Yuwei Li

Yuhe Tian, Kun Zhang, Haoran Ma et al.

While large language models (LLMs) have advanced CT report generation, existing methods typically encode 3D volumes holistically, failing to distinguish informative cues from redundant anatomical background. Inspired by radiological cognitive subtraction, we propose Differential Visual Prompting (DiffVP), which conditions report generation on explicit, high-level semantic scan-to-reference differences rather than solely on absolute visual features. DiffVP employs a hierarchical difference extractor to capture complementary global and local semantic discrepancies into a shared latent space, along with a difference-to-prompt generator that transforms these signals into learnable visual prefix tokens for LLM conditioning. These difference prompts serve as structured conditioning signals that implicitly suppress invariant anatomy while amplifying diagnostically relevant visual evidence, thereby facilitating accurate report generation without explicit lesion localization. On two large-scale benchmarks, DiffVP consistently outperforms prior methods, improving the average BLEU-1-4 by +10.98 and +4.36, respectively, and further boosts clinical efficacy on RadGenome-ChestCT (F1 score 0.421). All codes will be released at https://github.com/ArielTYH/DiffVP/.

Yifan Li, Fenghe Tang, Yingtai Li et al.

General-purpose large Vision-Language Models (VLMs) demonstrate strong capabilities in generating detailed descriptions for natural images. However, their performance in the medical domain remains suboptimal, even for relatively straightforward tasks, primarily due to the lack of large-scale, high-quality, specialized medical imaging datasets and the neglect of the diagnostic process that progresses from coarse to fine-grained. To address the first issue, we construct the CT-RATE-VQA dataset, which has 84K QA pairs. For the second issue, we propose MedReason-R1, a medical VLM with explicit reasoning process for disease diagnosis. MedReason-R1 incorporates a novel strategy that embeds zoom-in disease region-of-interest areas into the image, highlighting the crucial role of both global localization and disease-specific details in enhancing the model's diagnostic performance. Furthermore, we introduce the GRPO reinforcement learning framework to MedReason-R1, which enables effective reasoning without relying on costly manual annotations. Compared to recent general-purpose and medical VLMs, MedReason-R1 achieves state-of-the-art performance in CT disease diagnosis while retaining generalization. The code, checkpoints, and dataset are available at: https://github.com/Leevan001/MedReason-R1

Yingtai Li, Haoran Lai, Xiaoqian Zhou et al.

The emergence of Large Language Models (LLMs) presents unprecedented opportunities to revolutionize medical contrastive vision-language pre-training. In this paper, we show how LLMs can facilitate large-scale supervised pre-training, thereby advancing vision-language alignment. We begin by demonstrate that modern LLMs can automatically extract diagnostic labels from radiology reports with remarkable precision (>96\% AUC in our experiments) without complex prompt engineering, enabling the creation of large-scale "silver-standard" datasets at a minimal cost (~\$3 for 50k CT image-report pairs). Further, we find that vision encoder trained on this "silver-standard" dataset achieves performance comparable to those trained on labels extracted by specialized BERT-based models, thereby democratizing the access to large-scale supervised pre-training. Building on this foundation, we proceed to reveal that supervised pre-training fundamentally improves contrastive vision-language alignment. Our approach achieves state-of-the-art performance using only a 3D ResNet-18 with vanilla CLIP training, including 83.8\% AUC for zero-shot diagnosis on CT-RATE, 77.3\% AUC on RAD-ChestCT, and substantial improvements in cross-modal retrieval (MAP@50=53.7\% for image-image, Recall@100=52.2\% for report-image). These results demonstrate the potential of utilizing LLMs to facilitate {\bf more performant and scalable} medical AI systems. Our code is avaiable at https://github.com/SadVoxel/More-performant-and-scalable.

Xueming Fu, Pei Wu, Yingtai Li et al.

