PPDM: Pixel Puzzling Diffusion Model for Speed and Memory Efficient Volumetric Medical Image Translation

Diffusion models have demonstrated superior fidelity for medical image-to-image translation, but their extension to high-resolution 3D volumes is severely constrained by prohibitive computational cost and GPU memory requirements. Existing memory-efficient strategies often compromise global volumetric consistency or fine anatomical detail. In this work, we propose the Pixel Puzzling Diffusion Model (PPDM), a simple and effective framework for memory- and speed-efficient 3D medical image translation. PPDM introduces a reversible pixel puzzle-unpuzzle operator that trades spatial resolution for channel dimensionality, substantially reducing activation memory while preserving global context. To further improve efficiency and stability, we adopt a direct bridge diffusion formulation that starts from the conditional input rather than pure noise, enabling the model to focus on task-relevant residuals. In addition, a puzzle-gradient loss is incorporated to enforce spatial coherence and suppress grid-like artifacts introduced by spatial rearrangement. We evaluate PPDM on multiple challenging 3D medical image translation tasks, including low-count PET denoising, joint PET denoising and attenuation correction, and cross-modal MRI translation. Across all tasks, PPDM consistently matches or outperforms full 3D diffusion models while reducing training GPU memory usage by up to an order of magnitude and significantly accelerating inference, and it outperforms existing memory-efficient diffusion approaches based on latent compression or frequency decomposition. These results demonstrate that PPDM provides a practical and scalable solution for high-fidelity 3D diffusion-based medical image translation under limited computational resources.

Hybrid Open-Ended Tri-Evolution Makes Better Deep Researcher

Deep research and agent evolution serve as de-facto tasks for AI agents in real-world applications toward artificial general intelligence. The former enables autonomous retrieval and integration of information in open-ended environments to tackle open-ended research tasks, yet it is constrained by the static parametric deep research capabilities of agent systems. The latter allows agents to autonomously interact with the environment to gain experiences that evolve model capabilities. However, its effectiveness has been widely validated only on verifiable tasks with standard answers, leaving a gap with open-ended research tasks. To bridge these two critical tasks, we propose the Hybrid Open-Ended Tri-Evolution (HOTE) framework, which leverages hybrid-mode reinforcement learning to facilitate the collaborative evolution of a proposer, solver and judge based on web-scale knowledge, moving toward autonomous evolving agents in open-ended tasks and environments. Extensive experiments on three long-form deep research benchmarks demonstrate that the 8B model trained via HOTE surpasses the strongest static open 8-32B models as well as those trained by state-of-the-art deep research training methods with less time overhead, and further verify that the evolution of all three modules in HOTE is indispensable.

UniReason-Med: A Shared Grounded Reasoning Interface for 2D-to-3D Transfer in Medical VQA

We study whether grounded reasoning supervision from abundant 2D medical images can improve 3D medical VQA when both input types are aligned through a common reasoning interface. We introduce UniReason-Med, a single-checkpoint framework that processes either a 2D image or a slice-serialized 3D volume at inference time, generating interleaved textual reasoning and localized visual evidence through shared box syntax, region-token injection, and a common grounded reasoning policy. To train this interface, we construct UniMed-CoT, a 220K instruction-tuning dataset with interleaved textual reasoning and grounded visual evidence, including 170K 2D and 50K 3D samples. Through supervised fine-tuning followed by outcome-level reinforcement learning, UniReason-Med learns to generate grounded reasoning traces without IoU/Dice-based localization rewards during RL. Data-mixture and component ablations show that joint 2D+3D grounded supervision substantially improves 3D reasoning over 3D-only training, while grounding and region-token injection consistently benefit both 2D and 3D tasks. These results suggest that a shared grounded reasoning interface can transfer reasoning structure from 2D images to slice-serialized volumetric medical understanding. The code and data are publicly available at https://github.com/IQuestLab/unireason-med.

