UltrasoundAgents: Hierarchical Multi-Agent Evidence-Chain Reasoning for Breast Ultrasound Diagnosis

Breast ultrasound diagnosis typically proceeds from global lesion localization to local sign assessment and then evidence integration to assign a BI-RADS category and determine benignity or malignancy. Many existing methods rely on end-to-end prediction or provide only weakly grounded evidence, which can miss fine-grained lesion cues and limit auditability and clinical review. To align with the clinical workflow and improve evidence traceability, we propose a hierarchical multi-agent framework, termed UltrasoundAgents. A main agent localizes the lesion in the full image and triggers a crop-and-zoom operation. A sub-agent analyzes the local view and predicts four clinically relevant attributes, namely echogenicity pattern, calcification, boundary type, and edge (margin) morphology. The main agent then integrates these structured attributes to perform evidence-based reasoning and output the BI-RADS category and the malignancy prediction, while producing reviewable intermediate evidence. Furthermore, hierarchical multi-agent training often suffers from error propagation, difficult credit assignment, and sparse rewards. To alleviate this and improve training stability, we introduce a decoupled progressive training strategy. We first train the attribute agent, then train the main agent with oracle attributes to learn robust attribute-based reasoning, and finally apply corrective trajectory self-distillation with spatial supervision to build high-quality trajectories for supervised fine-tuning, yielding a deployable end-to-end policy. Experiments show consistent gains over strong vision-language baselines in diagnostic accuracy and attribute agreement, together with structured evidence and traceable reasoning.

Intent Mismatch Causes LLMs to Get Lost in Multi-Turn Conversation

Multi-turn conversation has emerged as a predominant interaction paradigm for Large Language Models (LLMs). Users often employ follow-up questions to refine their intent, expecting LLMs to adapt dynamically. However, recent research reveals that LLMs suffer a substantial performance drop in multi-turn settings compared to single-turn interactions with fully specified instructions, a phenomenon termed ``Lost in Conversation'' (LiC). While this prior work attributes LiC to model unreliability, we argue that the root cause lies in an intent alignment gap rather than intrinsic capability deficits. In this paper, we first demonstrate that LiC is not a failure of model capability but rather a breakdown in interaction between users and LLMs. We theoretically show that scaling model size or improving training alone cannot resolve this gap, as it arises from structural ambiguity in conversational context rather than representational limitations. To address this, we propose to decouple intent understanding from task execution through a Mediator-Assistant architecture. By utilizing an experience-driven Mediator to explicate user inputs into explicit, well-structured instructions based on historical interaction patterns, our approach effectively bridges the gap between vague user intent and model interpretation. Experimental results demonstrate that this method significantly mitigates performance degradation in multi-turn conversations across diverse LLMs.

UniSurg: A Video-Native Foundation Model for Universal Understanding of Surgical Videos

While foundation models have advanced surgical video analysis, current approaches rely predominantly on pixel-level reconstruction objectives that waste model capacity on low-level visual details - such as smoke, specular reflections, and fluid motion - rather than semantic structures essential for surgical understanding. We present UniSurg, a video-native foundation model that shifts the learning paradigm from pixel-level reconstruction to latent motion prediction. Built on the Video Joint Embedding Predictive Architecture (V-JEPA), UniSurg introduces three key technical innovations tailored to surgical videos: 1) motion-guided latent prediction to prioritize semantically meaningful regions, 2) spatiotemporal affinity self-distillation to enforce relational consistency, and 3) feature diversity regularization to prevent representation collapse in texture-sparse surgical scenes. To enable large-scale pretraining, we curate UniSurg-15M, the largest surgical video dataset to date, comprising 3,658 hours of video from 50 sources across 13 anatomical regions. Extensive experiments across 17 benchmarks demonstrate that UniSurg significantly outperforms state-of-the-art methods on surgical workflow recognition (+14.6% F1 on EgoSurgery, +10.3% on PitVis), action triplet recognition (39.54% mAP-IVT on CholecT50), skill assessment, polyp segmentation, and depth estimation. These results establish UniSurg as a new standard for universal, motion-oriented surgical video understanding.

VTCBench: Can Vision-Language Models Understand Long Context with Vision-Text Compression?

