Quanzheng Li

Zhengliang Liu, Yue Huang, Xiaowei Yu et al.

The digitization of healthcare has facilitated the sharing and re-using of medical data but has also raised concerns about confidentiality and privacy. HIPAA (Health Insurance Portability and Accountability Act) mandates removing re-identifying information before the dissemination of medical records. Thus, effective and efficient solutions for de-identifying medical data, especially those in free-text forms, are highly needed. While various computer-assisted de-identification methods, including both rule-based and learning-based, have been developed and used in prior practice, such solutions still lack generalizability or need to be fine-tuned according to different scenarios, significantly imposing restrictions in wider use. The advancement of large language models (LLM), such as ChatGPT and GPT-4, have shown great potential in processing text data in the medical domain with zero-shot in-context learning, especially in the task of privacy protection, as these models can identify confidential information by their powerful named entity recognition (NER) capability. In this work, we developed a novel GPT4-enabled de-identification framework (``DeID-GPT") to automatically identify and remove the identifying information. Compared to existing commonly used medical text data de-identification methods, our developed DeID-GPT showed the highest accuracy and remarkable reliability in masking private information from the unstructured medical text while preserving the original structure and meaning of the text. This study is one of the earliest to utilize ChatGPT and GPT-4 for medical text data processing and de-identification, which provides insights for further research and solution development on the use of LLMs such as ChatGPT/GPT-4 in healthcare. Codes and benchmarking data information are available at https://github.com/yhydhx/ChatGPT-API.

Cheng Chen, Juzheng Miao, Dufan Wu et al.

The Segment Anything Model (SAM), a foundation model for general image segmentation, has demonstrated impressive zero-shot performance across numerous natural image segmentation tasks. However, SAM's performance significantly declines when applied to medical images, primarily due to the substantial disparity between natural and medical image domains. To effectively adapt SAM to medical images, it is important to incorporate critical third-dimensional information, i.e., volumetric or temporal knowledge, during fine-tuning. Simultaneously, we aim to harness SAM's pre-trained weights within its original 2D backbone to the fullest extent. In this paper, we introduce a modality-agnostic SAM adaptation framework, named as MA-SAM, that is applicable to various volumetric and video medical data. Our method roots in the parameter-efficient fine-tuning strategy to update only a small portion of weight increments while preserving the majority of SAM's pre-trained weights. By injecting a series of 3D adapters into the transformer blocks of the image encoder, our method enables the pre-trained 2D backbone to extract third-dimensional information from input data. The effectiveness of our method has been comprehensively evaluated on four medical image segmentation tasks, by using 10 public datasets across CT, MRI, and surgical video data. Remarkably, without using any prompt, our method consistently outperforms various state-of-the-art 3D approaches, surpassing nnU-Net by 0.9%, 2.6%, and 9.9% in Dice for CT multi-organ segmentation, MRI prostate segmentation, and surgical scene segmentation respectively. Our model also demonstrates strong generalization, and excels in challenging tumor segmentation when prompts are used. Our code is available at: https://github.com/cchen-cc/MA-SAM.

Zhengliang Liu, Aoxiao Zhong, Yiwei Li et al.

We introduce Radiology-GPT, a large language model for radiology. Using an instruction tuning approach on an extensive dataset of radiology domain knowledge, Radiology-GPT demonstrates superior performance compared to general language models such as StableLM, Dolly and LLaMA. It exhibits significant versatility in radiological diagnosis, research, and communication. This work serves as a catalyst for future developments in clinical NLP. The successful implementation of Radiology-GPT is indicative of the potential of localizing generative large language models, specifically tailored for distinctive medical specialties, while ensuring adherence to privacy standards such as HIPAA. The prospect of developing individualized, large-scale language models that cater to specific needs of various hospitals presents a promising direction. The fusion of conversational competence and domain-specific knowledge in these models is set to foster future development in healthcare AI. A demo of Radiology-GPT is available at https://huggingface.co/spaces/allen-eric/radiology-gpt.

Haixing Dai, Chong Ma, Zhiling Yan et al.

This paper introduces SAMAug, a novel visual point augmentation method for the Segment Anything Model (SAM) that enhances interactive image segmentation performance. SAMAug generates augmented point prompts to provide more information about the user's intention to SAM. Starting with an initial point prompt, SAM produces an initial mask, which is then fed into our proposed SAMAug to generate augmented point prompts. By incorporating these extra points, SAM can generate augmented segmentation masks based on both the augmented point prompts and the initial prompt, resulting in improved segmentation performance. We conducted evaluations using four different point augmentation strategies: random sampling, sampling based on maximum difference entropy, maximum distance, and saliency. Experiment results on the COCO, Fundus, COVID QUEx, and ISIC2018 datasets show that SAMAug can boost SAM's segmentation results, especially using the maximum distance and saliency. SAMAug demonstrates the potential of visual prompt augmentation for computer vision. Codes of SAMAug are available at github.com/yhydhx/SAMAug

Yutong Xie, Quanzheng Li

We propose a novel and unified method, measurement-conditioned denoising diffusion probabilistic model (MC-DDPM), for under-sampled medical image reconstruction based on DDPM. Different from previous works, MC-DDPM is defined in measurement domain (e.g. k-space in MRI reconstruction) and conditioned on under-sampling mask. We apply this method to accelerate MRI reconstruction and the experimental results show excellent performance, outperforming full supervision baseline and the state-of-the-art score-based reconstruction method. Due to its generative nature, MC-DDPM can also quantify the uncertainty of reconstruction. Our code is available on github.

Haixing Dai, Yiwei Li, Zhengliang Liu et al.

In this pioneering study, inspired by AutoGPT, the state-of-the-art open-source application based on the GPT-4 large language model, we develop a novel tool called AD-AutoGPT which can conduct data collection, processing, and analysis about complex health narratives of Alzheimer's Disease in an autonomous manner via users' textual prompts. We collated comprehensive data from a variety of news sources, including the Alzheimer's Association, BBC, Mayo Clinic, and the National Institute on Aging since June 2022, leading to the autonomous execution of robust trend analyses, intertopic distance maps visualization, and identification of salient terms pertinent to Alzheimer's Disease. This approach has yielded not only a quantifiable metric of relevant discourse but also valuable insights into public focus on Alzheimer's Disease. This application of AD-AutoGPT in public health signifies the transformative potential of AI in facilitating a data-rich understanding of complex health narratives like Alzheimer's Disease in an autonomous manner, setting the groundwork for future AI-driven investigations in global health landscapes.

Se-In Jang, Tinsu Pan, Ye Li et al.