DyCo-RL: Dynamic Cross-Modal Coordination for Visual Reasoning

Reinforcement Learning with Verifiable Rewards (RLVR) has emerged as a leading paradigm for enhancing visual reasoning in Multimodal Large Language Models (MLLMs). However, existing RLVR methods optimize primarily for the reasoning outcome, fundamentally overlooking the fine-grained cross-modal coordination required during the generation process. Through token-level analyses and controlled interventions, we reveal that during Chain-of-Thought (CoT) reasoning, MLLMs frequently fail to dynamically alternate between extracting visual evidence and synthesizing textual context-a coordination breakdown that is causally linked to reasoning failures. Motivated by these findings, we propose DyCo-RL, which integrates dynamic cross-modal coordination into RLVR optimization. Specifically, DyCo-RL uses the Fisher-Rao geodesic distance to measure within-modality attention shifts, assigning tokens to either visually-oriented or text-oriented functional roles. It then evaluates the alignment between a token's actual attention allocation and its assigned role, leveraging this score for alignment-guided advantage reweighting during policy optimization. Extensive experiments demonstrate that the algorithm-agnostic DyCo-RL, when applied to Qwen2.5-VL-3B/7B, consistently improves four representative RLVR algorithms across seven benchmarks spanning visual-centric and mathematical reasoning.

Beyond Output Matching: Preserving Internal Geometry in NVFP4 LLM Distillatio

Demand for low-precision inference, including NVFP4-based approaches, has grown as large language models are increasingly deployed in latency and cost constrained production environments. Quantization-aware distillation (QAD) helps recover accuracy lost under low bit quantization by training a quantized student to match the output distribution of a frozen higher precision teacher via a KL-divergence loss. In this work, we first provide a representation level diagnosis of QAD: output matching alone can mask internal degradation, because many intermediate activation geometries can yield similar teacher-aligned logits. Using CKA, we show that KL-only QAD can reduce layerwise representational similarity relative to the BF16 teacher, with especially severe drift in RL-post-trained models. This drift correlates with downstream bottlenecks on reasoning and coding tasks, suggesting that low bit recovery requires preserving internal geometry rather than matching outputs alone. Motivated by this finding, we propose \textbf{CKA-QAD}, a CKA-guided representational alignment method for NVFP4 QAD and low bit LLM accuracy recovery. The method adds a lightweight regularizer that preserves internal representational geometry during distillation by aligning layerwise Gram matrices through CKA. Across Nemotron 3 Nano and Qwen3-4B-Thinking-2507, CKA-QAD substantially improves representational alignment and improves downstream reasoning and coding accuracy with modest training overhead. Our findings position CKA-guided representational alignment as a practical complement to output matching for quantized LLM recovery.

An Open Multi-Center Whole-Body FDG PET/CT Foundation Model for Tumor Segmentation

The synergistic interpretation of anatomical information from computed tomography (CT) and metabolic information from positron emission tomography (PET) is important to oncologic imaging. However, existing deep learning methods for PET/CT remain largely task-specific, are often trained on single-center cohorts, or adopt dual-branch fusion schemes that delay cross-modal interaction and underutilize early spatial correspondence between PET and CT. To address these limitations, we present an open-source, multi-center, whole-body FDG PET/CT foundation model utilizing 4,997 harmonized scans from four public datasets. Our framework employs hierarchical UNet-shaped backbones with early channel-wise concatenation, enabling anatomical and metabolic features to interact from the first embedding layer onward. We further introduce a masked autoencoding objective based on zero-mean imputation, combined with a weighted global reconstruction loss. This design avoids non-physical intensity discontinuities at masked-region boundaries that arise from learnable mask tokens. On downstream AutoPET lesion segmentation, the proposed models demonstrate strong label efficiency: with only 10\% of the labeled training data, they achieve performance comparable to models trained from scratch on the full dataset. Under extreme 5-shot linear probing, joint PET/CT pretraining also achieves higher Dice scores than separated-modality pretraining. This multi-center foundation model demonstrates label efficiency and cross-modality representation learning for PET/CT tumor segmentation. It provides a robust, open-source basis for advancing automated oncologic imaging, significantly reducing the need for large-scale manual annotations in clinical practice.

