Qixiang Zhang

Honglong Yang, Shanshan Song, Yi Qin et al.

Generalist Medical AI (GMAI) systems have demonstrated expert-level performance in biomedical perception tasks, yet their clinical utility remains limited by inadequate multi-modal explainability and suboptimal prognostic capabilities. Here, we present XMedGPT, a clinician-centric, multi-modal AI assistant that integrates textual and visual interpretability to support transparent and trustworthy medical decision-making. XMedGPT not only produces accurate diagnostic and descriptive outputs, but also grounds referenced anatomical sites within medical images, bridging critical gaps in interpretability and enhancing clinician usability. To support real-world deployment, we introduce a reliability indexing mechanism that quantifies uncertainty through consistency-based assessment via interactive question-answering. We validate XMedGPT across four pillars: multi-modal interpretability, uncertainty quantification, and prognostic modeling, and rigorous benchmarking. The model achieves an IoU of 0.703 across 141 anatomical regions, and a Kendall's tau-b of 0.479, demonstrating strong alignment between visual rationales and clinical outcomes. For uncertainty estimation, it attains an AUC of 0.862 on visual question answering and 0.764 on radiology report generation. In survival and recurrence prediction for lung and glioma cancers, it surpasses prior leading models by 26.9%, and outperforms GPT-4o by 25.0%. Rigorous benchmarking across 347 datasets covers 40 imaging modalities and external validation spans 4 anatomical systems confirming exceptional generalizability, with performance gains surpassing existing GMAI by 20.7% for in-domain evaluation and 16.7% on 11,530 in-house data evaluation. Together, XMedGPT represents a significant leap forward in clinician-centric AI integration, offering trustworthy and scalable support for diverse healthcare applications.

Haonan Wang, Jiaji Mao, Lehan Wang et al.

Medical AI assistants support doctors in disease diagnosis, medical image analysis, and report generation. However, they still face significant challenges in clinical use, including limited accuracy with multimodal content and insufficient validation in real-world settings. We propose RCMed, a full-stack AI assistant that improves multimodal alignment in both input and output, enabling precise anatomical delineation, accurate localization, and reliable diagnosis through hierarchical vision-language grounding. A self-reinforcing correlation mechanism allows visual features to inform language context, while language semantics guide pixel-wise attention, forming a closed loop that refines both modalities. This correlation is enhanced by a color region description strategy, translating anatomical structures into semantically rich text to learn shape-location-text relationships across scales. Trained on 20 million image-mask-description triplets, RCMed achieves state-of-the-art precision in contextualizing irregular lesions and subtle anatomical boundaries, excelling in 165 clinical tasks across 9 modalities. It achieved a 23.5% relative improvement in cell segmentation from microscopy images over prior methods. RCMed's strong vision-language alignment enables exceptional generalization, with state-of-the-art performance in external validation across 20 clinically significant cancer types, including novel tasks. This work demonstrates how integrated multimodal models capture fine-grained patterns, enabling human-level interpretation in complex scenarios and advancing human-centric AI healthcare.