Accurate analysis of cardiac motion is crucial for evaluating cardiac function. While dynamic cardiac magnetic resonance imaging (CMR) can capture detailed tissue motion throughout the cardiac cycle, the fine-grained 4D cardiac motion tracking remains challenging due to the homogeneous nature of myocardial tissue and the lack of distinctive features. Existing approaches can be broadly categorized into image based and representation-based, each with its limitations. Image-based methods, including both raditional and deep learning-based registration approaches, either struggle with topological consistency or rely heavily on extensive training data. Representation-based methods, while promising, often suffer from loss of image-level details. To address these limitations, we propose Dynamic 3D Gaussian Representation (Dyna3DGR), a novel framework that combines explicit 3D Gaussian representation with implicit neural motion field modeling. Our method simultaneously optimizes cardiac structure and motion in a self-supervised manner, eliminating the need for extensive training data or point-to-point correspondences. Through differentiable volumetric rendering, Dyna3DGR efficiently bridges continuous motion representation with image-space alignment while preserving both topological and temporal consistency. Comprehensive evaluations on the ACDC dataset demonstrate that our approach surpasses state-of-the-art deep learning-based diffeomorphic registration methods in tracking accuracy. The code will be available in https://github.com/windrise/Dyna3DGR.

Rundong Wang, Wei Ba, Ying Zhou et al.

Recent methods for pathology report generation from whole-slide image (WSI) are capable of producing slide-level diagnostic descriptions but fail to ground fine-grained statements in localized visual evidence. Furthermore, they lack control over which diagnostic details to include and how to verify them. Inspired by emerging agentic analysis paradigms and the diagnostic workflow of pathologists,who selectively examine multiple fields of view, we propose QCAgent, an agentic framework for quality-controllable WSI report generation. The core innovations of this framework are as follows: (i) it incorporates a customized critique mechanism guided by a user-defined checklist specifying required diagnostic details and constraints; (ii) it re-identifies informative regions in the WSI based on the critique feedback and text-patch semantic retrieval, a process that iteratively enriches and reconciles the report. Experiments demonstrate that by making report requirements explicitly prompt-defined, constraint-aware, and verifiable through evidence-grounded refinement, QCAgent enables controllable generation of clinically meaningful and high-coverage pathology reports from WSI.

Yingtai Li, Shuai Ming, Mingyue Zhao et al.

The development of radiology foundation models (RFMs) is hindered by a reliance on brute-force scaling. Existing approaches often directly translate methods for natural images, which prioritize scale over precision and hence lead to brittle and expensive models in clinical practice. To address this, we present a resource-efficient pre-training framework, GreenRFM, that achieves state-of-the-art performance. Our framework ensures robust generalization across diverse patient populations and imaging protocols, reducing computational requirements by orders of magnitude while surpassing complex, parameter-heavy models. These capabilities stem from principled supervision design that aims to maximally utilize supervisory signals via More distilled, Ubiquitous, Semantic-enforcing, and Task-aligning (MUST) supervision, rather than simply piling up the quantity of training data. We offer two GreenRFM configurations: (i) a performant model that establishes a new state-of-the-art using a single 24GB GPU within 24 hours, and (ii) a lightweight model that matches existing benchmarks with 6GB VRAM in 4 hours. We conduct extensive experiments using over 200,000 images from four institutions and of two modalities. GreenRFMs achieve superior performances on chest and abdominal CT datasets, regardless of public or private benchmark, surpassing a range of baseline models. In addition, the results on internal musculoskeletal MRI images show that the same supervision principles transfer between different modalities. Our performance and efficiency challenge the ``scale is all you need'' dogma and democratize the equitable development of state-of-the-art RFMs for clinicians even on a laptop.

Pu Zhang, Yuwei Li, Xingyuan Xian et al.

As the capabilities of Vision-Language Models (VLMs) advance, they can process increasingly large inputs, which, unlike in LLMs, generates significant visual token redundancy and leads to prohibitive inference costs. While many methods aim to reduce these costs by pruning visual tokens, existing approaches, whether based on attention or diversity, typically neglect the guidance of the text prompt and thus fail to prioritize task relevance. In this work, we propose a novel, zero-shot method that reframes the problem by introducing a prompt-aware perspective, explicitly modeling visual token pruning as a balance between task relevance and information diversity. Our hierarchical approach first selects a core set of task-relevant visual tokens and then supplements them with diversity tokens to preserve broader context. Experiments across multiple models and benchmarks show that our method achieves performance that matches or surpasses the state-of-the-art with only minimal accuracy loss, even when pruning up to 90\% of the tokens. Furthermore, these gains are accompanied by significant reductions in GPU memory footprint and inference latency.