Zhenxuan Zhang

Zi Wang, Mingkai Huang, Zhang Shi et al.

Multimodal cardiovascular magnetic resonance (CMR) imaging provides comprehensive and non-invasive insights into cardiovascular disease (CVD) diagnosis and underlying mechanisms. Despite decades of advancements, its widespread clinical adoption remains constrained by prolonged scan times and heterogeneity across medical environments. This underscores the urgent need for a generalist reconstruction foundation model for ultra-fast CMR imaging, one capable of adapting across diverse imaging scenarios and serving as the essential substrate for all downstream analyses. To enable this goal, we curate MMCMR-427K, the largest and most comprehensive multimodal CMR k-space database to date, comprising 427,465 multi-coil k-space data paired with structured metadata across 13 international centers, 12 CMR modalities, 15 scanners, and 17 CVD categories in populations across three continents. Building on this unprecedented resource, we introduce CardioMM, a generalist reconstruction foundation model capable of dynamically adapting to heterogeneous fast CMR imaging scenarios. CardioMM unifies semantic contextual understanding with physics-informed data consistency to deliver robust reconstructions across varied scanners, protocols, and patient presentations. Comprehensive evaluations demonstrate that CardioMM achieves state-of-the-art performance in the internal centers and exhibits strong zero-shot generalization to unseen external settings. Even at imaging acceleration up to 24x, CardioMM reliably preserves key cardiac phenotypes, quantitative myocardial biomarkers, and diagnostic image quality, enabling a substantial increase in CMR examination throughput without compromising clinical integrity. Together, our open-access MMCMR-427K database and CardioMM framework establish a scalable pathway toward high-throughput, high-quality, and clinically accessible cardiovascular imaging.

Yuxia Wang, Zenan Zhai, Haonan Li et al.

Many studies have demonstrated that large language models (LLMs) can produce harmful responses, exposing users to unexpected risks when LLMs are deployed. Previous studies have proposed comprehensive taxonomies of the risks posed by LLMs, as well as corresponding prompts that can be used to examine the safety mechanisms of LLMs. However, the focus has been almost exclusively on English, and little has been explored for other languages. Here we aim to bridge this gap. We first introduce a dataset for the safety evaluation of Chinese LLMs, and then extend it to two other scenarios that can be used to better identify false negative and false positive examples in terms of risky prompt rejections. We further present a set of fine-grained safety assessment criteria for each risk type, facilitating both manual annotation and automatic evaluation in terms of LLM response harmfulness. Our experiments on five LLMs show that region-specific risks are the prevalent type of risk, presenting the major issue with all Chinese LLMs we experimented with. Our data is available at https://github.com/Libr-AI/do-not-answer. Warning: this paper contains example data that may be offensive, harmful, or biased.

Kinhei Lee, Peiyuan Jing, Zhenxuan Zhang et al.

Large scale vision language models have shown promise in automating chest Xray interpretation, yet their clinical utility remains limited by a gap between model outputs and radiologist reasoning. Most systems optimize for semantic information without emulating how experts visually examine medical images, often overlooking critical findings or diverging from established diagnostic workflows. Radiologists follow structured protocols (e.g., the ABCDEF approach) that ensure all clinically relevant regions are systematically examined, reducing missed findings and supporting reliable diagnostic reasoning. We introduce GazeX, a vision language model that leverages radiologists' eye tracking data as a behavioral prior to model expert diagnostic reasoning. By incorporating gaze trajectories and fixation patterns into pretraining, GazeX learns to follow the spatial and temporal structure of radiologist attention and integrates observations in a clinically meaningful sequence. Using a curated dataset of over 30,000 gaze key frames from five radiologists, we demonstrate that GazeX produces more accurate, interpretable, and expert consistent outputs across radiology report generation, disease grounding, and visual question answering, utilizing 231,835 radiographic studies, 780,014 question answer pairs, and 1,162 image sentence pairs with bounding boxes. Unlike autonomous reporting systems, GazeX produces verifiable evidence artifacts, including inspection trajectories and finding linked localized regions, enabling efficient human verification and safe human AI collaboration. Learning through expert eyes provides a practical route toward more trustworthy, explainable, and diagnostically robust AI systems for radiology and beyond.

Ruicheng Yuan, Zhenxuan Zhang, Anbang Wang et al.

