Refining 3D Medical Segmentation with Verbal Instruction

Accurate 3D anatomical segmentation is essential for clinical diagnosis and surgical planning. However, automated models frequently generate suboptimal shape predictions due to factors such as limited and imbalanced training data, inadequate labeling quality, and distribution shifts between training and deployment settings. A natural solution is to iteratively refine the predicted shape based on the radiologists' verbal instructions. However, this is hindered by the scarcity of paired data that explicitly links erroneous shapes to corresponding corrective instructions. As an initial step toward addressing this limitation, we introduce CoWTalk, a benchmark comprising 3D arterial anatomies with controllable synthesized anatomical errors and their corresponding repairing instructions. Building on this benchmark, we further propose an iterative refinement model that represents 3D shapes as vector sets and interacts with textual instructions to progressively update the target shape. Experimental results demonstrate that our method achieves significant improvements over corrupted inputs and competitive baselines, highlighting the feasibility of language-driven clinician-in-the-loop refinement for 3D medical shapes modeling.

EyeWorld: A Generative World Model of Ocular State and Dynamics

Ophthalmic decision-making depends on subtle lesion-scale cues interpreted across multimodal imaging and over time, yet most medical foundation models remain static and degrade under modality and acquisition shifts. Here we introduce EyeWorld, a generative world model that conceptualizes the eye as a partially observed dynamical system grounded in clinical imaging. EyeWorld learns an observation-stable latent ocular state shared across modalities, unifying fine-grained parsing, structure-preserving cross-modality translation and quality-robust enhancement within a single framework. Longitudinal supervision further enables time-conditioned state transitions, supporting forecasting of clinically meaningful progression while preserving stable anatomy. By moving from static representation learning to explicit dynamical modeling, EyeWorld provides a unified approach to robust multimodal interpretation and prognosis-oriented simulation in medicine.

PlaneCycle: Training-Free 2D-to-3D Lifting of Foundation Models Without Adapters

Large-scale 2D foundation models exhibit strong transferable representations, yet extending them to 3D volumetric data typically requires retraining, adapters, or architectural redesign. We introduce PlaneCycle, a training-free, adapter-free operator for architecture-agnostic 2D-to-3D lifting of foundation models. PlaneCycle reuses the original pretrained 2D backbone by cyclically distributing spatial aggregation across orthogonal HW, DW, and DH planes throughout network depth, enabling progressive 3D fusion while preserving pretrained inductive biases. The method introduces no additional parameters and is applicable to arbitrary 2D networks. Using pretrained DINOv3 models, we evaluate PlaneCycle on six 3D classification and three 3D segmentation benchmarks. Without any training, the lifted models exhibit intrinsic 3D fusion capability and, under linear probing, outperform slice-wise 2D baselines and strong 3D counterparts, approaching the performance of fully trained models. With full fine-tuning, PlaneCycle matches standard 3D architectures, highlighting its potential as a seamless and practical 2D-to-3D lifting operator. These results demonstrate that 3D capability can be unlocked from pretrained 2D foundation models without structural modification or retraining. Code is available at https://github.com/HINTLab/PlaneCycle.

Learning to Read Where to Look: Disease-Aware Vision-Language Pretraining for 3D CT

Recent 3D CT vision-language models align volumes with reports via contrastive pretraining, but typically rely on limited public data and provide only coarse global supervision. We train a 3D CT vision-language model on 98k report-volume pairs (50k patients) collected at a single hospital, combined with public datasets, using SigLIP-style contrastive pretraining together with prompt-based disease supervision in the shared vision-text embedding space. On CT-RATE, our model achieves state-of-the-art text-to-image retrieval (R@10 31.5 vs. 22.2) and competitive disease classification (AUC 83.8 vs. 83.8), with consistent results on Rad-ChestCT (AUC 77.0 vs. 77.3). We further observe that radiologists routinely reference specific images within their reports (e.g., ``series X, image Y''), linking textual descriptions to precise axial locations. We automatically mine 262k such snippet-slice pairs and introduce the task of intra-scan snippet localization -- predicting the axial depth referred to by a text snippet -- reducing mean absolute error to 36.3 mm at 12 mm feature resolution, compared with 67.0 mm for the best baseline. Adding this localization objective leaves retrieval and classification broadly unchanged within confidence bounds, yielding a single unified model for retrieval, classification, and intra-scan grounding.

