Xian Yang

Shuai Niu, Jing Ma, Hongzhan Lin et al.

Interpretation is critical for disease diagnosis, but existing models struggle to balance predictive accuracy with human-understandable rationales. While large language models (LLMs) offer strong reasoning abilities, their clinical use is limited by high computational costs and restricted multimodal reasoning ability. Small language models (SLMs) are efficient but lack advanced reasoning for integrating multimodal medical data. In addition, both LLMs and SLMs lack domain knowledge for trustworthy reasoning. Therefore, we propose ClinRaGen, enhancing SLMs by leveraging LLM-derived reasoning ability via rationale distillation and domain knowledge injection for trustworthy multimodal rationale generation. Key innovations include a sequential rationale distillation framework that equips SLMs with LLM-comparable multimodal reasoning abilities, and a knowledge-augmented attention mechanism that jointly unifies multimodal representation from time series and textual data in the same encoding space, enabling it to be naturally interpreted by SLMs while incorporating domain knowledge for reliable rationale generation. Experiments on real-world medical datasets show that ClinRaGen achieves state-of-the-art performance in disease diagnosis and rationale generation, demonstrating the effectiveness of combining LLM-driven reasoning with knowledge augmentation for improved interpretability.

Jia Yu, Yan Zhu, Peiyao Fu et al.

Colorectal cancer (CRC) is a significant global health concern, and early detection through screening plays a critical role in reducing mortality. While deep learning models have shown promise in improving polyp detection, classification, and segmentation, their generalization across diverse clinical environments, particularly with out-of-distribution (OOD) data, remains a challenge. Multi-center datasets like PolypGen have been developed to address these issues, but their collection is costly and time-consuming. Traditional data augmentation techniques provide limited variability, failing to capture the complexity of medical images. Diffusion models have emerged as a promising solution for generating synthetic polyp images, but the image generation process in current models mainly relies on segmentation masks as the condition, limiting their ability to capture the full clinical context. To overcome these limitations, we propose a Progressive Spectrum Diffusion Model (PSDM) that integrates diverse clinical annotations-such as segmentation masks, bounding boxes, and colonoscopy reports-by transforming them into compositional prompts. These prompts are organized into coarse and fine components, allowing the model to capture both broad spatial structures and fine details, generating clinically accurate synthetic images. By augmenting training data with PSDM-generated samples, our model significantly improves polyp detection, classification, and segmentation. For instance, on the PolypGen dataset, PSDM increases the F1 score by 2.12% and the mean average precision by 3.09%, demonstrating superior performance in OOD scenarios and enhanced generalization.

Huimin Yan, Xian Yang, Liang Bai et al.

Local alignment between medical images and text is essential for accurate diagnosis, though it remains challenging due to the absence of natural local pairings and the limitations of rigid region recognition methods. Traditional approaches rely on hard boundaries, which introduce uncertainty, whereas medical imaging demands flexible soft region recognition to handle irregular structures. To overcome these challenges, we propose the Progressive Local Alignment Network (PLAN), which designs a novel contrastive learning-based approach for local alignment to establish meaningful word-pixel relationships and introduces a progressive learning strategy to iteratively refine these relationships, enhancing alignment precision and robustness. By combining these techniques, PLAN effectively improves soft region recognition while suppressing noise interference. Extensive experiments on multiple medical datasets demonstrate that PLAN surpasses state-of-the-art methods in phrase grounding, image-text retrieval, object detection, and zero-shot classification, setting a new benchmark for medical image-text alignment.