Yuanfeng Ji

Jianning Li, Zongwei Zhou, Jiancheng Yang et al.

Prior to the deep learning era, shape was commonly used to describe the objects. Nowadays, state-of-the-art (SOTA) algorithms in medical imaging are predominantly diverging from computer vision, where voxel grids, meshes, point clouds, and implicit surface models are used. This is seen from numerous shape-related publications in premier vision conferences as well as the growing popularity of ShapeNet (about 51,300 models) and Princeton ModelNet (127,915 models). For the medical domain, we present a large collection of anatomical shapes (e.g., bones, organs, vessels) and 3D models of surgical instrument, called MedShapeNet, created to facilitate the translation of data-driven vision algorithms to medical applications and to adapt SOTA vision algorithms to medical problems. As a unique feature, we directly model the majority of shapes on the imaging data of real patients. As of today, MedShapeNet includes 23 dataset with more than 100,000 shapes that are paired with annotations (ground truth). Our data is freely accessible via a web interface and a Python application programming interface (API) and can be used for discriminative, reconstructive, and variational benchmarks as well as various applications in virtual, augmented, or mixed reality, and 3D printing. Exemplary, we present use cases in the fields of classification of brain tumors, facial and skull reconstructions, multi-class anatomy completion, education, and 3D printing. In future, we will extend the data and improve the interfaces. The project pages are: https://medshapenet.ikim.nrw/ and https://github.com/Jianningli/medshapenet-feedback

Yuanfeng Ji, Haotian Bai, Jie Yang et al.

Despite the considerable progress in automatic abdominal multi-organ segmentation from CT/MRI scans in recent years, a comprehensive evaluation of the models' capabilities is hampered by the lack of a large-scale benchmark from diverse clinical scenarios. Constraint by the high cost of collecting and labeling 3D medical data, most of the deep learning models to date are driven by datasets with a limited number of organs of interest or samples, which still limits the power of modern deep models and makes it difficult to provide a fully comprehensive and fair estimate of various methods. To mitigate the limitations, we present AMOS, a large-scale, diverse, clinical dataset for abdominal organ segmentation. AMOS provides 500 CT and 100 MRI scans collected from multi-center, multi-vendor, multi-modality, multi-phase, multi-disease patients, each with voxel-level annotations of 15 abdominal organs, providing challenging examples and test-bed for studying robust segmentation algorithms under diverse targets and scenarios. We further benchmark several state-of-the-art medical segmentation models to evaluate the status of the existing methods on this new challenging dataset. We have made our datasets, benchmark servers, and baselines publicly available, and hope to inspire future research. Information can be found at https://amos22.grand-challenge.org.

Yuanfeng Ji, Zhe Chen, Enze Xie et al.

We propose a simple, efficient, yet powerful framework for dense visual predictions based on the conditional diffusion pipeline. Our approach follows a "noise-to-map" generative paradigm for prediction by progressively removing noise from a random Gaussian distribution, guided by the image. The method, called DDP, efficiently extends the denoising diffusion process into the modern perception pipeline. Without task-specific design and architecture customization, DDP is easy to generalize to most dense prediction tasks, e.g., semantic segmentation and depth estimation. In addition, DDP shows attractive properties such as dynamic inference and uncertainty awareness, in contrast to previous single-step discriminative methods. We show top results on three representative tasks with six diverse benchmarks, without tricks, DDP achieves state-of-the-art or competitive performance on each task compared to the specialist counterparts. For example, semantic segmentation (83.9 mIoU on Cityscapes), BEV map segmentation (70.6 mIoU on nuScenes), and depth estimation (0.05 REL on KITTI). We hope that our approach will serve as a solid baseline and facilitate future research

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.

Yuanfeng Ji, Chongjian Ge, Weikai Kong et al.

