Henggui Zhang

Zixian Su, Hongkai Zhang, Fan Gao et al.

Multimodal Large Language Models (MLLMs) have shown strong performance on public medical benchmarks, yet existing evaluations often remain weak proxies for clinical use, relying on isolated inputs and simplified recognition-style tasks. We introduce CardioLens, a leakage-resistant evaluation testbed for multi-sequence Cardiovascular Magnetic Resonance (CMR), constructed from private hospital archives through a rigorous report-to-QA construction and verification pipeline. CardioLens contains 473,896 slices and 13,494 verified QA pairs across 4D Cine, LGE, perfusion, and T2-weighted imaging, and evaluates three stages of CMR interpretation: image understanding, report generation, and disease diagnosis. Across 24 state-of-the-art MLLMs, CardioLens reveals a substantial clinical reality gap: models perform poorly overall, with performance degrading along the real CMR workflow. Confusion analysis further shows a category-collapse failure mode, where models default to frequent abnormal categories rather than distinguishing clinically distinct findings. To rule out MLLM-compatible input construction as the primary cause, we compare random, clinically motivated, and data-driven slice selection protocols under different slice budgets; performance changes only marginally, typically by about 1%. Explicit reasoning prompts also fail to rescue performance, often making models more conservative rather than improving visual evidence use. These results show that current MLLMs remain far from reliable CMR interpretation, where clinical decisions require integrating distributed evidence across sequences, views, and temporal phases. CardioLens provides a clinically grounded testbed for developing next-generation MLLMs toward real-world clinical deployment.

Taiping Qu, Hongkai Zhang, Lantian Zhang et al.

Cardiac magnetic resonance (CMR) is a cornerstone for diagnosing cardiovascular disease. However, it remains underutilized due to complex, time-consuming interpretation across multi-sequences, phases, quantitative measures that heavily reliant on specialized expertise. Here, we present BAAI Cardiac Agent, a multimodal intelligent system designed for end-to-end CMR interpretation. The agent integrates specialized cardiac expert models to perform automated segmentation of cardiac structures, functional quantification, tissue characterization and disease diagnosis, and generates structured clinical reports within a unified workflow. Evaluated on CMR datasets from two hospitals (2413 patients) spanning 7-types of major cardiovascular diseases, the agent achieved an area under the receiver-operating-characteristic curve exceeding 0.93 internally and 0.81 externally. In the task of estimating left ventricular function indices, the results generated by this system for core parameters such as ejection fraction, stroke volume, and left ventricular mass are highly consistent with clinical reports, with Pearson correlation coefficients all exceeding 0.90. The agent outperformed state-of-the-art models in segmentation and diagnostic tasks, and generated clinical reports showing high concordance with expert radiologists (six readers across three experience levels). By dynamically orchestrating expert models for coordinated multimodal analysis, this agent framework enables accurate, efficient CMR interpretation and highlights its potentials for complex clinical imaging workflows. Code is available at https://github.com/plantain-herb/Cardiac-Agent.

Yang Liu, Kuanquan Wang, Qince Li et al.

Supervised deep learning has been widely used in the studies of automatic ECG classification, which largely benefits from sufficient annotation of large datasets. However, most of the existing large ECG datasets are roughly annotated, so the classification model trained on them can only detect the existence of abnormalities in a whole recording, but cannot determine their exact occurrence time. In addition, it may take huge time and economic cost to construct a fine-annotated ECG dataset. Therefore, this study proposes weakly supervised deep learning models for detecting abnormal ECG events and their occurrence time. The available supervision information for the models is limited to the event types in an ECG record, excluding the specific occurring time of each event. By leverage of feature locality of deep convolution neural network, the models first make predictions based on the local features, and then aggregate the local predictions to infer the existence of each event during the whole record. Through training, the local predictions are expected to reflect the specific occurring time of each event. To test their potentials, we apply the models for detecting cardiac rhythmic and morphological arrhythmias by using the AFDB and MITDB datasets, respectively. The results show that the models achieve beat-level accuracies of 99.09% in detecting atrial fibrillation, and 99.13% in detecting morphological arrhythmias, which are comparable to that of fully supervised learning models, demonstrating their effectiveness. The local prediction maps revealed by this method are also helpful to analyze and diagnose the decision logic of record-level classification models.

