Boyun Zheng

Shengyuan Liu, Liuxin Bao, Qi Yang et al.

Medical image segmentation is evolving from task-specific models toward generalizable frameworks. Recent research leverages Multi-modal Large Language Models (MLLMs) as autonomous agents, employing reinforcement learning with verifiable reward (RLVR) to orchestrate specialized tools like the Segment Anything Model (SAM). However, these approaches often rely on single-turn, rigid interaction strategies and lack process-level supervision during training, which hinders their ability to fully exploit the dynamic potential of interactive tools and leads to redundant actions. To bridge this gap, we propose MedSAM-Agent, a framework that reformulates interactive segmentation as a multi-step autonomous decision-making process. First, we introduce a hybrid prompting strategy for expert-curated trajectory generation, enabling the model to internalize human-like decision heuristics and adaptive refinement strategies. Furthermore, we develop a two-stage training pipeline that integrates multi-turn, end-to-end outcome verification with a clinical-fidelity process reward design to promote interaction parsimony and decision efficiency. Extensive experiments across 6 medical modalities and 21 datasets demonstrate that MedSAM-Agent achieves state-of-the-art performance, effectively unifying autonomous medical reasoning with robust, iterative optimization. Code is available \href{https://github.com/CUHK-AIM-Group/MedSAM-Agent}{here}.

Fuqiang Chen, Ranran Zhang, Boyun Zheng et al.

Conventional hematoxylin-eosin (H&E) staining is limited to revealing cell morphology and distribution, whereas immunohistochemical (IHC) staining provides precise and specific visualization of protein activation at the molecular level. Virtual staining technology has emerged as a solution for highly efficient IHC examination, which directly transforms H&E-stained images to IHC-stained images. However, virtual staining is challenged by the insufficient mining of pathological semantics and the spatial misalignment of pathological semantics. To address these issues, we propose the Pathological Semantics-Preserving Learning method for Virtual Staining (PSPStain), which directly incorporates the molecular-level semantic information and enhances semantics interaction despite any spatial inconsistency. Specifically, PSPStain comprises two novel learning strategies: 1) Protein-Aware Learning Strategy (PALS) with Focal Optical Density (FOD) map maintains the coherence of protein expression level, which represents molecular-level semantic information; 2) Prototype-Consistent Learning Strategy (PCLS), which enhances cross-image semantic interaction by prototypical consistency learning. We evaluate PSPStain on two public datasets using five metrics: three clinically relevant metrics and two for image quality. Extensive experiments indicate that PSPStain outperforms current state-of-the-art H&E-to-IHC virtual staining methods and demonstrates a high pathological correlation between the staging of real and virtual stains.

Shengyuan Liu, Boyun Zheng, Wenting Chen et al.

Endoscopic procedures are essential for diagnosing and treating internal diseases, and multi-modal large language models (MLLMs) are increasingly applied to assist in endoscopy analysis. However, current benchmarks are limited, as they typically cover specific endoscopic scenarios and a small set of clinical tasks, failing to capture the real-world diversity of endoscopic scenarios and the full range of skills needed in clinical workflows. To address these issues, we introduce EndoBench, the first comprehensive benchmark specifically designed to assess MLLMs across the full spectrum of endoscopic practice with multi-dimensional capacities. EndoBench encompasses 4 distinct endoscopic scenarios, 12 specialized clinical tasks with 12 secondary subtasks, and 5 levels of visual prompting granularities, resulting in 6,832 rigorously validated VQA pairs from 21 diverse datasets. Our multi-dimensional evaluation framework mirrors the clinical workflow--spanning anatomical recognition, lesion analysis, spatial localization, and surgical operations--to holistically gauge the perceptual and diagnostic abilities of MLLMs in realistic scenarios. We benchmark 23 state-of-the-art models, including general-purpose, medical-specialized, and proprietary MLLMs, and establish human clinician performance as a reference standard. Our extensive experiments reveal: (1) proprietary MLLMs outperform open-source and medical-specialized models overall, but still trail human experts; (2) medical-domain supervised fine-tuning substantially boosts task-specific accuracy; and (3) model performance remains sensitive to prompt format and clinical task complexity. EndoBench establishes a new standard for evaluating and advancing MLLMs in endoscopy, highlighting both progress and persistent gaps between current models and expert clinical reasoning. We publicly release our benchmark and code.

Hongtao Wu, Boyun Zheng, Dingjie Song et al.

Autonomous systems that generate scientific hypotheses, conduct experiments, and draft manuscripts have recently emerged as a promising paradigm for accelerating discovery. However, existing AI Scientists remain largely domain-agnostic, limiting their applicability to clinical medicine, where research is required to be grounded in medical evidence with specialized data modalities. In this work, we introduce Medical AI Scientist, the first autonomous research framework tailored to clinical autonomous research. It enables clinically grounded ideation by transforming extensively surveyed literature into actionable evidence through clinician-engineer co-reasoning mechanism, which improves the traceability of generated research ideas. It further facilitates evidence-grounded manuscript drafting guided by structured medical compositional conventions and ethical policies. The framework operates under 3 research modes, namely paper-based reproduction, literature-inspired innovation, and task-driven exploration, each corresponding to a distinct level of automated scientific inquiry with progressively increasing autonomy. Comprehensive evaluations by both large language models and human experts demonstrate that the ideas generated by the Medical AI Scientist are of substantially higher quality than those produced by commercial LLMs across 171 cases, 19 clinical tasks, and 6 data modalities. Meanwhile, our system achieves strong alignment between the proposed method and its implementation, while also demonstrating significantly higher success rates in executable experiments. Double-blind evaluations by human experts and the Stanford Agentic Reviewer suggest that the generated manuscripts approach MICCAI-level quality, while consistently surpassing those from ISBI and BIBM. The proposed Medical AI Scientist highlights the potential of leveraging AI for autonomous scientific discovery in healthcare.