Position emission tomography (PET) is widely used in clinics and research due to its quantitative merits and high sensitivity, but suffers from low signal-to-noise ratio (SNR). Recently convolutional neural networks (CNNs) have been widely used to improve PET image quality. Though successful and efficient in local feature extraction, CNN cannot capture long-range dependencies well due to its limited receptive field. Global multi-head self-attention (MSA) is a popular approach to capture long-range information. However, the calculation of global MSA for 3D images has high computational costs. In this work, we proposed an efficient spatial and channel-wise encoder-decoder transformer, Spach Transformer, that can leverage spatial and channel information based on local and global MSAs. Experiments based on datasets of different PET tracers, i.e., $^{18}$F-FDG, $^{18}$F-ACBC, $^{18}$F-DCFPyL, and $^{68}$Ga-DOTATATE, were conducted to evaluate the proposed framework. Quantitative results show that the proposed Spach Transformer framework outperforms state-of-the-art deep learning architectures. Our codes are available at https://github.com/sijang/SpachTransformer

Arif Hassan Zidan, Yi Pan, Hanqi Jiang et al.

World models, internal simulators that learn the structure and dynamics of an environment, have emerged as a central paradigm in the pursuit of artificial general intelligence, enabling agents to predict, plan, and reason within learned representations. Despite rapid progress across reinforcement learning, robotics, autonomous driving, and video generation, the field lacks a unified framework integrating its diverse architectural choices, training methods, reasoning mechanisms, and application settings. This survey addresses that gap with a multi-axis taxonomy organized along four dimensions: (i) architecture, encompassing representation format, dynamics formulation, input modality, learning paradigm, and downstream application; (ii) methodological family, including state-space and recurrent approaches, transformer-based models, diffusion-based generators, physics-informed networks, and language-augmented multimodal systems; (iii) reasoning strategy, covering imagination-based planning, latent policy learning, counterfactual reasoning, and planning under uncertainty; and (iv) application domain, spanning robotics, autonomous driving, video prediction, multimodal agents, reinforcement learning, scientific modeling, medical imaging, educational measurement, and business and finance. Tracing the field from early cognitive-science foundations to milestone systems such as PlaNet, the Dreamer family, MuZero, Sora, Cosmos, and Genie, we examine how these dimensions interact and highlight the recent convergence of chain-of-thought reasoning with world-model imagination. We review evaluation protocols and benchmarks, identify persistent challenges such as compounding prediction errors, sim-to-real transfer, and fragmented evaluation, and outline future directions toward unified multimodal world models, foundation-scale interactive simulators, and safe deployment in safety-critical domains.

Haixing Dai, Zhengliang Liu, Wenxiong Liao et al.

Text data augmentation is an effective strategy for overcoming the challenge of limited sample sizes in many natural language processing (NLP) tasks. This challenge is especially prominent in the few-shot learning scenario, where the data in the target domain is generally much scarcer and of lowered quality. A natural and widely-used strategy to mitigate such challenges is to perform data augmentation to better capture the data invariance and increase the sample size. However, current text data augmentation methods either can't ensure the correct labeling of the generated data (lacking faithfulness) or can't ensure sufficient diversity in the generated data (lacking compactness), or both. Inspired by the recent success of large language models, especially the development of ChatGPT, which demonstrated improved language comprehension abilities, in this work, we propose a text data augmentation approach based on ChatGPT (named AugGPT). AugGPT rephrases each sentence in the training samples into multiple conceptually similar but semantically different samples. The augmented samples can then be used in downstream model training. Experiment results on few-shot learning text classification tasks show the superior performance of the proposed AugGPT approach over state-of-the-art text data augmentation methods in terms of testing accuracy and distribution of the augmented samples.

Yucheng Shi, Shaochen Xu, Tianze Yang et al. · harvard

Large Language Models (LLMs), although powerful in general domains, often perform poorly on domain-specific tasks such as medical question answering (QA). In addition, LLMs tend to function as "black-boxes", making it challenging to modify their behavior. To address the problem, our work employs a transparent process of retrieval augmented generation (RAG), aiming to improve LLM responses without the need for fine-tuning or retraining. Specifically, we propose a comprehensive retrieval strategy to extract medical facts from an external knowledge base, and then inject them into the LLM's query prompt. Focusing on medical QA, we evaluate the impact of different retrieval models and the number of facts on LLM performance using the MedQA-SMILE dataset. Notably, our retrieval-augmented Vicuna-7B model exhibited an accuracy improvement from 44.46% to 48.54%. This work underscores the potential of RAG to enhance LLM performance, offering a practical approach to mitigate the challenges posed by black-box LLMs.

Kuang Gong, Keith A. Johnson, Georges El Fakhri et al.

Due to various physical degradation factors and limited counts received, PET image quality needs further improvements. The denoising diffusion probabilistic models (DDPM) are distribution learning-based models, which try to transform a normal distribution into a specific data distribution based on iterative refinements. In this work, we proposed and evaluated different DDPM-based methods for PET image denoising. Under the DDPM framework, one way to perform PET image denoising is to provide the PET image and/or the prior image as the network input. Another way is to supply the prior image as the input with the PET image included in the refinement steps, which can fit for scenarios of different noise levels. 120 18F-FDG datasets and 140 18F-MK-6240 datasets were utilized to evaluate the proposed DDPM-based methods. Quantification show that the DDPM-based frameworks with PET information included can generate better results than the nonlocal mean and Unet-based denoising methods. Adding additional MR prior in the model can help achieve better performance and further reduce the uncertainty during image denoising. Solely relying on MR prior while ignoring the PET information can result in large bias. Regional and surface quantification shows that employing MR prior as the network input while embedding PET image as a data-consistency constraint during inference can achieve the best performance. In summary, DDPM-based PET image denoising is a flexible framework, which can efficiently utilize prior information and achieve better performance than the nonlocal mean and Unet-based denoising methods.

Hongmin Cai, Wenxiong Liao, Zhengliang Liu et al. · harvard

Modern supervised learning neural network models require a large amount of manually labeled data, which makes the construction of domain-specific knowledge graphs time-consuming and labor-intensive. In parallel, although there has been much research on named entity recognition and relation extraction based on distantly supervised learning, constructing a domain-specific knowledge graph from large collections of textual data without manual annotations is still an urgent problem to be solved. In response, we propose an integrated framework for adapting and re-learning knowledge graphs from one coarse domain (biomedical) to a finer-define domain (oncology). In this framework, we apply distant-supervision on cross-domain knowledge graph adaptation. Consequently, no manual data annotation is required to train the model. We introduce a novel iterative training strategy to facilitate the discovery of domain-specific named entities and triples. Experimental results indicate that the proposed framework can perform domain adaptation and construction of knowledge graph efficiently.