With the advancements in Large Language Models (LLMs), Vision-Language Models (VLMs) have reached a new level of sophistication, showing notable competence in executing intricate cognition and reasoning tasks. However, existing evaluation benchmarks, primarily relying on rigid, hand-crafted datasets to measure task-specific performance, face significant limitations in assessing the alignment of these increasingly anthropomorphic models with human intelligence. In this work, we address the limitations via Auto-Bench, which delves into exploring LLMs as proficient aligners, measuring the alignment between VLMs and human intelligence and value through automatic data curation and assessment. Specifically, for data curation, Auto-Bench utilizes LLMs (e.g., GPT-4) to automatically generate a vast set of question-answer-reasoning triplets via prompting on visual symbolic representations (e.g., captions, object locations, instance relationships, and etc.). The curated data closely matches human intent, owing to the extensive world knowledge embedded in LLMs. Through this pipeline, a total of 28.5K human-verified and 3,504K unfiltered question-answer-reasoning triplets have been curated, covering 4 primary abilities and 16 sub-abilities. We subsequently engage LLMs like GPT-3.5 to serve as judges, implementing the quantitative and qualitative automated assessments to facilitate a comprehensive evaluation of VLMs. Our validation results reveal that LLMs are proficient in both evaluation data curation and model assessment, achieving an average agreement rate of 85%. We envision Auto-Bench as a flexible, scalable, and comprehensive benchmark for evaluating the evolving sophisticated VLMs.

Jinxi Xiang, Mingjie Li, Siyu Hou et al.

Accurate diagnosis and treatment of complex diseases require integrating histological, molecular, and clinical data, yet in practice these modalities are often incomplete owing to tissue scarcity, assay cost, and workflow constraints. Existing computational approaches attempt to impute missing modalities from available data but rely on task-specific models trained on narrow, single source-target pairs, limiting their generalizability. Here we introduce MuPD (Multimodal Pathology Diffusion), a generative foundation model that embeds hematoxylin and eosin (H&E)-stained histology, molecular RNA profiles, and clinical text into a shared latent space through a diffusion transformer with decoupled cross-modal attention. Pretrained on 100 million histology image patches, 1.6 million text-histology pairs, and 10.8 million RNA-histology pairs spanning 34 human organs, MuPD supports diverse cross-modal synthesis tasks with minimal or no task-specific fine-tuning. For text-conditioned and image-to-image generation, MuPD synthesizes histologically faithful tissue architectures, reducing Fréchet inception distance (FID) scores by 50% relative to domain-specific models and improving few-shot classification accuracy by up to 47% through synthetic data augmentation. For RNA-conditioned histology generation, MuPD reduces FID by 23% compared with the next-best method while preserving cell-type distributions across five cancer types. As a virtual stainer, MuPD translates H&E images to immunohistochemistry and multiplex immunofluorescence, improving average marker correlation by 37% over existing approaches. These results demonstrate that a single, unified generative model pretrained across heterogeneous pathology modalities can substantially outperform specialized alternatives, providing a scalable computational framework for multimodal histopathology.

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.

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.

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.

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.

Yuanfeng Ji, Lu Zhang, Jiaxiang Wu et al.

AI-aided drug discovery (AIDD) is gaining increasing popularity due to its promise of making the search for new pharmaceuticals quicker, cheaper and more efficient. In spite of its extensive use in many fields, such as ADMET prediction, virtual screening, protein folding and generative chemistry, little has been explored in terms of the out-of-distribution (OOD) learning problem with \emph{noise}, which is inevitable in real world AIDD applications. In this work, we present DrugOOD, a systematic OOD dataset curator and benchmark for AI-aided drug discovery, which comes with an open-source Python package that fully automates the data curation and OOD benchmarking processes. We focus on one of the most crucial problems in AIDD: drug target binding affinity prediction, which involves both macromolecule (protein target) and small-molecule (drug compound). In contrast to only providing fixed datasets, DrugOOD offers automated dataset curator with user-friendly customization scripts, rich domain annotations aligned with biochemistry knowledge, realistic noise annotations and rigorous benchmarking of state-of-the-art OOD algorithms. Since the molecular data is often modeled as irregular graphs using graph neural network (GNN) backbones, DrugOOD also serves as a valuable testbed for \emph{graph OOD learning} problems. Extensive empirical studies have shown a significant performance gap between in-distribution and out-of-distribution experiments, which highlights the need to develop better schemes that can allow for OOD generalization under noise for AIDD.