Pathology reports are structured, multi-granular documents encoding diagnostic conclusions, histological grades, and ancillary test results across one or more anatomical sites; yet existing pathology vision-language models (VLMs) reduce this output to a flat label or free-form text. We present HiPath, a lightweight VLM framework built on frozen UNI2 and Qwen3 backbones that treats structured report prediction as its primary training objective. Three trainable modules totalling 15M parameters address complementary aspects of the problem: a Hierarchical Patch Aggregator (HiPA) for multi-image visual encoding, Hierarchical Contrastive Learning (HiCL) for cross-modal alignment via optimal transport, and Slot-based Masked Diagnosis Prediction (Slot-MDP) for structured diagnosis generation. Trained on 749K real-world Chinese pathology cases from three hospitals, HiPath achieves 68.9% strict and 74.7% clinically acceptable accuracy with a 97.3% safety rate, outperforming all baselines under the same frozen backbone. Cross-hospital evaluation confirms generalisation with only a 3.4pp drop in strict accuracy while maintaining 97.1% safety.

Haonan Li, Xudong Han, Zenan Zhai et al.

To address this gap, we introduce Libra-Leaderboard, a comprehensive framework designed to rank LLMs through a balanced evaluation of performance and safety. Combining a dynamic leaderboard with an interactive LLM arena, Libra-Leaderboard encourages the joint optimization of capability and safety. Unlike traditional approaches that average performance and safety metrics, Libra-Leaderboard uses a distance-to-optimal-score method to calculate the overall rankings. This approach incentivizes models to achieve a balance rather than excelling in one dimension at the expense of some other ones. In the first release, Libra-Leaderboard evaluates 26 mainstream LLMs from 14 leading organizations, identifying critical safety challenges even in state-of-the-art models.

Zenan Zhai, Hao Li, Xudong Han et al.

Recent advances in large language models (LLMs) have shown that they can answer questions requiring complex reasoning. However, their ability to identify and respond to text containing logical fallacies or deliberately misleading premises remains less studied. To address this gap, we introduce RuozhiBench, a bilingual dataset comprising 677 carefully curated questions that contain various forms of deceptive reasoning, meticulously crafted through extensive human effort and expert review. In a comprehensive evaluation of 17 LLMs from 5 Series over RuozhiBench using both open-ended and two-choice formats, we conduct extensive analyses on evaluation protocols and result patterns. Despite their high scores on conventional benchmarks, these models showed limited ability to detect and reason correctly about logical fallacies, with even the best-performing model, Claude-3-haiku, achieving only 62% accuracy compared to the human of more than 90%.

Peiyuan Jing, Kinhei Lee, Zhenxuan Zhang et al.

Radiology report generation is critical for efficiency but current models lack the structured reasoning of experts, hindering clinical trust and explainability by failing to link visual findings to precise anatomical locations. This paper introduces BoxMed-RL, a groundbreaking unified training framework for generating spatially verifiable and explainable radiology reports. Built on a large vision-language model, BoxMed-RL revolutionizes report generation through two integrated phases: (1) In the Pretraining Phase, we refine the model via medical concept learning, using Chain-of-Thought supervision to internalize the radiologist-like workflow, followed by spatially verifiable reinforcement, which applies reinforcement learning to align medical findings with bounding boxes. (2) In the Downstream Adapter Phase, we freeze the pretrained weights and train a downstream adapter to ensure fluent and clinically credible reports. This framework precisely mimics radiologists' workflow, compelling the model to connect high-level medical concepts with definitive anatomical evidence. Extensive experiments on public datasets demonstrate that BoxMed-RL achieves an average 7% improvement in both METEOR and ROUGE-L metrics compared to state-of-the-art methods. An average 5% improvement in large language model-based metrics further underscores BoxMed-RL's robustness in generating high-quality radiology reports.

Yingying Fang, Huichi Zhou, KinHei Lee et al.

Generating precise diagnostic reports from High-Resolution Computed Tomography (HRCT) is critical for clinical workflow, yet it remains a formidable challenge due to the high pathological diversity and spatial sparsity within 3D volumes. While Video Language Models (VideoLMs) have demonstrated remarkable spatio-temporal reasoning in general domains, their adaptability to domain-specific, high-volume medical interpretation remains underexplored. In this work, we present AbSteering, an abnormality-centric framework that steers VideoLMs toward precise HRCT report generation. Specifically, AbSteering introduces: (i) an abnormality-centric Chain-of-Thought scheme that enforces abnormality reasoning, and (ii) a Direct Preference Optimization objective that utilizes clinically confusable abnormalities as hard negatives to enhance fine-grained discrimination. Our results demonstrate that general-purpose VideoLMs possess strong transferability to high-volume medical imaging when guided by this paradigm. Notably, AbSteering outperforms state-of-the-art domain-specific CT foundation models, which are pretrained with large-scale CTs, achieving superior detection sensitivity while simultaneously mitigating hallucinations. Our data and model weights are released at https://anonymous.4open.science/r/hrct-report-generation-video-vlm-728C/

Congren Dai, Yue Yang, Krinos Li et al.

