Daily Papers

Recent Learned image compression (LIC) leverages Mamba-style state-space models (SSMs) for global receptive fields with linear complexity. However, vanilla Mamba is content-agnostic, relying on fixed and predefined selective scans, which restricts its ability to dynamically and fully exploit content dependencies. We introduce Content-Adaptive Mamba (CAM), a dynamic SSM that addresses two critical limitations. First, it employs content-aware token reorganization, clustering and reordering tokens based on content similarity to prioritize proximity in feature space over Euclidean space. Second, it integrates global priors into SSM via a prompt dictionary, effectively mitigating the strict causality and long-range decay in the token interactions of Mamba. These innovations enable CAM to better capture global dependencies while preserving computational efficiency. Leveraging CAM, our Content-Adaptive Mamba-based LIC model (CMIC) achieves state-of-the-art rate-distortion performance, surpassing VTM-21.0 by -15.91\%, -21.34\%, and -17.58\% BD-rate on Kodak, Tecnick, and CLIC benchmarks, respectively.

Video anomaly detection (VAD) methods are mostly CNN-based or Transformer-based, achieving impressive results, but the focus on detection accuracy often comes at the expense of inference speed. The emergence of state space models in computer vision, exemplified by the Mamba model, demonstrates improved computational efficiency through selective scans and showcases the great potential for long-range modeling. Our study pioneers the application of Mamba to VAD, dubbed VADMamba, which is based on multi-task learning for frame prediction and optical flow reconstruction. Specifically, we propose the VQ-Mamba Unet (VQ-MaU) framework, which incorporates a Vector Quantization (VQ) layer and Mamba-based Non-negative Visual State Space (NVSS) block. Furthermore, two individual VQ-MaU networks separately predict frames and reconstruct corresponding optical flows, further boosting accuracy through a clip-level fusion evaluation strategy. Experimental results validate the efficacy of the proposed VADMamba across three benchmark datasets, demonstrating superior performance in inference speed compared to previous work. Code is available at https://github.com/jLooo/VADMamba.

Liver Cirrhosis plays a critical role in the prognosis of chronic liver disease. Early detection and timely intervention are critical in significantly reducing mortality rates. However, the intricate anatomical architecture and diverse pathological changes of liver tissue complicate the accurate detection and characterization of lesions in clinical settings. Existing methods underutilize the spatial anatomical details in volumetric MRI data, thereby hindering their clinical effectiveness and explainability. To address this challenge, we introduce a novel Mamba-based network, SRMA-Mamba, designed to model the spatial relationships within the complex anatomical structures of MRI volumes. By integrating the Spatial Anatomy-Based Mamba module (SABMamba), SRMA-Mamba performs selective Mamba scans within liver cirrhotic tissues and combines anatomical information from the sagittal, coronal, and axial planes to construct a global spatial context representation, enabling efficient volumetric segmentation of pathological liver structures. Furthermore, we introduce the Spatial Reverse Attention module (SRMA), designed to progressively refine cirrhotic details in the segmentation map, utilizing both the coarse segmentation map and hierarchical encoding features. Extensive experiments demonstrate that SRMA-Mamba surpasses state-of-the-art methods, delivering exceptional performance in 3D pathological liver segmentation. Our code is available for public: https://github.com/JunZengz/SRMA-Mamba.

Video Question Answering (VQA) in long videos poses the key challenge of extracting relevant information and modeling long-range dependencies from many redundant frames. The self-attention mechanism provides a general solution for sequence modeling, but it has a prohibitive cost when applied to a massive number of spatiotemporal tokens in long videos. Most prior methods rely on compression strategies to lower the computational cost, such as reducing the input length via sparse frame sampling or compressing the output sequence passed to the large language model (LLM) via space-time pooling. However, these naive approaches over-represent redundant information and often miss salient events or fast-occurring space-time patterns. In this work, we introduce BIMBA, an efficient state-space model to handle long-form videos. Our model leverages the selective scan algorithm to learn to effectively select critical information from high-dimensional video and transform it into a reduced token sequence for efficient LLM processing. Extensive experiments demonstrate that BIMBA achieves state-of-the-art accuracy on multiple long-form VQA benchmarks, including PerceptionTest, NExT-QA, EgoSchema, VNBench, LongVideoBench, and Video-MME. Code, and models are publicly available at https://sites.google.com/view/bimba-mllm.

Prior efforts in light-weight model development mainly centered on CNN and Transformer-based designs yet faced persistent challenges. CNNs adept at local feature extraction compromise resolution while Transformers offer global reach but escalate computational demands O(N^2). This ongoing trade-off between accuracy and efficiency remains a significant hurdle. Recently, state space models (SSMs), such as Mamba, have shown outstanding performance and competitiveness in various tasks such as language modeling and computer vision, while reducing the time complexity of global information extraction to O(N). Inspired by this, this work proposes to explore the potential of visual state space models in light-weight model design and introduce a novel efficient model variant dubbed EfficientVMamba. Concretely, our EfficientVMamba integrates a atrous-based selective scan approach by efficient skip sampling, constituting building blocks designed to harness both global and local representational features. Additionally, we investigate the integration between SSM blocks and convolutions, and introduce an efficient visual state space block combined with an additional convolution branch, which further elevate the model performance. Experimental results show that, EfficientVMamba scales down the computational complexity while yields competitive results across a variety of vision tasks. For example, our EfficientVMamba-S with 1.3G FLOPs improves Vim-Ti with 1.5G FLOPs by a large margin of 5.6% accuracy on ImageNet. Code is available at: https://github.com/TerryPei/EfficientVMamba.

Recent advancements in state space models, notably Mamba, have demonstrated significant progress in modeling long sequences for tasks like language understanding. Yet, their application in vision tasks has not markedly surpassed the performance of traditional Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs). This paper posits that the key to enhancing Vision Mamba (ViM) lies in optimizing scan directions for sequence modeling. Traditional ViM approaches, which flatten spatial tokens, overlook the preservation of local 2D dependencies, thereby elongating the distance between adjacent tokens. We introduce a novel local scanning strategy that divides images into distinct windows, effectively capturing local dependencies while maintaining a global perspective. Additionally, acknowledging the varying preferences for scan patterns across different network layers, we propose a dynamic method to independently search for the optimal scan choices for each layer, substantially improving performance. Extensive experiments across both plain and hierarchical models underscore our approach's superiority in effectively capturing image representations. For example, our model significantly outperforms Vim-Ti by 3.1% on ImageNet with the same 1.5G FLOPs. Code is available at: https://github.com/hunto/LocalMamba.

Establishing semantic correspondences between images is a fundamental yet challenging task in computer vision. Traditional feature-metric methods enhance visual features but may miss complex inter-correlation relationships, while recent correlation-metric approaches are hindered by high computational costs due to processing 4D correlation maps. We introduce MambaMatcher, a novel method that overcomes these limitations by efficiently modeling high-dimensional correlations using selective state-space models (SSMs). By implementing a similarity-aware selective scan mechanism adapted from Mamba's linear-complexity algorithm, MambaMatcher refines the 4D correlation map effectively without compromising feature map resolution or receptive field. Experiments on standard semantic correspondence benchmarks demonstrate that MambaMatcher achieves state-of-the-art performance.

Recently, a novel visual state space (VSS) model, referred to as Mamba, has demonstrated significant progress in modeling long sequences with linear complexity, comparable to Transformer models, thereby enhancing its adaptability for processing visual data. Although most methods aim to enhance the global receptive field by directly modifying Mamba's scanning mechanism, they tend to overlook the critical importance of local information in dense prediction tasks. Additionally, whether Mamba can effectively extract local features as convolutional neural networks (CNNs) do remains an open question that merits further investigation. In this paper, We propose a novel model, AtrousMamba, which effectively balances the extraction of fine-grained local details with the integration of global contextual information. Specifically, our method incorporates an atrous-window selective scan mechanism, enabling a gradual expansion of the scanning range with adjustable rates. This design shortens the distance between adjacent tokens, enabling the model to effectively capture fine-grained local features and global context. By leveraging the atrous window scan visual state space (AWVSS) module, we design dedicated end-to-end Mamba-based frameworks for binary change detection (BCD) and semantic change detection (SCD), referred to as AWMambaBCD and AWMambaSCD, respectively. Experimental results on six benchmark datasets show that the proposed framework outperforms existing CNN-based, Transformer-based, and Mamba-based methods. These findings clearly demonstrate that Mamba not only captures long-range dependencies in visual data but also effectively preserves fine-grained local details.

Few-shot class-incremental learning (FSCIL) confronts the challenge of integrating new classes into a model with minimal training samples while preserving the knowledge of previously learned classes. Traditional methods widely adopt static adaptation relying on a fixed parameter space to learn from data that arrive sequentially, prone to overfitting to the current session. Existing dynamic strategies require the expansion of the parameter space continually, leading to increased complexity. To address these challenges, we integrate the recently proposed selective state space model (SSM) into FSCIL. Concretely, we propose a dual selective SSM projector that dynamically adjusts the projection parameters based on the intermediate features for dynamic adaptation. The dual design enables the model to maintain the robust features of base classes, while adaptively learning distinctive feature shifts for novel classes. Additionally, we develop a class-sensitive selective scan mechanism to guide dynamic adaptation. It minimizes the disruption to base-class representations caused by training on novel data, and meanwhile, forces the selective scan to perform in distinct patterns between base and novel classes. Experiments on miniImageNet, CUB-200, and CIFAR-100 demonstrate that our framework outperforms the existing state-of-the-art methods. The code is available at https://github.com/xiaojieli0903/Mamba-FSCIL.

Recently, State Space Models (SSMs), with Mamba as a prime example, have shown great promise for long-range dependency modeling with linear complexity. Then, Vision Mamba and the subsequent architectures are presented successively, and they perform well on visual tasks. The crucial step of applying Mamba to visual tasks is to construct 2D visual features in sequential manners. To effectively organize and construct visual features within the 2D image space through 1D selective scan, we propose a novel Multi-Head Scan (MHS) module. The embeddings extracted from the preceding layer are projected into multiple lower-dimensional subspaces. Subsequently, within each subspace, the selective scan is performed along distinct scan routes. The resulting sub-embeddings, obtained from the multi-head scan process, are then integrated and ultimately projected back into the high-dimensional space. Moreover, we incorporate a Scan Route Attention (SRA) mechanism to enhance the module's capability to discern complex structures. To validate the efficacy of our module, we exclusively substitute the 2D-Selective-Scan (SS2D) block in VM-UNet with our proposed module, and we train our models from scratch without using any pre-trained weights. The results indicate a significant improvement in performance while reducing the parameters of the original VM-UNet. The code for this study is publicly available at https://github.com/PixDeep/MHS-VM.

State Space Models (SSMs) have emerged as an appealing alternative to Transformers for large language models, achieving state-of-the-art accuracy with constant memory complexity which allows for holding longer context lengths than attention-based networks. The superior computational efficiency of SSMs in long sequence modeling positions them favorably over Transformers in many scenarios. However, improving the efficiency of SSMs on request-intensive cloud-serving and resource-limited edge applications is still a formidable task. SSM quantization is a possible solution to this problem, making SSMs more suitable for wide deployment, while still maintaining their accuracy. Quantization is a common technique to reduce the model size and to utilize the low bit-width acceleration features on modern computing units, yet existing quantization techniques are poorly suited for SSMs. Most notably, SSMs have highly sensitive feature maps within the selective scan mechanism (i.e., linear recurrence) and massive outliers in the output activations which are not present in the output of token-mixing in the self-attention modules. To address this issue, we propose a static 8-bit per-tensor SSM quantization method which suppresses the maximum values of the input activations to the selective SSM for finer quantization precision and quantizes the output activations in an outlier-free space with Hadamard transform. Our 8-bit weight-activation quantized Mamba 2.8B SSM benefits from hardware acceleration and achieves a 1.72x lower generation latency on an Nvidia Orin Nano 8G, with only a 0.9% drop in average accuracy on zero-shot tasks. The experiments demonstrate the effectiveness and practical applicability of our approach for deploying SSM-based models of all sizes on both cloud and edge platforms.

Multiple Instance Learning (MIL) has emerged as a dominant paradigm to extract discriminative feature representations within Whole Slide Images (WSIs) in computational pathology. Despite driving notable progress, existing MIL approaches suffer from limitations in facilitating comprehensive and efficient interactions among instances, as well as challenges related to time-consuming computations and overfitting. In this paper, we incorporate the Selective Scan Space State Sequential Model (Mamba) in Multiple Instance Learning (MIL) for long sequence modeling with linear complexity, termed as MambaMIL. By inheriting the capability of vanilla Mamba, MambaMIL demonstrates the ability to comprehensively understand and perceive long sequences of instances. Furthermore, we propose the Sequence Reordering Mamba (SR-Mamba) aware of the order and distribution of instances, which exploits the inherent valuable information embedded within the long sequences. With the SR-Mamba as the core component, MambaMIL can effectively capture more discriminative features and mitigate the challenges associated with overfitting and high computational overhead. Extensive experiments on two public challenging tasks across nine diverse datasets demonstrate that our proposed framework performs favorably against state-of-the-art MIL methods. The code is released at https://github.com/isyangshu/MambaMIL.

Recent efforts on image restoration have focused on developing "all-in-one" models that can handle different degradation types and levels within single model. However, most of mainstream Transformer-based ones confronted with dilemma between model capabilities and computation burdens, since self-attention mechanism quadratically increase in computational complexity with respect to image size, and has inadequacies in capturing long-range dependencies. Most of Mamba-related ones solely scanned feature map in spatial dimension for global modeling, failing to fully utilize information in channel dimension. To address aforementioned problems, this paper has proposed to fully utilize complementary advantages from Mamba and Transformer without sacrificing computation efficiency. Specifically, the selective scanning mechanism of Mamba is employed to focus on spatial modeling, enabling capture long-range spatial dependencies under linear complexity. The self-attention mechanism of Transformer is applied to focus on channel modeling, avoiding high computation burdens that are in quadratic growth with image's spatial dimensions. Moreover, to enrich informative prompts for effective image restoration, multi-dimensional prompt learning modules are proposed to learn prompt-flows from multi-scale encoder/decoder layers, benefiting for revealing underlying characteristic of various degradations from both spatial and channel perspectives, therefore, enhancing the capabilities of "all-in-one" model to solve various restoration tasks. Extensive experiment results on several image restoration benchmark tasks such as image denoising, dehazing, and deraining, have demonstrated that the proposed method can achieve new state-of-the-art performance, compared with many popular mainstream methods. Related source codes and pre-trained parameters will be public on github https://github.com/12138-chr/MTAIR.

Recent advancements in state-space models (SSMs) have showcased effective performance in modeling long-range dependencies with subquadratic complexity. However, pure SSM-based models still face challenges related to stability and achieving optimal performance on computer vision tasks. Our paper addresses the challenges of scaling SSM-based models for computer vision, particularly the instability and inefficiency of large model sizes. To address this, we introduce a Modulated Group Mamba layer which divides the input channels into four groups and applies our proposed SSM-based efficient Visual Single Selective Scanning (VSSS) block independently to each group, with each VSSS block scanning in one of the four spatial directions. The Modulated Group Mamba layer also wraps the four VSSS blocks into a channel modulation operator to improve cross-channel communication. Furthermore, we introduce a distillation-based training objective to stabilize the training of large models, leading to consistent performance gains. Our comprehensive experiments demonstrate the merits of the proposed contributions, leading to superior performance over existing methods for image classification on ImageNet-1K, object detection, instance segmentation on MS-COCO, and semantic segmentation on ADE20K. Our tiny variant with 23M parameters achieves state-of-the-art performance with a classification top-1 accuracy of 83.3% on ImageNet-1K, while being 26% efficient in terms of parameters, compared to the best existing Mamba design of same model size. Our code and models are available at: https://github.com/Amshaker/GroupMamba.

