Zhixuan Chen

Jiaxin Zhuang, Luyang Luo, Zhixuan Chen et al.

Deep-learning (DL) based methods are playing an important role in the task of abdominal organs and tumors segmentation in CT scans. However, the large requirements of annotated datasets heavily limit its development. The FLARE23 challenge provides a large-scale dataset with both partially and fully annotated data, which also focuses on both segmentation accuracy and computational efficiency. In this study, we propose to use the strategy of Semi-Supervised Learning (SSL) and iterative pseudo labeling to address FLARE23. Initially, a deep model (nn-UNet) trained on datasets with complete organ annotations (about 220 scans) generates pseudo labels for the whole dataset. These pseudo labels are then employed to train a more powerful segmentation model. Employing the FLARE23 dataset, our approach achieves an average DSC score of 89.63% for organs and 46.07% for tumors on online validation leaderboard. For organ segmentation, We obtain 0.9007\% DSC and 0.9493\% NSD. For tumor segmentation, we obtain 0.3785% DSC and 0.2842% NSD. Our code is available at https://github.com/USTguy/Flare23.

Jiayi Zhu, Fuxiang Huang, Yu Xie et al.

Breast cancer is a major global health concern, and mammography screening plays a central role in early detection. The large volume of screening examinations creates a substantial workload for radiologists, making accurate and consistent report generation a critical clinical challenge. Existing automated mammography report generation methods primarily focus on direct visual-to-text mapping, while overlooking the structured clinical reasoning process followed by radiologists in real-world practice. To address this limitation, we propose MammoRG, a mammography report generation framework that explicitly simulates the clinical reporting workflow by following the BI-RADS guideline and incorporating prior clinical knowledge to produce diagnostic reports. Specifically, MammoRG adopts a two-stage training framework. In the first stage, the model learns to integrate clinically relevant prior knowledge from a patient's four-view mammograms through classification-based supervision. In the second stage, a terminology-aware supervised fine-tuning strategy is introduced to model mammography-specific clinical terms as atomic semantic units, enabling the generation of high-quality reports with improved clinical consistency. To facilitate clinical efficacy evaluation of generated reports, we further develop MammoRGTool, a dedicated mammography report parsing tool that extracts structured clinical information from free-text reports. Extensive experiments demonstrate that MammoRG consistently outperforms existing methods across multiple clinical efficacy metrics, particularly in diagnosis-related BI-RADS F1, where it surpasses the second-best model by 2.73%, 2.04%, 1.90%, and 3.27% on the internal, external 1, external 2, and VinDr-Mammo datasets, respectively.

Zhengrui Guo, Zhengyu Zhang, Jiabo Ma et al.

Pathological assessment guides lung cancer diagnosis, treatment selection, and prognostic evaluation, yet current CPath approaches rely on task-specific models for isolated objectives. Although pan-cancer foundation models offer versatility, they lack subspecialty-level depth and have not been evaluated across clinical workflows or prospectively validated in real-world settings. We introduce PulmoFoundation, a multi-center, prospectively validated, randomized controlled trial (RCT)-evaluated foundation model for comprehensive lung pathology assessment across pre-operative, intra-operative, and post-operative care. Built upon Virchow2 via subspecialty-specific pretraining using ~40,000 diagnostic H&E-stained whole-slide images (WSIs), PulmoFoundation was systematically evaluated on ~26,000 WSIs across 32 clinically relevant tasks. In addition to accurately predicting molecular markers and patient survival, our model achieves clinical-grade performance in core diagnostic tasks across biopsy, frozen section, and surgical resection slides. In a registered prospective study of 1,357 patients across 11 diagnostic tasks, our model achieved an average AUC of 92.3%. Using pre-specified triage thresholds, PulmoFoundation could reduce additional second-review burden for 68.8% of biopsies and 83.0% of frozen sections, and defer 44.5% of IHC stain orders, with PPVs of 1.0, 0.991, and 0.966. Beyond prospective validation, we conducted a crossover RCT with eight pathologists, in which AI assistance improved diagnostic accuracy across 4,928 case-reader pairs (91.7% w/ AI vs. 83.8% w/o AI). AI assistance also reduced median diagnostic time by 19.6%, increased diagnostic confidence by 8.7%, and improved inter-rater agreement from moderate (kappa = 0.56) to substantial (kappa = 0.76). Together, these evaluations support PulmoFoundation as a clinically validated decision-support system for lung pathology.

