Native Intelligence Emerges from Large-Scale Clinical Practice: A Retinal Foundation Model with Deployment Efficiency

Current retinal foundation models remain constrained by curated research datasets that lack authentic clinical context, and require extensive task-specific optimization for each application, limiting their deployment efficiency in low-resource settings. Here, we show that these barriers can be overcome by building clinical native intelligence directly from real-world medical practice. Our key insight is that large-scale telemedicine programs, where expert centers provide remote consultations across distributed facilities, represent a natural reservoir for learning clinical image interpretation. We present ReVision, a retinal foundation model that learns from the natural alignment between 485,980 color fundus photographs and their corresponding diagnostic reports, accumulated through a decade-long telemedicine program spanning 162 medical institutions across China. Through extensive evaluation across 27 ophthalmic benchmarks, we demonstrate that ReVison enables deployment efficiency with minimal local resources. Without any task-specific training, ReVision achieves zero-shot disease detection with an average AUROC of 0.946 across 12 public benchmarks and 0.952 on 3 independent clinical cohorts. When minimal adaptation is feasible, ReVision matches extensively fine-tuned alternatives while requiring orders of magnitude fewer trainable parameters and labeled examples. The learned representations also transfer effectively to new clinical sites, imaging domains, imaging modalities, and systemic health prediction tasks. In a prospective reader study with 33 ophthalmologists, ReVision's zero-shot assistance improved diagnostic accuracy by 14.8% across all experience levels. These results demonstrate that clinical native intelligence can be directly extracted from clinical archives without any further annotation to build medical AI systems suited to various low-resource settings.

Semantic Prior Distillation with Vision Foundation Model for Enhanced Rapid Bone Scintigraphy Image Restoration

Rapid bone scintigraphy is an essential tool for diagnosing skeletal diseases and tumor metastasis in pediatric patients, as it reduces scan time and minimizes patient discomfort. However, rapid scans often result in poor image quality, potentially affecting diagnosis due to reduced resolution and detail, which make it challenging to identify and evaluate finer anatomical structures. To address this issue, we propose the first application of SAM-based semantic priors for medical image restoration, leveraging the Segment Anything Model (SAM) to enhance rapid bone scintigraphy images in pediatric populations. Our method comprises two cascaded networks, $f^{IR1}$ and $f^{IR2}$, augmented by three key modules: a Semantic Prior Integration (SPI) module, a Semantic Knowledge Distillation (SKD) module, and a Semantic Consistency Module (SCM). The SPI and SKD modules incorporate domain-specific semantic information from a fine-tuned SAM, while the SCM maintains consistent semantic feature representation throughout the cascaded networks. In addition, we will release a novel Rapid Bone Scintigraphy dataset called RBS, the first dataset dedicated to rapid bone scintigraphy image restoration in pediatric patients. RBS consists of 137 pediatric patients aged between 0.5 and 16 years who underwent both standard and rapid bone scans. The dataset includes scans performed at 20 cm/min (standard) and 40 cm/min (rapid), representing a $2\times$ acceleration. We conducted extensive experiments on both the publicly available endoscopic dataset and RBS. The results demonstrate that our method outperforms all existing methods across various metrics, including PSNR, SSIM, FID, and LPIPS.