Lingyun Wu, Zhiqiang Hu, Yuanfeng Ji et al.

Precise localization of polyp is crucial for early cancer screening in gastrointestinal endoscopy. Videos given by endoscopy bring both richer contextual information as well as more challenges than still images. The camera-moving situation, instead of the common camera-fixed-object-moving one, leads to significant background variation between frames. Severe internal artifacts (e.g. water flow in the human body, specular reflection by tissues) can make the quality of adjacent frames vary considerately. These factors hinder a video-based model to effectively aggregate features from neighborhood frames and give better predictions. In this paper, we present Spatial-Temporal Feature Transformation (STFT), a multi-frame collaborative framework to address these issues. Spatially, STFT mitigates inter-frame variations in the camera-moving situation with feature alignment by proposal-guided deformable convolutions. Temporally, STFT proposes a channel-aware attention module to simultaneously estimate the quality and correlation of adjacent frames for adaptive feature aggregation. Empirical studies and superior results demonstrate the effectiveness and stability of our method. For example, STFT improves the still image baseline FCOS by 10.6% and 20.6% on the comprehensive F1-score of the polyp localization task in CVC-Clinic and ASUMayo datasets, respectively, and outperforms the state-of-the-art video-based method by 3.6% and 8.0%, respectively. Code is available at \url{https://github.com/lingyunwu14/STFT}.

Yuanfeng Ji, Ruimao Zhang, Huijie Wang et al.

The recent vision transformer(i.e.for image classification) learns non-local attentive interaction of different patch tokens. However, prior arts miss learning the cross-scale dependencies of different pixels, the semantic correspondence of different labels, and the consistency of the feature representations and semantic embeddings, which are critical for biomedical segmentation. In this paper, we tackle the above issues by proposing a unified transformer network, termed Multi-Compound Transformer (MCTrans), which incorporates rich feature learning and semantic structure mining into a unified framework. Specifically, MCTrans embeds the multi-scale convolutional features as a sequence of tokens and performs intra- and inter-scale self-attention, rather than single-scale attention in previous works. In addition, a learnable proxy embedding is also introduced to model semantic relationship and feature enhancement by using self-attention and cross-attention, respectively. MCTrans can be easily plugged into a UNet-like network and attains a significant improvement over the state-of-the-art methods in biomedical image segmentation in six standard benchmarks. For example, MCTrans outperforms UNet by 3.64%, 3.71%, 4.34%, 2.8%, 1.88%, 1.57% in Pannuke, CVC-Clinic, CVC-Colon, Etis, Kavirs, ISIC2018 dataset, respectively. Code is available at https://github.com/JiYuanFeng/MCTrans.

Tianbin Li, Yanzhou Su, Wei Li et al.

Despite significant advancements in general AI, its effectiveness in the medical domain is limited by the lack of specialized medical knowledge. To address this, we formulate GMAI-VL-5.5M, a multimodal medical dataset created by converting hundreds of specialized medical datasets with various annotations into high-quality image-text pairs. This dataset offers comprehensive task coverage, diverse modalities, and rich image-text data. Building upon this dataset, we develop GMAI-VL, a general medical vision-language model, with a three-stage training strategy that enhances the integration of visual and textual information. This approach significantly improves the model's ability to process multimodal data, supporting accurate diagnoses and clinical decision-making. Experiments show that GMAI-VL achieves state-of-the-art performance across various multimodal medical tasks, including visual question answering and medical image diagnosis.

