Junzhi Ning

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.

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.

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.

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}.

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

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.

Jiyao Liu, Shangqi Gao, Lihao Liu et al.

Real-world MRI reconstruction systems face the open-world challenge: test data from unseen imaging centers, anatomical structures, or acquisition protocols can differ drastically from training data, causing severe performance degradation. Existing methods struggle with this challenge. To address this, we propose BiasRecon, a bias-calibrated adaptation framework grounded in the minimal intervention principle: preserve what transfers, calibrate what does not. Concretely, BiasRecon formulates open-world adaptation as an alternating optimization framework that jointly optimizes three components: (1) frequency-guided prior calibration that introduces layer-wise calibration variables to selectively modulate frequency-specific features of the pre-trained score network via self-supervised k-space signals, (2) score-based denoising that leverages the calibrated generative prior for high-fidelity image reconstruction, and (3) adaptive regularization that employs Stein's Unbiased Risk Estimator to dynamically balance the prior-measurement trade-off, matching test-time noise characteristics without requiring ground truth. By intervening minimally and precisely through this alternating scheme, BiasRecon achieves robust adaptation with fewer than 100 tunable parameters. Extensive experiments across four datasets demonstrate state-of-the-art performance on open-world reconstruction tasks.

Chenglong Ma, Yuanfeng Ji, Jin Ye et al.

Advanced autoregressive models have reshaped multimodal AI. However, their transformative potential in medical imaging remains largely untapped due to the absence of a unified visual tokenizer -- one capable of capturing fine-grained visual structures for faithful image reconstruction and realistic image synthesis, as well as rich semantics for accurate diagnosis and image interpretation. To this end, we present MedITok, the first unified tokenizer tailored for medical images, encoding both low-level structural details and high-level clinical semantics within a unified latent space. To balance these competing objectives, we introduce a novel two-stage training framework: a visual representation alignment stage that cold-starts the tokenizer reconstruction learning with a visual semantic constraint, followed by a textual semantic representation alignment stage that infuses detailed clinical semantics into the latent space. Trained on the meticulously collected large-scale dataset with over 30 million medical images and 2 million image-caption pairs, MedITok achieves state-of-the-art performance on more than 30 datasets across 9 imaging modalities and 4 different tasks. By providing a unified token space for autoregressive modeling, MedITok supports a wide range of tasks in clinical diagnostics and generative healthcare applications. Model and code will be made publicly available at: https://github.com/Masaaki-75/meditok.

Xiaodan Xing, Junzhi Ning, Yang Nan et al.

Deep generative models have significantly advanced medical imaging analysis by enhancing dataset size and quality. Beyond mere data augmentation, our research in this paper highlights an additional, significant capacity of deep generative models: their ability to reveal and demonstrate patterns in medical images. We employ a generative structure with hybrid conditions, combining clinical data and segmentation masks to guide the image synthesis process. Furthermore, we innovatively transformed the tabular clinical data into textual descriptions. This approach simplifies the handling of missing values and also enables us to leverage large pre-trained vision-language models that investigate the relations between independent clinical entries and comprehend general terms, such as gender and smoking status. Our approach differs from and presents a more challenging task than traditional medical report-guided synthesis due to the less visual correlation of our clinical information with the images. To overcome this, we introduce a text-visual embedding mechanism that strengthens the conditions, ensuring the network effectively utilizes the provided information. Our pipeline is generalizable to both GAN-based and diffusion models. Experiments on chest CT, particularly focusing on the smoking status, demonstrated a consistent intensity shift in the lungs which is in agreement with clinical observations, indicating the effectiveness of our method in capturing and visualizing the impact of specific attributes on medical image patterns. Our methods offer a new avenue for the early detection and precise visualization of complex clinical conditions with deep generative models. All codes are https://github.com/junzhin/DGM-VLC.

Jiyao Liu, Junzhi Ning, Wanying Qu et al.

Medical image quality assessment (Med-IQA) is a prerequisite for clinical AI deployment, yet multimodal large language models (MLLMs) still fall substantially short of human experts, particularly when required to provide descriptive assessments with clinical reasoning beyond simple quality scores. However, improving them is hindered by the high cost of acquiring descriptive annotations and by the inability of one-time data collection to adapt to the model's evolving weaknesses. To address these challenges, we propose MedQ-Engine, a closed-loop data engine that iteratively evaluates the model to discover failure prototypes via data-driven clustering, explores a million-scale image pool using these prototypes as retrieval anchors with progressive human-in-the-loop annotation, and evolves through quality-assured fine-tuning, forming a self-improving cycle. Models are evaluated on complementary perception and description tasks. An entropy-guided routing mechanism triages annotations to minimize labeling cost. Experiments across five medical imaging modalities show that MedQ-Engine elevates an 8B-parameter model to surpass GPT-4o by over 13% and narrow the gap with human experts to only 4.34%, using only 10K annotations with more than 4x sample efficiency over random sampling.