Yang Liu, Runnan He, Kuanquan Wang et al.

Heart disease is one of the most common diseases causing morbidity and mortality. Electrocardiogram (ECG) has been widely used for diagnosing heart diseases for its simplicity and non-invasive property. Automatic ECG analyzing technologies are expected to reduce human working load and increase diagnostic efficacy. However, there are still some challenges to be addressed for achieving this goal. In this study, we develop an algorithm to identify multiple abnormalities from 12-lead ECG recordings. In the algorithm pipeline, several preprocessing methods are firstly applied on the ECG data for denoising, augmentation and balancing recording numbers of variant classes. In consideration of efficiency and consistency of data length, the recordings are padded or truncated into a medium length, where the padding/truncating time windows are selected randomly to sup-press overfitting. Then, the ECGs are used to train deep neural network (DNN) models with a novel structure that combines a deep residual network with an attention mechanism. Finally, an ensemble model is built based on these trained models to make predictions on the test data set. Our method is evaluated based on the test set of the First China ECG Intelligent Competition dataset by using the F1 metric that is regarded as the harmonic mean between the precision and recall. The resultant overall F1 score of the algorithm is 0.875, showing a promising performance and potential for practical use.

Suyu Dong, Gongning Luo, Kuanquan Wang et al.

3D left ventricle (LV) segmentation on echocardiography is very important for diagnosis and treatment of cardiac disease. It is not only because of that echocardiography is a real-time imaging technology and widespread in clinical application, but also because of that LV segmentation on 3D echocardiography can provide more full volume information of heart than LV segmentation on 2D echocardiography. However, 3D LV segmentation on echocardiography is still an open and challenging task owing to the lower contrast, higher noise and data dimensionality, limited annotation of 3D echocardiography. In this paper, we proposed a novel real-time framework, i.e., VoxelAtlasGAN, for 3D LV segmentation on 3D echocardiography. This framework has three contributions: 1) It is based on voxel-to-voxel conditional generative adversarial nets (cGAN). For the first time, cGAN is used for 3D LV segmentation on echocardiography. And cGAN advantageously fuses substantial 3D spatial context information from 3D echocardiography by self-learning structured loss; 2) For the first time, it embeds the atlas into an end-to-end optimization framework, which uses 3D LV atlas as a powerful prior knowledge to improve the inference speed, address the lower contrast and the limited annotation problems of 3D echocardiography; 3) It combines traditional discrimination loss and the new proposed consistent constraint, which further improves the generalization of the proposed framework. VoxelAtlasGAN was validated on 60 subjects on 3D echocardiography and it achieved satisfactory segmentation results and high inference speed. The mean surface distance is 1.85 mm, the mean hausdorff surface distance is 7.26 mm, mean dice is 0.953, the correlation of EF is 0.918, and the mean inference speed is 0.1s. These results have demonstrated that our proposed method has great potential for clinical application

Gongning Luo, Suyu Dong, Kuanquan Wang et al.

Left ventricular (LV) volumes estimation is a critical procedure for cardiac disease diagnosis. The objective of this paper is to address direct LV volumes prediction task. Methods: In this paper, we propose a direct volumes prediction method based on the end-to-end deep convolutional neural networks (CNN). We study the end-to-end LV volumes prediction method in items of the data preprocessing, networks structure, and multi-views fusion strategy. The main contributions of this paper are the following aspects. First, we propose a new data preprocessing method on cardiac magnetic resonance (CMR). Second, we propose a new networks structure for end-to-end LV volumes estimation. Third, we explore the representational capacity of different slices, and propose a fusion strategy to improve the prediction accuracy. Results: The evaluation results show that the proposed method outperforms other state-of-the-art LV volumes estimation methods on the open accessible benchmark datasets. The clinical indexes derived from the predicted volumes agree well with the ground truth (EDV: R2=0.974, RMSE=9.6ml; ESV: R2=0.976, RMSE=7.1ml; EF: R2=0.828, RMSE =4.71%). Conclusion: Experimental results prove that the proposed method may be useful for LV volumes prediction task. Significance: The proposed method not only has application potential for cardiac diseases screening for large-scale CMR data, but also can be extended to other medical image research fields