Junjun He

Zhe Chen, Yuchen Duan, Wenhai Wang et al.

This work investigates a simple yet powerful dense prediction task adapter for Vision Transformer (ViT). Unlike recently advanced variants that incorporate vision-specific inductive biases into their architectures, the plain ViT suffers inferior performance on dense predictions due to weak prior assumptions. To address this issue, we propose the ViT-Adapter, which allows plain ViT to achieve comparable performance to vision-specific transformers. Specifically, the backbone in our framework is a plain ViT that can learn powerful representations from large-scale multi-modal data. When transferring to downstream tasks, a pre-training-free adapter is used to introduce the image-related inductive biases into the model, making it suitable for these tasks. We verify ViT-Adapter on multiple dense prediction tasks, including object detection, instance segmentation, and semantic segmentation. Notably, without using extra detection data, our ViT-Adapter-L yields state-of-the-art 60.9 box AP and 53.0 mask AP on COCO test-dev. We hope that the ViT-Adapter could serve as an alternative for vision-specific transformers and facilitate future research. The code and models will be released at https://github.com/czczup/ViT-Adapter.

Ziyan Huang, Haoyu Wang, Zhongying Deng et al.

Large-scale models pre-trained on large-scale datasets have profoundly advanced the development of deep learning. However, the state-of-the-art models for medical image segmentation are still small-scale, with their parameters only in the tens of millions. Further scaling them up to higher orders of magnitude is rarely explored. An overarching goal of exploring large-scale models is to train them on large-scale medical segmentation datasets for better transfer capacities. In this work, we design a series of Scalable and Transferable U-Net (STU-Net) models, with parameter sizes ranging from 14 million to 1.4 billion. Notably, the 1.4B STU-Net is the largest medical image segmentation model to date. Our STU-Net is based on nnU-Net framework due to its popularity and impressive performance. We first refine the default convolutional blocks in nnU-Net to make them scalable. Then, we empirically evaluate different scaling combinations of network depth and width, discovering that it is optimal to scale model depth and width together. We train our scalable STU-Net models on a large-scale TotalSegmentator dataset and find that increasing model size brings a stronger performance gain. This observation reveals that a large model is promising in medical image segmentation. Furthermore, we evaluate the transferability of our model on 14 downstream datasets for direct inference and 3 datasets for further fine-tuning, covering various modalities and segmentation targets. We observe good performance of our pre-trained model in both direct inference and fine-tuning. The code and pre-trained models are available at https://github.com/Ziyan-Huang/STU-Net.

Dequan Wang, Xiaosong Wang, Lilong Wang et al. · berkeley

Foundation models, often pre-trained with large-scale data, have achieved paramount success in jump-starting various vision and language applications. Recent advances further enable adapting foundation models in downstream tasks efficiently using only a few training samples, e.g., in-context learning. Yet, the application of such learning paradigms in medical image analysis remains scarce due to the shortage of publicly accessible data and benchmarks. In this paper, we aim at approaches adapting the foundation models for medical image classification and present a novel dataset and benchmark for the evaluation, i.e., examining the overall performance of accommodating the large-scale foundation models downstream on a set of diverse real-world clinical tasks. We collect five sets of medical imaging data from multiple institutes targeting a variety of real-world clinical tasks (22,349 images in total), i.e., thoracic diseases screening in X-rays, pathological lesion tissue screening, lesion detection in endoscopy images, neonatal jaundice evaluation, and diabetic retinopathy grading. Results of multiple baseline methods are demonstrated using the proposed dataset from both accuracy and cost-effective perspectives.

Jin Ye, Haoyu Wang, Ziyan Huang et al.

Tumor lesion segmentation is one of the most important tasks in medical image analysis. In clinical practice, Fluorodeoxyglucose Positron-Emission Tomography~(FDG-PET) is a widely used technique to identify and quantify metabolically active tumors. However, since FDG-PET scans only provide metabolic information, healthy tissue or benign disease with irregular glucose consumption may be mistaken for cancer. To handle this challenge, PET is commonly combined with Computed Tomography~(CT), with the CT used to obtain the anatomic structure of the patient. The combination of PET-based metabolic and CT-based anatomic information can contribute to better tumor segmentation results. %Computed tomography~(CT) is a popular modality to illustrate the anatomic structure of the patient. The combination of PET and CT is promising to handle this challenge by utilizing metabolic and anatomic information. In this paper, we explore the potential of U-Net for lesion segmentation in whole-body FDG-PET/CT scans from three aspects, including network architecture, data preprocessing, and data augmentation. The experimental results demonstrate that the vanilla U-Net with proper input shape can achieve satisfactory performance. Specifically, our method achieves first place in both preliminary and final leaderboards of the autoPET 2022 challenge. Our code is available at https://github.com/Yejin0111/autoPET2022_Blackbean.

Lei Zhou, Huidong Liu, Joseph Bae et al.

Masked Autoencoder (MAE) has recently been shown to be effective in pre-training Vision Transformers (ViT) for natural image analysis. By reconstructing full images from partially masked inputs, a ViT encoder aggregates contextual information to infer masked image regions. We believe that this context aggregation ability is particularly essential to the medical image domain where each anatomical structure is functionally and mechanically connected to other structures and regions. Because there is no ImageNet-scale medical image dataset for pre-training, we investigate a self pre-training paradigm with MAE for medical image analysis tasks. Our method pre-trains a ViT on the training set of the target data instead of another dataset. Thus, self pre-training can benefit more scenarios where pre-training data is hard to acquire. Our experimental results show that MAE self pre-training markedly improves diverse medical image tasks including chest X-ray disease classification, abdominal CT multi-organ segmentation, and MRI brain tumor segmentation. Code is available at https://github.com/cvlab-stonybrook/SelfMedMAE

Haoyu Wang, Sizheng Guo, Jin Ye et al.

Existing volumetric medical image segmentation models are typically task-specific, excelling at specific target but struggling to generalize across anatomical structures or modalities. This limitation restricts their broader clinical use. In this paper, we introduce SAM-Med3D for general-purpose segmentation on volumetric medical images. Given only a few 3D prompt points, SAM-Med3D can accurately segment diverse anatomical structures and lesions across various modalities. To achieve this, we gather and process a large-scale 3D medical image dataset, SA-Med3D-140K, from a blend of public sources and licensed private datasets. This dataset includes 22K 3D images and 143K corresponding 3D masks. Then SAM-Med3D, a promptable segmentation model characterized by the fully learnable 3D structure, is trained on this dataset using a two-stage procedure and exhibits impressive performance on both seen and unseen segmentation targets. We comprehensively evaluate SAM-Med3D on 16 datasets covering diverse medical scenarios, including different anatomical structures, modalities, targets, and zero-shot transferability to new/unseen tasks. The evaluation shows the efficiency and efficacy of SAM-Med3D, as well as its promising application to diverse downstream tasks as a pre-trained model. Our approach demonstrates that substantial medical resources can be utilized to develop a general-purpose medical AI for various potential applications. Our dataset, code, and models are available at https://github.com/uni-medical/SAM-Med3D.

Jin Ye, Junlong Cheng, Jianpin Chen et al.

Segment Anything Model (SAM) has achieved impressive results for natural image segmentation with input prompts such as points and bounding boxes. Its success largely owes to massive labeled training data. However, directly applying SAM to medical image segmentation cannot perform well because SAM lacks medical knowledge -- it does not use medical images for training. To incorporate medical knowledge into SAM, we introduce SA-Med2D-20M, a large-scale segmentation dataset of 2D medical images built upon numerous public and private datasets. It consists of 4.6 million 2D medical images and 19.7 million corresponding masks, covering almost the whole body and showing significant diversity. This paper describes all the datasets collected in SA-Med2D-20M and details how to process these datasets. Furthermore, comprehensive statistics of SA-Med2D-20M are presented to facilitate the better use of our dataset, which can help the researchers build medical vision foundation models or apply their models to downstream medical applications. We hope that the large scale and diversity of SA-Med2D-20M can be leveraged to develop medical artificial intelligence for enhancing diagnosis, medical image analysis, knowledge sharing, and education. The data with the redistribution license is publicly available at https://github.com/OpenGVLab/SAM-Med2D.