Open-vocabulary detection (OVD) aims to detect objects beyond a predefined set of categories. As a pioneering model incorporating the YOLO series into OVD, YOLO-World is well-suited for scenarios prioritizing speed and efficiency.However, its performance is hindered by its neck feature fusion mechanism, which causes the quadratic complexity and the limited guided receptive fields.To address these limitations, we present Mamba-YOLO-World, a novel YOLO-based OVD model employing the proposed MambaFusion Path Aggregation Network (MambaFusion-PAN) as its neck architecture. Specifically, we introduce an innovative State Space Model-based feature fusion mechanism consisting of a Parallel-Guided Selective Scan algorithm and a Serial-Guided Selective Scan algorithm with linear complexity and globally guided receptive fields. It leverages multi-modal input sequences and mamba hidden states to guide the selective scanning process.Experiments demonstrate that our model outperforms the original YOLO-World on the COCO and LVIS benchmarks in both zero-shot and fine-tuning settings while maintaining comparable parameters and FLOPs. Additionally, it surpasses existing state-of-the-art OVD methods with fewer parameters and FLOPs.

We present PlainMamba: a simple non-hierarchical state space model (SSM) designed for general visual recognition. The recent Mamba model has shown how SSMs can be highly competitive with other architectures on sequential data and initial attempts have been made to apply it to images. In this paper, we further adapt the selective scanning process of Mamba to the visual domain, enhancing its ability to learn features from two-dimensional images by (i) a continuous 2D scanning process that improves spatial continuity by ensuring adjacency of tokens in the scanning sequence, and (ii) direction-aware updating which enables the model to discern the spatial relations of tokens by encoding directional information. Our architecture is designed to be easy to use and easy to scale, formed by stacking identical PlainMamba blocks, resulting in a model with constant width throughout all layers. The architecture is further simplified by removing the need for special tokens. We evaluate PlainMamba on a variety of visual recognition tasks including image classification, semantic segmentation, object detection, and instance segmentation. Our method achieves performance gains over previous non-hierarchical models and is competitive with hierarchical alternatives. For tasks requiring high-resolution inputs, in particular, PlainMamba requires much less computing while maintaining high performance. Code and models are available at https://github.com/ChenhongyiYang/PlainMamba

Modeling multivariate time series is a well-established problem with a wide range of applications from healthcare to financial markets. Traditional State Space Models (SSMs) are classical approaches for univariate time series modeling due to their simplicity and expressive power to represent linear dependencies. They, however, have fundamentally limited expressive power to capture non-linear dependencies, are slow in practice, and fail to model the inter-variate information flow. Despite recent attempts to improve the expressive power of SSMs by using deep structured SSMs, the existing methods are either limited to univariate time series, fail to model complex patterns (e.g., seasonal patterns), fail to dynamically model the dependencies of variate and time dimensions, and/or are input-independent. We present Chimera that uses two input-dependent 2-D SSM heads with different discretization processes to learn long-term progression and seasonal patterns. To improve the efficiency of complex 2D recurrence, we present a fast training using a new 2-dimensional parallel selective scan. We further present and discuss 2-dimensional Mamba and Mamba-2 as the spacial cases of our 2D SSM. Our experimental evaluation shows the superior performance of Chimera on extensive and diverse benchmarks, including ECG and speech time series classification, long-term and short-term time series forecasting, and time series anomaly detection.

Traffic Salient Object Detection (TSOD) aims to segment the objects critical to driving safety by combining semantic (e.g., collision risks) and visual saliency. Unlike SOD in natural scene images (NSI-SOD), which prioritizes visually distinctive regions, TSOD emphasizes the objects that demand immediate driver attention due to their semantic impact, even with low visual contrast. This dual criterion, i.e., bridging perception and contextual risk, re-defines saliency for autonomous and assisted driving systems. To address the lack of task-specific benchmarks, we collect the first large-scale TSOD dataset with pixel-wise saliency annotations, named TSOD10K. TSOD10K covers the diverse object categories in various real-world traffic scenes under various challenging weather/illumination variations (e.g., fog, snowstorms, low-contrast, and low-light). Methodologically, we propose a Mamba-based TSOD model, termed Tramba. Considering the challenge of distinguishing inconspicuous visual information from complex traffic backgrounds, Tramba introduces a novel Dual-Frequency Visual State Space module equipped with shifted window partitioning and dilated scanning to enhance the perception of fine details and global structure by hierarchically decomposing high/low-frequency components. To emphasize critical regions in traffic scenes, we propose a traffic-oriented Helix 2D-Selective-Scan (Helix-SS2D) mechanism that injects driving attention priors while effectively capturing global multi-direction spatial dependencies. We establish a comprehensive benchmark by evaluating Tramba and 22 existing NSI-SOD models on TSOD10K, demonstrating Tramba's superiority. Our research establishes the first foundation for safety-aware saliency analysis in intelligent transportation systems.

Multimodal Large Language Models (MLLMs) have attracted much attention due to their multifunctionality. However, traditional Transformer architectures incur significant overhead due to their secondary computational complexity. To address this issue, we introduce ML-Mamba, a multimodal language model that utilizes the latest and efficient Mamba-2 model for inference. Mamba-2 is known for its linear extension and fast processing of long sequences. We replace the Transformer based backbone with a pre-trained Mamba-2 model and explore methods for integrating 2D visual selective scanning mechanisms into multimodal learning. We also try various visual encoders and Mamba-2 model variants. Our extensive experiments conducted in various multimodal benchmark tests have demonstrated the competitive performance of ML-Mamba and highlighted the potential of state space models in multimodal tasks. The experimental results show that: (1) ML-Mamba achieves performance comparable to state-of-the-art methods such as TinyLaVA and MobileVLM v2 through its linear sequential modeling, while also having faster inference speed; (2) ML-Mamba performs well in visual hallucinations and spatial relationship judgment in closed set benchmark tests; (3) ML-Mamba achieves performance comparable to LLaVA while reducing the number of parameters by 40\%.(4) Compared to the multimodal model using the original Mamba model, the Mamba-2 based large-scale multimodal language model has stronger inference performance and effectiveness.

Multimodal large language models (MLLMs) have attracted widespread interest and have rich applications. However, the inherent attention mechanism in its Transformer structure requires quadratic complexity and results in expensive computational overhead. Therefore, in this work, we propose VL-Mamba, a multimodal large language model based on state space models, which have been shown to have great potential for long-sequence modeling with fast inference and linear scaling in sequence length. Specifically, we first replace the transformer-based backbone language model such as LLama or Vicuna with the pre-trained Mamba language model. Then, we empirically explore how to effectively apply the 2D vision selective scan mechanism for multimodal learning and the combinations of different vision encoders and variants of pretrained Mamba language models. The extensive experiments on diverse multimodal benchmarks with competitive performance show the effectiveness of our proposed VL-Mamba and demonstrate the great potential of applying state space models for multimodal learning tasks.

Recent advancements in Mamba have shown promising results in image restoration. These methods typically flatten 2D images into multiple distinct 1D sequences along rows and columns, process each sequence independently using selective scan operation, and recombine them to form the outputs. However, such a paradigm overlooks two vital aspects: i) the local relationships and spatial continuity inherent in natural images, and ii) the discrepancies among sequences unfolded through totally different ways. To overcome the drawbacks, we explore two problems in Mamba-based restoration methods: i) how to design a scanning strategy preserving both locality and continuity while facilitating restoration, and ii) how to aggregate the distinct sequences unfolded in totally different ways. To address these problems, we propose a novel Mamba-based Image Restoration model (MaIR), which consists of Nested S-shaped Scanning strategy (NSS) and Sequence Shuffle Attention block (SSA). Specifically, NSS preserves locality and continuity of the input images through the stripe-based scanning region and the S-shaped scanning path, respectively. SSA aggregates sequences through calculating attention weights within the corresponding channels of different sequences. Thanks to NSS and SSA, MaIR surpasses 40 baselines across 14 challenging datasets, achieving state-of-the-art performance on the tasks of image super-resolution, denoising, deblurring and dehazing. The code is available at https://github.com/XLearning-SCU/2025-CVPR-MaIR.

Selective Classification, wherein models can reject low-confidence predictions, promises reliable translation of machine-learning based classification systems to real-world scenarios such as clinical diagnostics. While current evaluation of these systems typically assumes fixed working points based on pre-defined rejection thresholds, methodological progress requires benchmarking the general performance of systems akin to the AUROC in standard classification. In this work, we define 5 requirements for multi-threshold metrics in selective classification regarding task alignment, interpretability, and flexibility, and show how current approaches fail to meet them. We propose the Area under the Generalized Risk Coverage curve (AUGRC), which meets all requirements and can be directly interpreted as the average risk of undetected failures. We empirically demonstrate the relevance of AUGRC on a comprehensive benchmark spanning 6 data sets and 13 confidence scoring functions. We find that the proposed metric substantially changes metric rankings on 5 out of the 6 data sets.

With the increasing adoption of Large Language Models (LLMs) and Vision-Language Models (VLMs), rich document analysis technologies for applications like Retrieval-Augmented Generation (RAG) and visual RAG are gaining significant attention. Recent research indicates that using VLMs can achieve better RAG performance, but processing rich documents still remains a challenge since a single page contains large amounts of information. In this paper, we present SCAN (SemantiC Document Layout ANalysis), a novel approach enhancing both textual and visual Retrieval-Augmented Generation (RAG) systems working with visually rich documents. It is a VLM-friendly approach that identifies document components with appropriate semantic granularity, balancing context preservation with processing efficiency. SCAN uses a coarse-grained semantic approach that divides documents into coherent regions covering continuous components. We trained the SCAN model by fine-tuning object detection models with sophisticated annotation datasets. Our experimental results across English and Japanese datasets demonstrate that applying SCAN improves end-to-end textual RAG performance by up to 9.0\% and visual RAG performance by up to 6.4\%, outperforming conventional approaches and even commercial document processing solutions.

Model selection/optimization in conformal inference is challenging, since it may break the exchangeability between labeled and unlabeled data. We study this problem in the context of conformal selection, which uses conformal p-values to select ``interesting'' instances with large unobserved labels from a pool of unlabeled data, while controlling the FDR in finite sample. For validity, existing solutions require the model choice to be independent of the data used to construct the p-values and calibrate the selection set. However, when presented with many model choices and limited labeled data, it is desirable to (i) select the best model in a data-driven manner, and (ii) mitigate power loss due to sample splitting. This paper presents OptCS, a general framework that allows valid statistical testing (selection) after flexible data-driven model optimization. We introduce general conditions under which OptCS constructs valid conformal p-values despite substantial data reuse and handles complex p-value dependencies to maintain finite-sample FDR control via a novel multiple testing procedure. We instantiate this general recipe to propose three FDR-controlling procedures, each optimizing the models differently: (i) selecting the most powerful one among multiple pre-trained candidate models, (ii) using all data for model fitting without sample splitting, and (iii) combining full-sample model fitting and selection. We demonstrate the efficacy of our methods via simulation studies and real applications in drug discovery and alignment of large language models in radiology report generation.

The rapid increase of computed tomography (CT) scans and their time-consuming manual analysis have created an urgent need for robust automated analysis techniques in clinical settings. These aim to assist radiologists and help them managing their growing workload. Existing methods typically generate entire reports directly from 3D CT images, without explicitly focusing on observed abnormalities. This unguided approach often results in repetitive content or incomplete reports, failing to prioritize anomaly-specific descriptions. We propose a new anomaly-guided report generation model, which first predicts abnormalities and then generates targeted descriptions for each. Evaluation on a public dataset demonstrates significant improvements in report quality and clinical relevance. We extend our work by conducting an ablation study to demonstrate its effectiveness.

3D reconstruction techniques have widely been used for digital documentation of archaeological fragments. However, efficient digital capture of fragments remains as a challenge. In this work, we aim to develop a portable, high-throughput, and accurate reconstruction system for efficient digitization of fragments excavated in archaeological sites. To realize high-throughput digitization of large numbers of objects, an effective strategy is to perform scanning and reconstruction in batches. However, effective batch-based scanning and reconstruction face two key challenges: 1) how to correlate partial scans of the same object from multiple batch scans, and 2) how to register and reconstruct complete models from partial scans that exhibit only small overlaps. To tackle these two challenges, we develop a new batch-based matching algorithm that pairs the front and back sides of the fragments, and a new Bilateral Boundary ICP algorithm that can register partial scans sharing very narrow overlapping regions. Extensive validation in labs and testing in excavation sites demonstrate that these designs enable efficient batch-based scanning for fragments. We show that such a batch-based scanning and reconstruction pipeline can have immediate applications on digitizing sherds in archaeological excavations. Our project page: https://jiepengwang.github.io/FIRES/.

Purpose: Medical imaging has become increasingly important in diagnosing and treating oncological patients, particularly in radiotherapy. Recent advances in synthetic computed tomography (sCT) generation have increased interest in public challenges to provide data and evaluation metrics for comparing different approaches openly. This paper describes a dataset of brain and pelvis computed tomography (CT) images with rigidly registered CBCT and MRI images to facilitate the development and evaluation of sCT generation for radiotherapy planning. Acquisition and validation methods: The dataset consists of CT, CBCT, and MRI of 540 brains and 540 pelvic radiotherapy patients from three Dutch university medical centers. Subjects' ages ranged from 3 to 93 years, with a mean age of 60. Various scanner models and acquisition settings were used across patients from the three data-providing centers. Details are available in CSV files provided with the datasets. Data format and usage notes: The data is available on Zenodo (https://doi.org/10.5281/zenodo.7260705) under the SynthRAD2023 collection. The images for each subject are available in nifti format. Potential applications: This dataset will enable the evaluation and development of image synthesis algorithms for radiotherapy purposes on a realistic multi-center dataset with varying acquisition protocols. Synthetic CT generation has numerous applications in radiation therapy, including diagnosis, treatment planning, treatment monitoring, and surgical planning.

The Mamba layer offers an efficient selective state space model (SSM) that is highly effective in modeling multiple domains including NLP, long-range sequences processing, and computer vision. Selective SSMs are viewed as dual models, in which one trains in parallel on the entire sequence via IO-aware parallel scan, and deploys in an autoregressive manner. We add a third view and show that such models can be viewed as attention-driven models. This new perspective enables us to compare the underlying mechanisms to that of the self-attention layers in transformers and allows us to peer inside the inner workings of the Mamba model with explainability methods. Our code is publicly available.

We propose TAROT, a targeted data selection framework grounded in optimal transport theory. Previous targeted data selection methods primarily rely on influence-based greedy heuristics to enhance domain-specific performance. While effective on limited, unimodal data (i.e., data following a single pattern), these methods struggle as target data complexity increases. Specifically, in multimodal distributions, these heuristics fail to account for multiple inherent patterns, leading to suboptimal data selection. This work identifies two primary factors contributing to this limitation: (i) the disproportionate impact of dominant feature components in high-dimensional influence estimation, and (ii) the restrictive linear additive assumptions inherent in greedy selection strategies. To address these challenges, TAROT incorporates whitened feature distance to mitigate dominant feature bias, providing a more reliable measure of data influence. Building on this, TAROT uses whitened feature distance to quantify and minimize the optimal transport distance between the selected data and target domains. Notably, this minimization also facilitates the estimation of optimal selection ratios. We evaluate TAROT across multiple tasks, including semantic segmentation, motion prediction, and instruction tuning. Results consistently show that TAROT outperforms state-of-the-art methods, highlighting its versatility across various deep learning tasks. Code is available at https://github.com/vita-epfl/TAROT.