Jiyao Liu, Junzhi Ning, Wanying Qu et al.

Existing medical image restoration (Med-IR) methods are typically modality-specific or degradation-specific, failing to generalize across the heterogeneous degradations encountered in clinical practice. We argue this limitation stems from the isolation of Med-IR from medical image quality assessment (Med-IQA), as restoration models without explicit quality understanding struggle to adapt to diverse degradation types across modalities. To address these challenges, we propose MedQ-UNI, a unified vision-language model that follows an assess-then-restore paradigm, explicitly leveraging Med-IQA to guide Med-IR across arbitrary modalities and degradation types. MedQ-UNI adopts a multimodal autoregressive dual-expert architecture with shared attention: a quality assessment expert first identifies degradation issues through structured natural language descriptions, and a restoration expert then conditions on these descriptions to perform targeted image restoration. To support this paradigm, we construct a large-scale dataset of approximately 50K paired samples spanning three imaging modalities and five restoration tasks, each annotated with structured quality descriptions for joint Med-IQA and Med-IR training, along with a 2K-sample benchmark for evaluation. Extensive experiments demonstrate that a single MedQ-UNI model, without any task-specific adaptation, achieves state-of-the-art restoration performance across all tasks while generating superior descriptions, confirming that explicit quality understanding meaningfully improves restoration fidelity and interpretability.

Junzhi Ning, Wei Li, Cheng Tang et al.

Medical diagnostic applications require models that can process multimodal medical inputs (images, patient histories, lab results) and generate diverse outputs including both textual reports and visual content (annotations, segmentation masks, and images). Despite this need, existing medical AI systems disrupt this unified process: medical image understanding models interpret images but cannot generate visual outputs, while medical image generation models synthesize images but cannot provide textual explanations. This leads to gaps in data representation, feature integration, and task-level multimodal capabilities. To this end, we propose a multi-level framework that draws inspiration from diagnostic workflows through the Observation-Knowledge-Analysis (OKA) paradigm. Specifically, at the observation level, we construct UniMed-5M, a dataset comprising over 5.6M samples that reformat diverse unimodal data into multimodal pairs for foundational observation. At the knowledge level, we propose Progressive Curriculum Learning that systematically introduces medical multimodal knowledge. At the analysis level, we introduce UniMedVL, the first medical unified multimodal model for the simultaneous analysis of image understanding and generation tasks within a single architecture. UniMedVL achieves superior performance on five medical image understanding benchmarks, while matching specialized models in generation quality across eight medical imaging modalities. Crucially, our unified architecture enables bidirectional knowledge sharing: generation tasks enhance visual understanding features, demonstrating that integrating traditionally separate capabilities within a single medical framework unlocks improvements across diverse medical vision-language tasks. Code is available at https://github.com/uni-medical/UniMedVL.

Ming Hu, Chenglong Ma, Wei Li et al. · pku

Scientific Large Language Models (Sci-LLMs) are transforming how knowledge is represented, integrated, and applied in scientific research, yet their progress is shaped by the complex nature of scientific data. This survey presents a comprehensive, data-centric synthesis that reframes the development of Sci-LLMs as a co-evolution between models and their underlying data substrate. We formulate a unified taxonomy of scientific data and a hierarchical model of scientific knowledge, emphasizing the multimodal, cross-scale, and domain-specific challenges that differentiate scientific corpora from general natural language processing datasets. We systematically review recent Sci-LLMs, from general-purpose foundations to specialized models across diverse scientific disciplines, alongside an extensive analysis of over 270 pre-/post-training datasets, showing why Sci-LLMs pose distinct demands -- heterogeneous, multi-scale, uncertainty-laden corpora that require representations preserving domain invariance and enabling cross-modal reasoning. On evaluation, we examine over 190 benchmark datasets and trace a shift from static exams toward process- and discovery-oriented assessments with advanced evaluation protocols. These data-centric analyses highlight persistent issues in scientific data development and discuss emerging solutions involving semi-automated annotation pipelines and expert validation. Finally, we outline a paradigm shift toward closed-loop systems where autonomous agents based on Sci-LLMs actively experiment, validate, and contribute to a living, evolving knowledge base. Collectively, this work provides a roadmap for building trustworthy, continually evolving artificial intelligence (AI) systems that function as a true partner in accelerating scientific discovery.

Jinjie Wei, Jiyao Liu, Lihao Liu et al.