Understanding complete musical scores entails integrated reasoning over pitch, rhythm, harmony, and large-scale structure, yet the ability of Large Language Models and Vision-Language Models to interpret full musical notation remains insufficiently examined. We introduce the Musical Score Understanding Benchmark (MSU-Bench), the first large-scale, human-curated benchmark for score-level musical understanding across textual (ABC notation) and visual (PDF) modalities. MSU-Bench contains 1,800 generative Question-Answering pairs from works by Bach, Beethoven, Chopin, Debussy, and others, organised into four levels of increasing difficulty, ranging from onset information to texture and form. Evaluations of more than fifteen state-of-the-art models, in both zero-shot and fine-tuned settings, reveal pronounced modality gaps, unstable level-wise performance, and challenges in maintaining multilevel correctness. Fine-tuning substantially improves results across modalities while preserving general knowledge, positioning MSU-Bench as a robust foundation for future research in multimodal reasoning. To facilitate further research, we publicly release MSU-Bench and all associated resources.

Zhenxuan Zhang, Peiyuan Jing, Zi Wang et al.

Synthesizing high-quality images from low-field MRI holds significant potential. Low-field MRI is cheaper, more accessible, and safer, but suffers from low resolution and poor signal-to-noise ratio. This synthesis process can reduce reliance on costly acquisitions and expand data availability. However, synthesizing high-field MRI still suffers from a clinical fidelity gap. There is a need to preserve anatomical fidelity, enhance fine-grained structural details, and bridge domain gaps in image contrast. To address these issues, we propose a \emph{cyclic self-supervised diffusion (CSS-Diff)} framework for high-field MRI synthesis from real low-field MRI data. Our core idea is to reformulate diffusion-based synthesis under a cycle-consistent constraint. It enforces anatomical preservation throughout the generative process rather than just relying on paired pixel-level supervision. The CSS-Diff framework further incorporates two novel processes. The slice-wise gap perception network aligns inter-slice inconsistencies via contrastive learning. The local structure correction network enhances local feature restoration through self-reconstruction of masked and perturbed patches. Extensive experiments on cross-field synthesis tasks demonstrate the effectiveness of our method, achieving state-of-the-art performance (e.g., 31.80 $\pm$ 2.70 dB in PSNR, 0.943 $\pm$ 0.102 in SSIM, and 0.0864 $\pm$ 0.0689 in LPIPS). Beyond pixel-wise fidelity, our method also preserves fine-grained anatomical structures compared with the original low-field MRI (e.g., left cerebral white matter error drops from 12.1$\%$ to 2.1$\%$, cortex from 4.2$\%$ to 3.7$\%$). To conclude, our CSS-Diff can synthesize images that are both quantitatively reliable and anatomically consistent.

Zhenxuan Zhang, Lipei Zhang, Yanqi Cheng et al.

In motion-robust magnetic resonance imaging (MRI), slice-to-volume reconstruction is critical for recovering anatomically consistent 3D brain volumes from 2D slices, especially under accelerated acquisitions or patient motion. However, this task remains challenging due to hierarchical structural disruptions. It includes local detail loss from k-space undersampling, global structural aliasing caused by motion, and volumetric anisotropy. Therefore, we propose a progressive refinement implicit neural representation (PR-INR) framework. Our PR-INR unifies motion correction, structural refinement, and volumetric synthesis within a geometry-aware coordinate space. Specifically, a motion-aware diffusion module is first employed to generate coarse volumetric reconstructions that suppress motion artifacts and preserve global anatomical structures. Then, we introduce an implicit detail restoration module that performs residual refinement by aligning spatial coordinates with visual features. It corrects local structures and enhances boundary precision. Further, a voxel continuous-aware representation module represents the image as a continuous function over 3D coordinates. It enables accurate inter-slice completion and high-frequency detail recovery. We evaluate PR-INR on five public MRI datasets under various motion conditions (3% and 5% displacement), undersampling rates (4x and 8x) and slice resolutions (scale = 5). Experimental results demonstrate that PR-INR outperforms state-of-the-art methods in both quantitative reconstruction metrics and visual quality. It further shows generalization and robustness across diverse unseen domains.