Medical imaging is crucial for diagnosing a patient's health condition, and accurate segmentation of these images is essential for isolating regions of interest to ensure precise diagnosis and treatment planning. Existing methods primarily rely on bounding boxes or point-based prompts, while few have explored text-related prompts, despite clinicians often describing their observations and instructions in natural language. To address this gap, we first propose a RAG-based free-form text prompt generator, that leverages the domain corpus to generate diverse and realistic descriptions. Then, we introduce FLanS, a novel medical image segmentation model that handles various free-form text prompts, including professional anatomy-informed queries, anatomy-agnostic position-driven queries, and anatomy-agnostic size-driven queries. Additionally, our model also incorporates a symmetry-aware canonicalization module to ensure consistent, accurate segmentations across varying scan orientations and reduce confusion between the anatomical position of an organ and its appearance in the scan. FLanS is trained on a large-scale dataset of over 100k medical images from 7 public datasets. Comprehensive experiments demonstrate the model's superior language understanding and segmentation precision, along with a deep comprehension of the relationship between them, outperforming SOTA baselines on both in-domain and out-of-domain datasets.

Precision medicine, such as patient-adaptive treatments assisted by medical image analysis, poses new challenges for segmentation algorithms in adapting to new patients, due to the large variability across different patients and the limited availability of annotated data for each patient. In this work, we propose a data-efficient segmentation algorithm, namely Part-aware Prompted Segment Anything Model (P^2SAM). Without any model fine-tuning, P^2SAM enables seamless adaptation to any new patients relying only on one-shot patient-specific data. We introduce a novel part-aware prompt mechanism to select multiple-point prompts based on the part-level features of the one-shot data, which can be extensively integrated into different promptable segmentation models, such as SAM and SAM 2. Moreover, to determine the optimal number of parts for each specific case, we propose a distribution-guided retrieval approach that further enhances the robustness of the part-aware prompt mechanism. P^2SAM improves the performance by +8.0% and +2.0% mean Dice score for two different patient-adaptive segmentation applications, respectively. In addition, P^2SAM also exhibits impressive generalizability in other adaptive segmentation tasks in the natural image domain, e.g., +6.4% mIoU within personalized object segmentation task. The code is available at: https://github.com/Zch0414/p2sam

Multimodal language models (MLMs) show promise for clinical decision support and diagnostic reasoning, raising the prospect of end-to-end automated medical image interpretation. However, clinicians are highly selective in adopting AI tools; a model that makes errors on seemingly simple perception tasks such as determining image orientation or identifying whether a CT scan is contrast-enhance are unlikely to be adopted for clinical tasks. We introduce Medblink, a benchmark designed to probe these models for such perceptual abilities. Medblink spans eight clinically meaningful tasks across multiple imaging modalities and anatomical regions, totaling 1,429 multiple-choice questions over 1,605 images. We evaluate 19 state-of-the-art MLMs, including general purpose (GPT4o, Claude 3.5 Sonnet) and domain specific (Med Flamingo, LLaVA Med, RadFM) models. While human annotators achieve 96.4% accuracy, the best-performing model reaches only 65%. These results show that current MLMs frequently fail at routine perceptual checks, suggesting the need to strengthen their visual grounding to support clinical adoption. Data is available on our project page.

Large language models (LLMs) have recently shown great advances in a variety of tasks, including natural language understanding and generation. However, their use in high-stakes decision-making scenarios is still limited due to the potential for errors. Selective prediction is a technique that can be used to improve the reliability of the LLMs by allowing them to abstain from making predictions when they are unsure of the answer. In this work, we propose a novel framework for adaptation with self-evaluation to improve the selective prediction performance of LLMs. Our framework is based on the idea of using parameter-efficient tuning to adapt the LLM to the specific task at hand while improving its ability to perform self-evaluation. We evaluate our method on a variety of question-answering (QA) datasets and show that it outperforms state-of-the-art selective prediction methods. For example, on the CoQA benchmark, our method improves the AUACC from 91.23% to 92.63% and improves the AUROC from 74.61% to 80.25%.

Endorectal ultrasound (ERUS) is an important imaging modality that provides high reliability for diagnosing the depth and boundary of invasion in colorectal cancer. However, the lack of a large-scale ERUS dataset with high-quality annotations hinders the development of automatic ultrasound diagnostics. In this paper, we collected and annotated the first benchmark dataset that covers diverse ERUS scenarios, i.e. colorectal cancer segmentation, detection, and infiltration depth staging. Our ERUS-10K dataset comprises 77 videos and 10,000 high-resolution annotated frames. Based on this dataset, we further introduce a benchmark model for colorectal cancer segmentation, named the Adaptive Sparse-context TRansformer (ASTR). ASTR is designed based on three considerations: scanning mode discrepancy, temporal information, and low computational complexity. For generalizing to different scanning modes, the adaptive scanning-mode augmentation is proposed to convert between raw sector images and linear scan ones. For mining temporal information, the sparse-context transformer is incorporated to integrate inter-frame local and global features. For reducing computational complexity, the sparse-context block is introduced to extract contextual features from auxiliary frames. Finally, on the benchmark dataset, the proposed ASTR model achieves a 77.6% Dice score in rectal cancer segmentation, largely outperforming previous state-of-the-art methods.

In this paper, we introduce Medical SAM 2 (MedSAM-2), an advanced segmentation model that utilizes the SAM 2 framework to address both 2D and 3D medical image segmentation tasks. By adopting the philosophy of taking medical images as videos, MedSAM-2 not only applies to 3D medical images but also unlocks new One-prompt Segmentation capability. That allows users to provide a prompt for just one or a specific image targeting an object, after which the model can autonomously segment the same type of object in all subsequent images, regardless of temporal relationships between the images. We evaluated MedSAM-2 across a variety of medical imaging modalities, including abdominal organs, optic discs, brain tumors, thyroid nodules, and skin lesions, comparing it against state-of-the-art models in both traditional and interactive segmentation settings. Our findings show that MedSAM-2 not only surpasses existing models in performance but also exhibits superior generalization across a range of medical image segmentation tasks. Our code will be released at: https://github.com/MedicineToken/Medical-SAM2

Medical imaging is essential in modern radiotherapy, supporting diagnosis, treatment planning, and monitoring. Synthetic imaging, particularly synthetic computed tomography (sCT), is gaining traction in radiotherapy. The SynthRAD2025 dataset and Grand Challenge promote advancements in sCT generation by providing a benchmarking platform for algorithms using cone-beam CT (CBCT) and magnetic resonance imaging (MRI). The dataset includes 2362 cases: 890 MRI-CT and 1472 CBCT-CT pairs from head-and-neck, thoracic, and abdominal cancer patients treated at five European university medical centers (UMC Groningen, UMC Utrecht, Radboud UMC, LMU University Hospital Munich, and University Hospital of Cologne). Data were acquired with diverse scanners and protocols. Pre-processing, including rigid and deformable image registration, ensures high-quality, modality-aligned images. Extensive quality assurance validates image consistency and usability. All imaging data is provided in MetaImage (.mha) format, ensuring compatibility with medical image processing tools. Metadata, including acquisition parameters and registration details, is available in structured CSV files. To maintain dataset integrity, SynthRAD2025 is divided into training (65%), validation (10%), and test (25%) sets. The dataset is accessible at https://doi.org/10.5281/zenodo.14918089 under the SynthRAD2025 collection. This dataset supports benchmarking and the development of synthetic imaging techniques for radiotherapy applications. Use cases include sCT generation for MRI-only and MR-guided photon/proton therapy, CBCT-based dose calculations, and adaptive radiotherapy workflows. By integrating diverse acquisition settings, SynthRAD2025 fosters robust, generalizable image synthesis algorithms, advancing personalized cancer care and adaptive radiotherapy.

In this study, we aim to build up a model that can Segment Anything in radiology scans, driven by medical terminologies as Text prompts, termed as SAT. Our main contributions are three folds: (i) for dataset construction, we construct the first multi-modal knowledge tree on human anatomy, including 6502 anatomical terminologies; Then, we build up the largest and most comprehensive segmentation dataset for training, by collecting over 22K 3D medical image scans from72 segmentation datasets, across 497 classes, with careful standardization on both image scans and label space; (ii) for architecture design, we propose to inject medical knowledge into a text encoder via contrastive learning, and then formulate a universal segmentation model, that can be prompted by feeding in medical terminologies in text form; (iii) As a result, we have trained SAT-Nano (110M parameters) and SAT-Pro (447M parameters), demonstrating superior or comparable performance to 72 specialist models, i.e., nnU-Nets, U-Mamba or SwinUNETR, trained on each dataset/subsets. We validate SAT as a foundational segmentation model, with better generalization on external (cross-center) datasets, and can be further improved on specific tasks after fine-tuning adaptation. Comparing with state-of-the-art interactive segmentation model MedSAM, SAT demonstrate superior performance, scalability and robustness. We further compare SAT with BiomedParse, and observe SAT is significantly superior in both internal and external evaluation. Through extensive ablation study, we validate the benefit of domain knowledge on universal segmentation, especially on tail categories. As a use case, we demonstrate that SAT can act as a powerful out-of-the-box agent for large language models, enabling visual grounding in versatile application scenarios. All the data, codes, and models in this work have been released.

Given a sample of size N, it is often useful to select a subsample of smaller size n<N to be used for statistical estimation or learning. Such a data selection step is useful to reduce the requirements of data labeling and the computational complexity of learning. We assume to be given N unlabeled samples {{boldsymbol x}_i}_{ile N}, and to be given access to a `surrogate model' that can predict labels y_i better than random guessing. Our goal is to select a subset of the samples, to be denoted by {{boldsymbol x}_i}_{iin G}, of size |G|=n<N. We then acquire labels for this set and we use them to train a model via regularized empirical risk minimization. By using a mixture of numerical experiments on real and synthetic data, and mathematical derivations under low- and high- dimensional asymptotics, we show that: (i)~Data selection can be very effective, in particular beating training on the full sample in some cases; (ii)~Certain popular choices in data selection methods (e.g. unbiased reweighted subsampling, or influence function-based subsampling) can be substantially suboptimal.

Unneeded elements in the attention's context degrade performance. We introduce Selective Attention, a simple parameter-free change to the standard attention mechanism which reduces attention to unneeded elements. Selective attention improves language modeling performance in a variety of model sizes and context lengths. For example, a range of transformers trained with the language modeling objective on C4 with selective attention perform equivalently to standard transformers with ~2X more heads and parameters in their attention modules. Selective attention also allows decreasing the size of the attention's context buffer, leading to meaningful reductions in the memory and compute requirements during inference. For example, transformers with 100M parameters trained on C4 with context sizes of 512, 1,024, and 2,048 need 16X, 25X, and 47X less memory for their attention module, respectively, when equipped with selective attention, as those without selective attention, with the same validation perplexity.

Ultrasound imaging has become the preferred imaging modality for early cancer screening due to its advantages of non-ionizing radiation, low cost, and real-time imaging capabilities. However, conventional ultrasound diagnosis heavily relies on physician expertise, presenting challenges of high subjectivity and low diagnostic efficiency. Vision-language models (VLMs) offer promising solutions for this issue, but existing general-purpose models demonstrate limited knowledge in ultrasound medical tasks, with poor generalization in multi-organ lesion recognition and low efficiency across multi-task diagnostics. To address these limitations, we propose EchoVLM, a vision-language model specifically designed for ultrasound medical imaging. The model employs a Mixture of Experts (MoE) architecture trained on data spanning seven anatomical regions. This design enables the model to perform multiple tasks, including ultrasound report generation, diagnosis and visual question-answering (VQA). The experimental results demonstrated that EchoVLM achieved significant improvements of 10.15 and 4.77 points in BLEU-1 scores and ROUGE-1 scores respectively compared to Qwen2-VL on the ultrasound report generation task. These findings suggest that EchoVLM has substantial potential to enhance diagnostic accuracy in ultrasound imaging, thereby providing a viable technical solution for future clinical applications. Source code and model weights are available at https://github.com/Asunatan/EchoVLM.

Medical image segmentation poses challenges due to domain gaps, data modality variations, and dependency on domain knowledge or experts, especially for low- and middle-income countries (LMICs). Whereas for humans, given a few exemplars (with corresponding labels), we are able to segment different medical images even without exten-sive domain-specific clinical training. In addition, current SAM-based medical segmentation models use fine-grained visual prompts, such as the bounding rectangle generated from manually annotated target segmentation mask, as the bounding box (bbox) prompt during the testing phase. However, in actual clinical scenarios, no such precise prior knowledge is available. Our experimental results also reveal that previous models nearly fail to predict when given coarser bbox prompts. Considering these issues, in this paper, we introduce a domain-aware selective adaptation approach to adapt the general knowledge learned from a large model trained with natural images to the corresponding medical domains/modalities, with access to only a few (e.g. less than 5) exemplars. Our method mitigates the aforementioned limitations, providing an efficient and LMICs-friendly solution. Extensive experimental analysis showcases the effectiveness of our approach, offering potential advancements in healthcare diagnostics and clinical applications in LMICs.

Medical eye-tracking data is an important information source for understanding how radiologists visually interpret medical images. This information not only improves the accuracy of deep learning models for X-ray analysis but also their interpretability, enhancing transparency in decision-making. However, the current eye-tracking data is dispersed, unprocessed, and ambiguous, making it difficult to derive meaningful insights. Therefore, there is a need to create a new dataset with more focus and purposeful eyetracking data, improving its utility for diagnostic applications. In this work, we propose a refinement method inspired by the target-present visual search challenge: there is a specific finding and fixations are guided to locate it. After refining the existing eye-tracking datasets, we transform them into a curated visual search dataset, called GazeSearch, specifically for radiology findings, where each fixation sequence is purposefully aligned to the task of locating a particular finding. Subsequently, we introduce a scan path prediction baseline, called ChestSearch, specifically tailored to GazeSearch. Finally, we employ the newly introduced GazeSearch as a benchmark to evaluate the performance of current state-of-the-art methods, offering a comprehensive assessment for visual search in the medical imaging domain. Code is available at https://github.com/UARK-AICV/GazeSearch.

Survey data can contain a high number of features while having a comparatively low quantity of examples. Machine learning models that attempt to predict outcomes from survey data under these conditions can overfit and result in poor generalizability. One remedy to this issue is feature selection, which attempts to select an optimal subset of features to learn upon. A relatively unexplored source of information in the feature selection process is the usage of textual names of features, which may be semantically indicative of which features are relevant to a target outcome. The relationships between feature names and target names can be evaluated using language models (LMs) to produce semantic textual similarity (STS) scores, which can then be used to select features. We examine the performance using STS to select features directly and in the minimal-redundancy-maximal-relevance (mRMR) algorithm. The performance of STS as a feature selection metric is evaluated against preliminary survey data collected as a part of a clinical study on persistent post-surgical pain (PPSP). The results suggest that features selected with STS can result in higher performance models compared to traditional feature selection algorithms.