Min Tan, Yushun Tao, Boyun Zheng et al.

With the increasing application of automated robotic digestive endoscopy (RDE), ensuring safe and efficient navigation in the unstructured and narrow digestive tract has become a critical challenge. Existing automated reinforcement learning navigation algorithms often result in potentially risky collisions due to the absence of essential human intervention, which significantly limits the safety and effectiveness of RDE in actual clinical practice. To address this limitation, we proposed a Human Intervention (HI)-based Proximal Policy Optimization (PPO) framework, dubbed HI-PPO, which incorporates expert knowledge to enhance RDE's safety. Specifically, HI-PPO combines Enhanced Exploration Mechanism (EEM), Reward-Penalty Adjustment (RPA), and Behavior Cloning Similarity (BCS) to address PPO's exploration inefficiencies for safe navigation in complex gastrointestinal environments. Comparative experiments were conducted on a simulation platform, and the results showed that HI-PPO achieved a mean ATE (Average Trajectory Error) of \(8.02\ \text{mm}\) and a Security Score of \(0.862\), demonstrating performance comparable to human experts. The code will be publicly available once this paper is published.

Chenhui Wang, Boyun Zheng, Liuxin Bao et al.

Precise prognostic modeling of glioblastoma (GBM) under varying treatment interventions is essential for optimizing clinical outcomes. While generative AI has shown promise in simulating GBM evolution, existing methods typically treat interventions as static conditional inputs rather than dynamic decision variables. Consequently, they fail to capture the complex, reciprocal interplay between tumor evolution and treatment response. To bridge this gap, we present Brain-WM, a pioneering brain GBM world model that unifies next-step treatment prediction and future MRI generation, thereby capturing the co-evolutionary dynamics between tumor and treatment. Specifically, Brain-WM encodes spatiotemporal dynamics into a shared latent space for joint autoregressive treatment prediction and flow-based future MRI generation. Then, instead of a conventional monolithic framework, Brain-WM adopts a novel Y-shaped Mixture-of-Transformers (MoT) architecture. This design structurally disentangles heterogeneous objectives, successfully leveraging cross-task synergies while preventing feature collapse. Finally, a synergistic multi-timepoint mask alignment objective explicitly anchors latent representations to anatomically grounded tumor structures and progression-aware semantics. Extensive validation on internal and external multi-institutional cohorts demonstrates the superiority of Brain-WM, achieving 91.5% accuracy in treatment planning and SSIMs of 0.8524, 0.8581, and 0.8404 for FLAIR, T1CE, and T2W sequences, respectively. Ultimately, Brain-WM offers a robust clinical sandbox for optimizing patient healthcare. The source code is made available at https://github.com/thibault-wch/Brain-GBM-world-model.

Fuqiang Chen, Ranran Zhang, Wanming Hu et al.

Immunohistochemical (IHC) staining enables precise molecular profiling of protein expression, with over 200 clinically available antibody-based tests in modern pathology. However, comprehensive IHC analysis is frequently limited by insufficient tissue quantities in small biopsies. Therefore, virtual multiplex staining emerges as an innovative solution to digitally transform H&E images into multiple IHC representations, yet current methods still face three critical challenges: (1) inadequate semantic guidance for multi-staining, (2) inconsistent distribution of immunochemistry staining, and (3) spatial misalignment across different stain modalities. To overcome these limitations, we present a prompt-guided framework for virtual multiplex IHC staining using only uniplex training data (PGVMS). Our framework introduces three key innovations corresponding to each challenge: First, an adaptive prompt guidance mechanism employing a pathological visual language model dynamically adjusts staining prompts to resolve semantic guidance limitations (Challenge 1). Second, our protein-aware learning strategy (PALS) maintains precise protein expression patterns by direct quantification and constraint of protein distributions (Challenge 2). Third, the prototype-consistent learning strategy (PCLS) establishes cross-image semantic interaction to correct spatial misalignments (Challenge 3).

Shengyuan Liu, Wenting Chen, Boyun Zheng et al.

Tumor data synthesis offers a promising solution to the shortage of annotated medical datasets. However, current approaches either limit tumor diversity by using predefined masks or employ computationally expensive two-stage processes with multiple denoising steps, causing computational inefficiency. Additionally, these methods typically rely on binary masks that fail to capture the gradual transitions characteristic of tumor boundaries. We present TumorGen, a novel Boundary-Aware Tumor-Mask Synthesis with Rectified Flow Matching for efficient 3D tumor synthesis with three key components: a Boundary-Aware Pseudo Mask Generation module that replaces strict binary masks with flexible bounding boxes; a Spatial-Constraint Vector Field Estimator that simultaneously synthesizes tumor latents and masks using rectified flow matching to ensure computational efficiency; and a VAE-guided mask refiner that enhances boundary realism. TumorGen significantly improves computational efficiency by requiring fewer sampling steps while maintaining pathological accuracy through coarse and fine-grained spatial constraints. Experimental results demonstrate TumorGen's superior performance over existing tumor synthesis methods in both efficiency and realism, offering a valuable contribution to AI-driven cancer diagnostics.