Chongjian Ge, Chenfeng Xu, Yuanfeng Ji et al. · berkeley

Recent breakthroughs in text-guided image generation have significantly advanced the field of 3D generation. While generating a single high-quality 3D object is now feasible, generating multiple objects with reasonable interactions within a 3D space, a.k.a. compositional 3D generation, presents substantial challenges. This paper introduces CompGS, a novel generative framework that employs 3D Gaussian Splatting (GS) for efficient, compositional text-to-3D content generation. To achieve this goal, two core designs are proposed: (1) 3D Gaussians Initialization with 2D compositionality: We transfer the well-established 2D compositionality to initialize the Gaussian parameters on an entity-by-entity basis, ensuring both consistent 3D priors for each entity and reasonable interactions among multiple entities; (2) Dynamic Optimization: We propose a dynamic strategy to optimize 3D Gaussians using Score Distillation Sampling (SDS) loss. CompGS first automatically decomposes 3D Gaussians into distinct entity parts, enabling optimization at both the entity and composition levels. Additionally, CompGS optimizes across objects of varying scales by dynamically adjusting the spatial parameters of each entity, enhancing the generation of fine-grained details, particularly in smaller entities. Qualitative comparisons and quantitative evaluations on T3Bench demonstrate the effectiveness of CompGS in generating compositional 3D objects with superior image quality and semantic alignment over existing methods. CompGS can also be easily extended to controllable 3D editing, facilitating scene generation. We hope CompGS will provide new insights to the compositional 3D generation. Project page: https://chongjiange.github.io/compgs.html.

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.

Xiangde Luo, Xiyue Wang, Feyisope Eweje et al.

Histopathology is essential for disease diagnosis and treatment decision-making. Recent advances in artificial intelligence (AI) have enabled the development of pathology foundation models that learn rich visual representations from large-scale whole-slide images (WSIs). However, existing models are often trained on disparate datasets using varying strategies, leading to inconsistent performance and limited generalizability. Here, we introduce ELF (Ensemble Learning of Foundation models), a novel framework that integrates five state-of-the-art pathology foundation models to generate unified slide-level representations. Trained on 53,699 WSIs spanning 20 anatomical sites, ELF leverages ensemble learning to capture complementary information from diverse models while maintaining high data efficiency. Unlike traditional tile-level models, ELF's slide-level architecture is particularly advantageous in clinical contexts where data are limited, such as therapeutic response prediction. We evaluated ELF across a wide range of clinical applications, including disease classification, biomarker detection, and response prediction to major anticancer therapies, cytotoxic chemotherapy, targeted therapy, and immunotherapy, across multiple cancer types. ELF consistently outperformed all constituent foundation models and existing slide-level models, demonstrating superior accuracy and robustness. Our results highlight the power of ensemble learning for pathology foundation models and suggest ELF as a scalable and generalizable solution for advancing AI-assisted precision oncology.

Jin Ye, Ying Chen, Yanjun Li et al.

Computed Tomography (CT) is one of the most popular modalities for medical imaging. By far, CT images have contributed to the largest publicly available datasets for volumetric medical segmentation tasks, covering full-body anatomical structures. Large amounts of full-body CT images provide the opportunity to pre-train powerful models, e.g., STU-Net pre-trained in a supervised fashion, to segment numerous anatomical structures. However, it remains unclear in which conditions these pre-trained models can be transferred to various downstream medical segmentation tasks, particularly segmenting the other modalities and diverse targets. To address this problem, a large-scale benchmark for comprehensive evaluation is crucial for finding these conditions. Thus, we collected 87 public datasets varying in modality, target, and sample size to evaluate the transfer ability of full-body CT pre-trained models. We then employed a representative model, STU-Net with multiple model scales, to conduct transfer learning across modalities and targets. Our experimental results show that (1) there may be a bottleneck effect concerning the dataset size in fine-tuning, with more improvement on both small- and large-scale datasets than medium-size ones. (2) Models pre-trained on full-body CT demonstrate effective modality transfer, adapting well to other modalities such as MRI. (3) Pre-training on the full-body CT not only supports strong performance in structure detection but also shows efficacy in lesion detection, showcasing adaptability across target tasks. We hope that this large-scale open evaluation of transfer learning can direct future research in volumetric medical image segmentation.

Xiangde Luo, Jinxi Xiang, Yuanfeng Ji et al.