This paper presents a data-driven, task-specific paradigm for experimental design, to shorten acquisition time, reduce costs, and accelerate the deployment of imaging devices. Current approaches in experimental design focus on model-parameter estimation and require specification of a particular model, whereas in imaging, other tasks may drive the design. Furthermore, such approaches often lead to intractable optimization problems in real-world imaging applications. Here we present a new paradigm for experimental design that simultaneously optimizes the design (set of image channels) and trains a machine-learning model to execute a user-specified image-analysis task. The approach obtains data densely-sampled over the measurement space (many image channels) for a small number of acquisitions, then identifies a subset of channels of prespecified size that best supports the task. We propose a method: TADRED for TAsk-DRiven Experimental Design in imaging, to identify the most informative channel-subset whilst simultaneously training a network to execute the task given the subset. Experiments demonstrate the potential of TADRED in diverse imaging applications: several clinically-relevant tasks in magnetic resonance imaging; and remote sensing and physiological applications of hyperspectral imaging. Results show substantial improvement over classical experimental design, two recent application-specific methods within the new paradigm, and state-of-the-art approaches in supervised feature selection. We anticipate further applications of our approach. Code is available: https://github.com/sbb-gh/experimental-design-multichannel

Precise lesion resection depends on accurately identifying fine-grained anatomical structures. While many coarse-grained segmentation (CGS) methods have been successful in large-scale segmentation (e.g., organs), they fall short in clinical scenarios requiring fine-grained segmentation (FGS), which remains challenging due to frequent individual variations in small-scale anatomical structures. Although recent Mamba-based models have advanced medical image segmentation, they often rely on fixed manually-defined scanning orders, which limit their adaptability to individual variations in FGS. To address this, we propose ASM-UNet, a novel Mamba-based architecture for FGS. It introduces adaptive scan scores to dynamically guide the scanning order, generated by combining group-level commonalities and individual-level variations. Experiments on two public datasets (ACDC and Synapse) and a newly proposed challenging biliary tract FGS dataset, namely BTMS, demonstrate that ASM-UNet achieves superior performance in both CGS and FGS tasks. Our code and dataset are available at https://github.com/YqunYang/ASM-UNet.

Selecting high-quality and diverse training samples from extensive datasets plays a crucial role in reducing training overhead and enhancing the performance of Large Language Models (LLMs). However, existing studies fall short in assessing the overall value of selected data, focusing primarily on individual quality, and struggle to strike an effective balance between ensuring diversity and minimizing data point traversals. Therefore, this paper introduces a novel choice-based sample selection framework that shifts the focus from evaluating individual sample quality to comparing the contribution value of different samples when incorporated into the subset. Thanks to the advanced language understanding capabilities of LLMs, we utilize LLMs to evaluate the value of each option during the selection process. Furthermore, we design a greedy sampling process where samples are incrementally added to the subset, thereby improving efficiency by eliminating the need for exhaustive traversal of the entire dataset with the limited budget. Extensive experiments demonstrate that selected data from our method not only surpass the performance of the full dataset but also achieves competitive results with state-of-the-art (SOTA) studies, while requiring fewer selections. Moreover, we validate our approach on a larger medical dataset, highlighting its practical applicability in real-world applications.

Should prediction models always deliver a prediction? In the pursuit of maximum predictive performance, critical considerations of reliability and fairness are often overshadowed, particularly when it comes to the role of uncertainty. Selective regression, also known as the "reject option," allows models to abstain from predictions in cases of considerable uncertainty. Initially proposed seven decades ago, approaches to selective regression have mostly focused on distribution-based proxies for measuring uncertainty, particularly conditional variance. However, this focus neglects the significant influence of model-specific biases on a model's performance. In this paper, we propose a novel approach to selective regression by leveraging conformal prediction, which provides grounded confidence measures for individual predictions based on model-specific biases. In addition, we propose a standardized evaluation framework to allow proper comparison of selective regression approaches. Via an extensive experimental approach, we demonstrate how our proposed approach, conformalized selective regression, demonstrates an advantage over multiple state-of-the-art baselines.

Universal medical image segmentation models have emerged as a promising paradigm due to their strong generalizability across diverse tasks, showing great potential for a wide range of clinical applications. This potential has been partly driven by the success of general-purpose vision models such as the Segment Anything Model (SAM), which has inspired the development of various fine-tuned variants for medical segmentation tasks. However, fine-tuned variants like MedSAM are trained on comparatively limited medical imaging data that often suffers from heterogeneity, scarce annotations, and distributional shifts. These challenges limit their ability to generalize across a wide range of medical segmentation tasks. In this regard, we propose MedSAMix, a training-free model merging method that integrates the strengths of both generalist models (e.g., SAM) and specialist models (e.g., MedSAM) for medical image segmentation. In contrast to traditional model merging approaches that rely on manual configuration and often result in suboptimal outcomes, we propose a zero-order optimization method to automatically discover optimal layer-wise merging solutions. Furthermore, for clinical applications, we develop two regimes to meet the demand of domain-specificity and generalizability in different scenarios by single-task optimization and multi-objective optimization respectively. Extensive evaluations on 25 medical segmentation tasks demonstrate that MedSAMix effectively mitigates model bias and consistently improves performance in both domain-specific accuracy and generalization, achieving improvements of 6.67% on specialized tasks and 4.37% on multi-task evaluations.

Deep learning presents novel opportunities for the auto-segmentation of gross tumor volume (GTV) in head and neck cancer (HNC), yet fully automatic methods usually necessitate significant manual refinement. This study investigates the Segment Anything Model (SAM), recognized for requiring minimal human prompting and its zero-shot generalization ability across natural images. We specifically examine MedSAM, a version of SAM fine-tuned with large-scale public medical images. Despite its progress, the integration of multi-modality images (CT, PET, MRI) for effective GTV delineation remains a challenge. Focusing on SAM's application in HNC GTV segmentation, we assess its performance in both zero-shot and fine-tuned scenarios using single (CT-only) and fused multi-modality images. Our study demonstrates that fine-tuning SAM significantly enhances its segmentation accuracy, building upon the already effective zero-shot results achieved with bounding box prompts. These findings open a promising avenue for semi-automatic HNC GTV segmentation.

In this paper I investigate the effect of random seed selection on the accuracy when using popular deep learning architectures for computer vision. I scan a large amount of seeds (up to 10^4) on CIFAR 10 and I also scan fewer seeds on Imagenet using pre-trained models to investigate large scale datasets. The conclusions are that even if the variance is not very large, it is surprisingly easy to find an outlier that performs much better or much worse than the average.

Detecting breast cancer early is of the utmost importance to effectively treat the millions of women afflicted by breast cancer worldwide every year. Although mammography is the primary imaging modality for screening breast cancer, there is an increasing interest in adding magnetic resonance imaging (MRI) to screening programmes, particularly for women at high risk. Recent guidelines by the European Society of Breast Imaging (EUSOBI) recommended breast MRI as a supplemental screening tool for women with dense breast tissue. However, acquiring and reading MRI scans requires significantly more time from expert radiologists. This highlights the need to develop new automated methods to detect cancer accurately using MRI and Artificial Intelligence (AI), which have the potential to support radiologists in breast MRI interpretation and classification and help detect cancer earlier. For this reason, the ODELIA consortium has made this multi-centre dataset publicly available to assist in developing AI tools for the detection of breast cancer on MRI.

Language promptable X-ray image segmentation would enable greater flexibility for human-in-the-loop workflows in diagnostic and interventional precision medicine. Prior efforts have contributed task-specific models capable of solving problems within a narrow scope, but expanding to broader use requires additional data, annotations, and training time. Recently, language-aligned foundation models (LFMs) -- machine learning models trained on large amounts of highly variable image and text data thus enabling broad applicability -- have emerged as promising tools for automated image analysis. Existing foundation models for medical image analysis focus on scenarios and modalities where large, richly annotated datasets are available. However, the X-ray imaging modality features highly variable image appearance and applications, from diagnostic chest X-rays to interventional fluoroscopy, with varying availability of data. To pave the way toward an LFM for comprehensive and language-aligned analysis of arbitrary medical X-ray images, we introduce FluoroSAM, a language-promptable variant of the Segment Anything Model, trained from scratch on 3M synthetic X-ray images from a wide variety of human anatomies, imaging geometries, and viewing angles. These include pseudo-ground truth masks for 128 organ types and 464 tools with associated text descriptions. FluoroSAM is capable of segmenting myriad anatomical structures and tools based on natural language prompts, thanks to the novel incorporation of vector quantization (VQ) of text embeddings in the training process. We demonstrate FluoroSAM's performance quantitatively on real X-ray images and showcase on several applications how FluoroSAM is a key enabler for rich human-machine interaction in the X-ray image acquisition and analysis context. Code is available at https://github.com/arcadelab/fluorosam.

Selective state space models (SSMs), such as Mamba, highly excel at capturing long-range dependencies in 1D sequential data, while their applications to 2D vision tasks still face challenges. Current visual SSMs often convert images into 1D sequences and employ various scanning patterns to incorporate local spatial dependencies. However, these methods are limited in effectively capturing the complex image spatial structures and the increased computational cost caused by the lengthened scanning paths. To address these limitations, we propose Spatial-Mamba, a novel approach that establishes neighborhood connectivity directly in the state space. Instead of relying solely on sequential state transitions, we introduce a structure-aware state fusion equation, which leverages dilated convolutions to capture image spatial structural dependencies, significantly enhancing the flow of visual contextual information. Spatial-Mamba proceeds in three stages: initial state computation in a unidirectional scan, spatial context acquisition through structure-aware state fusion, and final state computation using the observation equation. Our theoretical analysis shows that Spatial-Mamba unifies the original Mamba and linear attention under the same matrix multiplication framework, providing a deeper understanding of our method. Experimental results demonstrate that Spatial-Mamba, even with a single scan, attains or surpasses the state-of-the-art SSM-based models in image classification, detection and segmentation. Source codes and trained models can be found at https://github.com/EdwardChasel/Spatial-Mamba.

Automated diagnostic systems (ADS) have shown significant potential in the early detection of polyps during endoscopic examinations, thereby reducing the incidence of colorectal cancer. However, due to high annotation costs and strict privacy concerns, acquiring high-quality endoscopic images poses a considerable challenge in the development of ADS. Despite recent advancements in generating synthetic images for dataset expansion, existing endoscopic image generation algorithms failed to accurately generate the details of polyp boundary regions and typically required medical priors to specify plausible locations and shapes of polyps, which limited the realism and diversity of the generated images. To address these limitations, we present Polyp-Gen, the first full-automatic diffusion-based endoscopic image generation framework. Specifically, we devise a spatial-aware diffusion training scheme with a lesion-guided loss to enhance the structural context of polyp boundary regions. Moreover, to capture medical priors for the localization of potential polyp areas, we introduce a hierarchical retrieval-based sampling strategy to match similar fine-grained spatial features. In this way, our Polyp-Gen can generate realistic and diverse endoscopic images for building reliable ADS. Extensive experiments demonstrate the state-of-the-art generation quality, and the synthetic images can improve the downstream polyp detection task. Additionally, our Polyp-Gen has shown remarkable zero-shot generalizability on other datasets. The source code is available at https://github.com/CUHK-AIM-Group/Polyp-Gen.

A long standing goal in neuroscience has been to elucidate the functional organization of the brain. Within higher visual cortex, functional accounts have remained relatively coarse, focusing on regions of interest (ROIs) and taking the form of selectivity for broad categories such as faces, places, bodies, food, or words. Because the identification of such ROIs has typically relied on manually assembled stimulus sets consisting of isolated objects in non-ecological contexts, exploring functional organization without robust a priori hypotheses has been challenging. To overcome these limitations, we introduce a data-driven approach in which we synthesize images predicted to activate a given brain region using paired natural images and fMRI recordings, bypassing the need for category-specific stimuli. Our approach -- Brain Diffusion for Visual Exploration ("BrainDiVE") -- builds on recent generative methods by combining large-scale diffusion models with brain-guided image synthesis. Validating our method, we demonstrate the ability to synthesize preferred images with appropriate semantic specificity for well-characterized category-selective ROIs. We then show that BrainDiVE can characterize differences between ROIs selective for the same high-level category. Finally we identify novel functional subdivisions within these ROIs, validated with behavioral data. These results advance our understanding of the fine-grained functional organization of human visual cortex, and provide well-specified constraints for further examination of cortical organization using hypothesis-driven methods.

The burgeoning integration of 3D medical imaging into healthcare has led to a substantial increase in the workload of medical professionals. To assist clinicians in their diagnostic processes and alleviate their workload, the development of a robust system for retrieving similar case studies presents a viable solution. While the concept holds great promise, the field of 3D medical text-image retrieval is currently limited by the absence of robust evaluation benchmarks and curated datasets. To remedy this, our study presents a groundbreaking dataset, BIMCV-R (This dataset will be released upon acceptance.), which includes an extensive collection of 8,069 3D CT volumes, encompassing over 2 million slices, paired with their respective radiological reports. Expanding upon the foundational work of our dataset, we craft a retrieval strategy, MedFinder. This approach employs a dual-stream network architecture, harnessing the potential of large language models to advance the field of medical image retrieval beyond existing text-image retrieval solutions. It marks our preliminary step towards developing a system capable of facilitating text-to-image, image-to-text, and keyword-based retrieval tasks.

Retrieval-augmented generation (RAG) systems are often bottlenecked by their reranking modules, which typically score passages independently and select a fixed Top-K size. This approach struggles with complex multi-hop queries that require synthesizing evidence across multiple documents, creating a trade-off where small K values omit crucial information and large K values introduce noise. To address this, we introduce the Dynamic Passage Selector (DPS), a novel reranking framework that treats passage selection as a supervised learning problem. Unlike traditional point-wise or list-wise methods, DPS is fine-tuned to capture inter-passage dependencies and dynamically select the most relevant set of passages for generation. As a seamless plug-and-play module, DPS requires no modifications to the standard RAG pipeline. Comprehensive evaluations on five benchmarks show that DPS consistently outperforms state-of-the-art rerankers and fine-tuning methods. Notably, on the challenging MuSiQue dataset, DPS improves the F1-score by 30.06% and 15.4% over strong baselines like Qwen3-reranker and RankingGPT, respectively. Our results demonstrate that by enabling adaptive evidence selection, DPS substantially enhances reasoning capabilities in complex RAG scenarios.

Positron emission tomography (PET) is a cornerstone of modern oncologic and neurologic imaging, distinguished by its unique ability to illuminate dynamic metabolic processes that transcend the anatomical focus of traditional imaging technologies. Radiology reports are essential for clinical decision making, yet their manual creation is labor-intensive and time-consuming. Recent advancements of vision-language models (VLMs) have shown strong potential in medical applications, presenting a promising avenue for automating report generation. However, existing applications of VLMs in the medical domain have predominantly focused on structural imaging modalities, while the unique characteristics of molecular PET imaging have largely been overlooked. To bridge the gap, we introduce PET2Rep, a large-scale comprehensive benchmark for evaluation of general and medical VLMs for radiology report generation for PET images. PET2Rep stands out as the first dedicated dataset for PET report generation with metabolic information, uniquely capturing whole-body image-report pairs that cover dozens of organs to fill the critical gap in existing benchmarks and mirror real-world clinical comprehensiveness. In addition to widely recognized natural language generation metrics, we introduce a series of clinical efficiency metrics to evaluate the quality of radiotracer uptake pattern description in key organs in generated reports. We conduct a head-to-head comparison of 30 cutting-edge general-purpose and medical-specialized VLMs. The results show that the current state-of-the-art VLMs perform poorly on PET report generation task, falling considerably short of fulfilling practical needs. Moreover, we identify several key insufficiency that need to be addressed to advance the development in medical applications.

Segment Anything Model (SAM) has gained significant attention because of its ability to segment a variety of objects in images given a prompt. The recently developed SAM 2 has extended this ability to video inputs. This opens an opportunity to apply SAM to 3D images, one of the fundamental tasks in the medical imaging field. In this paper, we provide an extensive evaluation of SAM 2's ability to segment both 2D and 3D medical images. We collect 18 medical imaging datasets, including common 3D modalities such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) as well as 2D modalities such as X-ray and ultrasound. We consider two evaluation pipelines of SAM 2: (1) multi-frame 3D segmentation, where prompts are provided to one or multiple slice(s) selected from the volume, and (2) single-frame 2D segmentation, where prompts are provided to each slice. The former is only applicable to 3D modalities, while the latter applies to both 2D and 3D modalities. We learn that SAM 2 exhibits similar performance as SAM under single-frame 2D segmentation, and has variable performance under multi-frame 3D segmentation depending on the choices of slices to annotate, the direction of the propagation, the predictions utilized during the propagation, etc.