Ziyan Huang, Zhongying Deng, Jin Ye et al.

Although deep learning have revolutionized abdominal multi-organ segmentation, models often struggle with generalization due to training on small, specific datasets. With the recent emergence of large-scale datasets, some important questions arise: \textbf{Can models trained on these datasets generalize well on different ones? If yes/no, how to further improve their generalizability?} To address these questions, we introduce A-Eval, a benchmark for the cross-dataset Evaluation ('Eval') of Abdominal ('A') multi-organ segmentation. We employ training sets from four large-scale public datasets: FLARE22, AMOS, WORD, and TotalSegmentator, each providing extensive labels for abdominal multi-organ segmentation. For evaluation, we incorporate the validation sets from these datasets along with the training set from the BTCV dataset, forming a robust benchmark comprising five distinct datasets. We evaluate the generalizability of various models using the A-Eval benchmark, with a focus on diverse data usage scenarios: training on individual datasets independently, utilizing unlabeled data via pseudo-labeling, mixing different modalities, and joint training across all available datasets. Additionally, we explore the impact of model sizes on cross-dataset generalizability. Through these analyses, we underline the importance of effective data usage in enhancing models' generalization capabilities, offering valuable insights for assembling large-scale datasets and improving training strategies. The code and pre-trained models are available at \href{https://github.com/uni-medical/A-Eval}{https://github.com/uni-medical/A-Eval}.

Junlong Cheng, Jin Ye, Zhongying Deng et al.

The Segment Anything Model (SAM) represents a state-of-the-art research advancement in natural image segmentation, achieving impressive results with input prompts such as points and bounding boxes. However, our evaluation and recent research indicate that directly applying the pretrained SAM to medical image segmentation does not yield satisfactory performance. This limitation primarily arises from significant domain gap between natural images and medical images. To bridge this gap, we introduce SAM-Med2D, the most comprehensive studies on applying SAM to medical 2D images. Specifically, we first collect and curate approximately 4.6M images and 19.7M masks from public and private datasets, constructing a large-scale medical image segmentation dataset encompassing various modalities and objects. Then, we comprehensively fine-tune SAM on this dataset and turn it into SAM-Med2D. Unlike previous methods that only adopt bounding box or point prompts as interactive segmentation approach, we adapt SAM to medical image segmentation through more comprehensive prompts involving bounding boxes, points, and masks. We additionally fine-tune the encoder and decoder of the original SAM to obtain a well-performed SAM-Med2D, leading to the most comprehensive fine-tuning strategies to date. Finally, we conducted a comprehensive evaluation and analysis to investigate the performance of SAM-Med2D in medical image segmentation across various modalities, anatomical structures, and organs. Concurrently, we validated the generalization capability of SAM-Med2D on 9 datasets from MICCAI 2023 challenge. Overall, our approach demonstrated significantly superior performance and generalization capability compared to SAM.

Yuncheng Yang, Meng Wei, Junjun He et al.

Transfer learning is a critical technique in training deep neural networks for the challenging medical image segmentation task that requires enormous resources. With the abundance of medical image data, many research institutions release models trained on various datasets that can form a huge pool of candidate source models to choose from. Hence, it's vital to estimate the source models' transferability (i.e., the ability to generalize across different downstream tasks) for proper and efficient model reuse. To make up for its deficiency when applying transfer learning to medical image segmentation, in this paper, we therefore propose a new Transferability Estimation (TE) method. We first analyze the drawbacks of using the existing TE algorithms for medical image segmentation and then design a source-free TE framework that considers both class consistency and feature variety for better estimation. Extensive experiments show that our method surpasses all current algorithms for transferability estimation in medical image segmentation. Code is available at https://github.com/EndoluminalSurgicalVision-IMR/CCFV

Xiaoyu Ren, Zhongying Deng, Jin Ye et al.

Fully convolutional network (FCN) is a seminal work for semantic segmentation. However, due to its limited receptive field, FCN cannot effectively capture global context information which is vital for semantic segmentation. As a result, it is beaten by state-of-the-art methods that leverage different filter sizes for larger receptive fields. However, such a strategy usually introduces more parameters and increases the computational cost. In this paper, we propose a novel global receptive convolution (GRC) to effectively increase the receptive field of FCN for context information extraction, which results in an improved FCN termed FCN+. The GRC provides the global receptive field for convolution without introducing any extra learnable parameters. The motivation of GRC is that different channels of a convolutional filter can have different grid sampling locations across the whole input feature map. Specifically, the GRC first divides the channels of the filter into two groups. The grid sampling locations of the first group are shifted to different spatial coordinates across the whole feature map, according to their channel indexes. This can help the convolutional filter capture the global context information. The grid sampling location of the second group remains unchanged to keep the original location information. By convolving using these two groups, the GRC can integrate the global context into the original location information of each pixel for better dense prediction results. With the GRC built in, FCN+ can achieve comparable performance to state-of-the-art methods for semantic segmentation tasks, as verified on PASCAL VOC 2012, Cityscapes, and ADE20K. Our code will be released at https://github.com/Zhongying-Deng/FCN_Plus.

Pengcheng Chen, Jin Ye, Guoan Wang et al. · pku

Large Vision-Language Models (LVLMs) are capable of handling diverse data types such as imaging, text, and physiological signals, and can be applied in various fields. In the medical field, LVLMs have a high potential to offer substantial assistance for diagnosis and treatment. Before that, it is crucial to develop benchmarks to evaluate LVLMs' effectiveness in various medical applications. Current benchmarks are often built upon specific academic literature, mainly focusing on a single domain, and lacking varying perceptual granularities. Thus, they face specific challenges, including limited clinical relevance, incomplete evaluations, and insufficient guidance for interactive LVLMs. To address these limitations, we developed the GMAI-MMBench, the most comprehensive general medical AI benchmark with well-categorized data structure and multi-perceptual granularity to date. It is constructed from 284 datasets across 38 medical image modalities, 18 clinical-related tasks, 18 departments, and 4 perceptual granularities in a Visual Question Answering (VQA) format. Additionally, we implemented a lexical tree structure that allows users to customize evaluation tasks, accommodating various assessment needs and substantially supporting medical AI research and applications. We evaluated 50 LVLMs, and the results show that even the advanced GPT-4o only achieves an accuracy of 53.96%, indicating significant room for improvement. Moreover, we identified five key insufficiencies in current cutting-edge LVLMs that need to be addressed to advance the development of better medical applications. We believe that GMAI-MMBench will stimulate the community to build the next generation of LVLMs toward GMAI.

Xin You, Junjun He, Jie Yang et al.