MemLens: Benchmarking Multimodal Long-Term Memory in Large Vision-Language Models

Memory is essential for large vision-language models (LVLMs) to handle long, multimodal interactions, with two method directions providing this capability: long-context LVLMs and memory-augmented agents. However, no existing benchmark conducts a systematic comparison of the two on questions that genuinely require multimodal evidence. To close this gap, we introduce MEMLENS, a comprehensive benchmark for memory in multimodal multi-session conversations, comprising 789 questions across five memory abilities (information extraction, multi-session reasoning, temporal reasoning, knowledge update, and answer refusal) at four standard context lengths (32K-256K tokens) under a cross-modal token-counting scheme. An image-ablation study confirms that solving MEMLENS requires visual evidence: removing evidence images drops two frontier LVLMs below 2% accuracy on the 80.4% of questions whose evidence includes images. Evaluating 27 LVLMs and 7 memory-augmented agents, we find that long-context LVLMs achieve high short-context accuracy through direct visual grounding but degrade as conversations grow, whereas memory agents are length-stable but lose visual fidelity under storage-time compression. Multi-session reasoning caps most systems below 30%, and neither approach alone solves the task. These results motivate hybrid architectures that combine long-context attention with structured multimodal retrieval. Our code is available at https://github.com/xrenaf/MEMLENS.

Fundus Image-based Glaucoma Screening via Retinal Knowledge-Oriented Dynamic Multi-Level Feature Integration

Automated diagnosis based on color fundus photography is essential for large-scale glaucoma screening. However, existing deep learning models are typically data-driven and lack explicit integration of retinal anatomical knowledge, which limits their robustness across heterogeneous clinical datasets. Moreover, pathological cues in fundus images may appear beyond predefined anatomical regions, making fixed-region feature extraction insufficient for reliable diagnosis. To address these challenges, we propose a retinal knowledge-oriented glaucoma screening framework that integrates dynamic multi-scale feature learning with domain-specific retinal priors. The framework adopts a tri-branch structure to capture complementary retinal representations, including global retinal context, structural features of the optic disc/cup, and dynamically localized pathological regions. A Dynamic Window Mechanism is devised to adaptively identify diagnostically informative regions, while a Knowledge-Enhanced Convolutional Attention Module incorporates retinal priors extracted from a pre-trained foundation model to guide attention learning. Extensive experiments on the large-scale AIROGS dataset demonstrate that the proposed method outperforms diverse baselines, achieving an AUC of 98.5% and an accuracy of 94.6%. Additional evaluations on multiple datasets from the SMDG-19 benchmark further confirm its strong cross-domain generalization capability, indicating that knowledge-guided attention combined with adaptive lesion localization can significantly improve the robustness of automated glaucoma screening systems.

Unsupervised Adaptation from FDG to PSMA PET/CT for 3D Lesion Detection under Label Shift

In this work, we propose an unsupervised domain adaptation (UDA) framework for 3D volumetric lesion detection that adapts a detector trained on labeled FDG PET/CT to unlabeled PSMA PET/CT. Beyond covariate shift, cross tracer adaptation also exhibits label shift in both lesion size composition and the number of lesions per subject. We introduce self-training with two mechanisms that explicitly model and compensate for this label shift. First, we adaptively adjust the detection anchor shapes by re-estimating target domain box scales from selected pseudo labels and updating anchors with an exponential moving average. This increases positive anchor coverage for small PSMA lesions and stabilizes box regression. Second, instead of a fixed confidence threshold for pseudo-label selection, we allocate size bin-wise quotas according to the estimated target domain histogram over lesion volumes. The self-training alternates between supervised learning with prior-guided pseudo labeling on PSMA and supervised learning on labeled FDG. On AutoPET 2024, adapting from 501 labeled FDG studies to 369 $^{18}$F-PSMA studies, the proposed method improves both AP and FROC over the source-only baseline and conventional self-training without label-shift mitigation, indicating that modeling target lesion prevalence and size composition is an effective path to robust cross-tracer detection.

GLEAM: A Multimodal Imaging Dataset and HAMM for Glaucoma Classification

We propose glaucoma lesion evaluation and analysis with multimodal imaging (GLEAM), the first publicly available tri-modal glaucoma dataset comprising scanning laser ophthalmoscopy fundus images, circumpapillary OCT images, and visual field pattern deviation maps, annotated with four disease stages, enabling effective exploitation of multimodal complementary information and facilitating accurate diagnosis and treatment across disease stages. To effectively integrate cross-modal information, we propose hierarchical attentive masked modeling (HAMM) for multimodal glaucoma classification. Our framework employs hierarchical attentive encoders and light decoders to focus cross-modal representation learning on the encoder.