Jun Ma

Jingfeng Yao, Xinggang Wang, Yuehao Song et al.

The diagnosis and treatment of chest diseases play a crucial role in maintaining human health. X-ray examination has become the most common clinical examination means due to its efficiency and cost-effectiveness. Artificial intelligence analysis methods for chest X-ray images are limited by insufficient annotation data and varying levels of annotation, resulting in weak generalization ability and difficulty in clinical dissemination. Here we present EVA-X, an innovative foundational model based on X-ray images with broad applicability to various chest disease detection tasks. EVA-X is the first X-ray image based self-supervised learning method capable of capturing both semantic and geometric information from unlabeled images for universal X-ray image representation. Through extensive experimentation, EVA-X has demonstrated exceptional performance in chest disease analysis and localization, becoming the first model capable of spanning over 20 different chest diseases and achieving leading results in over 11 different detection tasks in the medical field. Additionally, EVA-X significantly reduces the burden of data annotation in the medical AI field, showcasing strong potential in the domain of few-shot learning. The emergence of EVA-X will greatly propel the development and application of foundational medical models, bringing about revolutionary changes in future medical research and clinical practice. Our codes and models are available at: https://github.com/hustvl/EVA-X.

Zhe Xu, Ziyi Liu, Junlin Hou et al.

Multimodal large language models (MLLMs) have emerged as powerful tools for computational pathology, offering unprecedented opportunities to integrate pathological images with language context for comprehensive diagnostic analysis. These models hold particular promise for automating complex tasks that traditionally require expert interpretation of pathologists. However, current MLLM approaches in pathology demonstrate significantly constrained reasoning capabilities, primarily due to their reliance on expensive chain-of-thought annotations. Additionally, existing methods remain limited to simplex application of visual question answering (VQA) at the region-of-interest (ROI) level, failing to address the full spectrum of diagnostic needs such as ROI classification, detection, segmentation, whole-slide-image (WSI) classification and VQA in clinical practice. In this study, we present SmartPath-R1, a versatile MLLM capable of simultaneously addressing both ROI-level and WSI-level tasks while demonstrating robust pathological reasoning capability. Our framework combines scale-dependent supervised fine-tuning and task-aware reinforcement fine-tuning, which circumvents the requirement for chain-of-thought supervision by leveraging the intrinsic knowledge within MLLM. Furthermore, SmartPath-R1 integrates multiscale and multitask analysis through a mixture-of-experts mechanism, enabling dynamic processing for diverse tasks. We curate a large-scale dataset comprising 2.3M ROI samples and 188K WSI samples for training and evaluation. Extensive experiments across 72 tasks validate the effectiveness and superiority of the proposed approach. This work represents a significant step toward developing versatile, reasoning-enhanced AI systems for precision pathology.