Medical image segmentation is fundamental for biomedical discovery. Existing methods lack generalizability and demand extensive, time-consuming manual annotation for new clinical application. Here, we propose MedSAM-3, a text promptable medical segmentation model for medical image and video segmentation. By fine-tuning the Segment Anything Model (SAM) 3 architecture on medical images paired with semantic conceptual labels, our MedSAM-3 enables medical Promptable Concept Segmentation (PCS), allowing precise targeting of anatomical structures via open-vocabulary text descriptions rather than solely geometric prompts. We further introduce the MedSAM-3 Agent, a framework that integrates Multimodal Large Language Models (MLLMs) to perform complex reasoning and iterative refinement in an agent-in-the-loop workflow. Comprehensive experiments across diverse medical imaging modalities, including X-ray, MRI, Ultrasound, CT, and video, demonstrate that our approach significantly outperforms existing specialist and foundation models. We will release our code and model at https://github.com/Joey-S-Liu/MedSAM3.

With over 85 million CT scans performed annually in the United States, creating tumor-related reports is a challenging and time-consuming task for radiologists. To address this need, we present RadGPT, an Anatomy-Aware Vision-Language AI Agent for generating detailed reports from CT scans. RadGPT first segments tumors, including benign cysts and malignant tumors, and their surrounding anatomical structures, then transforms this information into both structured reports and narrative reports. These reports provide tumor size, shape, location, attenuation, volume, and interactions with surrounding blood vessels and organs. Extensive evaluation on unseen hospitals shows that RadGPT can produce accurate reports, with high sensitivity/specificity for small tumor (<2 cm) detection: 80/73% for liver tumors, 92/78% for kidney tumors, and 77/77% for pancreatic tumors. For large tumors, sensitivity ranges from 89% to 97%. The results significantly surpass the state-of-the-art in abdominal CT report generation. RadGPT generated reports for 17 public datasets. Through radiologist review and refinement, we have ensured the reports' accuracy, and created the first publicly available image-text 3D medical dataset, comprising over 1.8 million text tokens and 2.7 million images from 9,262 CT scans, including 2,947 tumor scans/reports of 8,562 tumor instances. Our reports can: (1) localize tumors in eight liver sub-segments and three pancreatic sub-segments annotated per-voxel; (2) determine pancreatic tumor stage (T1-T4) in 260 reports; and (3) present individual analyses of multiple tumors--rare in human-made reports. Importantly, 948 of the reports are for early-stage tumors.

Early tumor detection save lives. Each year, more than 300 million computed tomography (CT) scans are performed worldwide, offering a vast opportunity for effective cancer screening. However, detecting small or early-stage tumors on these CT scans remains challenging, even for experts. Artificial intelligence (AI) models can assist by highlighting suspicious regions, but training such models typically requires extensive tumor masks--detailed, voxel-wise outlines of tumors manually drawn by radiologists. Drawing these masks is costly, requiring years of effort and millions of dollars. In contrast, nearly every CT scan in clinical practice is already accompanied by medical reports describing the tumor's size, number, appearance, and sometimes, pathology results--information that is rich, abundant, and often underutilized for AI training. We introduce R-Super, which trains AI to segment tumors that match their descriptions in medical reports. This approach scales AI training with large collections of readily available medical reports, substantially reducing the need for manually drawn tumor masks. When trained on 101,654 reports, AI models achieved performance comparable to those trained on 723 masks. Combining reports and masks further improved sensitivity by +13% and specificity by +8%, surpassing radiologists in detecting five of the seven tumor types. Notably, R-Super enabled segmentation of tumors in the spleen, gallbladder, prostate, bladder, uterus, and esophagus, for which no public masks or AI models previously existed. This study challenges the long-held belief that large-scale, labor-intensive tumor mask creation is indispensable, establishing a scalable and accessible path toward early detection across diverse tumor types. We plan to release our trained models, code, and dataset at https://github.com/MrGiovanni/R-Super

MRI is an indispensable clinical tool, offering a rich variety of tissue contrasts to support broad diagnostic and research applications. Clinical exams routinely acquire multiple structural sequences that provide complementary information for differential diagnosis, while research protocols often incorporate advanced functional, diffusion, spectroscopic, and relaxometry sequences to capture multidimensional insights into tissue structure and composition. However, these capabilities come at the cost of prolonged scan times, which reduce patient throughput, increase susceptibility to motion artifacts, and may require trade-offs in image quality or diagnostic scope. Over the last two decades, advances in image reconstruction algorithms--alongside improvements in hardware and pulse sequence design--have made it possible to accelerate acquisitions while preserving diagnostic quality. Central to this progress is the ability to incorporate prior information to regularize the solutions to the reconstruction problem. In this tutorial, we overview the basics of MRI reconstruction and highlight state-of-the-art approaches, beginning with classical methods that rely on explicit hand-crafted priors, and then turning to deep learning methods that leverage a combination of learned and crafted priors to further push the performance envelope. We also explore the translational aspects and eventual clinical implications of these methods. We conclude by discussing future directions to address remaining challenges in MRI reconstruction. The tutorial is accompanied by a Python toolbox (https://github.com/tutorial-MRI-recon/tutorial) to demonstrate select methods discussed in the article.

As fine-tuning (FT) becomes increasingly impractical at scale, probing is emerging as the preferred evaluation protocol for self-supervised learning (SSL). Yet, the standard linear probing (LP) fails to adequately reflect the potential of models trained with Masked Image Modeling (MIM), due to the distributed nature of patch tokens. This motivates the need for attentive probing, an alternative that uses attention to selectively aggregate patch-level features. Despite its growing adoption, attentive probing remains under-explored, with existing methods suffering from excessive parameterization and poor computational efficiency. In this work, we revisit attentive probing through the lens of the accuracy-efficiency trade-off. We conduct a systematic study of existing methods, analyzing their mechanisms and benchmarking their performance. We introduce efficient probing (EP), a multi-query cross-attention mechanism that eliminates redundant projections, reduces the number of trainable parameters, and achieves up to a 10times speed-up over conventional multi-head attention. Despite its simplicity, EP outperforms LP and prior attentive probing approaches across seven benchmarks, generalizes well beyond MIM to diverse pre-training paradigms, produces interpretable attention maps, and achieves strong gains in low-shot and layer-wise settings. Code available at https://github.com/billpsomas/efficient-probing.

We explore the problem of generating minority samples using diffusion models. The minority samples are instances that lie on low-density regions of a data manifold. Generating a sufficient number of such minority instances is important, since they often contain some unique attributes of the data. However, the conventional generation process of the diffusion models mostly yields majority samples (that lie on high-density regions of the manifold) due to their high likelihoods, making themselves ineffective and time-consuming for the minority generating task. In this work, we present a novel framework that can make the generation process of the diffusion models focus on the minority samples. We first highlight that Tweedie's denoising formula yields favorable results for majority samples. The observation motivates us to introduce a metric that describes the uniqueness of a given sample. To address the inherent preference of the diffusion models w.r.t. the majority samples, we further develop minority guidance, a sampling technique that can guide the generation process toward regions with desired likelihood levels. Experiments on benchmark real datasets demonstrate that our minority guidance can greatly improve the capability of generating high-quality minority samples over existing generative samplers. We showcase that the performance benefit of our framework persists even in demanding real-world scenarios such as medical imaging, further underscoring the practical significance of our work. Code is available at https://github.com/soobin-um/minority-guidance.

Reconstructing medical images from partial measurements is an important inverse problem in Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). Existing solutions based on machine learning typically train a model to directly map measurements to medical images, leveraging a training dataset of paired images and measurements. These measurements are typically synthesized from images using a fixed physical model of the measurement process, which hinders the generalization capability of models to unknown measurement processes. To address this issue, we propose a fully unsupervised technique for inverse problem solving, leveraging the recently introduced score-based generative models. Specifically, we first train a score-based generative model on medical images to capture their prior distribution. Given measurements and a physical model of the measurement process at test time, we introduce a sampling method to reconstruct an image consistent with both the prior and the observed measurements. Our method does not assume a fixed measurement process during training, and can thus be flexibly adapted to different measurement processes at test time. Empirically, we observe comparable or better performance to supervised learning techniques in several medical imaging tasks in CT and MRI, while demonstrating significantly better generalization to unknown measurement processes.

Large Multimodal Models (LMMs) have shown remarkable progress in the field of medical Visual Question Answering (Med-VQA), achieving high accuracy on existing benchmarks. However, their reliability under robust evaluation is questionable. This study reveals that state-of-the-art models, when subjected to simple probing evaluation, perform worse than random guessing on medical diagnosis questions. To address this critical evaluation problem, we introduce the Probing Evaluation for Medical Diagnosis (ProbMed) dataset to rigorously assess LMM performance in medical imaging through probing evaluation and procedural diagnosis. Particularly, probing evaluation features pairing original questions with negation questions with hallucinated attributes, while procedural diagnosis requires reasoning across various diagnostic dimensions for each image, including modality recognition, organ identification, clinical findings, abnormalities, and positional grounding. Our evaluation reveals that top-performing models like GPT-4V and Gemini Pro perform worse than random guessing on specialized diagnostic questions, indicating significant limitations in handling fine-grained medical inquiries. Besides, models like LLaVA-Med struggle even with more general questions, and results from CheXagent demonstrate the transferability of expertise across different modalities of the same organ, showing that specialized domain knowledge is still crucial for improving performance. This study underscores the urgent need for more robust evaluation to ensure the reliability of LMMs in critical fields like medical diagnosis, and current LMMs are still far from applicable to those fields.

Magnetic resonance imaging (MRI) is a common and life-saving medical imaging technique. However, acquiring high signal-to-noise ratio MRI scans requires long scan times, resulting in increased costs and patient discomfort, and decreased throughput. Thus, there is great interest in denoising MRI scans, especially for the subtype of diffusion MRI scans that are severely SNR-limited. While most prior MRI denoising methods are supervised in nature, acquiring supervised training datasets for the multitude of anatomies, MRI scanners, and scan parameters proves impractical. Here, we propose Denoising Diffusion Models for Denoising Diffusion MRI (DDM^2), a self-supervised denoising method for MRI denoising using diffusion denoising generative models. Our three-stage framework integrates statistic-based denoising theory into diffusion models and performs denoising through conditional generation. During inference, we represent input noisy measurements as a sample from an intermediate posterior distribution within the diffusion Markov chain. We conduct experiments on 4 real-world in-vivo diffusion MRI datasets and show that our DDM^2 demonstrates superior denoising performances ascertained with clinically-relevant visual qualitative and quantitative metrics.

Radiography imaging protocols focus on particular body regions, therefore producing images of great similarity and yielding recurrent anatomical structures across patients. To exploit this structured information, we propose the use of Space-aware Memory Queues for In-painting and Detecting anomalies from radiography images (abbreviated as SQUID). We show that SQUID can taxonomize the ingrained anatomical structures into recurrent patterns; and in the inference, it can identify anomalies (unseen/modified patterns) in the image. SQUID surpasses 13 state-of-the-art methods in unsupervised anomaly detection by at least 5 points on two chest X-ray benchmark datasets measured by the Area Under the Curve (AUC). Additionally, we have created a new dataset (DigitAnatomy), which synthesizes the spatial correlation and consistent shape in chest anatomy. We hope DigitAnatomy can prompt the development, evaluation, and interpretability of anomaly detection methods.

Predicting human gaze scanpaths is crucial for understanding visual attention, with applications in human-computer interaction, autonomous systems, and cognitive robotics. While deep learning models have advanced scanpath prediction, most existing approaches generate averaged behaviors, failing to capture the variability of human visual exploration. In this work, we present ScanDiff, a novel architecture that combines diffusion models with Vision Transformers to generate diverse and realistic scanpaths. Our method explicitly models scanpath variability by leveraging the stochastic nature of diffusion models, producing a wide range of plausible gaze trajectories. Additionally, we introduce textual conditioning to enable task-driven scanpath generation, allowing the model to adapt to different visual search objectives. Experiments on benchmark datasets show that ScanDiff surpasses state-of-the-art methods in both free-viewing and task-driven scenarios, producing more diverse and accurate scanpaths. These results highlight its ability to better capture the complexity of human visual behavior, pushing forward gaze prediction research. Source code and models are publicly available at https://aimagelab.github.io/ScanDiff.

Multi-modal Retrieval-Augmented Generation (RAG) has become a critical method for empowering LLMs by leveraging candidate visual documents. However, current methods consider the entire document as the basic retrieval unit, introducing substantial irrelevant visual content in two ways: 1) Relevant documents often contain large regions unrelated to the query, diluting the focus on salient information; 2) Retrieving multiple documents to increase recall further introduces redundant and irrelevant documents. These redundant contexts distract the model's attention and further degrade the performance. To address this challenge, we propose RegionRAG, a novel framework that shifts the retrieval paradigm from the document level to the region level. During training, we design a hybrid supervision strategy from both labeled data and unlabeled data to pinpoint relevant patches. During inference, we propose a dynamic pipeline that intelligently groups salient patches into complete semantic regions. By delegating the task of identifying relevant regions to the retriever, RegionRAG enables the generator to focus solely on concise, query-relevant visual content, improving both efficiency and accuracy. Experiments on six benchmarks demonstrate that RegionRAG achieves state-of-the-art performance. It improves retrieval accuracy by 10.02% in R@1 on average, and boosts question answering accuracy by 3.56% while using only 71.42% visual tokens compared with prior methods.

Active learning promises to improve annotation efficiency by iteratively selecting the most important data to be annotated first. However, we uncover a striking contradiction to this promise: active learning fails to select data as efficiently as random selection at the first few choices. We identify this as the cold start problem in vision active learning, caused by a biased and outlier initial query. This paper seeks to address the cold start problem by exploiting the three advantages of contrastive learning: (1) no annotation is required; (2) label diversity is ensured by pseudo-labels to mitigate bias; (3) typical data is determined by contrastive features to reduce outliers. Experiments are conducted on CIFAR-10-LT and three medical imaging datasets (i.e. Colon Pathology, Abdominal CT, and Blood Cell Microscope). Our initial query not only significantly outperforms existing active querying strategies but also surpasses random selection by a large margin. We foresee our solution to the cold start problem as a simple yet strong baseline to choose the initial query for vision active learning. Code is available: https://github.com/c-liangyu/CSVAL

Accurate detection of pulmonary nodules with high sensitivity and specificity is essential for automatic lung cancer diagnosis from CT scans. Although many deep learning-based algorithms make great progress for improving the accuracy of nodule detection, the high false positive rate is still a challenging problem which limited the automatic diagnosis in routine clinical practice. In this paper, we propose a novel pulmonary nodule detection framework based on a 3D Feature Pyramid Network (3DFPN) to improve the sensitivity of nodule detection by employing multi-scale features to increase the resolution of nodules, as well as a parallel top-down path to transit the high-level semantic features to complement low-level general features. Furthermore, a High Sensitivity and Specificity (HS^2) network is introduced to eliminate the falsely detected nodule candidates by tracking the appearance changes in continuous CT slices of each nodule candidate. The proposed framework is evaluated on the public Lung Nodule Analysis (LUNA16) challenge dataset. Our method is able to accurately detect lung nodules at high sensitivity and specificity and achieves 90.4% sensitivity with 1/8 false positive per scan which outperforms the state-of-the-art results 15.6%.