Medical image segmentation is a fundamental task for medical image analysis and surgical planning. In recent years, UNet-based networks have prevailed in the field of medical image segmentation. However, convolution-neural networks (CNNs) suffer from limited receptive fields, which fail to model the long-range dependency of organs or tumors. Besides, these models are heavily dependent on the training of the final segmentation head. And existing methods can not well address these two limitations at the same time. Hence, in our work, we proposed a novel shape prior module (SPM), which can explicitly introduce shape priors to promote the segmentation performance of UNet-based models. The explicit shape priors consist of global and local shape priors. The former with coarse shape representations provides networks with capabilities to model global contexts. The latter with finer shape information serves as additional guidance to boost the segmentation performance, which relieves the heavy dependence on the learnable prototype in the segmentation head. To evaluate the effectiveness of SPM, we conduct experiments on three challenging public datasets. And our proposed model achieves state-of-the-art performance. Furthermore, SPM shows an outstanding generalization ability on classic CNNs and recent Transformer-based backbones, which can serve as a plug-and-play structure for the segmentation task of different datasets. Source codes are available at https://github.com/AlexYouXin/Explicit-Shape-Priors

Zhongying Deng, Kaiyang Zhou, Da Li et al.

Most existing studies on unsupervised domain adaptation (UDA) assume that each domain's training samples come with domain labels (e.g., painting, photo). Samples from each domain are assumed to follow the same distribution and the domain labels are exploited to learn domain-invariant features via feature alignment. However, such an assumption often does not hold true -- there often exist numerous finer-grained domains (e.g., dozens of modern painting styles have been developed, each differing dramatically from those of the classic styles). Therefore, forcing feature distribution alignment across each artificially-defined and coarse-grained domain can be ineffective. In this paper, we address both single-source and multi-source UDA from a completely different perspective, which is to view each instance as a fine domain. Feature alignment across domains is thus redundant. Instead, we propose to perform dynamic instance domain adaptation (DIDA). Concretely, a dynamic neural network with adaptive convolutional kernels is developed to generate instance-adaptive residuals to adapt domain-agnostic deep features to each individual instance. This enables a shared classifier to be applied to both source and target domain data without relying on any domain annotation. Further, instead of imposing intricate feature alignment losses, we adopt a simple semi-supervised learning paradigm using only a cross-entropy loss for both labeled source and pseudo labeled target data. Our model, dubbed DIDA-Net, achieves state-of-the-art performance on several commonly used single-source and multi-source UDA datasets including Digits, Office-Home, DomainNet, Digit-Five, and PACS.

Zhenqi He, Junjun He, Jin Ye et al.

Histological whole slide images (WSIs) can be usually compromised by artifacts, such as tissue folding and bubbles, which will increase the examination difficulty for both pathologists and Computer-Aided Diagnosis (CAD) systems. Existing approaches to restoring artifact images are confined to Generative Adversarial Networks (GANs), where the restoration process is formulated as an image-to-image transfer. Those methods are prone to suffer from mode collapse and unexpected mistransfer in the stain style, leading to unsatisfied and unrealistic restored images. Innovatively, we make the first attempt at a denoising diffusion probabilistic model for histological artifact restoration, namely ArtiFusion.Specifically, ArtiFusion formulates the artifact region restoration as a gradual denoising process, and its training relies solely on artifact-free images to simplify the training complexity.Furthermore, to capture local-global correlations in the regional artifact restoration, a novel Swin-Transformer denoising architecture is designed, along with a time token scheme. Our extensive evaluations demonstrate the effectiveness of ArtiFusion as a pre-processing method for histology analysis, which can successfully preserve the tissue structures and stain style in artifact-free regions during the restoration. Code is available at https://github.com/zhenqi-he/ArtiFusion.

Jiyao Liu, Jianghan Shen, Sida Song et al.

Recent advances in deep research systems enable large language models to retrieve, synthesize, and reason over large-scale external knowledge. In medicine, developing clinical guidelines critically depends on such deep evidence integration. However, existing benchmarks fail to evaluate this capability in realistic workflows requiring multi-step evidence integration and expert-level judgment. To address this gap, we introduce MedProbeBench, the first benchmark leveraging high-quality clinical guidelines as expert-level references. Medical guidelines, with their rigorous standards in neutrality and verifiability, represent the pinnacle of medical expertise and pose substantial challenges for deep research agents. For evaluation, we propose MedProbe-Eval, a comprehensive evaluation framework featuring: (1) Holistic Rubrics with 1,200+ task-adaptive rubric criteria for comprehensive quality assessment, and (2) Fine-grained Evidence Verification for rigorous validation of evidence precision, grounded in 5,130+ atomic claims. Evaluation of 17 LLMs and deep research agents reveals critical gaps in evidence integration and guideline generation, underscoring the substantial distance between current capabilities and expert-level clinical guideline development. Project: https://github.com/uni-medical/MedProbeBench

Zhongying Deng, Cheng Tang, Ziyan Huang et al. · pku

Foundation models have demonstrated remarkable success across diverse domains and tasks, primarily due to the thrive of large-scale, diverse, and high-quality datasets. However, in the field of medical imaging, the curation and assembling of such medical datasets are highly challenging due to the reliance on clinical expertise and strict ethical and privacy constraints, resulting in a scarcity of large-scale unified medical datasets and hindering the development of powerful medical foundation models. In this work, we present the largest survey to date of medical image datasets, covering over 1,000 open-access datasets with a systematic catalog of their modalities, tasks, anatomies, annotations, limitations, and potential for integration. Our analysis exposes a landscape that is modest in scale, fragmented across narrowly scoped tasks, and unevenly distributed across organs and modalities, which in turn limits the utility of existing medical image datasets for developing versatile and robust medical foundation models. To turn fragmentation into scale, we propose a metadata-driven fusion paradigm (MDFP) that integrates public datasets with shared modalities or tasks, thereby transforming multiple small data silos into larger, more coherent resources. Building on MDFP, we release an interactive discovery portal that enables end-to-end, automated medical image dataset integration, and compile all surveyed datasets into a unified, structured table that clearly summarizes their key characteristics and provides reference links, offering the community an accessible and comprehensive repository. By charting the current terrain and offering a principled path to dataset consolidation, our survey provides a practical roadmap for scaling medical imaging corpora, supporting faster data discovery, more principled dataset creation, and more capable medical foundation models.

Fangjian Lin, Zhanhao Liang, Sitong Wu et al.

In previous deep-learning-based methods, semantic segmentation has been regarded as a static or dynamic per-pixel classification task, \textit{i.e.,} classify each pixel representation to a specific category. However, these methods only focus on learning better pixel representations or classification kernels while ignoring the structural information of objects, which is critical to human decision-making mechanism. In this paper, we present a new paradigm for semantic segmentation, named structure-aware extraction. Specifically, it generates the segmentation results via the interactions between a set of learned structure tokens and the image feature, which aims to progressively extract the structural information of each category from the feature. Extensive experiments show that our StructToken outperforms the state-of-the-art on three widely-used benchmarks, including ADE20K, Cityscapes, and COCO-Stuff-10K.

Lei Zhou, Huidong Liu, Joseph Bae et al.

Can we use sparse tokens for dense prediction, e.g., segmentation? Although token sparsification has been applied to Vision Transformers (ViT) to accelerate classification, it is still unknown how to perform segmentation from sparse tokens. To this end, we reformulate segmentation as a sparse encoding -> token completion -> dense decoding (SCD) pipeline. We first empirically show that naively applying existing approaches from classification token pruning and masked image modeling (MIM) leads to failure and inefficient training caused by inappropriate sampling algorithms and the low quality of the restored dense features. In this paper, we propose Soft-topK Token Pruning (STP) and Multi-layer Token Assembly (MTA) to address these problems. In sparse encoding, STP predicts token importance scores with a lightweight sub-network and samples the topK tokens. The intractable topK gradients are approximated through a continuous perturbed score distribution. In token completion, MTA restores a full token sequence by assembling both sparse output tokens and pruned multi-layer intermediate ones. The last dense decoding stage is compatible with existing segmentation decoders, e.g., UNETR. Experiments show SCD pipelines equipped with STP and MTA are much faster than baselines without token pruning in both training (up to 120% higher throughput and inference up to 60.6% higher throughput) while maintaining segmentation quality.