The computational and memory overheads associated with expanding the context window of LLMs severely limit their scalability. A noteworthy solution is vision-text compression (VTC), exemplified by frameworks like DeepSeek-OCR and Glyph, which convert long texts into dense 2D visual representations, thereby achieving token compression ratios of 3x-20x. However, the impact of this high information density on the core long-context capabilities of vision-language models (VLMs) remains under-investigated. To address this gap, we introduce the first benchmark for VTC and systematically assess the performance of VLMs across three long-context understanding settings: VTC-Retrieval, which evaluates the model's ability to retrieve and aggregate information; VTC-Reasoning, which requires models to infer latent associations to locate facts with minimal lexical overlap; and VTC-Memory, which measures comprehensive question answering within long-term dialogue memory. Furthermore, we establish the VTCBench-Wild to simulate diverse input scenarios.We comprehensively evaluate leading open-source and proprietary models on our benchmarks. The results indicate that, despite being able to decode textual information (e.g., OCR) well, most VLMs exhibit a surprisingly poor long-context understanding ability with VTC-processed information, failing to capture long associations or dependencies in the context.This study provides a deep understanding of VTC and serves as a foundation for designing more efficient and scalable VLMs.

PDE-Agent: A toolchain-augmented multi-agent framework for PDE solving

Solving Partial Differential Equations (PDEs) is a cornerstone of engineering and scientific research. Traditional methods for PDE solving are cumbersome, relying on manual setup and domain expertise. While Physics-Informed Neural Network (PINNs) introduced end-to-end neural network-based solutions, and frameworks like DeepXDE further enhanced automation, these approaches still depend on expert knowledge and lack full autonomy. In this work, we frame PDE solving as tool invocation via LLM-driven agents and introduce PDE-Agent, the first toolchain-augmented multi-agent collaboration framework, inheriting the reasoning capacity of LLMs and the controllability of external tools and enabling automated PDE solving from natural language descriptions. PDE-Agent leverages the strengths of multi-agent and multi-tool collaboration through two key innovations: (1) A Prog-Act framework with graph memory for multi-agent collaboration, which enables effective dynamic planning and error correction via dual-loop mechanisms (localized fixes and global revisions). (2) A Resource-Pool integrated with a tool-parameter separation mechanism for multi-tool collaboration. This centralizes the management of runtime artifacts and resolves inter-tool dependency gaps in existing frameworks. To validate and evaluate this new paradigm for PDE solving , we develop PDE-Bench, a multi-type PDE Benchmark for agent-based tool collaborative solving, and propose multi-level metrics for assessing tool coordination. Evaluations verify that PDE-Agent exhibits superior applicability and performance in complex multi-step, cross-step dependent tasks. This new paradigm of toolchain-augmented multi-agent PDE solving will further advance future developments in automated scientific computing. Our source code and dataset will be made publicly available.

PADReg: Physics-Aware Deformable Registration Guided by Contact Force for Ultrasound Sequences

Ultrasound deformable registration estimates spatial transformations between pairs of deformed ultrasound images, which is crucial for capturing biomechanical properties and enhancing diagnostic accuracy in diseases such as thyroid nodules and breast cancer. However, ultrasound deformable registration remains highly challenging, especially under large deformation. The inherently low contrast, heavy noise and ambiguous tissue boundaries in ultrasound images severely hinder reliable feature extraction and correspondence matching. Existing methods often suffer from poor anatomical alignment and lack physical interpretability. To address the problem, we propose PADReg, a physics-aware deformable registration framework guided by contact force. PADReg leverages synchronized contact force measured by robotic ultrasound systems as a physical prior to constrain the registration. Specifically, instead of directly predicting deformation fields, we first construct a pixel-wise stiffness map utilizing the multi-modal information from contact force and ultrasound images. The stiffness map is then combined with force data to estimate a dense deformation field, through a lightweight physics-aware module inspired by Hooke's law. This design enables PADReg to achieve physically plausible registration with better anatomical alignment than previous methods relying solely on image similarity. Experiments on in-vivo datasets demonstrate that it attains a HD95 of 12.90, which is 21.34\% better than state-of-the-art methods. The source code is available at https://github.com/evelynskip/PADReg.