Learning Topology-Aware Implicit Field for Unified Pulmonary Tree Modeling with Incomplete Topological Supervision

Pulmonary trees extracted from CT images frequently exhibit topological incompleteness, such as missing or disconnected branches, which substantially degrades downstream anatomical analysis and limits the applicability of existing pulmonary tree modeling pipelines. Current approaches typically rely on dense volumetric processing or explicit graph reasoning, leading to limited efficiency and reduced robustness under realistic structural corruption. We propose TopoField, a topology-aware implicit modeling framework that treats topology repair as a first-class modeling problem and enables unified multi-task inference for pulmonary tree analysis. TopoField represents pulmonary anatomy using sparse surface and skeleton point clouds and learns a continuous implicit field that supports topology repair without relying on complete or explicit disconnection annotations, by training on synthetically introduced structural disruptions over \textit{already} incomplete trees. Building upon the repaired implicit representation, anatomical labeling and lung segment reconstruction are jointly inferred through task-specific implicit functions within a single forward pass.Extensive experiments on the Lung3D+ dataset demonstrate that TopoField consistently improves topological completeness and achieves accurate anatomical labeling and lung segment reconstruction under challenging incomplete scenarios. Owing to its implicit formulation, TopoField attains high computational efficiency, completing all tasks in just over one second per case, highlighting its practicality for large-scale and time-sensitive clinical applications. Code and data will be available at https://github.com/HINTLab/TopoField.

Bonnet: Ultra-fast whole-body bone segmentation from CT scans

This work proposes Bonnet, an ultra-fast sparse-volume pipeline for whole-body bone segmentation from CT scans. Accurate bone segmentation is important for surgical planning and anatomical analysis, but existing 3D voxel-based models such as nnU-Net and STU-Net require heavy computation and often take several minutes per scan, which limits time-critical use. The proposed Bonnet addresses this by integrating a series of novel framework components including HU-based bone thresholding, patch-wise inference with a sparse spconv-based U-Net, and multi-window fusion into a full-volume prediction. Trained on TotalSegmentator and evaluated without additional tuning on RibSeg, CT-Pelvic1K, and CT-Spine1K, Bonnet achieves high Dice across ribs, pelvis, and spine while running in only 2.69 seconds per scan on an RTX A6000. Compared to strong voxel baselines, Bonnet attains a similar accuracy but reduces inference time by roughly 25x on the same hardware and tiling setup. The toolkit and pre-trained models will be released at https://github.com/HINTLab/Bonnet.

AortaDiff: A Unified Multitask Diffusion Framework For Contrast-Free AAA Imaging

While contrast-enhanced CT (CECT) is standard for assessing abdominal aortic aneurysms (AAA), the required iodinated contrast agents pose significant risks, including nephrotoxicity, patient allergies, and environmental harm. To reduce contrast agent use, recent deep learning methods have focused on generating synthetic CECT from non-contrast CT (NCCT) scans. However, most adopt a multi-stage pipeline that first generates images and then performs segmentation, which leads to error accumulation and fails to leverage shared semantic and anatomical structures. To address this, we propose a unified deep learning framework that generates synthetic CECT images from NCCT scans while simultaneously segmenting the aortic lumen and thrombus. Our approach integrates conditional diffusion models (CDM) with multi-task learning, enabling end-to-end joint optimization of image synthesis and anatomical segmentation. Unlike previous multitask diffusion models, our approach requires no initial predictions (e.g., a coarse segmentation mask), shares both encoder and decoder parameters across tasks, and employs a semi-supervised training strategy to learn from scans with missing segmentation labels, a common constraint in real-world clinical data. We evaluated our method on a cohort of 264 patients, where it consistently outperformed state-of-the-art single-task and multi-stage models. For image synthesis, our model achieved a PSNR of 25.61 dB, compared to 23.80 dB from a single-task CDM. For anatomical segmentation, it improved the lumen Dice score to 0.89 from 0.87 and the challenging thrombus Dice score to 0.53 from 0.48 (nnU-Net). These segmentation enhancements led to more accurate clinical measurements, reducing the lumen diameter MAE to 4.19 mm from 5.78 mm and the thrombus area error to 33.85% from 41.45% when compared to nnU-Net. Code is available at https://github.com/yuxuanou623/AortaDiff.git.