Guoan Wang, Jin Ye, Junlong Cheng et al.

Volumetric medical image segmentation is pivotal in enhancing disease diagnosis, treatment planning, and advancing medical research. While existing volumetric foundation models for medical image segmentation, such as SAM-Med3D and SegVol, have shown remarkable performance on general organs and tumors, their ability to segment certain categories in clinical downstream tasks remains limited. Supervised Finetuning (SFT) serves as an effective way to adapt such foundation models for task-specific downstream tasks but at the cost of degrading the general knowledge previously stored in the original foundation model.To address this, we propose SAM-Med3D-MoE, a novel framework that seamlessly integrates task-specific finetuned models with the foundational model, creating a unified model at minimal additional training expense for an extra gating network. This gating network, in conjunction with a selection strategy, allows the unified model to achieve comparable performance of the original models in their respective tasks both general and specialized without updating any parameters of them.Our comprehensive experiments demonstrate the efficacy of SAM-Med3D-MoE, with an average Dice performance increase from 53 to 56.4 on 15 specific classes. It especially gets remarkable gains of 29.6, 8.5, 11.2 on the spinal cord, esophagus, and right hip, respectively. Additionally, it achieves 48.9 Dice on the challenging SPPIN2023 Challenge, significantly surpassing the general expert's performance of 32.3. We anticipate that SAM-Med3D-MoE can serve as a new framework for adapting the foundation model to specific areas in medical image analysis. Codes and datasets will be publicly available.

Adrito Das, Danyal Z. Khan, Dimitrios Psychogyios et al.

The field of computer vision applied to videos of minimally invasive surgery is ever-growing. Workflow recognition pertains to the automated recognition of various aspects of a surgery: including which surgical steps are performed; and which surgical instruments are used. This information can later be used to assist clinicians when learning the surgery; during live surgery; and when writing operation notes. The Pituitary Vision (PitVis) 2023 Challenge tasks the community to step and instrument recognition in videos of endoscopic pituitary surgery. This is a unique task when compared to other minimally invasive surgeries due to the smaller working space, which limits and distorts vision; and higher frequency of instrument and step switching, which requires more precise model predictions. Participants were provided with 25-videos, with results presented at the MICCAI-2023 conference as part of the Endoscopic Vision 2023 Challenge in Vancouver, Canada, on 08-Oct-2023. There were 18-submissions from 9-teams across 6-countries, using a variety of deep learning models. A commonality between the top performing models was incorporating spatio-temporal and multi-task methods, with greater than 50% and 10% macro-F1-score improvement over purely spacial single-task models in step and instrument recognition respectively. The PitVis-2023 Challenge therefore demonstrates state-of-the-art computer vision models in minimally invasive surgery are transferable to a new dataset, with surgery specific techniques used to enhance performance, progressing the field further. Benchmark results are provided in the paper, and the dataset is publicly available at: https://doi.org/10.5522/04/26531686.

Yi Xin, Siqi Luo, Qi Qin et al.

Diffusion Multi-modal Large Language Models (dMLLMs) have recently emerged as a novel architecture unifying image generation and understanding. However, developing effective and efficient Test-Time Scaling (TTS) methods to unlock their full generative potential remains an underexplored challenge. To address this, we propose dMLLM-TTS, a novel framework operating on two complementary scaling axes: (1) trajectory exploration scaling to enhance the diversity of generated hypotheses, and (2) iterative refinement scaling for stable generation. Conventional TTS approaches typically perform linear search across these two dimensions, incurring substantial computational costs of O(NT) and requiring an external verifier for best-of-N selection. To overcome these limitations, we propose two innovations. First, we design an efficient hierarchical search algorithm with O(N+T) complexity that adaptively expands and prunes sampling trajectories. Second, we introduce a self-verified feedback mechanism that leverages the dMLLMs' intrinsic image understanding capabilities to assess text-image alignment, eliminating the need for external verifier. Extensive experiments on the GenEval benchmark across three representative dMLLMs (e.g., Lumina-DiMOO, MMaDA, Muddit) show that our framework substantially improves generation quality while achieving up to 6x greater efficiency than linear search. Project page: https://github.com/Alpha-VLLM/Lumina-DiMOO.

Jinguo Zhu, Weiyun Wang, Zhe Chen et al.

We introduce InternVL3, a significant advancement in the InternVL series featuring a native multimodal pre-training paradigm. Rather than adapting a text-only large language model (LLM) into a multimodal large language model (MLLM) that supports visual inputs, InternVL3 jointly acquires multimodal and linguistic capabilities from both diverse multimodal data and pure-text corpora during a single pre-training stage. This unified training paradigm effectively addresses the complexities and alignment challenges commonly encountered in conventional post-hoc training pipelines for MLLMs. To further improve performance and scalability, InternVL3 incorporates variable visual position encoding (V2PE) to support extended multimodal contexts, employs advanced post-training techniques such as supervised fine-tuning (SFT) and mixed preference optimization (MPO), and adopts test-time scaling strategies alongside an optimized training infrastructure. Extensive empirical evaluations demonstrate that InternVL3 delivers superior performance across a wide range of multi-modal tasks. In particular, InternVL3-78B achieves a score of 72.2 on the MMMU benchmark, setting a new state-of-the-art among open-source MLLMs. Its capabilities remain highly competitive with leading proprietary models, including ChatGPT-4o, Claude 3.5 Sonnet, and Gemini 2.5 Pro, while also maintaining strong pure-language proficiency. In pursuit of open-science principles, we will publicly release both the training data and model weights to foster further research and development in next-generation MLLMs.

Jing Hao, Siyuan Dai, Yongxin Zhang et al.

Dental image analysis plays a pivotal role in supporting accurate diagnosis and treatment planning in oral healthcare. Although recent advances have produced dental AI models for specific tasks and individual imaging modalities, their isolated designs limit practical use in real-world clinical workflows. In this paper, we present OralAgent, the first dental-specialized AI agent that unifies multimodal reasoning, tool-based decision-making, and knowledge-grounded retrieval within an end-to-end automated framework. It integrates 22 visual analysis tools and 368 widely-used classical dental textbooks, enabling autonomous reasoning, planning, tool use, knowledge retrieval, and multi-step workflow execution. Furthermore, we introduce OralCorpus, a large-scale, high-quality bilingual textual resource containing 134.8M tokens curated for dental retrieval-augmented generation (RAG). To evaluate models' multidisciplinary dental knowledge, we construct OralQA-ZH, a Chinese multiple-choice question benchmark consisting of 798 items across eleven oral subspecialties. Extensive experiments demonstrate that OralAgent achieves state-of-the-art performance on the MMOral-Uni, MMOral-OPG, and OralQA-ZH benchmarks, highlighting its effectiveness, interpretability, and adaptability in real-world clinical settings. The code and models are publicly available at https://github.com/isjinghao/OralAgent.

Yiqing Shen, Zan Chen, Michail Mamalakis et al.