The ability of language models in RAG systems to selectively refuse to answer based on flawed context is critical for safety, yet remains a significant failure point. Our large-scale study reveals that even frontier models struggle in this setting, with refusal accuracy dropping below 50% on multi-document tasks, while exhibiting either dangerous overconfidence or overcaution. Static benchmarks fail to reliably evaluate this capability, as models exploit dataset-specific artifacts and memorize test instances. We introduce RefusalBench, a generative methodology that programmatically creates diagnostic test cases through controlled linguistic perturbation. Our framework employs 176 distinct perturbation strategies across six categories of informational uncertainty and three intensity levels. Evaluation of over 30 models uncovers systematic failure patterns: refusal comprises separable detection and categorization skills, and neither scale nor extended reasoning improves performance. We find that selective refusal is a trainable, alignment-sensitive capability, offering a clear path for improvement. We release two benchmarks -- RefusalBench-NQ (single document) and RefusalBench-GaRAGe (multi-document) -- and our complete generation framework to enable continued, dynamic evaluation of this critical capability.

In some medical imaging tasks and other settings where only small parts of the image are informative for the classification task, traditional CNNs can sometimes struggle to generalise. Manually annotated Regions of Interest (ROI) are sometimes used to isolate the most informative parts of the image. However, these are expensive to collect and may vary significantly across annotators. To overcome these issues, we propose a framework that employs saliency maps to obtain soft spatial attention masks that modulate the image features at different scales. We refer to our method as Adversarial Counterfactual Attention (ACAT). ACAT increases the baseline classification accuracy of lesions in brain CT scans from 71.39% to 72.55% and of COVID-19 related findings in lung CT scans from 67.71% to 70.84% and exceeds the performance of competing methods. We investigate the best way to generate the saliency maps employed in our architecture and propose a way to obtain them from adversarially generated counterfactual images. They are able to isolate the area of interest in brain and lung CT scans without using any manual annotations. In the task of localising the lesion location out of 6 possible regions, they obtain a score of 65.05% on brain CT scans, improving the score of 61.29% obtained with the best competing method.

Colonoscopy is currently one of the most sensitive screening methods for colorectal cancer. This study investigates the frontiers of intelligent colonoscopy techniques and their prospective implications for multimodal medical applications. With this goal, we begin by assessing the current data-centric and model-centric landscapes through four tasks for colonoscopic scene perception, including classification, detection, segmentation, and vision-language understanding. This assessment enables us to identify domain-specific challenges and reveals that multimodal research in colonoscopy remains open for further exploration. To embrace the coming multimodal era, we establish three foundational initiatives: a large-scale multimodal instruction tuning dataset ColonINST, a colonoscopy-designed multimodal language model ColonGPT, and a multimodal benchmark. To facilitate ongoing monitoring of this rapidly evolving field, we provide a public website for the latest updates: https://github.com/ai4colonoscopy/IntelliScope.

Accurate and efficient 3D segmentation is essential for both clinical and research applications. While foundation models like SAM have revolutionized interactive segmentation, their 2D design and domain shift limitations make them ill-suited for 3D medical images. Current adaptations address some of these challenges but remain limited, either lacking volumetric awareness, offering restricted interactivity, or supporting only a small set of structures and modalities. Usability also remains a challenge, as current tools are rarely integrated into established imaging platforms and often rely on cumbersome web-based interfaces with restricted functionality. We introduce nnInteractive, the first comprehensive 3D interactive open-set segmentation method. It supports diverse prompts-including points, scribbles, boxes, and a novel lasso prompt-while leveraging intuitive 2D interactions to generate full 3D segmentations. Trained on 120+ diverse volumetric 3D datasets (CT, MRI, PET, 3D Microscopy, etc.), nnInteractive sets a new state-of-the-art in accuracy, adaptability, and usability. Crucially, it is the first method integrated into widely used image viewers (e.g., Napari, MITK), ensuring broad accessibility for real-world clinical and research applications. Extensive benchmarking demonstrates that nnInteractive far surpasses existing methods, setting a new standard for AI-driven interactive 3D segmentation. nnInteractive is publicly available: https://github.com/MIC-DKFZ/napari-nninteractive (Napari plugin), https://www.mitk.org/MITK-nnInteractive (MITK integration), https://github.com/MIC-DKFZ/nnInteractive (Python backend).

Through a controlled study, we identify a systematic deficiency in the multimodal grounding of Vision Language Models (VLMs). While VLMs can recall factual associations when provided a textual reference to an entity; their ability to do so is significantly diminished when the reference is visual instead. Forcing VLMs to rely on image representations of an entity halves their ability to recall factual knowledge, suggesting that VLMs struggle to link their internal knowledge of an entity with its image representation. We show that such linking failures are correlated with the expression of distinct patterns in model internal states, and that probes on these internal states achieve over 92% accuracy at flagging cases where the VLM response is unreliable. These probes can be applied, without retraining, to identify when a VLM will fail to correctly answer a question that requires an understanding of multimodal input. When used to facilitate selective prediction on a visual question answering task, the probes increase coverage by 7.87% (absolute) while also reducing the risk of error by 0.9% (absolute). Addressing the systematic, detectable deficiency is an important avenue in language grounding, and we provide informed recommendations for future directions.

The PI-CAI (Prostate Imaging: Cancer AI) challenge led to expert-level diagnostic algorithms for clinically significant prostate cancer detection. The algorithms receive biparametric MRI scans as input, which consist of T2-weighted and diffusion-weighted scans. These scans can be misaligned due to multiple factors in the scanning process. Image registration can alleviate this issue by predicting the deformation between the sequences. We investigate the effect of image registration on the diagnostic performance of AI-based prostate cancer diagnosis. First, the image registration algorithm, developed in MeVisLab, is analyzed using a dataset with paired lesion annotations. Second, the effect on diagnosis is evaluated by comparing case-level cancer diagnosis performance between using the original dataset, rigidly aligned diffusion-weighted scans, or deformably aligned diffusion-weighted scans. Rigid registration showed no improvement. Deformable registration demonstrated a substantial improvement in lesion overlap (+10% median Dice score) and a positive yet non-significant improvement in diagnostic performance (+0.3% AUROC, p=0.18). Our investigation shows that a substantial improvement in lesion alignment does not directly lead to a significant improvement in diagnostic performance. Qualitative analysis indicated that jointly developing image registration methods and diagnostic AI algorithms could enhance diagnostic accuracy and patient outcomes.

Formulating selective information needs results in queries that implicitly specify set operations, such as intersection, union, and difference. For instance, one might search for "shorebirds that are not sandpipers" or "science-fiction films shot in England". To study the ability of retrieval systems to meet such information needs, we construct QUEST, a dataset of 3357 natural language queries with implicit set operations, that map to a set of entities corresponding to Wikipedia documents. The dataset challenges models to match multiple constraints mentioned in queries with corresponding evidence in documents and correctly perform various set operations. The dataset is constructed semi-automatically using Wikipedia category names. Queries are automatically composed from individual categories, then paraphrased and further validated for naturalness and fluency by crowdworkers. Crowdworkers also assess the relevance of entities based on their documents and highlight attribution of query constraints to spans of document text. We analyze several modern retrieval systems, finding that they often struggle on such queries. Queries involving negation and conjunction are particularly challenging and systems are further challenged with combinations of these operations.

Multi-center positron emission tomography (PET) image synthesis aims at recovering low-dose PET images from multiple different centers. The generalizability of existing methods can still be suboptimal for a multi-center study due to domain shifts, which result from non-identical data distribution among centers with different imaging systems/protocols. While some approaches address domain shifts by training specialized models for each center, they are parameter inefficient and do not well exploit the shared knowledge across centers. To address this, we develop a generalist model that shares architecture and parameters across centers to utilize the shared knowledge. However, the generalist model can suffer from the center interference issue, i.e. the gradient directions of different centers can be inconsistent or even opposite owing to the non-identical data distribution. To mitigate such interference, we introduce a novel dynamic routing strategy with cross-layer connections that routes data from different centers to different experts. Experiments show that our generalist model with dynamic routing (DRMC) exhibits excellent generalizability across centers. Code and data are available at: https://github.com/Yaziwel/Multi-Center-PET-Image-Synthesis.

Purpose: In radiology, large language models (LLMs), including ChatGPT, have recently gained attention, and their utility is being rapidly evaluated. However, concerns have emerged regarding their reliability in clinical applications due to limitations such as hallucinations and insufficient referencing. To address these issues, we focus on the latest technology, retrieval-augmented generation (RAG), which enables LLMs to reference reliable external knowledge (REK). Specifically, this study examines the utility and reliability of a recently released RAG-equipped LLM (RAG-LLM), NotebookLM, for staging lung cancer. Materials and methods: We summarized the current lung cancer staging guideline in Japan and provided this as REK to NotebookLM. We then tasked NotebookLM with staging 100 fictional lung cancer cases based on CT findings and evaluated its accuracy. For comparison, we performed the same task using a gold-standard LLM, GPT-4 Omni (GPT-4o), both with and without the REK. Results: NotebookLM achieved 86% diagnostic accuracy in the lung cancer staging experiment, outperforming GPT-4o, which recorded 39% accuracy with the REK and 25% without it. Moreover, NotebookLM demonstrated 95% accuracy in searching reference locations within the REK. Conclusion: NotebookLM successfully performed lung cancer staging by utilizing the REK, demonstrating superior performance compared to GPT-4o. Additionally, it provided highly accurate reference locations within the REK, allowing radiologists to efficiently evaluate the reliability of NotebookLM's responses and detect possible hallucinations. Overall, this study highlights the potential of NotebookLM, a RAG-LLM, in image diagnosis.

Diffusion-weighted magnetic resonance imaging (DW-MRI) can be used to characterise the microstructure of the nervous tissue, e.g. to delineate brain white matter connections in a non-invasive manner via fibre tracking. Magnetic Resonance Imaging (MRI) in high spatial resolution would play an important role in visualising such fibre tracts in a superior manner. However, obtaining an image of such resolution comes at the expense of longer scan time. Longer scan time can be associated with the increase of motion artefacts, due to the patient's psychological and physical conditions. Single Image Super-Resolution (SISR), a technique aimed to obtain high-resolution (HR) details from one single low-resolution (LR) input image, achieved with Deep Learning, is the focus of this study. Compared to interpolation techniques or sparse-coding algorithms, deep learning extracts prior knowledge from big datasets and produces superior MRI images from the low-resolution counterparts. In this research, a deep learning based super-resolution technique is proposed and has been applied for DW-MRI. Images from the IXI dataset have been used as the ground-truth and were artificially downsampled to simulate the low-resolution images. The proposed method has shown statistically significant improvement over the baselines and achieved an SSIM of 0.913pm0.045.

Chest X-rays (CXRs) are commonly utilized as a low-dose modality for lung screening. Nonetheless, the efficacy of CXRs is somewhat impeded, given that approximately 75% of the lung area overlaps with bone, which in turn hampers the detection and diagnosis of diseases. As a remedial measure, bone suppression techniques have been introduced. The current dual-energy subtraction imaging technique in the clinic requires costly equipment and subjects being exposed to high radiation. To circumvent these issues, deep learning-based image generation algorithms have been proposed. However, existing methods fall short in terms of producing high-quality images and capturing texture details, particularly with pulmonary vessels. To address these issues, this paper proposes a new bone suppression framework, termed BS-Diff, that comprises a conditional diffusion model equipped with a U-Net architecture and a simple enhancement module to incorporate an autoencoder. Our proposed network cannot only generate soft tissue images with a high bone suppression rate but also possesses the capability to capture fine image details. Additionally, we compiled the largest dataset since 2010, including data from 120 patients with high-definition, high-resolution paired CXRs and soft tissue images collected by our affiliated hospital. Extensive experiments, comparative analyses, ablation studies, and clinical evaluations indicate that the proposed BS-Diff outperforms several bone-suppression models across multiple metrics. Our code can be accessed at https://github.com/Benny0323/BS-Diff.

Feature selection is the problem of selecting a subset of features for a machine learning model that maximizes model quality subject to a budget constraint. For neural networks, prior methods, including those based on ell_1 regularization, attention, and other techniques, typically select the entire feature subset in one evaluation round, ignoring the residual value of features during selection, i.e., the marginal contribution of a feature given that other features have already been selected. We propose a feature selection algorithm called Sequential Attention that achieves state-of-the-art empirical results for neural networks. This algorithm is based on an efficient one-pass implementation of greedy forward selection and uses attention weights at each step as a proxy for feature importance. We give theoretical insights into our algorithm for linear regression by showing that an adaptation to this setting is equivalent to the classical Orthogonal Matching Pursuit (OMP) algorithm, and thus inherits all of its provable guarantees. Our theoretical and empirical analyses offer new explanations towards the effectiveness of attention and its connections to overparameterization, which may be of independent interest.

In standard Convolutional Neural Networks (CNNs), the receptive fields of artificial neurons in each layer are designed to share the same size. It is well-known in the neuroscience community that the receptive field size of visual cortical neurons are modulated by the stimulus, which has been rarely considered in constructing CNNs. We propose a dynamic selection mechanism in CNNs that allows each neuron to adaptively adjust its receptive field size based on multiple scales of input information. A building block called Selective Kernel (SK) unit is designed, in which multiple branches with different kernel sizes are fused using softmax attention that is guided by the information in these branches. Different attentions on these branches yield different sizes of the effective receptive fields of neurons in the fusion layer. Multiple SK units are stacked to a deep network termed Selective Kernel Networks (SKNets). On the ImageNet and CIFAR benchmarks, we empirically show that SKNet outperforms the existing state-of-the-art architectures with lower model complexity. Detailed analyses show that the neurons in SKNet can capture target objects with different scales, which verifies the capability of neurons for adaptively adjusting their receptive field sizes according to the input. The code and models are available at https://github.com/implus/SKNet.

Developing advanced medical imaging retrieval systems is challenging due to the varying definitions of `similar images' across different medical contexts. This challenge is compounded by the lack of large-scale, high-quality medical imaging retrieval datasets and benchmarks. In this paper, we propose a novel methodology that leverages dense radiology reports to define image-wise similarity ordering at multiple granularities in a scalable and fully automatic manner. Using this approach, we construct two comprehensive medical imaging retrieval datasets: MIMIC-IR for Chest X-rays and CTRATE-IR for CT scans, providing detailed image-image ranking annotations conditioned on diverse anatomical structures. Furthermore, we develop two retrieval systems, RadIR-CXR and model-ChestCT, which demonstrate superior performance in traditional image-image and image-report retrieval tasks. These systems also enable flexible, effective image retrieval conditioned on specific anatomical structures described in text, achieving state-of-the-art results on 77 out of 78 metrics.

Automated slice classification is clinically relevant since it can be incorporated into medical image segmentation workflows as a preprocessing step that would flag slices with a higher probability of containing tumors, thereby directing physicians attention to the important slices. In this work, we train a ResNet-18 network to classify axial slices of lymphoma PET/CT images (collected from two institutions) depending on whether the slice intercepted a tumor (positive slice) in the 3D image or if the slice did not (negative slice). Various instances of the network were trained on 2D axial datasets created in different ways: (i) slice-level split and (ii) patient-level split; inputs of different types were used: (i) only PET slices and (ii) concatenated PET and CT slices; and different training strategies were employed: (i) center-aware (CAW) and (ii) center-agnostic (CAG). Model performances were compared using the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC), and various binary classification metrics. We observe and describe a performance overestimation in the case of slice-level split as compared to the patient-level split training. The model trained using patient-level split data with the network input containing only PET slices in the CAG training regime was the best performing/generalizing model on a majority of metrics. Our models were additionally more closely compared using the sensitivity metric on the positive slices from their respective test sets.

Pre-trained on a large and diverse dataset, the segment anything model (SAM) is the first promptable foundation model in computer vision aiming at object segmentation tasks. In this work, we evaluate SAM for the task of nuclear instance segmentation performance with zero-shot learning and finetuning. We compare SAM with other representative methods in nuclear instance segmentation, especially in the context of model generalisability. To achieve automatic nuclear instance segmentation, we propose using a nuclei detection model to provide bounding boxes or central points of nu-clei as visual prompts for SAM in generating nuclear instance masks from histology images.