Zhengliang Liu, Yiwei Li, Peng Shu et al.

This paper introduces Radiology-Llama2, a large language model specialized for radiology through a process known as instruction tuning. Radiology-Llama2 is based on the Llama2 architecture and further trained on a large dataset of radiology reports to generate coherent and clinically useful impressions from radiological findings. Quantitative evaluations using ROUGE metrics on the MIMIC-CXR and OpenI datasets demonstrate that Radiology-Llama2 achieves state-of-the-art performance compared to other generative language models, with a Rouge-1 score of 0.4834 on MIMIC-CXR and 0.4185 on OpenI. Additional assessments by radiology experts highlight the model's strengths in understandability, coherence, relevance, conciseness, and clinical utility. The work illustrates the potential of localized language models designed and tuned for specialized domains like radiology. When properly evaluated and deployed, such models can transform fields like radiology by automating rote tasks and enhancing human expertise.

Xiang Li, Lin Zhao, Lu Zhang et al.

Large-scale Artificial General Intelligence (AGI) models, including Large Language Models (LLMs) such as ChatGPT/GPT-4, have achieved unprecedented success in a variety of general domain tasks. Yet, when applied directly to specialized domains like medical imaging, which require in-depth expertise, these models face notable challenges arising from the medical field's inherent complexities and unique characteristics. In this review, we delve into the potential applications of AGI models in medical imaging and healthcare, with a primary focus on LLMs, Large Vision Models, and Large Multimodal Models. We provide a thorough overview of the key features and enabling techniques of LLMs and AGI, and further examine the roadmaps guiding the evolution and implementation of AGI models in the medical sector, summarizing their present applications, potentialities, and associated challenges. In addition, we highlight potential future research directions, offering a holistic view on upcoming ventures. This comprehensive review aims to offer insights into the future implications of AGI in medical imaging, healthcare, and beyond.

Juzheng Miao, Cheng Chen, Keli Zhang et al.

Semi-supervised learning (SSL) has achieved notable progress in medical image segmentation. To achieve effective SSL, a model needs to be able to efficiently learn from limited labeled data and effectively exploiting knowledge from abundant unlabeled data. Recent developments in visual foundation models, such as the Segment Anything Model (SAM), have demonstrated remarkable adaptability with improved sample efficiency. To harness the power of foundation models for application in SSL, we propose a cross prompting consistency method with segment anything model (CPC-SAM) for semi-supervised medical image segmentation. Our method employs SAM's unique prompt design and innovates a cross-prompting strategy within a dual-branch framework to automatically generate prompts and supervisions across two decoder branches, enabling effectively learning from both scarce labeled and valuable unlabeled data. We further design a novel prompt consistency regularization, to reduce the prompt position sensitivity and to enhance the output invariance under different prompts. We validate our method on two medical image segmentation tasks. The extensive experiments with different labeled-data ratios and modalities demonstrate the superiority of our proposed method over the state-of-the-art SSL methods, with more than 9% Dice improvement on the breast cancer segmentation task.

Zhengliang Liu, Peilong Wang, Yiwei Li et al.

This paper presents RadOnc-GPT, a large language model specialized for radiation oncology through advanced tuning methods. RadOnc-GPT was finetuned on a large dataset of radiation oncology patient records from the Mayo Clinic in Arizona. The model employs instruction tuning on three key tasks - generating radiotherapy treatment regimens, determining optimal radiation modalities, and providing diagnostic descriptions/ICD codes based on patient diagnostic details. Evaluations conducted by comparing RadOnc-GPT outputs to general large language model outputs showed higher ROUGE scores in these three tasks. The study demonstrated the potential of using large language models fine-tuned using domain-specific knowledge like RadOnc-GPT to achieve transformational capabilities in highly specialized healthcare fields such as radiation oncology. However, our model's clinical relevance requires confirmation, and it specializes in only the aforementioned three specific tasks and lacks broader applicability. Furthermore, its evaluation through ROUGE scores might not reflect the true semantic and clinical accuracy - challenges we intend to address in future research.

Lian Zhang, Zhengliang Liu, Lu Zhang et al.

In this study, we evaluate the performance of the Segment Anything Model (SAM) in clinical radiotherapy. Our results indicate that SAM's 'segment anything' mode can achieve clinically acceptable segmentation results in most organs-at-risk (OARs) with Dice scores higher than 0.7. SAM's 'box prompt' mode further improves the Dice scores by 0.1 to 0.5. Considering the size of the organ and the clarity of its boundary, SAM displays better performance for large organs with clear boundaries but performs worse for smaller organs with unclear boundaries. Given that SAM, a model pre-trained purely on natural images, can handle the delineation of OARs from medical images with clinically acceptable accuracy, these results highlight SAM's robust generalization capabilities with consistent accuracy in automatic segmentation for radiotherapy. In other words, SAM can achieve delineation of different OARs at different sites using a generic automatic segmentation model. SAM's generalization capabilities across different disease sites suggest that it is technically feasible to develop a generic model for automatic segmentation in radiotherapy.

Chenhao Tang, Zhengliang Liu, Chong Ma et al.

Privacy policies serve as the primary conduit through which online service providers inform users about their data collection and usage procedures. However, in a bid to be comprehensive and mitigate legal risks, these policy documents are often quite verbose. In practical use, users tend to click the Agree button directly rather than reading them carefully. This practice exposes users to risks of privacy leakage and legal issues. Recently, the advent of Large Language Models (LLM) such as ChatGPT and GPT-4 has opened new possibilities for text analysis, especially for lengthy documents like privacy policies. In this study, we investigate a privacy policy text analysis framework PolicyGPT based on the LLM. This framework was tested using two datasets. The first dataset comprises of privacy policies from 115 websites, which were meticulously annotated by legal experts, categorizing each segment into one of 10 classes. The second dataset consists of privacy policies from 304 popular mobile applications, with each sentence manually annotated and classified into one of another 10 categories. Under zero-shot learning conditions, PolicyGPT demonstrated robust performance. For the first dataset, it achieved an accuracy rate of 97%, while for the second dataset, it attained an 87% accuracy rate, surpassing that of the baseline machine learning and neural network models.

Zhengliang Liu, Tianyang Zhong, Yiwei Li et al.

The rise of large language models (LLMs) has marked a pivotal shift in the field of natural language processing (NLP). LLMs have revolutionized a multitude of domains, and they have made a significant impact in the medical field. Large language models are now more abundant than ever, and many of these models exhibit bilingual capabilities, proficient in both English and Chinese. However, a comprehensive evaluation of these models remains to be conducted. This lack of assessment is especially apparent within the context of radiology NLP. This study seeks to bridge this gap by critically evaluating thirty two LLMs in interpreting radiology reports, a crucial component of radiology NLP. Specifically, the ability to derive impressions from radiologic findings is assessed. The outcomes of this evaluation provide key insights into the performance, strengths, and weaknesses of these LLMs, informing their practical applications within the medical domain.