The structural similarities between protein sequences and natural languages have led to parallel advancements in deep learning across both domains. While large language models (LLMs) have achieved much progress in the domain of natural language processing, their potential in protein engineering remains largely unexplored. Previous approaches have equipped LLMs with protein understanding capabilities by incorporating external protein encoders, but this fails to fully leverage the inherent similarities between protein sequences and natural languages, resulting in sub-optimal performance and increased model complexity. To address this gap, we present TourSynbio-7B, the first multi-modal large model specifically designed for protein engineering tasks without external protein encoders. TourSynbio-7B demonstrates that LLMs can inherently learn to understand proteins as language. The model is post-trained and instruction fine-tuned on InternLM2-7B using ProteinLMDataset, a dataset comprising 17.46 billion tokens of text and protein sequence for self-supervised pretraining and 893K instructions for supervised fine-tuning. TourSynbio-7B outperforms GPT-4 on the ProteinLMBench, a benchmark of 944 manually verified multiple-choice questions, with 62.18% accuracy. Leveraging TourSynbio-7B's enhanced protein sequence understanding capability, we introduce TourSynbio-Agent, an innovative framework capable of performing various protein engineering tasks, including mutation analysis, inverse folding, protein folding, and visualization. TourSynbio-Agent integrates previously disconnected deep learning models in the protein engineering domain, offering a unified conversational user interface for improved usability. Finally, we demonstrate the efficacy of TourSynbio-7B and TourSynbio-Agent through two wet lab case studies on vanilla key enzyme modification and steroid compound catalysis.

Jianghan Shen, Siqi Luo, Xinyu Cheng et al.

Reinforcement Learning with Verifiable Rewards (RLVR) has emerged as a promising paradigm for training agentic retrieval-augmented generation (RAG) systems from outcome-only supervision. Most existing methods optimize policies from uniformly sampled rollouts, implicitly treating all trajectories as equally informative. However, trajectories differ substantially in search depth and are therefore not equally informative: deeper-search trajectories contain more retrieval decision points and provide denser direct supervision for the retrieval sub-policy. Moreover, this heterogeneity grows over training as the within-batch depth distribution shifts toward higher values, yet uniform rollout sampling remains blind to this shift. To address this, we propose CuSearch, a curriculum rollout sampling framework built on Search-Depth Greedy Allocation (SDGA), a batch-level operator that reallocates a fixed update budget toward deeper-search trajectories. SDGA-Auto always targets the deepest available trajectories in the current batch, yielding an implicit training-aligned curriculum as the depth distribution shifts upward. SDGA-Phase explicitly advances the curriculum threshold as deeper trajectories become sufficiently abundant. Experiments across model types and retrieval frameworks show that CuSearch consistently improves performance, achieving up to 11.8 exact-match points over standard GRPO on ZeroSearch. These results establish per-trajectory search depth as a reliable, annotation-free proxy for retrieval supervision density in RLVR-based agentic RAG training. The code is available at https://github.com/MrToser/CuSearch.

Zhongying Deng, Da Li, Junjun He et al.

Target domain pseudo-labelling has shown effectiveness in unsupervised domain adaptation (UDA). However, pseudo-labels of unlabeled target domain data are inevitably noisy due to the distribution shift between source and target domains. This paper proposes a Generative model-based Noise-Robust Training method (GeNRT), which eliminates domain shift while mitigating label noise. GeNRT incorporates a Distribution-based Class-wise Feature Augmentation (D-CFA) and a Generative-Discriminative classifier Consistency (GDC), both based on the class-wise target distributions modelled by generative models. D-CFA minimizes the domain gap by augmenting the source data with distribution-sampled target features, and trains a noise-robust discriminative classifier by using target domain knowledge from the generative models. GDC regards all the class-wise generative models as generative classifiers and enforces a consistency regularization between the generative and discriminative classifiers. It exploits an ensemble of target knowledge from all the generative models to train a noise-robust discriminative classifier and eventually gets theoretically linked to the Ben-David domain adaptation theorem for reducing the domain gap. Extensive experiments on Office-Home, PACS, and Digit-Five show that our GeNRT achieves comparable performance to state-of-the-art methods under single-source and multi-source UDA settings.

Dongyang Liu, Renrui Zhang, Longtian Qiu et al. · stanford, tsinghua

We propose SPHINX-X, an extensive Multimodality Large Language Model (MLLM) series developed upon SPHINX. To improve the architecture and training efficiency, we modify the SPHINX framework by removing redundant visual encoders, bypassing fully-padded sub-images with skip tokens, and simplifying multi-stage training into a one-stage all-in-one paradigm. To fully unleash the potential of MLLMs, we assemble a comprehensive multi-domain and multimodal dataset covering publicly available resources in language, vision, and vision-language tasks. We further enrich this collection with our curated OCR intensive and Set-of-Mark datasets, extending the diversity and generality. By training over different base LLMs including TinyLlama1.1B, InternLM2-7B, LLaMA2-13B, and Mixtral8x7B, we obtain a spectrum of MLLMs that vary in parameter size and multilingual capabilities. Comprehensive benchmarking reveals a strong correlation between the multi-modal performance with the data and parameter scales. Code and models are released at https://github.com/Alpha-VLLM/LLaMA2-Accessory

Wenhui Liao, Hongliang Li, Pengyu Xie et al.

Document parsing is a fundamental task in multimodal understanding, supporting a wide range of downstream applications such as information extraction and intelligent document analysis. Benefiting from strong semantic modeling and robust generalization, VLM-based end-to-end approaches have emerged as the mainstream paradigm in recent years. However, these models often suffer from substantial inference latency, as they must auto-regressively generate long token sequences when processing long-form documents. In this work, motivated by the extremely long outputs and complex layout structures commonly found in document parsing, we propose a training-free and highly efficient acceleration method. Inspired by speculative decoding, we employ a lightweight document parsing pipeline as a draft model to predict batches of future tokens, while the more accurate VLM verifies these draft predictions in parallel. Moreover, we further exploit the layout-structured nature of documents by partitioning each page into independent regions, enabling parallel decoding of each region using the same draft-verify strategy. The final predictions are then assembled according to the natural reading order. Experimental results demonstrate the effectiveness of our approach: on the general-purpose OmniDocBench, our method provides a 2.42x lossless acceleration for the dots.ocr model, and achieves up to 4.89x acceleration on long-document parsing tasks. We will release our code to facilitate reproducibility and future research.

Yutao Hu, Tianbin Li, Quanfeng Lu et al.

Large Vision-Language Models (LVLMs) have demonstrated remarkable capabilities in various multimodal tasks. However, their potential in the medical domain remains largely unexplored. A significant challenge arises from the scarcity of diverse medical images spanning various modalities and anatomical regions, which is essential in real-world medical applications. To solve this problem, in this paper, we introduce OmniMedVQA, a novel comprehensive medical Visual Question Answering (VQA) benchmark. This benchmark is collected from 73 different medical datasets, including 12 different modalities and covering more than 20 distinct anatomical regions. Importantly, all images in this benchmark are sourced from authentic medical scenarios, ensuring alignment with the requirements of the medical field and suitability for evaluating LVLMs. Through our extensive experiments, we have found that existing LVLMs struggle to address these medical VQA problems effectively. Moreover, what surprises us is that medical-specialized LVLMs even exhibit inferior performance to those general-domain models, calling for a more versatile and robust LVLM in the biomedical field. The evaluation results not only reveal the current limitations of LVLM in understanding real medical images but also highlight our dataset's significance. Our code with dataset are available at https://github.com/OpenGVLab/Multi-Modality-Arena.

Weiyun Wang, Zhangwei Gao, Lixin Gu et al. · cmu, pku

We introduce InternVL 3.5, a new family of open-source multimodal models that significantly advances versatility, reasoning capability, and inference efficiency along the InternVL series. A key innovation is the Cascade Reinforcement Learning (Cascade RL) framework, which enhances reasoning through a two-stage process: offline RL for stable convergence and online RL for refined alignment. This coarse-to-fine training strategy leads to substantial improvements on downstream reasoning tasks, e.g., MMMU and MathVista. To optimize efficiency, we propose a Visual Resolution Router (ViR) that dynamically adjusts the resolution of visual tokens without compromising performance. Coupled with ViR, our Decoupled Vision-Language Deployment (DvD) strategy separates the vision encoder and language model across different GPUs, effectively balancing computational load. These contributions collectively enable InternVL3.5 to achieve up to a +16.0\% gain in overall reasoning performance and a 4.05$\times$ inference speedup compared to its predecessor, i.e., InternVL3. In addition, InternVL3.5 supports novel capabilities such as GUI interaction and embodied agency. Notably, our largest model, i.e., InternVL3.5-241B-A28B, attains state-of-the-art results among open-source MLLMs across general multimodal, reasoning, text, and agentic tasks -- narrowing the performance gap with leading commercial models like GPT-5. All models and code are publicly released.