Zhixiong Zhao, Zukang Xu, Zhixuan Chen et al.

Mixture-of-Experts (MoE) based large language models (LLMs) offer strong performance but suffer from high memory and computation costs. Weight binarization provides extreme efficiency, yet existing binary methods designed for dense LLMs struggle with MoE-specific issues, including cross-expert redundancy, task-agnostic importance estimation, and quantization-induced routing shifts. To this end, we propose MoBiE, the first binarization framework tailored for MoE-based LLMs. MoBiE is built on three core innovations: 1. using joint SVD decomposition to reduce cross-expert redundancy; 2. integrating global loss gradients into local Hessian metrics to enhance weight importance estimation; 3. introducing an error constraint guided by the input null space to mitigate routing distortion. Notably, MoBiE achieves these optimizations while incurring no additional storage overhead, striking a balance between efficiency and model performance. Extensive experiments demonstrate that MoBiE consistently outperforms state-of-the-art binary methods across multiple MoE-based LLMs and benchmarks. For example, on Qwen3-30B-A3B, MoBiE reduces perplexity by 52.2$\%$, improves average zero-shot performance by 43.4$\%$, achieves over 2 $\times$ inference speedup, and further shortens quantization time. The code is available at https://github.com/Kishon-zzx/MoBiE.

Xiying Zhao, Zhoufutu Wen, Zhixuan Chen et al.

The evaluation of discourse-level translation in expert domains remains inadequate, despite its centrality to knowledge dissemination and cross-lingual scholarly communication. While these translations demand discourse-level coherence and strict terminological precision, current evaluation methods predominantly focus on segment-level accuracy and fluency. To address this limitation, we introduce DiscoX, a new benchmark for discourse-level and expert-level Chinese-English translation. It comprises 200 professionally-curated texts from 7 domains, with an average length exceeding 1700 tokens. To evaluate performance on DiscoX, we also develop Metric-S, a reference-free system that provides fine-grained automatic assessments across accuracy, fluency, and appropriateness. Metric-S demonstrates strong consistency with human judgments, significantly outperforming existing metrics. Our experiments reveal a remarkable performance gap: even the most advanced LLMs still trail human experts on these tasks. This finding validates the difficulty of DiscoX and underscores the challenges that remain in achieving professional-grade machine translation. The proposed benchmark and evaluation system provide a robust framework for more rigorous evaluation, facilitating future advancements in LLM-based translation.

Sunan He, Yuxiang Nie, Hongmei Wang et al.

Generalist foundation models (GFMs) are renowned for their exceptional capability and flexibility in effectively generalizing across diverse tasks and modalities. In the field of medicine, while GFMs exhibit superior generalizability based on their extensive intrinsic knowledge as well as proficiency in instruction following and in-context learning, specialist models excel in precision due to their domain knowledge. In this work, for the first time, we explore the synergy between the GFM and specialist models, to enable precise medical image analysis on a broader scope. Specifically, we propose a cooperative framework, Generalist-Specialist Collaboration (GSCo), which consists of two stages, namely the construction of GFM and specialists, and collaborative inference on downstream tasks. In the construction stage, we develop MedDr, the largest open-source GFM tailored for medicine, showcasing exceptional instruction-following and in-context learning capabilities. Meanwhile, a series of lightweight specialists are crafted for downstream tasks with low computational cost. In the collaborative inference stage, we introduce two cooperative mechanisms, Mixture-of-Expert Diagnosis and Retrieval-Augmented Diagnosis, to harvest the generalist's in-context learning abilities alongside the specialists' domain expertise. For a comprehensive evaluation, we curate a large-scale benchmark featuring 28 datasets and about 250,000 images. Extensive results demonstrate that MedDr consistently outperforms state-of-the-art GFMs on downstream datasets. Furthermore, GSCo exceeds both GFMs and specialists across all out-of-domain disease diagnosis datasets. These findings indicate a significant paradigm shift in the application of GFMs, transitioning from separate models for specific tasks to a collaborative approach between GFMs and specialists, thereby advancing the frontiers of generalizable AI in medicine.

