Abstract:Multimodal large language models (MLLMs) excel at high-level reasoning yet fail on OCR tasks where fine-grained visual details are compromised or misaligned. We identify an overlooked optimization issue in multi-layer feature fusion. Skip pathways introduce direct back-propagation paths from high-level semantic objectives to early visual layers. This mechanism overwrites low-level signals and destabilizes training. To mitigate this gradient interference, we propose Detached Skip-Links, a minimal modification that reuses shallow features in the forward pass while stopping gradients through the skip branch during joint training. This asymmetric design reduces gradient interference, improving stability and convergence without adding learnable parameters. To diagnose whether fine-grained information is preserved and usable by an LLM, we introduce $R$-Probe, which measures pixel-level reconstructability of projected visual tokens using a shallow decoder initialized from the first quarter of the LLM layers. Across multiple ViT backbones and multimodal benchmarks, and at scales up to 7M training samples, our approach consistently improves OCR-centric benchmarks and delivers clear gains on general multimodal tasks.
Abstract:Automated 3D CT diagnosis empowers clinicians to make timely, evidence-based decisions by enhancing diagnostic accuracy and workflow efficiency. While multimodal large language models (MLLMs) exhibit promising performance in visual-language understanding, existing methods mainly focus on 2D medical images, which fundamentally limits their ability to capture complex 3D anatomical structures. This limitation often leads to misinterpretation of subtle pathologies and causes diagnostic hallucinations. In this paper, we present Hybrid Spatial Encoding Network (HSENet), a framework that exploits enriched 3D medical visual cues by effective visual perception and projection for accurate and robust vision-language understanding. Specifically, HSENet employs dual-3D vision encoders to perceive both global volumetric contexts and fine-grained anatomical details, which are pre-trained by dual-stage alignment with diagnostic reports. Furthermore, we propose Spatial Packer, an efficient multimodal projector that condenses high-resolution 3D spatial regions into a compact set of informative visual tokens via centroid-based compression. By assigning spatial packers with dual-3D vision encoders, HSENet can seamlessly perceive and transfer hybrid visual representations to LLM's semantic space, facilitating accurate diagnostic text generation. Experimental results demonstrate that our method achieves state-of-the-art performance in 3D language-visual retrieval (39.85% of R@100, +5.96% gain), 3D medical report generation (24.01% of BLEU-4, +8.01% gain), and 3D visual question answering (73.60% of Major Class Accuracy, +1.99% gain), confirming its effectiveness. Our code is available at https://github.com/YanzhaoShi/HSENet.




Abstract:Brain CT report generation is significant to aid physicians in diagnosing cranial diseases. Recent studies concentrate on handling the consistency between visual and textual pathological features to improve the coherence of report. However, there exist some challenges: 1) Redundant visual representing: Massive irrelevant areas in 3D scans distract models from representing salient visual contexts. 2) Shifted semantic representing: Limited medical corpus causes difficulties for models to transfer the learned textual representations to generative layers. This study introduces a Pathological Clue-driven Representation Learning (PCRL) model to build cross-modal representations based on pathological clues and naturally adapt them for accurate report generation. Specifically, we construct pathological clues from perspectives of segmented regions, pathological entities, and report themes, to fully grasp visual pathological patterns and learn cross-modal feature representations. To adapt the representations for the text generation task, we bridge the gap between representation learning and report generation by using a unified large language model (LLM) with task-tailored instructions. These crafted instructions enable the LLM to be flexibly fine-tuned across tasks and smoothly transfer the semantic representation for report generation. Experiments demonstrate that our method outperforms previous methods and achieves SoTA performance. Our code is available at https://github.com/Chauncey-Jheng/PCRL-MRG.