Zihao Wu, Lu Zhang, Chao Cao et al.

Recently, ChatGPT and GPT-4 have emerged and gained immense global attention due to their unparalleled performance in language processing. Despite demonstrating impressive capability in various open-domain tasks, their adequacy in highly specific fields like radiology remains untested. Radiology presents unique linguistic phenomena distinct from open-domain data due to its specificity and complexity. Assessing the performance of large language models (LLMs) in such specific domains is crucial not only for a thorough evaluation of their overall performance but also for providing valuable insights into future model design directions: whether model design should be generic or domain-specific. To this end, in this study, we evaluate the performance of ChatGPT/GPT-4 on a radiology NLI task and compare it to other models fine-tuned specifically on task-related data samples. We also conduct a comprehensive investigation on ChatGPT/GPT-4's reasoning ability by introducing varying levels of inference difficulty. Our results show that 1) GPT-4 outperforms ChatGPT in the radiology NLI task; 2) other specifically fine-tuned models require significant amounts of data samples to achieve comparable performance to ChatGPT/GPT-4. These findings demonstrate that constructing a generic model that is capable of solving various tasks across different domains is feasible.

Arman Rahmim, Tyler J. Bradshaw, Irène Buvat et al. · uw

The SNMMI Artificial Intelligence (SNMMI-AI) Summit, organized by the SNMMI AI Task Force, took place in Bethesda, MD on March 21-22, 2022. It brought together various community members and stakeholders from academia, healthcare, industry, patient representatives, and government (NIH, FDA), and considered various key themes to envision and facilitate a bright future for routine, trustworthy use of AI in nuclear medicine. In what follows, essential issues, challenges, controversies and findings emphasized in the meeting are summarized.

Pengfei Jin, Na Li, Quanzheng Li

Generative models are increasingly used as priors for inverse problems, but their ability to produce realistic images creates a basic trust problem: a plausible reconstruction may be supported by the measurements, or it may be filled in by the prior along unobserved directions. This distinction is especially important in medical imaging, where acquisition operators are designed under scan-time, dose, and calibration constraints. We study generative inverse problems from a measurement-geometry perspective. The central question is whether a fixed measurement operator can distinguish nearby images that are plausible under the generative prior, and whether this relationship can guide better measurements. We introduce a local measurement-manifold compatibility measure that quantifies how well the operator observes prior-relevant tangent directions. Under local regularity assumptions, we prove that this quantity controls the stable part of the reconstruction error, while the generative prior controls off-manifold drift. This worst-direction certificate motivates practical fixed and sequential acquisition rules based on overall local volume preservation, including a posterior-cloud design that adapts measurements at test time without training a sampling policy. Across row-sampling, tomographic, and MR acquisition settings, the proposed scores predict failure modes, explain measurement-induced hallucinations, and guide better sampling. In fastMRI Cartesian sampling, posterior-cloud measurement design improves over strong non-learned ACS-preserving baselines, including variable-density and Poisson-like masks.

Pengfei Jin, Yiqi Tian, Kailong Fan et al.

Diffusion-based inverse problem solvers can produce realistic reconstructions, but realism alone does not ensure that the recovered details are supported by the measurement. We study this failure as measurement-conditioned hallucination: visually meaningful content that is either implausible or inconsistent with the measured instance. Our analysis separates Bayes-rule-based diffusion inverse solvers into a prior update and a measurement-conditioning step, showing that hallucinated content can enter through the prior-side proposal before the measurement correction is applied. Motivated by this view, we propose Robust Prior Update (RPU), a solver-level module that probes the local stability of the diffusion prior update, re-anchors the resulting displacement at the current iterate, and leaves the measurement update unchanged. We instantiate RPU in DPS and evaluate it on FFHQ and ImageNet inverse problems using automatic metrics and human faithfulness studies. On FFHQ, RPU improves PSNR and LPIPS over DPS across box inpainting, Gaussian deblurring, and motion deblurring. In human judgments, RPU receives 91.9% of blind non-tie majority preferences and 91.1% of ground-truth-assisted non-tie preferences on FFHQ box inpainting, while the ImageNet Gaussian reader study is tie-heavy but favors RPU among non-tie cases. These results support a targeted claim: robustifying the prior update can improve instance faithfulness in diffusion inverse solvers, especially when the prior shapes weakly constrained content.

Pengcheng Jiang, Jiacheng Lin, Zhiyi Shi et al. · stanford

Cutting-edge agentic AI systems are built on foundation models that can be adapted to plan, reason, and interact with external tools to perform increasingly complex and specialized tasks. As these systems grow in capability and scope, adaptation becomes a central mechanism for improving performance, reliability, and generalization. In this paper, we unify the rapidly expanding research landscape into a systematic framework that spans both agent adaptations and tool adaptations. We further decompose these into tool-execution-signaled and agent-output-signaled forms of agent adaptation, as well as agent-agnostic and agent-supervised forms of tool adaptation. We demonstrate that this framework helps clarify the design space of adaptation strategies in agentic AI, makes their trade-offs explicit, and provides practical guidance for selecting or switching among strategies during system design. We then review the representative approaches in each category, analyze their strengths and limitations, and highlight key open challenges and future opportunities. Overall, this paper aims to offer a conceptual foundation and practical roadmap for researchers and practitioners seeking to build more capable, efficient, and reliable agentic AI systems.

Hongmin Cai, Xiaoke Huang, Zhengliang Liu et al.

Alzheimer's disease (AD) is a common form of dementia that severely impacts patient health. As AD impairs the patient's language understanding and expression ability, the speech of AD patients can serve as an indicator of this disease. This study investigates various methods for detecting AD using patients' speech and transcripts data from the DementiaBank Pitt database. The proposed approach involves pre-trained language models and Graph Neural Network (GNN) that constructs a graph from the speech transcript, and extracts features using GNN for AD detection. Data augmentation techniques, including synonym replacement, GPT-based augmenter, and so on, were used to address the small dataset size. Audio data was also introduced, and WavLM model was used to extract audio features. These features were then fused with text features using various methods. Finally, a contrastive learning approach was attempted by converting speech transcripts back to audio and using it for contrastive learning with the original audio. We conducted intensive experiments and analysis on the above methods. Our findings shed light on the challenges and potential solutions in AD detection using speech and audio data.

Yutong Xie, Minne Yuan, Bin Dong et al.