Zhixuan Chen, Yequan Bie, Haibo Jin et al.

Computed tomography (CT) report generation is crucial to assist radiologists in interpreting CT volumes, which can be time-consuming and labor-intensive. Existing methods primarily only consider the global features of the entire volume, making it struggle to focus on specific regions and potentially missing abnormalities. To address this issue, we propose Reg2RG, the first region-guided referring and grounding framework for CT report generation, which enhances diagnostic performance by focusing on anatomical regions within the volume. Specifically, we utilize masks from a universal segmentation module to capture local features for each referring region. A local feature decoupling (LFD) strategy is proposed to preserve the local high-resolution details with little computational overhead. Then the local features are integrated with global features to capture inter-regional relationships within a cohesive context. Moreover, we propose a novel region-report alignment (RRA) training strategy. It leverages the recognition of referring regions to guide the generation of region-specific reports, enhancing the model's referring and grounding capabilities while also improving the report's interpretability. A large language model (LLM) is further employed as the language decoder to generate reports from integrated visual features, facilitating region-level comprehension. Extensive experiments on two large-scale chest CT-report datasets demonstrate the superiority of our method, which outperforms several state-of-the-art methods in terms of both natural language generation and clinical efficacy metrics while preserving promising interpretability. The code is available at https://github.com/zhi-xuan-chen/Reg2RG.

Zukang Xu, Zhixiong Zhao, Xing Hu et al.

Mixture of Experts (MoE) models have achieved great success by significantly improving performance while maintaining computational efficiency through sparse expert activation. However, their enormous parameter sizes and memory demands pose major challenges for deployment in resource-constrained environments. Vector Quantization (VQ) offers a promising approach for ultra-low-bit compression in Large Language Models (LLMs) by leveraging a codebook, where weight vectors are mapped to the most similar discrete codewords. Yet, directly applying VQ to MoEs often leads to substantial performance degradation due to two critical obstacles: (1) redundant representations among experts cause VQ to repeatedly quantize similar representations for each expert, resulting in inefficient use of limited codebook capacity; and (2) cumulative output bias is amplified by expert aggregation in MoE layers, leading to distributional shifts in the quantized outputs. To address these issues, we propose KBVQ-MoE, a novel VQ framework to enhance extremely low-bit quantization for MoE-based LLMs. KBVQ-MoE integrates two techniques: (1) input-driven redundancy elimination, where a Karhunen-Loeve Transform (KLT) guided singular value decomposition (SVD) extracts dominant weight components and shares them across experts; and (2) bias-corrected output stabilization, where vector quantization is applied only to expert-specific (non-redundant) representations and the quantized outputs are corrected via channel-wise affine compensation. Experiments on various MoE LLMs demonstrate that KBVQ-MoE preserves accuracy substantially better than existing quantization methods. For example, 3-bit quantization of Qwen1.5-MoE-A2.7B achieves an average accuracy of 67.99, nearly identical to the FP16 baseline of 68.07, underscoring KBVQ-MoE's potential for efficient deployment on edge devices and other resource-constrained platforms.

Xing Hu, Dawei Yang, Yuan Cheng et al.