Computational pathology holds substantial promise for improving diagnosis and guiding treatment decisions. Recent pathology foundation models enable the extraction of rich patch-level representations from large-scale whole-slide images (WSIs), but current approaches for aggregating these features into slide-level predictions remain constrained by design limitations that hinder generalizability and reliability. Here, we developed nnMIL, a simple yet broadly applicable multiple-instance learning framework that connects patch-level foundation models to robust slide-level clinical inference. nnMIL introduces random sampling at both the patch and feature levels, enabling large-batch optimization, task-aware sampling strategies, and efficient and scalable training across datasets and model architectures. A lightweight aggregator performs sliding-window inference to generate ensemble slide-level predictions and supports principled uncertainty estimation. Across 40,000 WSIs encompassing 35 clinical tasks and four pathology foundation models, nnMIL consistently outperformed existing MIL methods for disease diagnosis, histologic subtyping, molecular biomarker detection, and pan- cancer prognosis prediction. It further demonstrated strong cross-model generalization, reliable uncertainty quantification, and robust survival stratification in multiple external cohorts. In conclusion, nnMIL offers a practical and generalizable solution for translating pathology foundation models into clinically meaningful predictions, advancing the development and deployment of reliable AI systems in real-world settings.

Yuanfeng Ji, Dan Lin, Xiyue Wang et al.

The scarcity of well-annotated diverse medical images is a major hurdle for developing reliable AI models in healthcare. Substantial technical advances have been made in generative foundation models for natural images. Here we develop `ChexGen', a generative vision-language foundation model that introduces a unified framework for text-, mask-, and bounding box-guided synthesis of chest radiographs. Built upon the latent diffusion transformer architecture, ChexGen was pretrained on the largest curated chest X-ray dataset to date, consisting of 960,000 radiograph-report pairs. ChexGen achieves accurate synthesis of radiographs through expert evaluations and quantitative metrics. We demonstrate the utility of ChexGen for training data augmentation and supervised pretraining, which led to performance improvements across disease classification, detection, and segmentation tasks using a small fraction of training data. Further, our model enables the creation of diverse patient cohorts that enhance model fairness by detecting and mitigating demographic biases. Our study supports the transformative role of generative foundation models in building more accurate, data-efficient, and equitable medical AI systems.

Liang Qiu, Wenhao Chi, Xiaohan Xing et al.

Precision therapy for liver cancer necessitates accurately delineating liver sub-regions to protect healthy tissue while targeting tumors, which is essential for reducing recurrence and improving survival rates. However, the segmentation of hepatic segments, known as Couinaud segmentation, is challenging due to indistinct sub-region boundaries and the need for extensive annotated datasets. This study introduces LiverFormer, a novel Couinaud segmentation model that effectively integrates global context with low-level local features based on a 3D hybrid CNN-Transformer architecture. Additionally, a registration-based data augmentation strategy is equipped to enhance the segmentation performance with limited labeled data. Evaluated on CT images from 123 patients, LiverFormer demonstrated high accuracy and strong concordance with expert annotations across various metrics, allowing for enhanced treatment planning for surgery and radiation therapy. It has great potential to reduces complications and minimizes potential damages to surrounding tissue, leading to improved outcomes for patients undergoing complex liver cancer treatments.

Yuanfeng Ji, Yatao Bian, Guoji Fu et al.

The regulation of various cellular processes heavily relies on the protein complexes within a living cell, necessitating a comprehensive understanding of their three-dimensional structures to elucidate the underlying mechanisms. While neural docking techniques have exhibited promising outcomes in binary protein docking, the application of advanced neural architectures to multimeric protein docking remains uncertain. This study introduces SyNDock, an automated framework that swiftly assembles precise multimeric complexes within seconds, showcasing performance that can potentially surpass or be on par with recent advanced approaches. SyNDock possesses several appealing advantages not present in previous approaches. Firstly, SyNDock formulates multimeric protein docking as a problem of learning global transformations to holistically depict the placement of chain units of a complex, enabling a learning-centric solution. Secondly, SyNDock proposes a trainable two-step SE(3) algorithm, involving initial pairwise transformation and confidence estimation, followed by global transformation synchronization. This enables effective learning for assembling the complex in a globally consistent manner. Lastly, extensive experiments conducted on our proposed benchmark dataset demonstrate that SyNDock outperforms existing docking software in crucial performance metrics, including accuracy and runtime. For instance, it achieves a 4.5% improvement in performance and a remarkable millionfold acceleration in speed.