Benchmarking Large Multimodal Models for Ophthalmic Visual Question Answering with OphthalWeChat

Purpose: To develop a bilingual multimodal visual question answering (VQA) benchmark for evaluating VLMs in ophthalmology. Methods: Ophthalmic image posts and associated captions published between January 1, 2016, and December 31, 2024, were collected from WeChat Official Accounts. Based on these captions, bilingual question-answer (QA) pairs in Chinese and English were generated using GPT-4o-mini. QA pairs were categorized into six subsets by question type and language: binary (Binary_CN, Binary_EN), single-choice (Single-choice_CN, Single-choice_EN), and open-ended (Open-ended_CN, Open-ended_EN). The benchmark was used to evaluate the performance of three VLMs: GPT-4o, Gemini 2.0 Flash, and Qwen2.5-VL-72B-Instruct. Results: The final OphthalWeChat dataset included 3,469 images and 30,120 QA pairs across 9 ophthalmic subspecialties, 548 conditions, 29 imaging modalities, and 68 modality combinations. Gemini 2.0 Flash achieved the highest overall accuracy (0.548), outperforming GPT-4o (0.522, P < 0.001) and Qwen2.5-VL-72B-Instruct (0.514, P < 0.001). It also led in both Chinese (0.546) and English subsets (0.550). Subset-specific performance showed Gemini 2.0 Flash excelled in Binary_CN (0.687), Single-choice_CN (0.666), and Single-choice_EN (0.646), while GPT-4o ranked highest in Binary_EN (0.717), Open-ended_CN (BLEU-1: 0.301; BERTScore: 0.382), and Open-ended_EN (BLEU-1: 0.183; BERTScore: 0.240). Conclusions: This study presents the first bilingual VQA benchmark for ophthalmology, distinguished by its real-world context and inclusion of multiple examinations per patient. The dataset reflects authentic clinical decision-making scenarios and enables quantitative evaluation of VLMs, supporting the development of accurate, specialized, and trustworthy AI systems for eye care.

Template-Guided Reconstruction of Pulmonary Segments with Neural Implicit Functions

High-quality 3D reconstruction of pulmonary segments plays a crucial role in segmentectomy and surgical treatment planning for lung cancer. Due to the resolution requirement of the target reconstruction, conventional deep learning-based methods often suffer from computational resource constraints or limited granularity. Conversely, implicit modeling is favored due to its computational efficiency and continuous representation at any resolution. We propose a neural implicit function-based method to learn a 3D surface to achieve anatomy-aware, precise pulmonary segment reconstruction, represented as a shape by deforming a learnable template. Additionally, we introduce two clinically relevant evaluation metrics to assess the reconstruction comprehensively. Further, due to the absence of publicly available shape datasets to benchmark reconstruction algorithms, we developed a shape dataset named Lung3D, including the 3D models of 800 labeled pulmonary segments and the corresponding airways, arteries, veins, and intersegmental veins. We demonstrate that the proposed approach outperforms existing methods, providing a new perspective for pulmonary segment reconstruction. Code and data will be available at https://github.com/M3DV/ImPulSe.

AI-powered virtual eye: perspective, challenges and opportunities

We envision the "virtual eye" as a next-generation, AI-powered platform that uses interconnected foundation models to simulate the eye's intricate structure and biological function across all scales. Advances in AI, imaging, and multiomics provide a fertile ground for constructing a universal, high-fidelity digital replica of the human eye. This perspective traces the evolution from early mechanistic and rule-based models to contemporary AI-driven approaches, integrating in a unified model with multimodal, multiscale, dynamic predictive capabilities and embedded feedback mechanisms. We propose a development roadmap emphasizing the roles of large-scale multimodal datasets, generative AI, foundation models, agent-based architectures, and interactive interfaces. Despite challenges in interpretability, ethics, data processing and evaluation, the virtual eye holds the potential to revolutionize personalized ophthalmic care and accelerate research into ocular health and disease.