Automatic security inspection using computer vision technology is a challenging task in real-world scenarios due to various factors, including intra-class variance, class imbalance, and occlusion. Most of the previous methods rarely solve the cases that the prohibited items are deliberately hidden in messy objects due to the lack of large-scale datasets, restricted their applications in real-world scenarios. Towards real-world prohibited item detection, we collect a large-scale dataset, named as PIDray, which covers various cases in real-world scenarios for prohibited item detection, especially for deliberately hidden items. With an intensive amount of effort, our dataset contains 12 categories of prohibited items in 47,677 X-ray images with high-quality annotated segmentation masks and bounding boxes. To the best of our knowledge, it is the largest prohibited items detection dataset to date. Meanwhile, we design the selective dense attention network (SDANet) to construct a strong baseline, which consists of the dense attention module and the dependency refinement module. The dense attention module formed by the spatial and channel-wise dense attentions, is designed to learn the discriminative features to boost the performance. The dependency refinement module is used to exploit the dependencies of multi-scale features. Extensive experiments conducted on the collected PIDray dataset demonstrate that the proposed method performs favorably against the state-of-the-art methods, especially for detecting the deliberately hidden items.

Radiologists rely on eye movements to navigate and interpret medical images. A trained radiologist possesses knowledge about the potential diseases that may be present in the images and, when searching, follows a mental checklist to locate them using their gaze. This is a key observation, yet existing models fail to capture the underlying intent behind each fixation. In this paper, we introduce a deep learning-based approach, RadGazeIntent, designed to model this behavior: having an intention to find something and actively searching for it. Our transformer-based architecture processes both the temporal and spatial dimensions of gaze data, transforming fine-grained fixation features into coarse, meaningful representations of diagnostic intent to interpret radiologists' goals. To capture the nuances of radiologists' varied intention-driven behaviors, we process existing medical eye-tracking datasets to create three intention-labeled subsets: RadSeq (Systematic Sequential Search), RadExplore (Uncertainty-driven Exploration), and RadHybrid (Hybrid Pattern). Experimental results demonstrate RadGazeIntent's ability to predict which findings radiologists are examining at specific moments, outperforming baseline methods across all intention-labeled datasets.

The automated generation of imaging reports proves invaluable in alleviating the workload of radiologists. A clinically applicable reports generation algorithm should demonstrate its effectiveness in producing reports that accurately describe radiology findings and attend to patient-specific indications. In this paper, we introduce a novel method, Structural Entities extraction and patient indications Incorporation (SEI) for chest X-ray report generation. Specifically, we employ a structural entities extraction (SEE) approach to eliminate presentation-style vocabulary in reports and improve the quality of factual entity sequences. This reduces the noise in the following cross-modal alignment module by aligning X-ray images with factual entity sequences in reports, thereby enhancing the precision of cross-modal alignment and further aiding the model in gradient-free retrieval of similar historical cases. Subsequently, we propose a cross-modal fusion network to integrate information from X-ray images, similar historical cases, and patient-specific indications. This process allows the text decoder to attend to discriminative features of X-ray images, assimilate historical diagnostic information from similar cases, and understand the examination intention of patients. This, in turn, assists in triggering the text decoder to produce high-quality reports. Experiments conducted on MIMIC-CXR validate the superiority of SEI over state-of-the-art approaches on both natural language generation and clinical efficacy metrics.

Beam search is the default decoding strategy for many sequence generation tasks in NLP. The set of approximate K-best items returned by the algorithm is a useful summary of the distribution for many applications; however, the candidates typically exhibit high overlap and may give a highly biased estimate for expectations under our model. These problems can be addressed by instead using stochastic decoding strategies. In this work, we propose a new method for turning beam search into a stochastic process: Conditional Poisson stochastic beam search. Rather than taking the maximizing set at each iteration, we sample K candidates without replacement according to the conditional Poisson sampling design. We view this as a more natural alternative to Kool et. al. 2019's stochastic beam search (SBS). Furthermore, we show how samples generated under the CPSBS design can be used to build consistent estimators and sample diverse sets from sequence models. In our experiments, we observe CPSBS produces lower variance and more efficient estimators than SBS, even showing improvements in high entropy settings.

The recent release of RadGenome-Chest CT has significantly advanced CT-based report generation. However, existing methods primarily focus on global features, making it challenging to capture region-specific details, which may cause certain abnormalities to go unnoticed. To address this, we propose MedRegion-CT, a region-focused Multi-Modal Large Language Model (MLLM) framework, featuring three key innovations. First, we introduce Region Representative (R^2) Token Pooling, which utilizes a 2D-wise pretrained vision model to efficiently extract 3D CT features. This approach generates global tokens representing overall slice features and region tokens highlighting target areas, enabling the MLLM to process comprehensive information effectively. Second, a universal segmentation model generates pseudo-masks, which are then processed by a mask encoder to extract region-centric features. This allows the MLLM to focus on clinically relevant regions, using six predefined region masks. Third, we leverage segmentation results to extract patient-specific attributions, including organ size, diameter, and locations. These are converted into text prompts, enriching the MLLM's understanding of patient-specific contexts. To ensure rigorous evaluation, we conducted benchmark experiments on report generation using the RadGenome-Chest CT. MedRegion-CT achieved state-of-the-art performance, outperforming existing methods in natural language generation quality and clinical relevance while maintaining interpretability. The code for our framework is publicly available.

Given the dominance of dense retrievers that do not generalize well beyond their training dataset distributions, domain-specific test sets are essential in evaluating retrieval. There are few test datasets for retrieval systems intended for use by healthcare providers in a point-of-care setting. To fill this gap we have collaborated with medical professionals to create CURE, an ad-hoc retrieval test dataset for passage ranking with 2000 queries spanning 10 medical domains with a monolingual (English) and two cross-lingual (French/Spanish -> English) conditions. In this paper, we describe how CURE was constructed and provide baseline results to showcase its effectiveness as an evaluation tool. CURE is published with a Creative Commons Attribution Non Commercial 4.0 license and can be accessed on Hugging Face.

The Bright Transient Survey (BTS) aims to obtain a classification spectrum for all bright (m_peak,leq,18.5,mag) extragalactic transients found in the Zwicky Transient Facility (ZTF) public survey. BTS critically relies on visual inspection ("scanning") to select targets for spectroscopic follow-up, which, while effective, has required a significant time investment over the past sim5 yr of ZTF operations. We present BTSbot, a multi-modal convolutional neural network, which provides a bright transient score to individual ZTF detections using their image data and 25 extracted features. BTSbot is able to eliminate the need for daily human scanning by automatically identifying and requesting spectroscopic follow-up observations of new bright transient candidates. BTSbot recovers all bright transients in our test split and performs on par with scanners in terms of identification speed (on average, sim1 hour quicker than scanners). We also find that BTSbot is not significantly impacted by any data shift by comparing performance across a concealed test split and a sample of very recent BTS candidates. BTSbot has been integrated into Fritz and Kowalski, ZTF's first-party marshal and alert broker, and now sends automatic spectroscopic follow-up requests for the new transients it identifies. During the month of October 2023, BTSbot selected 296 sources in real-time, 93% of which were real extragalactic transients. With BTSbot and other automation tools, the BTS workflow has produced the first fully automatic end-to-end discovery and classification of a transient, representing a significant reduction in the human-time needed to scan. Future development has tremendous potential for creating similar models to identify and request follow-up observations for specific types of transients.

Rerankers play a critical role in multimodal Retrieval-Augmented Generation (RAG) by refining ranking of an initial set of retrieved documents. Rerankers are typically trained using hard negative mining, whose goal is to select pages for each query which rank high, but are actually irrelevant. However, this selection process is typically passive and restricted to what the retriever can find in the available corpus, leading to several inherent limitations. These include: limited diversity, negative examples which are often not hard enough, low controllability, and frequent false negatives which harm training. Our paper proposes an alternative approach: Single-Page Hard Negative Query Generation, which goes the other way around. Instead of retrieving negative pages per query, we generate hard negative queries per page. Using an automated LLM-VLM pipeline, and given a page and its positive query, we create hard negatives by rephrasing the query to be as similar as possible in form and context, yet not answerable from the page. This paradigm enables fine-grained control over the generated queries, resulting in diverse, hard, and targeted negatives. It also supports efficient false negative verification. Our experiments show that rerankers trained with data generated using our approach outperform existing models and significantly improve retrieval performance.

The DESI Legacy Imaging Surveys are a combination of three public projects (the Dark Energy Camera Legacy Survey, the Beijing-Arizona Sky Survey, and the Mayall z-band Legacy Survey) that will jointly image approximately 14,000 deg^2 of the extragalactic sky visible from the northern hemisphere in three optical bands (g, r, and z) using telescopes at the Kitt Peak National Observatory and the Cerro Tololo Inter-American Observatory. The combined survey footprint is split into two contiguous areas by the Galactic plane. The optical imaging is conducted using a unique strategy of dynamically adjusting the exposure times and pointing selection during observing that results in a survey of nearly uniform depth. In addition to calibrated images, the project is delivering a catalog, constructed by using a probabilistic inference-based approach to estimate source shapes and brightnesses. The catalog includes photometry from the grz optical bands and from four mid-infrared bands (at 3.4, 4.6, 12 and 22 micorons) observed by the Wide-field Infrared Survey Explorer (WISE) satellite during its full operational lifetime. The project plans two public data releases each year. All the software used to generate the catalogs is also released with the data. This paper provides an overview of the Legacy Surveys project.

Instruction tuning (IT) is crucial to tailoring large language models (LLMs) towards human-centric interactions. Recent advancements have shown that the careful selection of a small, high-quality subset of IT data can significantly enhance the performance of LLMs. Despite this, common approaches often rely on additional models or data sets, which increases costs and limits widespread adoption. In this work, we propose a novel approach, termed SelectIT, that capitalizes on the foundational capabilities of the LLM itself. Specifically, we exploit the intrinsic uncertainty present in LLMs to more effectively select high-quality IT data, without the need for extra resources. Furthermore, we introduce a novel IT dataset, the Selective Alpaca, created by applying SelectIT to the Alpaca-GPT4 dataset. Empirical results demonstrate that IT using Selective Alpaca leads to substantial model ability enhancement. The robustness of SelectIT has also been corroborated in various foundation models and domain-specific tasks. Our findings suggest that longer and more computationally intensive IT data may serve as superior sources of IT, offering valuable insights for future research in this area. Data, code, and scripts are freely available at https://github.com/Blue-Raincoat/SelectIT.

When reading medical images such as a computed tomography (CT) scan, radiologists generally search across the image to find lesions, characterize and measure them, and then describe them in the radiological report. To automate this process, we propose a multitask universal lesion analysis network (MULAN) for joint detection, tagging, and segmentation of lesions in a variety of body parts, which greatly extends existing work of single-task lesion analysis on specific body parts. MULAN is based on an improved Mask R-CNN framework with three head branches and a 3D feature fusion strategy. It achieves the state-of-the-art accuracy in the detection and tagging tasks on the DeepLesion dataset, which contains 32K lesions in the whole body. We also analyze the relationship between the three tasks and show that tag predictions can improve detection accuracy via a score refinement layer.

Eliminating examination bias accurately is pivotal to apply click-through data to train an unbiased ranking model. However, most examination-bias estimators are limited to the hypothesis of Position-Based Model (PBM), which supposes that the calculation of examination bias only depends on the rank of the document. Recently, although some works introduce information such as clicks in the same query list and contextual information when calculating the examination bias, they still do not model the impact of document representation on search engine result pages (SERPs) that seriously affects one's perception of document relevance to a query when examining. Therefore, we propose a Multi-Feature Integration Model (MFIM) where the examination bias depends on the representation of document except the rank of it. Furthermore, we mine a key factor slipoff counts that can indirectly reflects the influence of all perception-bias factors. Real world experiments on Baidu-ULTR dataset demonstrate the superior effectiveness and robustness of the new approach. The source code is available at https://github.com/lixsh6/Tencent_wsdm_cup2023/tree/main/pytorch_unbias{https://github.com/lixsh6/Tencent\_wsdm\_cup2023}

Most of the existing chest X-ray datasets include labels from a list of findings without specifying their locations on the radiographs. This limits the development of machine learning algorithms for the detection and localization of chest abnormalities. In this work, we describe a dataset of more than 100,000 chest X-ray scans that were retrospectively collected from two major hospitals in Vietnam. Out of this raw data, we release 18,000 images that were manually annotated by a total of 17 experienced radiologists with 22 local labels of rectangles surrounding abnormalities and 6 global labels of suspected diseases. The released dataset is divided into a training set of 15,000 and a test set of 3,000. Each scan in the training set was independently labeled by 3 radiologists, while each scan in the test set was labeled by the consensus of 5 radiologists. We designed and built a labeling platform for DICOM images to facilitate these annotation procedures. All images are made publicly available (https://www.physionet.org/content/vindr-cxr/1.0.0/) in DICOM format along with the labels of both the training set and the test set.

This work introduces a new framework, ProtoSAM, for one-shot medical image segmentation. It combines the use of prototypical networks, known for few-shot segmentation, with SAM - a natural image foundation model. The method proposed creates an initial coarse segmentation mask using the ALPnet prototypical network, augmented with a DINOv2 encoder. Following the extraction of an initial mask, prompts are extracted, such as points and bounding boxes, which are then input into the Segment Anything Model (SAM). State-of-the-art results are shown on several medical image datasets and demonstrate automated segmentation capabilities using a single image example (one shot) with no need for fine-tuning of the foundation model. Our code is available at: https://github.com/levayz/ProtoSAM

Late-interaction multimodal retrieval models like ColPali achieve state-of-the-art document retrieval by embedding pages as images and computing fine-grained similarity between query tokens and visual patches. However, they return entire pages rather than specific regions, limiting utility for retrieval-augmented generation (RAG) where precise context is paramount. Conversely, OCR-based systems extract structured text with bounding box coordinates but lack semantic grounding for relevance assessment. We propose a hybrid architecture that unifies these paradigms: using ColPali's patch-level similarity scores as spatial relevance filters over OCR-extracted regions. We formalize the coordinate mapping between vision transformer patch grids and OCR bounding boxes, introduce intersection metrics for relevance propagation, and establish theoretical bounds on area efficiency. We evaluate on BBox-DocVQA with ground-truth bounding boxes. For within-page localization (given correct page retrieval), ColQwen3-4B with percentile-50 thresholding achieves 59.7% hit rate at [email protected] (84.4% at [email protected], 35.8% at [email protected]), with mean IoU of 0.569, compared to ~6.7% for random region selection. Our approach reduces context tokens by 28.8% compared to returning all OCR regions and by 52.3% compared to full-page image tokens. Our approach operates at inference time without additional training. We release Snappy, an open-source implementation at https://github.com/athrael-soju/Snappy.

We combine beam search with the probabilistic pruning technique of nucleus sampling to create two deterministic nucleus search algorithms for natural language generation. The first algorithm, p-exact search, locally prunes the next-token distribution and performs an exact search over the remaining space. The second algorithm, dynamic beam search, shrinks and expands the beam size according to the entropy of the candidate's probability distribution. Despite the probabilistic intuition behind nucleus search, experiments on machine translation and summarization benchmarks show that both algorithms reach the same performance levels as standard beam search.