The rapid growth in the parameter scale of large language models (LLMs) has created a high demand for efficient compression techniques. As a hardware-agnostic and highly compatible technique, low-rank compression has been widely adopted. However, existing methods typically compress each layer independently by minimizing per-layer reconstruction error, overlooking a critical limitation: the reconstruction error propagates and accumulates through the network, which leads to amplified global deviations from the full-precision baseline. To address this, we propose Self-Adaptive Error Suppression SVD (SAES-SVD), a LLMs compression framework that jointly optimizes intra-layer reconstruction and inter-layer error compensation. SAES-SVD is composed of two novel components: (1) Cumulative Error-Aware Layer Compression (CEALC), which formulates the compression objective as a combination of local reconstruction and weighted cumulative error compensation. Based on it, we derive a closed-form low-rank solution relied on second-order activation statistics, which explicitly aligns each layer's output with its full-precision counterpart to compensate for accumulated errors. (2) Adaptive Collaborative Error Suppression (ACES), which automatically adjusts the weighting coefficient to enhance the low-rank structure of the compression objective in CEALC. Specifically, the coefficient is optimized to maximize the ratio between the Frobenius norm of the compressed layer's output and that of the compression objective under a fixed rank, thus ensuring that the rank budget is utilized effectively. Extensive experiments across multiple LLM architectures and tasks show that, without fine-tuning or mixed-rank strategies, SAES-SVD consistently improves post-compression performance.

Zhixuan Chen, Luyang Luo, Yequan Bie et al.

Medical report generation has achieved remarkable advancements yet has still been faced with several challenges. First, the inherent imbalance in the distribution of normal and abnormal cases may lead models to exhibit a biased focus on normal samples, resulting in unreliable diagnoses. Second, the frequent occurrence of common template sentences in the reports may overwhelm the critical abnormal information. Moreover, existing works focus on 2D chest X-rays, leaving CT report generation underexplored due to the high-dimensional nature of CT images and the limited availability of CT-report pairs. Recently, LLM has shown a great ability to generate reliable answers with appropriate prompts, which shed light on addressing the aforementioned challenges. In this paper, we propose Dia-LLaMA, a framework to adapt the LLaMA2-7B for CT report generation by incorporating diagnostic information as guidance prompts. Considering the high dimension of CT, we leverage a pre-trained ViT3D with perceiver to extract the visual information. To tailor the LLM for report generation and emphasize abnormality, we extract additional diagnostic information by referring to a disease prototype memory bank, which is updated during training to capture common disease representations. Furthermore, we introduce disease-aware attention to enable the model to adjust attention for different diseases. Experiments on the chest CT dataset demonstrated that our proposed method outperformed previous methods and achieved state-of-the-art on both clinical efficacy performance and natural language generation metrics. The code will be made publically available.

Zukang Xu, Yuxuan Yue, Xing Hu et al.

Mamba is an efficient sequence model that rivals Transformers and demonstrates significant potential as a foundational architecture for various tasks. Quantization is commonly used in neural networks to reduce model size and computational latency. However, applying quantization to Mamba remains underexplored, and existing quantization methods, which have been effective for CNN and Transformer models, appear inadequate for Mamba models (e.g., Quarot suffers a 21% accuracy drop on Vim-T$^\dagger$ even under W8A8). We have pioneered the exploration of this issue and identified several key challenges. First, significant outliers are present in gate projections, output projections, and matrix multiplications. Second, Mamba's unique parallel scan further amplifies these outliers, leading to uneven and heavy-tailed data distributions. Third, even with the application of the Hadamard transform, the variance across channels in weights and activations still remains inconsistent. To these ends, we propose MambaQuant, a post-training quantization (PTQ) framework consisting of: 1) Karhunen-Loeve Transformation (KLT) enhanced rotation, rendering the rotation matrix adaptable to diverse channel distributions. 2) Smooth-Fused rotation, which equalizes channel variances and can merge additional parameters into model weights. Experiments show that MambaQuant can quantize both weights and activations into 8-bit with less than 1% accuracy loss for Mamba-based vision and language tasks. To the best of our knowledge, MambaQuant is the first comprehensive PTQ design for the Mamba family, paving the way for further advancements in its application.