In supervised learning for image denoising, usually the paired clean images and noisy images are collected or synthesised to train a denoising model. L2 norm loss or other distance functions are used as the objective function for training. It often leads to an over-smooth result with less image details. In this paper, we regard the denoising task as a problem of estimating the posterior distribution of clean images conditioned on noisy images. We apply the idea of diffusion model to realize generative image denoising. According to the noise model in denoising tasks, we redefine the diffusion process such that it is different from the original one. Hence, the sampling of the posterior distribution is a reverse process of dozens of steps from the noisy image. We consider three types of noise model, Gaussian, Gamma and Poisson noise. With the guarantee of theory, we derive a unified strategy for model training. Our method is verified through experiments on three types of noise models and achieves excellent performance.

Zihan Guan, Zihao Wu, Zhengliang Liu et al.

Participant recruitment based on unstructured medical texts such as clinical notes and radiology reports has been a challenging yet important task for the cohort establishment in clinical research. Recently, Large Language Models (LLMs) such as ChatGPT have achieved tremendous success in various downstream tasks thanks to their promising performance in language understanding, inference, and generation. It is then natural to test their feasibility in solving the cohort recruitment task, which involves the classification of a given paragraph of medical text into disease label(s). However, when applied to knowledge-intensive problem settings such as medical text classification, where the LLMs are expected to understand the decision made by human experts and accurately identify the implied disease labels, the LLMs show a mediocre performance. A possible explanation is that, by only using the medical text, the LLMs neglect to use the rich context of additional information that languages afford. To this end, we propose to use a knowledge graph as auxiliary information to guide the LLMs in making predictions. Moreover, to further boost the LLMs adapt to the problem setting, we apply a chain-of-thought (CoT) sample selection strategy enhanced by reinforcement learning, which selects a set of CoT samples given each individual medical report. Experimental results and various ablation studies show that our few-shot learning method achieves satisfactory performance compared with fine-tuning strategies and gains superb advantages when the available data is limited. The code and sample dataset of the proposed CohortGPT model is available at: https://anonymous.4open.science/r/CohortGPT-4872/

Juzheng Miao, Cheng Chen, Keli Zhang et al.

One-shot detection of anatomical landmarks is gaining significant attention for its efficiency in using minimal labeled data to produce promising results. However, the success of current methods heavily relies on the employment of extensive unlabeled data to pre-train an effective feature extractor, which limits their applicability in scenarios where a substantial amount of unlabeled data is unavailable. In this paper, we propose the first foundation model-enabled one-shot landmark detection (FM-OSD) framework for accurate landmark detection in medical images by utilizing solely a single template image without any additional unlabeled data. Specifically, we use the frozen image encoder of visual foundation models as the feature extractor, and introduce dual-branch global and local feature decoders to increase the resolution of extracted features in a coarse to fine manner. The introduced feature decoders are efficiently trained with a distance-aware similarity learning loss to incorporate domain knowledge from the single template image. Moreover, a novel bidirectional matching strategy is developed to improve both robustness and accuracy of landmark detection in the case of scattered similarity map obtained by foundation models. We validate our method on two public anatomical landmark detection datasets. By using solely a single template image, our method demonstrates significant superiority over strong state-of-the-art one-shot landmark detection methods.

Gary Y. Li, Junyu Chen, Se-In Jang et al.

Radiotherapy (RT) combined with cetuximab is the standard treatment for patients with inoperable head and neck cancers. Segmentation of head and neck (H&N) tumors is a prerequisite for radiotherapy planning but a time-consuming process. In recent years, deep convolutional neural networks have become the de facto standard for automated image segmentation. However, due to the expensive computational cost associated with enlarging the field of view in DCNNs, their ability to model long-range dependency is still limited, and this can result in sub-optimal segmentation performance for objects with background context spanning over long distances. On the other hand, Transformer models have demonstrated excellent capabilities in capturing such long-range information in several semantic segmentation tasks performed on medical images. Inspired by the recent success of Vision Transformers and advances in multi-modal image analysis, we propose a novel segmentation model, debuted, Cross-Modal Swin Transformer (SwinCross), with cross-modal attention (CMA) module to incorporate cross-modal feature extraction at multiple resolutions.To validate the effectiveness of the proposed method, we performed experiments on the HECKTOR 2021 challenge dataset and compared it with the nnU-Net (the backbone of the top-5 methods in HECKTOR 2021) and other state-of-the-art transformer-based methods such as UNETR, and Swin UNETR. The proposed method is experimentally shown to outperform these comparing methods thanks to the ability of the CMA module to capture better inter-modality complimentary feature representations between PET and CT, for the task of head-and-neck tumor segmentation.

Zhengliang Liu, Hanqi Jiang, Tianyang Zhong et al.

In this paper, we present a large-scale evaluation probing GPT-4V's capabilities and limitations for biomedical image analysis. GPT-4V represents a breakthrough in artificial general intelligence (AGI) for computer vision, with applications in the biomedical domain. We assess GPT-4V's performance across 16 medical imaging categories, including radiology, oncology, ophthalmology, pathology, and more. Tasks include modality recognition, anatomy localization, disease diagnosis, report generation, and lesion detection. The extensive experiments provide insights into GPT-4V's strengths and weaknesses. Results show GPT-4V's proficiency in modality and anatomy recognition but difficulty with disease diagnosis and localization. GPT-4V excels at diagnostic report generation, indicating strong image captioning skills. While promising for biomedical imaging AI, GPT-4V requires further enhancement and validation before clinical deployment. We emphasize responsible development and testing for trustworthy integration of biomedical AGI. This rigorous evaluation of GPT-4V on diverse medical images advances understanding of multimodal large language models (LLMs) and guides future work toward impactful healthcare applications.

Aoxiao Zhong, Hao He, Zhaolin Ren et al.

Cross-silo Federated learning (FL) has become a promising tool in machine learning applications for healthcare. It allows hospitals/institutions to train models with sufficient data while the data is kept private. To make sure the FL model is robust when facing heterogeneous data among FL clients, most efforts focus on personalizing models for clients. However, the latent relationships between clients' data are ignored. In this work, we focus on a special non-iid FL problem, called Domain-mixed FL, where each client's data distribution is assumed to be a mixture of several predefined domains. Recognizing the diversity of domains and the similarity within domains, we propose a novel method, FedDAR, which learns a domain shared representation and domain-wise personalized prediction heads in a decoupled manner. For simplified linear regression settings, we have theoretically proved that FedDAR enjoys a linear convergence rate. For general settings, we have performed intensive empirical studies on both synthetic and real-world medical datasets which demonstrate its superiority over prior FL methods.

Jiang Hu, Kangkang Deng, Na Li et al.