Michela Antonelli, Annika Reinke, Spyridon Bakas et al.

International challenges have become the de facto standard for comparative assessment of image analysis algorithms given a specific task. Segmentation is so far the most widely investigated medical image processing task, but the various segmentation challenges have typically been organized in isolation, such that algorithm development was driven by the need to tackle a single specific clinical problem. We hypothesized that a method capable of performing well on multiple tasks will generalize well to a previously unseen task and potentially outperform a custom-designed solution. To investigate the hypothesis, we organized the Medical Segmentation Decathlon (MSD) - a biomedical image analysis challenge, in which algorithms compete in a multitude of both tasks and modalities. The underlying data set was designed to explore the axis of difficulties typically encountered when dealing with medical images, such as small data sets, unbalanced labels, multi-site data and small objects. The MSD challenge confirmed that algorithms with a consistent good performance on a set of tasks preserved their good average performance on a different set of previously unseen tasks. Moreover, by monitoring the MSD winner for two years, we found that this algorithm continued generalizing well to a wide range of other clinical problems, further confirming our hypothesis. Three main conclusions can be drawn from this study: (1) state-of-the-art image segmentation algorithms are mature, accurate, and generalize well when retrained on unseen tasks; (2) consistent algorithmic performance across multiple tasks is a strong surrogate of algorithmic generalizability; (3) the training of accurate AI segmentation models is now commoditized to non AI experts.

Yuanfeng Ji, Ruimao Zhang, Zhen Li et al.

Aggregating multi-level feature representation plays a critical role in achieving robust volumetric medical image segmentation, which is important for the auxiliary diagnosis and treatment. Unlike the recent neural architecture search (NAS) methods that typically searched the optimal operators in each network layer, but missed a good strategy to search for feature aggregations, this paper proposes a novel NAS method for 3D medical image segmentation, named UXNet, which searches both the scale-wise feature aggregation strategies as well as the block-wise operators in the encoder-decoder network. UXNet has several appealing benefits. (1) It significantly improves flexibility of the classical UNet architecture, which only aggregates feature representations of encoder and decoder in equivalent resolution. (2) A continuous relaxation of UXNet is carefully designed, enabling its searching scheme performed in an efficient differentiable manner. (3) Extensive experiments demonstrate the effectiveness of UXNet compared with recent NAS methods for medical image segmentation. The architecture discovered by UXNet outperforms existing state-of-the-art models in terms of Dice on several public 3D medical image segmentation benchmarks, especially for the boundary locations and tiny tissues. The searching computational complexity of UXNet is cheap, enabling to search a network with the best performance less than 1.5 days on two TitanXP GPUs.

Yuanfeng Ji, Hao Chen, Dan Lin et al.

Bone age is one of the most important indicators for assessing bone's maturity, which can help to interpret human's growth development level and potential progress. In the clinical practice, bone age assessment (BAA) of X-ray images requires the joint consideration of the appearance and location information of hand bones. These kinds of information can be effectively captured by the relation of different anatomical parts of hand bone. Recently developed methods differ mostly in how they model the part relation and choose useful parts for BAA. However, these methods neglect the mining of relationship among different parts, which can help to improve the assessment accuracy. In this paper, we propose a novel part relation module, which accurately discovers the underlying concurrency of parts by using multi-scale context information of deep learning feature representation. Furthermore, based on the part relation, we explore a new part selection module, which comprehensively measures the importance of parts and select the top ranking parts for assisting BAA. We jointly train our part relation and selection modules in an end-to-end way, achieving state-of-the-art performance on the public RSNA 2017 Pediatric Bone Age benchmark dataset and outperforming other competitive methods by a significant margin.