Xing Hu, Zhixuan Chen, Dawei Yang et al.

Mixture-of-Experts (MoE) large language models (LLMs), which leverage dynamic routing and sparse activation to enhance efficiency and scalability, have achieved higher performance while reducing computational costs. However, these models face significant memory overheads, limiting their practical deployment and broader adoption. Post-training quantization (PTQ), a widely used method for compressing LLMs, encounters severe accuracy degradation and diminished generalization performance when applied to MoE models. This paper investigates the impact of MoE's sparse and dynamic characteristics on quantization and identifies two primary challenges: (1) Inter-expert imbalance, referring to the uneven distribution of samples across experts, which leads to insufficient and biased calibration for less frequently utilized experts; (2) Intra-expert imbalance, arising from MoE's unique aggregation mechanism, which leads to varying degrees of correlation between different samples and their assigned experts. To address these challenges, we propose MoEQuant, a novel quantization framework tailored for MoE LLMs. MoE-Quant includes two novel techniques: 1) Expert-Balanced Self-Sampling (EBSS) is an efficient sampling method that efficiently constructs a calibration set with balanced expert distributions by leveraging the cumulative probabilities of tokens and expert balance metrics as guiding factors. 2) Affinity-Guided Quantization (AGQ), which incorporates affinities between experts and samples into the quantization process, thereby accurately assessing the impact of individual samples on different experts within the MoE layer. Experiments demonstrate that MoEQuant achieves substantial performance gains (more than 10 points accuracy gain in the HumanEval for DeepSeekMoE-16B under 4-bit quantization) and boosts efficiency.

Zhixuan Chen, Junlin Hou, Liqi Lin et al.

Pathology image segmentation is crucial in computational pathology for analyzing histological features relevant to cancer diagnosis and prognosis. However, current methods face major challenges in clinical applications due to limited annotated data and restricted category definitions. To address these limitations, we propose PathSegmentor, the first text-prompted segmentation foundation model designed specifically for pathology images. We also introduce PathSeg, the largest and most comprehensive dataset for pathology segmentation, built from 21 public sources and containing 275k image-mask-label triples across 160 diverse categories. With PathSegmentor, users can perform semantic segmentation using natural language prompts, eliminating the need for laborious spatial inputs such as points or boxes. Extensive experiments demonstrate that PathSegmentor outperforms specialized models with higher accuracy and broader applicability, while maintaining a compact architecture. It significantly surpasses existing spatial- and text-prompted models by 0.145 and 0.429 in overall Dice scores, respectively, showing strong robustness in segmenting complex structures and generalizing to external datasets. Moreover, PathSegmentor's outputs enhance the interpretability of diagnostic models through feature importance estimation and imaging biomarker discovery, offering pathologists evidence-based support for clinical decision-making. This work advances the development of explainable AI in precision oncology.

Chen Xu, Yuxuan Yue, Zukang Xu et al.

RWKV is a modern RNN architecture with comparable performance to Transformer, but still faces challenges when deployed to resource-constrained devices. Post Training Quantization (PTQ), which is a an essential technique to reduce model size and inference latency, has been widely used in Transformer models. However, it suffers significant degradation of performance when applied to RWKV. This paper investigates and identifies two key constraints inherent in the properties of RWKV: (1) Non-linear operators hinder the parameter-fusion of both smooth- and rotation-based quantization, introducing extra computation overhead. (2) The larger amount of uniformly distributed weights poses challenges for cluster-based quantization, leading to reduced accuracy. To this end, we propose RWKVQuant, a PTQ framework tailored for RWKV models, consisting of two novel techniques: (1) a coarse-to-fine proxy capable of adaptively selecting different quantization approaches by assessing the uniformity and identifying outliers in the weights, and (2) a codebook optimization algorithm that enhances the performance of cluster-based quantization methods for element-wise multiplication in RWKV. Experiments show that RWKVQuant can quantize RWKV-6-14B into about 3-bit with less than 1% accuracy loss and 2.14x speed up.

