Zhen Chen

Qing Xu, Jiaxuan Li, Xiangjian He et al.

The universality of deep neural networks across different modalities and their generalization capabilities to unseen domains play an essential role in medical image segmentation. The recent segment anything model (SAM) has demonstrated strong adaptability across diverse natural scenarios. However, the huge computational costs, demand for manual annotations as prompts and conflict-prone decoding process of SAM degrade its generalization capabilities in medical scenarios. To address these limitations, we propose a modality-decoupled lightweight SAM for domain-generalized medical image segmentation, named De-LightSAM. Specifically, we first devise a lightweight domain-controllable image encoder (DC-Encoder) that produces discriminative visual features for diverse modalities. Further, we introduce the self-patch prompt generator (SP-Generator) to automatically generate high-quality dense prompt embeddings for guiding segmentation decoding. Finally, we design the query-decoupled modality decoder (QM-Decoder) that leverages a one-to-one strategy to provide an independent decoding channel for every modality, preventing mutual knowledge interference of different modalities. Moreover, we design a multi-modal decoupled knowledge distillation (MDKD) strategy to leverage robust common knowledge to complement domain-specific medical feature representations. Extensive experiments indicate that De-LightSAM outperforms state-of-the-arts in diverse medical imaging segmentation tasks, displaying superior modality universality and generalization capabilities. Especially, De-LightSAM uses only 2.0% parameters compared to SAM-H. The source code is available at https://github.com/xq141839/De-LightSAM.

Zhen Chen, Yihang Fu, Gabriel Madera et al.

Multi-modal large language models (MLLMs) have shown promise in advancing healthcare. However, most existing models remain confined to single-image understanding, which greatly limits their applicability in clinical workflows. In practice, medical diagnosis and progression often require synthesizing information across multiple images from different modalities or time points. The development of medical MLLMs capable of such multi-image understanding has been hindered by the lack of large-scale, high-quality annotated training data. To address this limitation, we propose a novel framework that leverages license-permissive compound images in biomedical literature, as a rich yet underutilized data source for multi-image analysis. Specifically, we design a five-stage, context-aware instruction generation paradigm underpinned by a divide-and-conquer strategy. By decomposing multi-image analysis into manageable sub-tasks, this paradigm empowers MLLMs to move beyond single-panel analysis and provide a composite understanding by learning the complex spatial, temporal, and cross-modal relationships inherent in these compound figures. By parsing over 237,000 compound figures and their contextual text for instruction generation, we develop M3LLM, a medical multi-image multi-modal large language model. For benchmarking, we construct PMC-MI-Bench for composite understanding, manually validated by medical experts. Extensive experiments show that M3LLM significantly outperforms both general-purpose and specialized medical MLLMs across multi-image, single-image, text-only, and multi-choice scenarios. Notably, M3LLM exhibits strong generalization to longitudinal chest X-ray analysis using the MIMIC dataset. This work establishes a scalable and efficient paradigm for developing medical MLLMs capable of composite reasoning, bridging the gap between biomedical literature and real-world clinical applications.