We present MInDI-3D (Medical Inversion by Direct Iteration in 3D), the first 3D conditional diffusion-based model for real-world sparse-view Cone Beam Computed Tomography (CBCT) artefact removal, aiming to reduce imaging radiation exposure. A key contribution is extending the "InDI" concept from 2D to a full 3D volumetric approach for medical images, implementing an iterative denoising process that refines the CBCT volume directly from sparse-view input. A further contribution is the generation of a large pseudo-CBCT dataset (16,182) from chest CT volumes of the CT-RATE public dataset to robustly train MInDI-3D. We performed a comprehensive evaluation, including quantitative metrics, scalability analysis, generalisation tests, and a clinical assessment by 11 clinicians. Our results show MInDI-3D's effectiveness, achieving a 12.96 (6.10) dB PSNR gain over uncorrected scans with only 50 projections on the CT-RATE pseudo-CBCT (independent real-world) test set and enabling an 8x reduction in imaging radiation exposure. We demonstrate its scalability by showing that performance improves with more training data. Importantly, MInDI-3D matches the performance of a 3D U-Net on real-world scans from 16 cancer patients across distortion and task-based metrics. It also generalises to new CBCT scanner geometries. Clinicians rated our model as sufficient for patient positioning across all anatomical sites and found it preserved lung tumour boundaries well.

Breast cancer is a major cause of cancer death among women, emphasising the importance of early detection for improved treatment outcomes and quality of life. Mammography, the primary diagnostic imaging test, poses challenges due to the high variability and patterns in mammograms. Double reading of mammograms is recommended in many screening programs to improve diagnostic accuracy but increases radiologists' workload. Researchers explore Machine Learning models to support expert decision-making. Stand-alone models have shown comparable or superior performance to radiologists, but some studies note decreased sensitivity with multiple datasets, indicating the need for high generalisation and robustness models. This work devises MammoDG, a novel deep-learning framework for generalisable and reliable analysis of cross-domain multi-center mammography data. MammoDG leverages multi-view mammograms and a novel contrastive mechanism to enhance generalisation capabilities. Extensive validation demonstrates MammoDG's superiority, highlighting the critical importance of domain generalisation for trustworthy mammography analysis in imaging protocol variations.

Radiation therapy plays a crucial role in cancer treatment, necessitating precise delivery of radiation to tumors while sparing healthy tissues over multiple days. Computed tomography (CT) is integral for treatment planning, offering electron density data crucial for accurate dose calculations. However, accurately representing patient anatomy is challenging, especially in adaptive radiotherapy, where CT is not acquired daily. Magnetic resonance imaging (MRI) provides superior soft-tissue contrast. Still, it lacks electron density information while cone beam CT (CBCT) lacks direct electron density calibration and is mainly used for patient positioning. Adopting MRI-only or CBCT-based adaptive radiotherapy eliminates the need for CT planning but presents challenges. Synthetic CT (sCT) generation techniques aim to address these challenges by using image synthesis to bridge the gap between MRI, CBCT, and CT. The SynthRAD2023 challenge was organized to compare synthetic CT generation methods using multi-center ground truth data from 1080 patients, divided into two tasks: 1) MRI-to-CT and 2) CBCT-to-CT. The evaluation included image similarity and dose-based metrics from proton and photon plans. The challenge attracted significant participation, with 617 registrations and 22/17 valid submissions for tasks 1/2. Top-performing teams achieved high structural similarity indices (>0.87/0.90) and gamma pass rates for photon (>98.1%/99.0%) and proton (>99.0%/97.3%) plans. However, no significant correlation was found between image similarity metrics and dose accuracy, emphasizing the need for dose evaluation when assessing the clinical applicability of sCT. SynthRAD2023 facilitated the investigation and benchmarking of sCT generation techniques, providing insights for developing MRI-only and CBCT-based adaptive radiotherapy.

The galaxy population is strongly bimodal in both colour and morphology, and the two measures correlate strongly, with most blue galaxies being late-types (spirals) and most early-types, typically ellipticals, being red. This observation has led to the use of colour as a convenient selection criteria to make samples which are then labelled by morphology. Such use of colour as a proxy for morphology results in necessarily impure and incomplete samples. In this paper, we make use of the morphological labels produced by Galaxy Zoo to measure how incomplete and impure such samples are, considering optical (ugriz), NUV and NIR (JHK) bands. The best single colour optical selection is found using a threshold of g-r = 0.742, but this still results in a sample where only 56% of red galaxies are smooth and 56% of smooth galaxies are red. Use of the NUV gives some improvement over purely optical bands, particularly for late-types, but still results in low purity/completeness for early-types. No significant improvement is found by adding NIR bands. With any two bands, including NUV, a sample of early-types with greater than two-thirds purity cannot be constructed. Advances in quantitative galaxy morphologies have made colour-morphology proxy selections largely unnecessary going forward; where such assumptions are still required, we recommend studies carefully consider the implications of sample incompleteness/impurity.

Computed Tomography (CT) scan, which produces 3D volumetric medical data that can be viewed as hundreds of cross-sectional images (a.k.a. slices), provides detailed anatomical information for diagnosis. For radiologists, creating CT radiology reports is time-consuming and error-prone. A visual question answering (VQA) system that can answer radiologists' questions about some anatomical regions on the CT scan and even automatically generate a radiology report is urgently needed. However, existing VQA systems cannot adequately handle the CT radiology question answering (CTQA) task for: (1) anatomic complexity makes CT images difficult to understand; (2) spatial relationship across hundreds slices is difficult to capture. To address these issues, this paper proposes CT-Agent, a multimodal agentic framework for CTQA. CT-Agent adopts anatomically independent tools to break down the anatomic complexity; furthermore, it efficiently captures the across-slice spatial relationship with a global-local token compression strategy. Experimental results on two 3D chest CT datasets, CT-RATE and RadGenome-ChestCT, verify the superior performance of CT-Agent.

One of the most challenging problems facing NLP today is evaluation. Some of the most pressing issues pertain to benchmark saturation, data contamination, and diversity in the quality of test examples. To address these concerns, we propose Selection Methodology for Accurate, Reduced, and Targeted (SMART) filtering, a novel approach to select a high-quality subset of examples from existing benchmark datasets by systematically removing less informative and less challenging examples. Our approach applies three filtering criteria, removing (i) easy examples, (ii) data-contaminated examples, and (iii) examples that are similar to each other based on distance in an embedding space. We demonstrate the effectiveness of SMART on three multiple choice QA datasets, where our methodology increases efficiency by reducing dataset size by 48\% on average, while increasing Pearson correlation with rankings from ChatBot Arena, a more open-ended human evaluation setting. Our method enables us to be more efficient, whether using SMART to make new benchmarks more challenging or to revitalize older datasets, while still preserving the relative model rankings.

Linear attention mechanisms have gained prominence in causal language models due to their linear computational complexity and enhanced speed. However, the inherent decay mechanism in linear attention presents challenges when applied to multi-dimensional sequence modeling tasks, such as image processing and multi-modal learning. In these scenarios, the utilization of sequential scanning to establish a global receptive field necessitates multiple scans for multi-dimensional data, thereby leading to inefficiencies. This paper identifies the inefficiency caused by a multiplicative linear recurrence and proposes an efficient alternative additive linear recurrence to avoid the issue, as it can handle multi-dimensional data within a single scan. We further develop an efficient multi-dimensional sequential modeling framework called LightNet based on the new recurrence. Moreover, we present two new multi-dimensional linear relative positional encoding methods, MD-TPE and MD-LRPE to enhance the model's ability to discern positional information in multi-dimensional scenarios. Our empirical evaluations across various tasks, including image classification, image generation, bidirectional language modeling, and autoregressive language modeling, demonstrate the efficacy of LightNet, showcasing its potential as a versatile and efficient solution for multi-dimensional sequential modeling.

With the growing size of pre-trained models, full fine-tuning and storing all the parameters for various downstream tasks is costly and infeasible. In this paper, we propose a new parameter-efficient fine-tuning method, Gradient-based Parameter Selection (GPS), demonstrating that only tuning a few selected parameters from the pre-trained model while keeping the remainder of the model frozen can generate similar or better performance compared with the full model fine-tuning method. Different from the existing popular and state-of-the-art parameter-efficient fine-tuning approaches, our method does not introduce any additional parameters and computational costs during both the training and inference stages. Another advantage is the model-agnostic and non-destructive property, which eliminates the need for any other design specific to a particular model. Compared with the full fine-tuning, GPS achieves 3.33% (91.78% vs. 88.45%, FGVC) and 9.61% (73.1% vs. 65.57%, VTAB) improvement of the accuracy with tuning only 0.36% parameters of the pre-trained model on average over 24 image classification tasks; it also demonstrates a significant improvement of 17% and 16.8% in mDice and mIoU, respectively, on medical image segmentation task. Moreover, GPS achieves state-of-the-art performance compared with existing PEFT methods.

Fine-tuning large language models (LLMs) on downstream tasks requires substantial computational resources. Selective PEFT, a class of parameter-efficient fine-tuning (PEFT) methodologies, aims to mitigate these computational challenges by selectively fine-tuning only a small fraction of the model parameters. Although parameter-efficient, these techniques often fail to match the performance of fully fine-tuned models, primarily due to inherent biases introduced during parameter selection. Traditional selective PEFT techniques use a fixed set of parameters selected using different importance heuristics, failing to capture parameter importance dynamically and often leading to suboptimal performance. We introduce ID^3, a novel selective PEFT method that calculates parameter importance continually, and dynamically unmasks parameters by balancing exploration and exploitation in parameter selection. Our empirical study on 16 tasks spanning natural language understanding, mathematical reasoning and summarization demonstrates the effectiveness of our method compared to fixed-masking selective PEFT techniques. We analytically show that ID^3 reduces the number of gradient updates by a factor of two, enhancing computational efficiency. Since ID^3 is robust to random initialization of neurons and operates directly on the optimization process, it is highly flexible and can be integrated with existing additive and reparametrization-based PEFT techniques such as adapters and LoRA respectively.

The rapid advancement of Artificial Intelligence (AI) in biomedical imaging and radiotherapy is hindered by the limited availability of large imaging data repositories. With recent research and improvements in denoising diffusion probabilistic models (DDPM), high quality synthetic medical scans are now possible. Despite this, there is currently no way of generating multiple related images, such as a corresponding ground truth which can be used to train models, so synthetic scans are often manually annotated before use. This research introduces a novel architecture that is able to generate multiple, related PET-CT-tumour mask pairs using paired networks and conditional encoders. Our approach includes innovative, time step-controlled mechanisms and a `noise-seeding' strategy to improve DDPM sampling consistency. While our model requires a modified perceptual loss function to ensure accurate feature alignment we show generation of clearly aligned synthetic images and improvement in segmentation accuracy with generated images.

The field of medical image segmentation is hindered by the scarcity of large, publicly available annotated datasets. Not all datasets are made public for privacy reasons, and creating annotations for a large dataset is time-consuming and expensive, as it requires specialized expertise to accurately identify regions of interest (ROIs) within the images. To address these challenges, we evaluate the performance of the Segment Anything Model (SAM) as an annotation tool for medical data by using it to produce so-called "pseudo labels" on the Medical Segmentation Decathlon (MSD) computed tomography (CT) tasks. The pseudo labels are then used in place of ground truth labels to train a UNet model in a weakly-supervised manner. We experiment with different prompt types on SAM and find that the bounding box prompt is a simple yet effective method for generating pseudo labels. This method allows us to develop a weakly-supervised model that performs comparably to a fully supervised model.

This paper highlights the need to bring document classification benchmarking closer to real-world applications, both in the nature of data tested (X: multi-channel, multi-paged, multi-industry; Y: class distributions and label set variety) and in classification tasks considered (f: multi-page document, page stream, and document bundle classification, ...). We identify the lack of public multi-page document classification datasets, formalize different classification tasks arising in application scenarios, and motivate the value of targeting efficient multi-page document representations. An experimental study on proposed multi-page document classification datasets demonstrates that current benchmarks have become irrelevant and need to be updated to evaluate complete documents, as they naturally occur in practice. This reality check also calls for more mature evaluation methodologies, covering calibration evaluation, inference complexity (time-memory), and a range of realistic distribution shifts (e.g., born-digital vs. scanning noise, shifting page order). Our study ends on a hopeful note by recommending concrete avenues for future improvements.}

This work proposes a procedure for designing algorithms for specific adaptive data collection tasks like active learning and pure-exploration multi-armed bandits. Unlike the design of traditional adaptive algorithms that rely on concentration of measure and careful analysis to justify the correctness and sample complexity of the procedure, our adaptive algorithm is learned via adversarial training over equivalence classes of problems derived from information theoretic lower bounds. In particular, a single adaptive learning algorithm is learned that competes with the best adaptive algorithm learned for each equivalence class. Our procedure takes as input just the available queries, set of hypotheses, loss function, and total query budget. This is in contrast to existing meta-learning work that learns an adaptive algorithm relative to an explicit, user-defined subset or prior distribution over problems which can be challenging to define and be mismatched to the instance encountered at test time. This work is particularly focused on the regime when the total query budget is very small, such as a few dozen, which is much smaller than those budgets typically considered by theoretically derived algorithms. We perform synthetic experiments to justify the stability and effectiveness of the training procedure, and then evaluate the method on tasks derived from real data including a noisy 20 Questions game and a joke recommendation task.

The Segment Anything Model (SAM) has demonstrated outstanding adaptation to medical image segmentation but still faces three major challenges. Firstly, the huge computational costs of SAM limit its real-world applicability. Secondly, SAM depends on manual annotations (e.g., points, boxes) as prompts, which are laborious and impractical in clinical scenarios. Thirdly, SAM handles all segmentation targets equally, which is suboptimal for diverse medical modalities with inherent heterogeneity. To address these issues, we propose an Efficient Self-Prompting SAM for universal medical image segmentation, named ESP-MedSAM. We devise a Multi-Modal Decoupled Knowledge Distillation (MMDKD) strategy to distil common image knowledge and domain-specific medical knowledge from the foundation model to train a lightweight image encoder and a modality controller. Further, they combine with the additionally introduced Self-Patch Prompt Generator (SPPG) and Query-Decoupled Modality Decoder (QDMD) to construct ESP-MedSAM. Specifically, SPPG aims to generate a set of patch prompts automatically and QDMD leverages a one-to-one strategy to provide an independent decoding channel for every modality. Extensive experiments indicate that ESP-MedSAM outperforms state-of-the-arts in diverse medical imaging segmentation takes, displaying superior zero-shot learning and modality transfer ability. Especially, our framework uses only 31.4% parameters compared to SAM-Base.

BACKGROUND: Radiology reports are typically written in a free-text format, making clinical information difficult to extract and use. Recently the adoption of structured reporting (SR) has been recommended by various medical societies thanks to the advantages it offers, e.g. standardization, completeness and information retrieval. We propose a pipeline to extract information from free-text radiology reports, that fits with the items of the reference SR registry proposed by a national society of interventional and medical radiology, focusing on CT staging of patients with lymphoma. METHODS: Our work aims to leverage the potential of Natural Language Processing (NLP) and Transformer-based models to deal with automatic SR registry filling. With the availability of 174 radiology reports, we investigate a rule-free generative Question Answering approach based on a domain-specific version of T5 (IT5). Two strategies (batch-truncation and ex-post combination) are implemented to comply with the model's context length limitations. Performance is evaluated in terms of strict accuracy, F1, and format accuracy, and compared with the widely used GPT-3.5 Large Language Model. A 5-point Likert scale questionnaire is used to collect human-expert feedback on the similarity between medical annotations and generated answers. RESULTS: The combination of fine-tuning and batch splitting allows IT5 to achieve notable results; it performs on par with GPT-3.5 albeit its size being a thousand times smaller in terms of parameters. Human-based assessment scores show a high correlation (Spearman's correlation coefficients>0.88, p-values<0.001) with AI performance metrics (F1) and confirm the superior ability of LLMs (i.e., GPT-3.5, 175B of parameters) in generating plausible human-like statements.