Yuxiang Nie, Sunan He, Yequan Bie et al.

The clinical adoption of artificial intelligence (AI) in medical imaging requires models that are both diagnostically accurate and interpretable to clinicians. While current multimodal biomedical foundation models prioritize performance, their black-box nature hinders explaining the decision-making process in clinically meaningful concepts. Here, we present ConceptCLIP, the first explainable biomedical foundation model that achieves state-of-the-art diagnostic accuracy while delivering human-interpretable explanations across diverse imaging modalities. We curate MedConcept-23M, the largest pre-training dataset comprising 23 million image-text-concept triplets across diverse medical modalities, where clinical concepts are derived from the Unified Medical Language System. Leveraging this dataset, we develop ConceptCLIP through a novel dual-alignment approach that simultaneously learns global image-text representations and fine-grained region-concept associations for precise and interpretable medical image analysis. We curate the most extensive evaluation benchmark for multimodal biomedical foundation models, covering 52 clinical tasks spanning 10 imaging modalities. Extensive experiments demonstrate that ConceptCLIP outperforms existing state-of-the-art multimodal biomedical foundation models. Importantly, ConceptCLIP demonstrates superior diagnostic performance while providing human-understandable explanations validated by clinical experts. As the first precise and interpretable biomedical foundation model, ConceptCLIP represents a critical milestone toward the widespread clinical adoption of AI, thereby advancing trustworthy AI in medicine.

Shaoyuan Chen, Zhixuan Chen, Dawei Yang et al.

Large Language Models (LLMs) fine-tuning techniques not only improve the adaptability to diverse downstream tasks, but also mitigate adverse effects of model quantization. Despite this, conventional quantization suffers from its structural limitation that hinders flexibility during the fine-tuning and deployment stages. Practical on-device tasks demand different quantization precisions (i.e. different bit-widths), e.g., understanding tasks tend to exhibit higher tolerance to reduced precision compared to generation tasks. Conventional quantization, typically relying on scaling factors that are incompatible across bit-widths, fails to support the on-device switching of precisions when confronted with complex real-world scenarios. To overcome the dilemma, we propose OTARo, a novel method that enables on-device LLMs to flexibly switch quantization precisions while maintaining performance robustness through once fine-tuning. OTARo introduces Shared Exponent Floating Point (SEFP), a distinct quantization mechanism, to produce different bit-widths through simple mantissa truncations of a single model. Moreover, to achieve bit-width robustness in downstream applications, OTARo performs a learning process toward losses induced by different bit-widths. The method involves two critical strategies: (1) Exploitation-Exploration Bit-Width Path Search (BPS), which iteratively updates the search path via a designed scoring mechanism; (2) Low-Precision Asynchronous Accumulation (LAA), which performs asynchronous gradient accumulations and delayed updates under low bit-widths. Experiments on popular LLMs, e.g., LLaMA3.2-1B, LLaMA3-8B, demonstrate that OTARo achieves consistently strong and robust performance for all precisions.

Fuxiang Huang, Jiayi Zhu, Yunfang Yu et al.

Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer-related mortality in women globally. Mammography is essential for the early detection and diagnosis of breast lesions. Despite recent progress in foundation models (FMs) for mammogram analysis, their clinical translation remains constrained by several fundamental limitations, including insufficient diversity in training data, limited model generalizability, and a lack of comprehensive evaluation across clinically relevant tasks. Here, we introduce VersaMammo, a versatile foundation model for mammograms, designed to overcome these limitations. We curated the largest multi-institutional mammogram dataset to date, comprising 706,239 images from 21 sources. To improve generalization, we propose a two-stage pre-training strategy to develop VersaMammo, a mammogram foundation model. First, a teacher model is trained via self-supervised learning to extract transferable features from unlabeled mammograms. Then, supervised learning combined with knowledge distillation transfers both features and clinical knowledge into VersaMammo. To ensure a comprehensive evaluation, we established a benchmark comprising 92 specific tasks, including 68 internal tasks and 24 external validation tasks, spanning 5 major clinical task categories: lesion detection, segmentation, classification, image retrieval, and visual question answering. VersaMammo achieves state-of-the-art performance, ranking first in 50 out of 68 specific internal tasks and 20 out of 24 external validation tasks, with average ranks of 1.5 and 1.2, respectively. These results demonstrate its superior generalization and clinical utility, offering a substantial advancement toward reliable and scalable breast cancer screening and diagnosis.