Graphical User Interface (GUI) agents have made significant progress in automating digital tasks through the utilization of computer vision and language models. Nevertheless, existing agent systems encounter notable limitations. Firstly, they predominantly depend on trial and error decision making rather than progressive reasoning, thereby lacking the capability to learn and adapt from interactive encounters. Secondly, these systems are assessed using overly simplistic single step accuracy metrics, which do not adequately reflect the intricate nature of real world GUI interactions. In this paper, we present CogniGUI, a cognitive framework developed to overcome these limitations by enabling adaptive learning for GUI automation resembling human-like behavior. Inspired by Kahneman's Dual Process Theory, our approach combines two main components: (1) an omni parser engine that conducts immediate hierarchical parsing of GUI elements through quick visual semantic analysis to identify actionable components, and (2) a Group based Relative Policy Optimization (GRPO) grounding agent that assesses multiple interaction paths using a unique relative reward system, promoting minimal and efficient operational routes. This dual-system design facilitates iterative ''exploration learning mastery'' cycles, enabling the agent to enhance its strategies over time based on accumulated experience. Moreover, to assess the generalization and adaptability of agent systems, we introduce ScreenSeek, a comprehensive benchmark that includes multi application navigation, dynamic state transitions, and cross interface coherence, which are often overlooked challenges in current benchmarks. Experimental results demonstrate that CogniGUI surpasses state-of-the-art methods in both the current GUI grounding benchmarks and our newly proposed benchmark.

Junzhi Ning, Dominic Marshall, Yijian Gao et al.

Chest X-ray radiographs (CXRs) play a pivotal role in diagnosing and monitoring cardiopulmonary diseases. However, lung opacities in CXRs frequently obscure anatomical structures, impeding clear identification of lung borders and complicating the localization of pathology. This challenge significantly hampers segmentation accuracy and precise lesion identification, which are crucial for diagnosis. To tackle these issues, our study proposes an unpaired CXR translation framework that converts CXRs with lung opacities into counterparts without lung opacities while preserving semantic features. Central to our approach is the use of adaptive activation masks to selectively modify opacity regions in lung CXRs. Cross-domain alignment ensures translated CXRs without opacity issues align with feature maps and prediction labels from a pre-trained CXR lesion classifier, facilitating the interpretability of the translation process. We validate our method using RSNA, MIMIC-CXR-JPG and JSRT datasets, demonstrating superior translation quality through lower Frechet Inception Distance (FID) and Kernel Inception Distance (KID) scores compared to existing methods (FID: 67.18 vs. 210.4, KID: 0.01604 vs. 0.225). Evaluation on RSNA opacity, MIMIC acute respiratory distress syndrome (ARDS) patient CXRs and JSRT CXRs show our method enhances segmentation accuracy of lung borders and improves lesion classification, further underscoring its potential in clinical settings (RSNA: mIoU: 76.58% vs. 62.58%, Sensitivity: 85.58% vs. 77.03%; MIMIC ARDS: mIoU: 86.20% vs. 72.07%, Sensitivity: 92.68% vs. 86.85%; JSRT: mIoU: 91.08% vs. 85.6%, Sensitivity: 97.62% vs. 95.04%). Our approach advances CXR imaging analysis, especially in investigating segmentation impacts through image translation techniques.

Jiyao Liu, Jinjie Wei, Wanying Qu et al.

Medical Image Quality Assessment (IQA) serves as the first-mile safety gate for clinical AI, yet existing approaches remain constrained by scalar, score-based metrics and fail to reflect the descriptive, human-like reasoning process central to expert evaluation. To address this gap, we introduce MedQ-Bench, a comprehensive benchmark that establishes a perception-reasoning paradigm for language-based evaluation of medical image quality with Multi-modal Large Language Models (MLLMs). MedQ-Bench defines two complementary tasks: (1) MedQ-Perception, which probes low-level perceptual capability via human-curated questions on fundamental visual attributes; and (2) MedQ-Reasoning, encompassing both no-reference and comparison reasoning tasks, aligning model evaluation with human-like reasoning on image quality. The benchmark spans five imaging modalities and over forty quality attributes, totaling 2,600 perceptual queries and 708 reasoning assessments, covering diverse image sources including authentic clinical acquisitions, images with simulated degradations via physics-based reconstructions, and AI-generated images. To evaluate reasoning ability, we propose a multi-dimensional judging protocol that assesses model outputs along four complementary axes. We further conduct rigorous human-AI alignment validation by comparing LLM-based judgement with radiologists. Our evaluation of 14 state-of-the-art MLLMs demonstrates that models exhibit preliminary but unstable perceptual and reasoning skills, with insufficient accuracy for reliable clinical use. These findings highlight the need for targeted optimization of MLLMs in medical IQA. We hope that MedQ-Bench will catalyze further exploration and unlock the untapped potential of MLLMs for medical image quality evaluation.

Yingying Fang, Zihao Jin, Shaojie Guo et al.