With a computationally efficient approximation of the second-order information, natural gradient methods have been successful in solving large-scale structured optimization problems. We study the natural gradient methods for the large-scale decentralized optimization problems on Riemannian manifolds, where the local objective function defined by the local dataset is of a log-probability type. By utilizing the structure of the Riemannian Fisher information matrix (RFIM), we present an efficient decentralized Riemannian natural gradient descent (DRNGD) method. To overcome the communication issue of the high-dimension RFIM, we consider a class of structured problems for which the RFIM can be approximated by a Kronecker product of two low-dimension matrices. By performing the communications over the Kronecker factors, a high-quality approximation of the RFIM can be obtained in a low cost. We prove that DRNGD converges to a stationary point with the best-known rate of $\mathcal{O}(1/K)$. Numerical experiments demonstrate the efficiency of our proposed method compared with the state-of-the-art ones. To the best of our knowledge, this is the first Riemannian second-order method for solving decentralized manifold optimization problems.

Yutong Xie, Mingze Yuan, Bin Dong et al.

Though achieving excellent performance in some cases, current unsupervised learning methods for single image denoising usually have constraints in applications. In this paper, we propose a new approach which is more general and applicable to complicated noise models. Utilizing the property of score function, the gradient of logarithmic probability, we define a solving system for denoising. Once the score function of noisy images has been estimated, the denoised result can be obtained through the solving system. Our approach can be applied to multiple noise models, such as the mixture of multiplicative and additive noise combined with structured correlation. Experimental results show that our method is comparable when the noise model is simple, and has good performance in complicated cases where other methods are not applicable or perform poorly.

Zhiling Yan, Weixiang Sun, Rong Zhou et al.

Medical image segmentation and video object segmentation are essential for diagnosing and analyzing diseases by identifying and measuring biological structures. Recent advances in natural domain have been driven by foundation models like the Segment Anything Model 2 (SAM-2). To explore the performance of SAM-2 in biomedical applications, we designed three evaluation pipelines for single-frame 2D image segmentation, multi-frame 3D image segmentation and multi-frame video segmentation with varied prompt designs, revealing SAM-2's limitations in medical contexts. Consequently, we developed BioSAM-2, an enhanced foundation model optimized for biomedical data based on SAM-2. Our experiments show that BioSAM-2 not only surpasses the performance of existing state-of-the-art foundation models but also matches or even exceeds specialist models, demonstrating its efficacy and potential in the medical domain.

Ye Li, Jianan Cui, Junyu Chen et al.

In PET, the amount of relative (signal-dependent) noise present in different body regions can be significantly different and is inherently related to the number of counts present in that region. The number of counts in a region depends, in principle and among other factors, on the total administered activity, scanner sensitivity, image acquisition duration, radiopharmaceutical tracer uptake in the region, and patient local body morphometry surrounding the region. In theory, less amount of denoising operations is needed to denoise a high-count (low relative noise) image than images a low-count (high relative noise) image, and vice versa. The current deep-learning-based methods for PET image denoising are predominantly trained on image appearance only and have no special treatment for images of different noise levels. Our hypothesis is that by explicitly providing the local relative noise level of the input image to a deep convolutional neural network (DCNN), the DCNN can outperform itself trained on image appearance only. To this end, we propose a noise-level-aware framework denoising framework that allows embedding of local noise level into a DCNN. The proposed is trained and tested on 30 and 15 patient PET images acquired on a GE Discovery MI PET/CT system. Our experiments showed that the increases in both PSNR and SSIM from our backbone network with relative noise level embedding (NLE) versus the same network without NLE were statistically significant with p<0.001, and the proposed method significantly outperformed a strong baseline method by a large margin.

Rui Hu, Yunmei Chen, Kyungsang Kim et al.

Deep learning based PET image reconstruction methods have achieved promising results recently. However, most of these methods follow a supervised learning paradigm, which rely heavily on the availability of high-quality training labels. In particular, the long scanning time required and high radiation exposure associated with PET scans make obtaining this labels impractical. In this paper, we propose a dual-domain unsupervised PET image reconstruction method based on learned decent algorithm, which reconstructs high-quality PET images from sinograms without the need for image labels. Specifically, we unroll the proximal gradient method with a learnable l2,1 norm for PET image reconstruction problem. The training is unsupervised, using measurement domain loss based on deep image prior as well as image domain loss based on rotation equivariance property. The experimental results domonstrate the superior performance of proposed method compared with maximum likelihood expectation maximazation (MLEM), total-variation regularized EM (EM-TV) and deep image prior based method (DIP).

Weixiang Sun, Xiaocao You, Ruizhe Zheng et al.

Generative models hold promise for revolutionizing medical education, robot-assisted surgery, and data augmentation for medical AI development. Diffusion models can now generate realistic images from text prompts, while recent advancements have demonstrated their ability to create diverse, high-quality videos. However, these models often struggle with generating accurate representations of medical procedures and detailed anatomical structures. This paper introduces Bora, the first spatio-temporal diffusion probabilistic model designed for text-guided biomedical video generation. Bora leverages Transformer architecture and is pre-trained on general-purpose video generation tasks. It is fine-tuned through model alignment and instruction tuning using a newly established medical video corpus, which includes paired text-video data from various biomedical fields. To the best of our knowledge, this is the first attempt to establish such a comprehensive annotated biomedical video dataset. Bora is capable of generating high-quality video data across four distinct biomedical domains, adhering to medical expert standards and demonstrating consistency and diversity. This generalist video generative model holds significant potential for enhancing medical consultation and decision-making, particularly in resource-limited settings. Additionally, Bora could pave the way for immersive medical training and procedure planning. Extensive experiments on distinct medical modalities such as endoscopy, ultrasound, MRI, and cell tracking validate the effectiveness of our model in understanding biomedical instructions and its superior performance across subjects compared to state-of-the-art generation models.

Haixing Dai, Mengxuan Hu, Qing Li et al.

Alzheimer's disease (AD) is a neurodegenerative disorder that is beginning with amyloidosis, followed by neuronal loss and deterioration in structure, function, and cognition. The accumulation of amyloid-beta in the brain, measured through 18F-florbetapir (AV45) positron emission tomography (PET) imaging, has been widely used for early diagnosis of AD. However, the relationship between amyloid-beta accumulation and AD pathophysiology remains unclear, and causal inference approaches are needed to uncover how amyloid-beta levels can impact AD development. In this paper, we propose a graph varying coefficient neural network (GVCNet) for estimating the individual treatment effect with continuous treatment levels using a graph convolutional neural network. We highlight the potential of causal inference approaches, including GVCNet, for measuring the regional causal connections between amyloid-beta accumulation and AD pathophysiology, which may serve as a robust tool for early diagnosis and tailored care.