Shuting Xu, Runtong Liu, Zhixuan Chen et al.

Deep learning has driven significant advances in mitotic figure analysis within computational pathology. In this paper, we present our approach to the Mitosis Domain Generalization (MIDOG) 2025 Challenge, which consists of two distinct tasks, i.e., mitotic figure detection and atypical mitosis classification. For the mitotic figure detection task, we propose a two-stage detection-classification framework that first localizes candidate mitotic figures and subsequently refines the predictions using a dedicated classification module. For the atypical mitosis classification task, we employ an ensemble strategy that integrates predictions from multiple state-of-the-art deep learning architectures to improve robustness and accuracy. Extensive experiments demonstrate the effectiveness of our proposed methods across both tasks.

Zhe Xu, Ziyi Liu, Junlin Hou et al.

Multimodal large language models (MLLMs) have emerged as powerful tools for computational pathology, offering unprecedented opportunities to integrate pathological images with language context for comprehensive diagnostic analysis. These models hold particular promise for automating complex tasks that traditionally require expert interpretation of pathologists. However, current MLLM approaches in pathology demonstrate significantly constrained reasoning capabilities, primarily due to their reliance on expensive chain-of-thought annotations. Additionally, existing methods remain limited to simplex application of visual question answering (VQA) at the region-of-interest (ROI) level, failing to address the full spectrum of diagnostic needs such as ROI classification, detection, segmentation, whole-slide-image (WSI) classification and VQA in clinical practice. In this study, we present SmartPath-R1, a versatile MLLM capable of simultaneously addressing both ROI-level and WSI-level tasks while demonstrating robust pathological reasoning capability. Our framework combines scale-dependent supervised fine-tuning and task-aware reinforcement fine-tuning, which circumvents the requirement for chain-of-thought supervision by leveraging the intrinsic knowledge within MLLM. Furthermore, SmartPath-R1 integrates multiscale and multitask analysis through a mixture-of-experts mechanism, enabling dynamic processing for diverse tasks. We curate a large-scale dataset comprising 2.3M ROI samples and 188K WSI samples for training and evaluation. Extensive experiments across 72 tasks validate the effectiveness and superiority of the proposed approach. This work represents a significant step toward developing versatile, reasoning-enhanced AI systems for precision pathology.

Yequan Bie, Luyang Luo, Zhixuan Chen et al.

Utilizing potent representations of the large vision-language models (VLMs) to accomplish various downstream tasks has attracted increasing attention. Within this research field, soft prompt learning has become a representative approach for efficiently adapting VLMs such as CLIP, to tasks like image classification. However, most existing prompt learning methods learn text tokens that are unexplainable, which cannot satisfy the stringent interpretability requirements of Explainable Artificial Intelligence (XAI) in high-stakes scenarios like healthcare. To address this issue, we propose a novel explainable prompt learning framework that leverages medical knowledge by aligning the semantics of images, learnable prompts, and clinical concept-driven prompts at multiple granularities. Moreover, our framework addresses the lack of valuable concept annotations by eliciting knowledge from large language models and offers both visual and textual explanations for the prompts. Extensive experiments and explainability analyses conducted on various datasets, with and without concept labels, demonstrate that our method simultaneously achieves superior diagnostic performance, flexibility, and interpretability, shedding light on the effectiveness of foundation models in facilitating XAI. The code will be made publically available.