Fanqing Meng, Lingxiao Du, Zongkai Liu et al.

DeepSeek R1, and o1 have demonstrated powerful reasoning capabilities in the text domain through stable large-scale reinforcement learning. To enable broader applications, some works have attempted to transfer these capabilities to multimodal reasoning. However, these efforts have been limited by the limited difficulty of selected tasks and relatively small training scales, making it challenging to demonstrate strong multimodal reasoning abilities. To address this gap, we introduce the MMK12 dataset and MM-EUREKA with 7B and 32B parameters. The former is a high-quality multimodal mathematics reasoning dataset featuring diverse knowledge domains with human-verified answers and solution processes. The latter is a multimodal model employing rule-based reinforcement learning on MMK12, utilizing online filtering and two-stage training strategy to enhance training stability. MM-EUREKA demonstrates remarkable performance gains in multimodal mathematical reasoning, outperforming previous powerful models like InternVL2.5-78B or InternVL2.5-38B-MPO. In particular, MM-EUREKA achieves competitive or superior performance compared to both open-source and closed-source models, and trails slightly behind o1 in multidisciplinary reasoning tasks. We open-source our complete pipeline to foster further research in this area. We release all our codes, models, data, etc. at https://github.com/ModalMinds/MM-EUREKA

Junzhi Ning, Jiashi Lin, Yingying Fang et al.

Multimodal large language models (MLLMs) have advanced clinical tasks for common conditions, but their performance on rare diseases remains largely untested. In rare-disease scenarios, clinicians often lack prior clinical knowledge, forcing them to rely strictly on case-level evidence for clinical judgments. Existing benchmarks predominantly evaluate common-condition, single-image settings, leaving multimodal and multi-image evidence integration under rare-disease data scarcity systematically unevaluated. We introduce MMRareBench, to our knowledge the first rare-disease benchmark jointly evaluating multimodal and multi-image clinical capability across four workflow-aligned tracks: diagnosis, treatment planning, cross-image evidence alignment, and examination suggestion. The benchmark comprises 1,756 question-answer pairs with 7,958 associated medical images curated from PMC case reports, with Orphanet-anchored ontology alignment, track-specific leakage control, evidence-grounded annotations, and a two-level evaluation protocol. A systematic evaluation of 23 MLLMs reveals fragmented capability profiles and universally low treatment-planning performance, with medical-domain models trailing general-purpose MLLMs substantially on multi-image tracks despite competitive diagnostic scores. These patterns are consistent with a capacity dilution effect: medical fine-tuning can narrow the diagnostic gap but may erode the compositional multi-image capability that rare-disease evidence integration demands.

Zhangwei Gao, Zhe Chen, Erfei Cui et al.

Multimodal large language models (MLLMs) have demonstrated impressive performance in vision-language tasks across a broad spectrum of domains. However, the large model scale and associated high computational costs pose significant challenges for training and deploying MLLMs on consumer-grade GPUs or edge devices, thereby hindering their widespread application. In this work, we introduce Mini-InternVL, a series of MLLMs with parameters ranging from 1B to 4B, which achieves 90% of the performance with only 5% of the parameters. This significant improvement in efficiency and effectiveness makes our models more accessible and applicable in various real-world scenarios. To further promote the adoption of our models, we develop a unified adaptation framework for Mini-InternVL, which enables our models to transfer and outperform specialized models in downstream tasks, including autonomous driving, medical images, and remote sensing. We believe that our study can provide valuable insights and resources to advance the development of efficient and effective MLLMs. Code is available at https://github.com/OpenGVLab/InternVL.

Haoyu Wang, Ziyan Huang, Jin Ye et al.

Renal structure segmentation from computed tomography angiography~(CTA) is essential for many computer-assisted renal cancer treatment applications. Kidney PArsing~(KiPA 2022) Challenge aims to build a fine-grained multi-structure dataset and improve the segmentation of multiple renal structures. Recently, U-Net has dominated the medical image segmentation. In the KiPA challenge, we evaluated several U-Net variants and selected the best models for the final submission.

Wanghan Xu, Yuhao Zhou, Yifan Zhou et al.

Despite advances in scientific AI, a coherent framework for Scientific General Intelligence (SGI)-the ability to autonomously conceive, investigate, and reason across scientific domains-remains lacking. We present an operational SGI definition grounded in the Practical Inquiry Model (PIM: Deliberation, Conception, Action, Perception) and operationalize it via four scientist-aligned tasks: deep research, idea generation, dry/wet experiments, and experimental reasoning. SGI-Bench comprises over 1,000 expert-curated, cross-disciplinary samples inspired by Science's 125 Big Questions, enabling systematic evaluation of state-of-the-art LLMs. Results reveal gaps: low exact match (10--20%) in deep research despite step-level alignment; ideas lacking feasibility and detail; high code executability but low execution result accuracy in dry experiments; low sequence fidelity in wet protocols; and persistent multimodal comparative-reasoning challenges. We further introduce Test-Time Reinforcement Learning (TTRL), which optimizes retrieval-augmented novelty rewards at inference, enhancing hypothesis novelty without reference answer. Together, our PIM-grounded definition, workflow-centric benchmark, and empirical insights establish a foundation for AI systems that genuinely participate in scientific discovery.

Jiyao Liu, Shangqi Gao, Yuxin Li et al.

Multi-modal Magnetic Resonance Imaging (MRI) translation leverages information from source MRI sequences to generate target modalities, enabling comprehensive diagnosis while overcoming the limitations of acquiring all sequences. While existing deep-learning-based multi-modal MRI translation methods have shown promising potential, they still face two key challenges: 1) lack of reliable uncertainty quantification for synthesized images, and 2) limited robustness when deployed across different medical centers. To address these challenges, we propose a novel framework that reformulates multi-modal MRI translation as a multi-modal evidential regression problem with distribution calibration. Our approach incorporates two key components: 1) an evidential regression module that estimates uncertainties from different source modalities and an explicit distribution mixture strategy for transparent multi-modal fusion, and 2) a distribution calibration mechanism that adapts to source-target mapping shifts to ensure consistent performance across different medical centers. Extensive experiments on three datasets from the BraTS2023 challenge demonstrate that our framework achieves superior performance and robustness across domains.

Pedro R. A. S. Bassi, Wenxuan Li, Yucheng Tang et al.

How can we test AI performance? This question seems trivial, but it isn't. Standard benchmarks often have problems such as in-distribution and small-size test sets, oversimplified metrics, unfair comparisons, and short-term outcome pressure. As a consequence, good performance on standard benchmarks does not guarantee success in real-world scenarios. To address these problems, we present Touchstone, a large-scale collaborative segmentation benchmark of 9 types of abdominal organs. This benchmark is based on 5,195 training CT scans from 76 hospitals around the world and 5,903 testing CT scans from 11 additional hospitals. This diverse test set enhances the statistical significance of benchmark results and rigorously evaluates AI algorithms across various out-of-distribution scenarios. We invited 14 inventors of 19 AI algorithms to train their algorithms, while our team, as a third party, independently evaluated these algorithms on three test sets. In addition, we also evaluated pre-existing AI frameworks--which, differing from algorithms, are more flexible and can support different algorithms--including MONAI from NVIDIA, nnU-Net from DKFZ, and numerous other open-source frameworks. We are committed to expanding this benchmark to encourage more innovation of AI algorithms for the medical domain.