Ye Li, Junyu Chen, Se-in Jang et al.

Inspired by the recent success of Transformers for Natural Language Processing and vision Transformer for Computer Vision, many researchers in the medical imaging community have flocked to Transformer-based networks for various main stream medical tasks such as classification, segmentation, and estimation. In this study, we analyze, two recently published Transformer-based network architectures for the task of multimodal head-and-tumor segmentation and compare their performance to the de facto standard 3D segmentation network - the nnU-Net. Our results showed that modeling long-range dependencies may be helpful in cases where large structures are present and/or large field of view is needed. However, for small structures such as head-and-neck tumor, the convolution-based U-Net architecture seemed to perform well, especially when training dataset is small and computational resource is limited.

Aoxiao Zhong, Dengyao Mo, Guiyang Liu et al.

Logs are ubiquitous digital footprints, playing an indispensable role in system diagnostics, security analysis, and performance optimization. The extraction of actionable insights from logs is critically dependent on the log parsing process, which converts raw logs into structured formats for downstream analysis. Yet, the complexities of contemporary systems and the dynamic nature of logs pose significant challenges to existing automatic parsing techniques. The emergence of Large Language Models (LLM) offers new horizons. With their expansive knowledge and contextual prowess, LLMs have been transformative across diverse applications. Building on this, we introduce LogParser-LLM, a novel log parser integrated with LLM capabilities. This union seamlessly blends semantic insights with statistical nuances, obviating the need for hyper-parameter tuning and labeled training data, while ensuring rapid adaptability through online parsing. Further deepening our exploration, we address the intricate challenge of parsing granularity, proposing a new metric and integrating human interactions to allow users to calibrate granularity to their specific needs. Our method's efficacy is empirically demonstrated through evaluations on the Loghub-2k and the large-scale LogPub benchmark. In evaluations on the LogPub benchmark, involving an average of 3.6 million logs per dataset across 14 datasets, our LogParser-LLM requires only 272.5 LLM invocations on average, achieving a 90.6% F1 score for grouping accuracy and an 81.1% for parsing accuracy. These results demonstrate the method's high efficiency and accuracy, outperforming current state-of-the-art log parsers, including pattern-based, neural network-based, and existing LLM-enhanced approaches.

Siyeop Yoon, Rui Hu, Yuang Wang et al.

PET imaging is a powerful modality offering quantitative assessments of molecular and physiological processes. The necessity for PET denoising arises from the intrinsic high noise levels in PET imaging, which can significantly hinder the accurate interpretation and quantitative analysis of the scans. With advances in deep learning techniques, diffusion model-based PET denoising techniques have shown remarkable performance improvement. However, these models often face limitations when applied to volumetric data. Additionally, many existing diffusion models do not adequately consider the unique characteristics of PET imaging, such as its 3D volumetric nature, leading to the potential loss of anatomic consistency. Our Conditional Score-based Residual Diffusion (CSRD) model addresses these issues by incorporating a refined score function and 3D patch-wise training strategy, optimizing the model for efficient volumetric PET denoising. The CSRD model significantly lowers computational demands and expedites the denoising process. By effectively integrating volumetric data from PET and MRI scans, the CSRD model maintains spatial coherence and anatomical detail. Lastly, we demonstrate that the CSRD model achieves superior denoising performance in both qualitative and quantitative evaluations while maintaining image details and outperforms existing state-of-the-art methods.

Yucheng Shi, Peng Shu, Zhengliang Liu et al.

In recent years, the field of radiology has increasingly harnessed the power of artificial intelligence (AI) to enhance diagnostic accuracy, streamline workflows, and improve patient care. Large language models (LLMs) have emerged as particularly promising tools, offering significant potential in assisting radiologists with report generation, clinical decision support, and patient communication. This paper presents an advanced radiology-focused large language model: MGH Radiology Llama. It is developed using the Llama 3 70B model, building upon previous domain-specific models like Radiology-GPT and Radiology-Llama2. Leveraging a unique and comprehensive dataset from Massachusetts General Hospital, comprising over 6.5 million de-identified medical reports across various imaging modalities, the model demonstrates significant improvements in generating accurate and clinically relevant radiology impressions given the corresponding findings. Our evaluation, incorporating both traditional metrics and a GPT-4-based assessment, highlights the enhanced performance of this work over general-purpose LLMs.

Zhengliang Liu, Zihao Wu, Mengxuan Hu et al.

In this study, we introduce PharmacyGPT, a novel framework to assess the capabilities of large language models (LLMs) such as ChatGPT and GPT-4 in emulating the role of clinical pharmacists. Our methodology encompasses the utilization of LLMs to generate comprehensible patient clusters, formulate medication plans, and forecast patient outcomes. We conduct our investigation using real data acquired from the intensive care unit (ICU) at the University of North Carolina Chapel Hill (UNC) Hospital. Our analysis offers valuable insights into the potential applications and limitations of LLMs in the field of clinical pharmacy, with implications for both patient care and the development of future AI-driven healthcare solutions. By evaluating the performance of PharmacyGPT, we aim to contribute to the ongoing discourse surrounding the integration of artificial intelligence in healthcare settings, ultimately promoting the responsible and efficacious use of such technologies.

Yujin Oh, Sangjoon Park, Xiang Li et al.

Clinical decision-making reflects diverse strategies shaped by regional patient populations and institutional protocols. However, most existing medical artificial intelligence (AI) models are trained on highly prevalent data patterns, which reinforces biases and fails to capture the breadth of clinical expertise. Inspired by the recent advances in Mixture of Experts (MoE), we propose a Mixture of Multicenter Experts (MoME) framework to address AI bias in the medical domain without requiring data sharing across institutions. MoME integrates specialized expertise from diverse clinical strategies to enhance model generalizability and adaptability across medical centers. We validate this framework using a multimodal target volume delineation model for prostate cancer radiotherapy. With few-shot training that combines imaging and clinical notes from each center, the model outperformed baselines, particularly in settings with high inter-center variability or limited data availability. Furthermore, MoME enables model customization to local clinical preferences without cross-institutional data exchange, making it especially suitable for resource-constrained settings while promoting broadly generalizable medical AI.

Pawel Renc, Yugang Jia, Anthony E. Samir et al.

Integrating modern machine learning and clinical decision-making has great promise for mitigating healthcare's increasing cost and complexity. We introduce the Enhanced Transformer for Health Outcome Simulation (ETHOS), a novel application of the transformer deep-learning architecture for analyzing high-dimensional, heterogeneous, and episodic health data. ETHOS is trained using Patient Health Timelines (PHTs)-detailed, tokenized records of health events-to predict future health trajectories, leveraging a zero-shot learning approach. ETHOS represents a significant advancement in foundation model development for healthcare analytics, eliminating the need for labeled data and model fine-tuning. Its ability to simulate various treatment pathways and consider patient-specific factors positions ETHOS as a tool for care optimization and addressing biases in healthcare delivery. Future developments will expand ETHOS' capabilities to incorporate a wider range of data types and data sources. Our work demonstrates a pathway toward accelerated AI development and deployment in healthcare.