The Docking Game: Loop Self-Play for Fast, Dynamic, and Accurate Prediction of Flexible Protein--Ligand Binding

Molecular docking is a crucial aspect of drug discovery, as it predicts the binding interactions between small-molecule ligands and protein pockets. However, current multi-task learning models for docking often show inferior performance in ligand docking compared to protein pocket docking. This disparity arises largely due to the distinct structural complexities of ligands and proteins. To address this issue, we propose a novel game-theoretic framework that models the protein-ligand interaction as a two-player game called the Docking Game, with the ligand docking module acting as the ligand player and the protein pocket docking module as the protein player. To solve this game, we develop a novel Loop Self-Play (LoopPlay) algorithm, which alternately trains these players through a two-level loop. In the outer loop, the players exchange predicted poses, allowing each to incorporate the other's structural predictions, which fosters mutual adaptation over multiple iterations. In the inner loop, each player dynamically refines its predictions by incorporating its own predicted ligand or pocket poses back into its model. We theoretically show the convergence of LoopPlay, ensuring stable optimization. Extensive experiments conducted on public benchmark datasets demonstrate that LoopPlay achieves approximately a 10\% improvement in predicting accurate binding modes compared to previous state-of-the-art methods. This highlights its potential to enhance the accuracy of molecular docking in drug discovery.

F2PASeg: Feature Fusion for Pituitary Anatomy Segmentation in Endoscopic Surgery

Pituitary tumors often cause deformation or encapsulation of adjacent vital structures. Anatomical structure segmentation can provide surgeons with early warnings of regions that pose surgical risks, thereby enhancing the safety of pituitary surgery. However, pixel-level annotated video stream datasets for pituitary surgeries are extremely rare. To address this challenge, we introduce a new dataset for Pituitary Anatomy Segmentation (PAS). PAS comprises 7,845 time-coherent images extracted from 120 videos. To mitigate class imbalance, we apply data augmentation techniques that simulate the presence of surgical instruments in the training data. One major challenge in pituitary anatomy segmentation is the inconsistency in feature representation due to occlusions, camera motion, and surgical bleeding. By incorporating a Feature Fusion module, F2PASeg is proposed to refine anatomical structure segmentation by leveraging both high-resolution image features and deep semantic embeddings, enhancing robustness against intraoperative variations. Experimental results demonstrate that F2PASeg consistently segments critical anatomical structures in real time, providing a reliable solution for intraoperative pituitary surgery planning. Code: https://github.com/paulili08/F2PASeg.

MM2CT: MR-to-CT translation for multi-modal image fusion with mamba

Magnetic resonance (MR)-to-computed tomography (CT) translation offers significant advantages, including the elimination of radiation exposure associated with CT scans and the mitigation of imaging artifacts caused by patient motion. The existing approaches are based on single-modality MR-to-CT translation, with limited research exploring multimodal fusion. To address this limitation, we introduce Multi-modal MR to CT (MM2CT) translation method by leveraging multimodal T1- and T2-weighted MRI data, an innovative Mamba-based framework for multi-modal medical image synthesis. Mamba effectively overcomes the limited local receptive field in CNNs and the high computational complexity issues in Transformers. MM2CT leverages this advantage to maintain long-range dependencies modeling capabilities while achieving multi-modal MR feature integration. Additionally, we incorporate a dynamic local convolution module and a dynamic enhancement module to improve MRI-to-CT synthesis. The experiments on a public pelvis dataset demonstrate that MM2CT achieves state-of-the-art performance in terms of Structural Similarity Index Measure (SSIM) and Peak Signal-to-Noise Ratio (PSNR). Our code is publicly available at https://github.com/Gots-ch/MM2CT.

MLLM-CL: Continual Learning for Multimodal Large Language Models

Recent Multimodal Large Language Models (MLLMs) excel in vision-language understanding but face challenges in adapting to dynamic real-world scenarios that require continuous integration of new knowledge and skills. While continual learning (CL) offers a potential solution, existing benchmarks and methods suffer from critical limitations. In this paper, we introduce MLLM-CL, a novel benchmark encompassing domain and ability continual learning, where the former focuses on independently and identically distributed (IID) evaluation across evolving mainstream domains, whereas the latter evaluates on non-IID scenarios with emerging model ability. Methodologically, we propose preventing catastrophic interference through parameter isolation, along with an MLLM-based routing mechanism. Extensive experiments demonstrate that our approach can integrate domain-specific knowledge and functional abilities with minimal forgetting, significantly outperforming existing methods.