Junlong Cheng, Bin Fu, Jin Ye et al.

Interactive Medical Image Segmentation (IMIS) has long been constrained by the limited availability of large-scale, diverse, and densely annotated datasets, which hinders model generalization and consistent evaluation across different models. In this paper, we introduce the IMed-361M benchmark dataset, a significant advancement in general IMIS research. First, we collect and standardize over 6.4 million medical images and their corresponding ground truth masks from multiple data sources. Then, leveraging the strong object recognition capabilities of a vision foundational model, we automatically generated dense interactive masks for each image and ensured their quality through rigorous quality control and granularity management. Unlike previous datasets, which are limited by specific modalities or sparse annotations, IMed-361M spans 14 modalities and 204 segmentation targets, totaling 361 million masks-an average of 56 masks per image. Finally, we developed an IMIS baseline network on this dataset that supports high-quality mask generation through interactive inputs, including clicks, bounding boxes, text prompts, and their combinations. We evaluate its performance on medical image segmentation tasks from multiple perspectives, demonstrating superior accuracy and scalability compared to existing interactive segmentation models. To facilitate research on foundational models in medical computer vision, we release the IMed-361M and model at https://github.com/uni-medical/IMIS-Bench.

Lei Bai, Zhongrui Cai, Yuhang Cao et al.

In recent years, a plethora of open-source foundation models have emerged, achieving remarkable progress in some widely attended fields, with performance being quite close to that of closed-source models. However, in high-value but more challenging scientific professional fields, either the fields still rely on expert models, or the progress of general foundation models lags significantly compared to those in popular areas, far from sufficient for transforming scientific research and leaving substantial gap between open-source models and closed-source models in these scientific domains. To mitigate this gap and explore a step further toward Artificial General Intelligence (AGI), we introduce Intern-S1, a specialized generalist equipped with general understanding and reasoning capabilities with expertise to analyze multiple science modal data. Intern-S1 is a multimodal Mixture-of-Experts (MoE) model with 28 billion activated parameters and 241 billion total parameters, continually pre-trained on 5T tokens, including over 2.5T tokens from scientific domains. In the post-training stage, Intern-S1 undergoes offline and then online reinforcement learning (RL) in InternBootCamp, where we propose Mixture-of-Rewards (MoR) to synergize the RL training on more than 1000 tasks simultaneously. Through integrated innovations in algorithms, data, and training systems, Intern-S1 achieved top-tier performance in online RL training. On comprehensive evaluation benchmarks, Intern-S1 demonstrates competitive performance on general reasoning tasks among open-source models and significantly outperforms open-source models in scientific domains, surpassing closed-source state-of-the-art models in professional tasks, such as molecular synthesis planning, reaction condition prediction, predicting thermodynamic stabilities for crystals. Our models are available at https://huggingface.co/internlm/Intern-S1.

Yanzhou Su, Tianbin Li, Jiyao Liu et al.

Recent advances in general medical AI have made significant strides, but existing models often lack the reasoning capabilities needed for complex medical decision-making. This paper presents GMAI-VL-R1, a multimodal medical reasoning model enhanced by reinforcement learning (RL) to improve its reasoning abilities. Through iterative training, GMAI-VL-R1 optimizes decision-making, significantly boosting diagnostic accuracy and clinical support. We also develop a reasoning data synthesis method, generating step-by-step reasoning data via rejection sampling, which further enhances the model's generalization. Experimental results show that after RL training, GMAI-VL-R1 excels in tasks such as medical image diagnosis and visual question answering. While the model demonstrates basic memorization with supervised fine-tuning, RL is crucial for true generalization. Our work establishes new evaluation benchmarks and paves the way for future advancements in medical reasoning models. Code, data, and model will be released at \href{https://github.com/uni-medical/GMAI-VL-R1}{this link}.

Ying Chen, Guoan Wang, Yuanfeng Ji et al.

Despite the progress made by multimodal large language models (MLLMs) in computational pathology, they remain limited by a predominant focus on patch-level analysis, missing essential contextual information at the whole-slide level. The lack of large-scale instruction datasets and the gigapixel scale of whole slide images (WSIs) pose significant developmental challenges. In this paper, we present SlideChat, the first vision-language assistant capable of understanding gigapixel whole-slide images, exhibiting excellent multimodal conversational capability and response complex instruction across diverse pathology scenarios. To support its development, we created SlideInstruction, the largest instruction-following dataset for WSIs consisting of 4.2K WSI captions and 176K VQA pairs with multiple categories. Furthermore, we propose SlideBench, a multimodal benchmark that incorporates captioning and VQA tasks to assess SlideChat's capabilities in varied clinical settings such as microscopy, diagnosis. Compared to both general and specialized MLLMs, SlideChat exhibits exceptional capabilities achieving state-of-the-art performance on 18 of 22 tasks. For example, it achieved an overall accuracy of 81.17% on SlideBench-VQA (TCGA), and 54.15% on SlideBench-VQA (BCNB). Our code, data, and model is publicly accessible at https://uni-medical.github.io/SlideChat.github.io.

Chong Wang, Mengyao Li, Junjun He et al.

Recent breakthroughs in large language models (LLMs) offer unprecedented natural language understanding and generation capabilities. However, existing surveys on LLMs in biomedicine often focus on specific applications or model architectures, lacking a comprehensive analysis that integrates the latest advancements across various biomedical domains. This review, based on an analysis of 484 publications sourced from databases including PubMed, Web of Science, and arXiv, provides an in-depth examination of the current landscape, applications, challenges, and prospects of LLMs in biomedicine, distinguishing itself by focusing on the practical implications of these models in real-world biomedical contexts. Firstly, we explore the capabilities of LLMs in zero-shot learning across a broad spectrum of biomedical tasks, including diagnostic assistance, drug discovery, and personalized medicine, among others, with insights drawn from 137 key studies. Then, we discuss adaptation strategies of LLMs, including fine-tuning methods for both uni-modal and multi-modal LLMs to enhance their performance in specialized biomedical contexts where zero-shot fails to achieve, such as medical question answering and efficient processing of biomedical literature. Finally, we discuss the challenges that LLMs face in the biomedicine domain including data privacy concerns, limited model interpretability, issues with dataset quality, and ethics due to the sensitive nature of biomedical data, the need for highly reliable model outputs, and the ethical implications of deploying AI in healthcare. To address these challenges, we also identify future research directions of LLM in biomedicine including federated learning methods to preserve data privacy and integrating explainable AI methodologies to enhance the transparency of LLMs.

Xiaosong Wang, Xiaofan Zhang, Guotai Wang et al.

The emerging trend of advancing generalist artificial intelligence, such as GPTv4 and Gemini, has reshaped the landscape of research (academia and industry) in machine learning and many other research areas. However, domain-specific applications of such foundation models (e.g., in medicine) remain untouched or often at their very early stages. It will require an individual set of transfer learning and model adaptation techniques by further expanding and injecting these models with domain knowledge and data. The development of such technologies could be largely accelerated if the bundle of data, algorithms, and pre-trained foundation models were gathered together and open-sourced in an organized manner. In this work, we present OpenMEDLab, an open-source platform for multi-modality foundation models. It encapsulates not only solutions of pioneering attempts in prompting and fine-tuning large language and vision models for frontline clinical and bioinformatic applications but also building domain-specific foundation models with large-scale multi-modal medical data. Importantly, it opens access to a group of pre-trained foundation models for various medical image modalities, clinical text, protein engineering, etc. Inspiring and competitive results are also demonstrated for each collected approach and model in a variety of benchmarks for downstream tasks. We welcome researchers in the field of medical artificial intelligence to continuously contribute cutting-edge methods and models to OpenMEDLab, which can be accessed via https://github.com/openmedlab.