Xinhe Zhang, Yuyang Zhang, Pengfei Jin et al.

High-resolution 3D medical image generation remains challenging because fully volumetric models are computationally expensive, while efficient 2D slice generators often fail to preserve anatomical consistency across the third dimension. We propose LiFT, a framework for Lifted inter-slice Feature Trajectories that factorizes 3D volume synthesis into per-slice image generation and inter-slice trajectory learning. Rather than modeling the volumetric distribution end-to-end, LiFT treats a volume as an ordered trajectory in feature space, capturing how anatomical structures appear, transform, and disappear across depth. A tri-planar drifting loss aligns the trajectory of generated slices with the trajectories of real volumes, enabling distributional learning over inter-slice progressions in unconditional generation; in paired translation, a bidirectional $z$-context mixer trained against the registered target supplies through-plane coherence while preserving per-slice fidelity. We evaluate LiFT on BraTS 2023 (unconditional and missing-modality MR) and SynthRAD2023 (MR-to-CT). Across these settings, LiFT preserves per-slice quality, approaches the reported cWDM missing-MR reconstruction quality at $\sim$$135\times$ lower inference cost (without formal equivalence testing), and improves through-plane coherence on MR-to-CT relative to a no-mapper ablation, demonstrating that lightweight inter-slice trajectory learning is a viable route to high-resolution 3D medical synthesis.

Siyeop Yoon, Yujin Oh, Xiang Li et al.

Acute respiratory distress syndrome (ARDS) is a severe condition characterized by lung inflammation and respiratory failure, with a high mortality rate of approximately 40%. Traditional imaging methods, such as chest X-rays, provide only two-dimensional views, limiting their effectiveness in fully assessing lung pathology. Three-dimensional (3D) computed tomography (CT) offers a more comprehensive visualization, enabling detailed analysis of lung aeration, atelectasis, and the effects of therapeutic interventions. However, the routine use of CT in ARDS management is constrained by practical challenges and risks associated with transporting critically ill patients to remote scanners. In this study, we synthesize high-fidelity 3D lung CT from 2D generated X-ray images with associated physiological parameters using a score-based 3D residual diffusion model. Our preliminary results demonstrate that this approach can produce high-quality 3D CT images that are validated with ground truth, offering a promising solution for enhancing ARDS management.

Cheng Wang, Yu Jiang, Zhihao Peng et al.

Functional Magnetic Resonance Imaging (fMRI) is essential for studying brain function and diagnosing neurological disorders, but current analysis methods face reproducibility and transferability issues due to complex pre-processing and task-specific models. We introduce NeuroSTORM (Neuroimaging Foundation Model with Spatial-Temporal Optimized Representation Modeling), a generalizable framework that directly learns from 4D fMRI volumes and enables efficient knowledge transfer across diverse applications. NeuroSTORM is pre-trained on 28.65 million fMRI frames (>9,000 hours) from over 50,000 subjects across multiple centers and ages 5 to 100. Using a Mamba backbone and a shifted scanning strategy, it efficiently processes full 4D volumes. We also propose a spatial-temporal optimized pre-training approach and task-specific prompt tuning to improve transferability. NeuroSTORM outperforms existing methods across five tasks: age/gender prediction, phenotype prediction, disease diagnosis, fMRI-to-image retrieval, and task-based fMRI classification. It demonstrates strong clinical utility on datasets from hospitals in the U.S., South Korea, and Australia, achieving top performance in disease diagnosis and cognitive phenotype prediction. NeuroSTORM provides a standardized, open-source foundation model to improve reproducibility and transferability in fMRI-based clinical research.

Zhiling Yan, Sifan Song, Dingjie Song et al.

Recent "segment anything" efforts show promise by learning from large-scale data, but adapting such models directly to medical images remains challenging due to the complexity of medical data, noisy annotations, and continual learning requirements across diverse modalities and anatomical structures. In this work, we propose SAMed-2, a new foundation model for medical image segmentation built upon the SAM-2 architecture. Specifically, we introduce a temporal adapter into the image encoder to capture image correlations and a confidence-driven memory mechanism to store high-certainty features for later retrieval. This memory-based strategy counters the pervasive noise in large-scale medical datasets and mitigates catastrophic forgetting when encountering new tasks or modalities. To train and evaluate SAMed-2, we curate MedBank-100k, a comprehensive dataset spanning seven imaging modalities and 21 medical segmentation tasks. Our experiments on both internal benchmarks and 10 external datasets demonstrate superior performance over state-of-the-art baselines in multi-task scenarios. The code is available at: https://github.com/ZhilingYan/Medical-SAM-Bench.

Peilong Wang, Zhengliang Liu, Yiwei Li et al.

Background: The radiation oncology clinical practice involves many steps relying on the dynamic interplay of abundant text data. Large language models have displayed remarkable capabilities in processing complex text information. But their direct applications in specific fields like radiation oncology remain underexplored. Purpose: This study aims to investigate whether fine-tuning LLMs with domain knowledge can improve the performance on Task (1) treatment regimen generation, Task (2) treatment modality selection (photon, proton, electron, or brachytherapy), and Task (3) ICD-10 code prediction in radiation oncology. Methods: Data for 15,724 patient cases were extracted. Cases where patients had a single diagnostic record, and a clearly identifiable primary treatment plan were selected for preprocessing and manual annotation to have 7,903 cases of the patient diagnosis, treatment plan, treatment modality, and ICD-10 code. Each case was used to construct a pair consisting of patient diagnostics details and an answer (treatment regimen, treatment modality, or ICD-10 code respectively) for the supervised fine-tuning of these three tasks. Open source LLaMA2-7B and Mistral-7B models were utilized for the fine-tuning with the Low-Rank Approximations method. Accuracy and ROUGE-1 score were reported for the fine-tuned models and original models. Clinical evaluation was performed on Task (1) by radiation oncologists, while precision, recall, and F-1 score were evaluated for Task (2) and (3). One-sided Wilcoxon signed-rank tests were used to statistically analyze the results. Results: Fine-tuned LLMs outperformed original LLMs across all tasks with p-value <= 0.001. Clinical evaluation demonstrated that over 60% of the fine-tuned LLMs-generated treatment regimens were clinically acceptable. Precision, recall, and F1-score showed improved performance of fine-tuned LLMs.