs with expert judgment. Additionally, we develop baseline models that demonstrate substantial performance improvements through fine-tuning.

Chun-Hung Wu, Shih-Hong Chen, Chih-Yao Hu et al.

This paper presents Deformable Neural Vessel Representations (DeNVeR), an unsupervised approach for vessel segmentation in X-ray angiography videos without annotated ground truth. DeNVeR utilizes optical flow and layer separation techniques, enhancing segmentation accuracy and adaptability through test-time training. Key contributions include a novel layer separation bootstrapping technique, a parallel vessel motion loss, and the integration of Eulerian motion fields for modeling complex vessel dynamics. A significant component of this research is the introduction of the XACV dataset, the first X-ray angiography coronary video dataset with high-quality, manually labeled segmentation ground truth. Extensive evaluations on both XACV and CADICA datasets demonstrate that DeNVeR outperforms current state-of-the-art methods in vessel segmentation accuracy and generalization capability while maintaining temporal coherency.