Despite significant advancements in automated report generation, the opaqueness of text interpretability continues to cast doubt on the reliability of the content produced. This paper introduces a novel approach to identify specific image features in X-ray images that influence the outputs of report generation models. Specifically, we propose Cyclic Vision-Language Manipulator CVLM, a module to generate a manipulated X-ray from an original X-ray and its report from a designated report generator. The essence of CVLM is that cycling manipulated X-rays to the report generator produces altered reports aligned with the alterations pre-injected into the reports for X-ray generation, achieving the term "cyclic manipulation". This process allows direct comparison between original and manipulated X-rays, clarifying the critical image features driving changes in reports and enabling model users to assess the reliability of the generated texts. Empirical evaluations demonstrate that CVLM can identify more precise and reliable features compared to existing explanation methods, significantly enhancing the transparency and applicability of AI-generated reports.

Jiyao Liu, Junzhi Ning, Chenglong Ma et al.

Despite impressive performance on standard benchmarks, multimodal large language models (MLLMs) face critical challenges in real-world clinical environments where medical images inevitably suffer various quality degradations. Existing benchmarks exhibit two key limitations: (1) absence of large-scale, multidimensional assessment across medical image quality gradients and (2) no systematic confidence calibration analysis. To address these gaps, we present MedQ-Deg, a comprehensive benchmark for evaluating medical MLLMs under image quality degradations. MedQ-Deg provides multi-dimensional evaluation spanning 18 distinct degradation types, 30 fine-grained capability dimensions, and 7 imaging modalities, with 24,894 question-answer pairs. Each degradation is implemented at 3 severity degrees, calibrated by expert radiologists. We further introduce Calibration Shift metric, which quantifies the gap between a model's perceived confidence and actual performance to assess metacognitive reliability under degradation. Our comprehensive evaluation of 40 mainstream MLLMs reveals several critical findings: (1) overall model performance degrades systematically as degradation severity increases, (2) models universally exhibit the AI Dunning-Kruger Effect, maintaining inappropriately high confidence despite severe accuracy collapse, and (3) models display markedly differentiated behavioral patterns across capability dimensions, imaging modalities, and degradation types. We hope MedQ-Deg drives progress toward medical MLLMs that are robust and trustworthy in real clinical practice.

Xin Wang, Jiyao Liu, Yulong Xiao et al.

Large Language Models (LLMs) are accelerating scientific idea generation, but rigorously evaluating these numerous, often superficial, AI-generated propositions for novelty and factual accuracy is a critical bottleneck; manual verification is too slow. Existing validation methods are inadequate: LLMs as standalone verifiers may hallucinate and lack domain knowledge (our findings show 60% unawareness of relevant papers in specific domains), while traditional citation networks lack explicit causality and narrative surveys are unstructured. This underscores a core challenge: the absence of structured, verifiable, and causally-linked historical data of scientific evolution.To address this,we introduce \textbf{THE-Tree} (\textbf{T}echnology \textbf{H}istory \textbf{E}volution Tree), a computational framework that constructs such domain-specific evolution trees from scientific literature. THE-Tree employs a search algorithm to explore evolutionary paths. During its node expansion, it utilizes a novel "Think-Verbalize-Cite-Verify" process: an LLM proposes potential advancements and cites supporting literature. Critically, each proposed evolutionary link is then validated for logical coherence and evidential support by a recovered natural language inference mechanism that interrogates the cited literature, ensuring that each step is grounded. We construct and validate 88 THE-Trees across diverse domains and release a benchmark dataset including up to 71k fact verifications covering 27k papers to foster further research. Experiments demonstrate that i) in graph completion, our THE-Tree improves hit@1 by 8% to 14% across multiple models compared to traditional citation networks; ii) for predicting future scientific developments, it improves hit@1 metric by nearly 10%; and iii) when combined with other methods, it boosts the performance of evaluating important scientific papers by almost 100%.

Yijian Gao, Dominic Marshall, Xiaodan Xing et al.

Radiology reporting generative AI holds significant potential to alleviate clinical workloads and streamline medical care. However, achieving high clinical accuracy is challenging, as radiological images often feature subtle lesions and intricate structures. Existing systems often fall short, largely due to their reliance on fixed size, patch-level image features and insufficient incorporation of pathological information. This can result in the neglect of such subtle patterns and inconsistent descriptions of crucial pathologies. To address these challenges, we propose an innovative approach that leverages pathology-aware regional prompts to explicitly integrate anatomical and pathological information of various scales, significantly enhancing the precision and clinical relevance of generated reports. We develop an anatomical region detector that extracts features from distinct anatomical areas, coupled with a novel multi-label lesion detector that identifies global pathologies. Our approach emulates the diagnostic process of radiologists, producing clinically accurate reports with comprehensive diagnostic capabilities. Experimental results show that our model outperforms previous state-of-the-art methods on most natural language generation and clinical efficacy metrics, with formal expert evaluations affirming its potential to enhance radiology practice.