Yi Xin, Qi Qin, Siqi Luo et al.

We introduce Lumina-DiMOO, an open-source foundational model for seamless multi-modal generation and understanding. Lumina-DiMOO sets itself apart from prior unified models by utilizing a fully discrete diffusion modeling to handle inputs and outputs across various modalities. This innovative approach allows Lumina-DiMOO to achieve higher sampling efficiency compared to previous autoregressive (AR) or hybrid AR-Diffusion paradigms and adeptly support a broad spectrum of multi-modal tasks, including text-to-image generation, image-to-image generation (e.g., image editing, subject-driven generation, and image inpainting, etc.), as well as image understanding. Lumina-DiMOO achieves state-of-the-art performance on multiple benchmarks, surpassing existing open-source unified multi-modal models. To foster further advancements in multi-modal and discrete diffusion model research, we release our code and checkpoints to the community. Project Page: https://synbol.github.io/Lumina-DiMOO.

Huihui Xu, Yuanpeng Nie, Hualiang Wang et al.

Medical Image Grounding (MIG), which involves localizing specific regions in medical images based on textual descriptions, requires models to not only perceive regions but also deduce spatial relationships of these regions. Existing Vision-Language Models (VLMs) for MIG often rely on Supervised Fine-Tuning (SFT) with large amounts of Chain-of-Thought (CoT) reasoning annotations, which are expensive and time-consuming to acquire. Recently, DeepSeek-R1 demonstrated that Large Language Models (LLMs) can acquire reasoning abilities through Group Relative Policy Optimization (GRPO) without requiring CoT annotations. In this paper, we adapt the GRPO reinforcement learning framework to VLMs for Medical Image Grounding. We propose the Spatial-Semantic Rewarded Group Relative Policy Optimization to train the model without CoT reasoning annotations. Specifically, we introduce Spatial-Semantic Rewards, which combine spatial accuracy reward and semantic consistency reward to provide nuanced feedback for both spatially positive and negative completions. Additionally, we propose to use the Chain-of-Box template, which integrates visual information of referring bounding boxes into the <think> reasoning process, enabling the model to explicitly reason about spatial regions during intermediate steps. Experiments on three datasets MS-CXR, ChestX-ray8, and M3D-RefSeg demonstrate that our method achieves state-of-the-art performance in Medical Image Grounding. Ablation studies further validate the effectiveness of each component in our approach. Code, checkpoints, and datasets are available at https://github.com/bio-mlhui/MedGround-R1

Pengcheng Chen, Ziyan Huang, Zhongying Deng et al.

OpenAI's latest large vision-language model (LVLM), GPT-4V(ision), has piqued considerable interest for its potential in medical applications. Despite its promise, recent studies and internal reviews highlight its underperformance in specialized medical tasks. This paper explores the boundary of GPT-4V's capabilities in medicine, particularly in processing complex imaging data from endoscopies, CT scans, and MRIs etc. Leveraging open-source datasets, we assessed its foundational competencies, identifying substantial areas for enhancement. Our research emphasizes prompt engineering, an often-underutilized strategy for improving AI responsiveness. Through iterative testing, we refined the model's prompts, significantly improving its interpretative accuracy and relevance in medical imaging. From our comprehensive evaluations, we distilled 10 effective prompt engineering techniques, each fortifying GPT-4V's medical acumen. These methodical enhancements facilitate more reliable, precise, and clinically valuable insights from GPT-4V, advancing its operability in critical healthcare environments. Our findings are pivotal for those employing AI in medicine, providing clear, actionable guidance on harnessing GPT-4V's full diagnostic potential.

Siqi Luo, Jianghan Shen, Yi Xin et al.

Diffusion Multi-Modal Large Language Models (dMLLMs) are powerful for image generation, but optimizing them through reinforcement learning (RL) remains a major challenge. One primary difficulty is that a single image can be generated through many different unmasking sequences, which makes calculating importance ratios often intractable. Additionally, existing methods tend to ignore the hierarchical generation process of dMLLMs, where early tokens define the global layout and later tokens focus on local details. By assigning uniform rewards to all tokens, these current methods fail to reflect the actual contribution of each token to the final image. To address these issues, we propose Hierarchical Token GRPO (HT-GRPO), which integrates this hierarchy directly into the policy optimization process. Our approach features a Sketch-Then-Paint training scheme that organizes updates into three distinct stages: global, structure, and refinement. We also use a prompt-conditioned estimator to calculate importance ratios starting from a fully masked state. Furthermore, we introduce a Hierarchical Credit Assignment mechanism that prioritizes key structural tokens to ensure accurate reward propagation. Experiments using two popular dMLLM backbones, MMaDA and Lumina-DiMOO, demonstrate that HT-GRPO achieves substantial gains on the GenEval and DPG benchmarks. Evaluations across six additional metrics confirm significant improvements in image quality, aesthetics, and human preference.

Junzhi Ning, Cheng Tang, Kaijing Zhou et al.

The scarcity of high-quality, labelled retinal imaging data, which presents a significant challenge in the development of machine learning models for ophthalmology, hinders progress in the field. Existing methods for synthesising Colour Fundus Photographs (CFPs) largely rely on predefined disease labels, which restricts their ability to generate images that reflect fine-grained anatomical variations, subtle disease stages, and diverse pathological features beyond coarse class categories. To overcome these challenges, we first introduce an innovative pipeline that creates a large-scale, captioned retinal dataset comprising 1.4 million entries, called RetinaLogos-1400k. Specifically, RetinaLogos-1400k uses the visual language model(VLM) to describe retinal conditions and key structures, such as optic disc configuration, vascular distribution, nerve fibre layers, and pathological features. Building on this dataset, we employ a novel three-step training framework, RetinaLogos, which enables fine-grained semantic control over retinal images and accurately captures different stages of disease progression, subtle anatomical variations, and specific lesion types. Through extensive experiments, our method demonstrates superior performance across multiple datasets, with 62.07% of text-driven synthetic CFPs indistinguishable from real ones by ophthalmologists. Moreover, the synthetic data improves accuracy by 5%-10% in diabetic retinopathy grading and glaucoma detection. Codes are available at https://github.com/uni-medical/retina-text2cfp.

Wei Li, Ming Hu, Guoan Wang et al.

In ophthalmic surgery, developing an AI system capable of interpreting surgical videos and predicting subsequent operations requires numerous ophthalmic surgical videos with high-quality annotations, which are difficult to collect due to privacy concerns and labor consumption. Text-guided video generation (T2V) emerges as a promising solution to overcome this issue by generating ophthalmic surgical videos based on surgeon instructions. In this paper, we present Ophora, a pioneering model that can generate ophthalmic surgical videos following natural language instructions. To construct Ophora, we first propose a Comprehensive Data Curation pipeline to convert narrative ophthalmic surgical videos into a large-scale, high-quality dataset comprising over 160K video-instruction pairs, Ophora-160K. Then, we propose a Progressive Video-Instruction Tuning scheme to transfer rich spatial-temporal knowledge from a T2V model pre-trained on natural video-text datasets for privacy-preserved ophthalmic surgical video generation based on Ophora-160K. Experiments on video quality evaluation via quantitative analysis and ophthalmologist feedback demonstrate that Ophora can generate realistic and reliable ophthalmic surgical videos based on surgeon instructions. We also validate the capability of Ophora for empowering downstream tasks of ophthalmic surgical workflow understanding. Code is available at https://github.com/uni-medical/Ophora.