De-Xing Kong

Shijie Wang, Yilun Zhang, Zeyu Lai et al.

Multimodal large language models (MLLMs) have shown great potential in general domains but perform poorly in some specific domains due to a lack of domain-specific data, such as image-text data or vedio-text data. In some specific domains, there is abundant graphic and textual data scattered around, but lacks standardized arrangement. In the field of medical ultrasound, there are ultrasonic diagnostic books, ultrasonic clinical guidelines, ultrasonic diagnostic reports, and so on. However, these ultrasonic materials are often saved in the forms of PDF, images, etc., and cannot be directly used for the training of MLLMs. This paper proposes a novel image-text reasoning supervised fine-tuning data generation pipeline to create specific domain quadruplets (image, question, thinking trace, and answer) from domain-specific materials. A medical ultrasound domain dataset ReMUD is established, containing over 45,000 reasoning and non-reasoning supervised fine-tuning Question Answering (QA) and Visual Question Answering (VQA) data. The ReMUD-7B model, fine-tuned on Qwen2.5-VL-7B-Instruct, outperforms general-domain MLLMs in medical ultrasound field. To facilitate research, the ReMUD dataset, data generation codebase, and ReMUD-7B parameters will be released at https://github.com/ShiDaizi/ReMUD, addressing the data shortage issue in specific domain MLLMs.

Yilun Zhang, Dexing Kong

Large Language Models (LLMs) show promise in medicine but are prone to factual and logical errors, which is unacceptable in this high-stakes field. To address this, we introduce the "Haibu Mathematical-Medical Intelligent Agent" (MMIA), an LLM-driven architecture that ensures reliability through a formally verifiable reasoning process. MMIA recursively breaks down complex medical tasks into atomic, evidence-based steps. This entire reasoning chain is then automatically audited for logical coherence and evidence traceability, similar to theorem proving. A key innovation is MMIA's "bootstrapping" mode, which stores validated reasoning chains as "theorems." Subsequent tasks can then be efficiently solved using Retrieval-Augmented Generation (RAG), shifting from costly first-principles reasoning to a low-cost verification model. We validated MMIA across four healthcare administration domains, including DRG/DIP audits and medical insurance adjudication, using expert-validated benchmarks. Results showed MMIA achieved an error detection rate exceeding 98% with a false positive rate below 1%, significantly outperforming baseline LLMs. Furthermore, the RAG matching mode is projected to reduce average processing costs by approximately 85% as the knowledge base matures. In conclusion, MMIA's verifiable reasoning framework is a significant step toward creating trustworthy, transparent, and cost-effective AI systems, making LLM technology viable for critical applications in medicine.

Xinling Zhang, Xu Li, Ying Chen et al.

In this paper, a multi-scale framework with local region based active contour and boundary shape similarity constraint is proposed for the segmentation of levator hiatus in ultrasound images. In this paper, we proposed a multiscale active contour framework to segment levator hiatus ultrasound images by combining the local region information and boundary shape similarity constraint. In order to get more precisely initializations and reduce the computational cost, Gaussian pyramid method is used to decompose the image into coarse-to-fine scales. A localized region active contour model is firstly performed on the coarsest scale image to get a rough contour of the levator hiatus, then the segmentation result on the coarse scale is interpolated into the finer scale image as the initialization. The boundary shape similarity between different scales is incorporate into the local region based active contour model so that the result from coarse scale can guide the contour evolution at finer scale. By incorporating the multi-scale and boundary shape similarity, the proposed method can precisely locate the levator hiatus boundaries despite various ultrasound image artifacts. With a data set of 90 levator hiatus ultrasound images, the efficiency and accuracy of the proposed method are validated by quantitative and qualitative evaluations (TP, FP, Js) and comparison with other two state-of-art active contour segmentation methods (C-V model, DRLSE model).

Fang Lu, Fa Wu, Peijun Hu et al.

Purpose Segmentation of the liver from abdominal computed tomography (CT) image is an essential step in some computer assisted clinical interventions, such as surgery planning for living donor liver transplant (LDLT), radiotherapy and volume measurement. In this work, we develop a deep learning algorithm with graph cut refinement to automatically segment liver in CT scans. Methods The proposed method consists of two main steps: (i) simultaneously liver detection and probabilistic segmentation using 3D convolutional neural networks (CNNs); (ii) accuracy refinement of initial segmentation with graph cut and the previously learned probability map. Results The proposed approach was validated on forty CT volumes taken from two public databases MICCAI-Sliver07 and 3Dircadb. For the MICCAI-Sliver07 test set, the calculated mean ratios of volumetric overlap error (VOE), relative volume difference (RVD), average symmetric surface distance (ASD), root mean square symmetric surface distance (RMSD) and maximum symmetric surface distance (MSD) are 5.9%, 2.7%, 0.91%, 1.88 mm, and 18.94 mm, respectively. In the case of 20 3Dircadb data, the calculated mean ratios of VOE, RVD, ASD, RMSD and MSD are 9.36%, 0.97%, 1.89%, 4.15 mm and 33.14 mm, respectively. Conclusion The proposed method is fully automatic without any user interaction. Quantitative results reveal that the proposed approach is efficient and accurate for hepatic volume estimation in a clinical setup. The high correlation between the automatic and manual references shows that the proposed method can be good enough to replace the time-consuming and non-reproducible manual segmentation method.