Adapting Vision-Language Foundation Model for Next Generation Medical Ultrasound Image Analysis

Medical ultrasonography is an essential imaging technique for examining superficial organs and tissues, including lymph nodes, breast, and thyroid. It employs high-frequency ultrasound waves to generate detailed images of the internal structures of the human body. However, manually contouring regions of interest in these images is a labor-intensive task that demands expertise and often results in inconsistent interpretations among individuals. Vision-language foundation models, which have excelled in various computer vision applications, present new opportunities for enhancing ultrasound image analysis. Yet, their performance is hindered by the significant differences between natural and medical imaging domains. This research seeks to overcome these challenges by developing domain adaptation methods for vision-language foundation models. In this study, we explore the fine-tuning pipeline for vision-language foundation models by utilizing large language model as text refiner with special-designed adaptation strategies and task-driven heads. Our approach has been extensively evaluated on six ultrasound datasets and two tasks: segmentation and classification. The experimental results show that our method can effectively improve the performance of vision-language foundation models for ultrasound image analysis, and outperform the existing state-of-the-art vision-language and pure foundation models. The source code of this study is available at https://github.com/jinggqu/NextGen-UIA.

Efficient Medical Vision-Language Alignment Through Adapting Masked Vision Models

Medical vision-language alignment through cross-modal contrastive learning shows promising performance in image-text matching tasks, such as retrieval and zero-shot classification. However, conventional cross-modal contrastive learning (CLIP-based) methods suffer from suboptimal visual representation capabilities, which also limits their effectiveness in vision-language alignment. In contrast, although the models pretrained via multimodal masked modeling struggle with direct cross-modal matching, they excel in visual representation. To address this contradiction, we propose ALTA (ALign Through Adapting), an efficient medical vision-language alignment method that utilizes only about 8% of the trainable parameters and less than 1/5 of the computational consumption required for masked record modeling. ALTA achieves superior performance in vision-language matching tasks like retrieval and zero-shot classification by adapting the pretrained vision model from masked record modeling. Additionally, we integrate temporal-multiview radiograph inputs to enhance the information consistency between radiographs and their corresponding descriptions in reports, further improving the vision-language alignment. Experimental evaluations show that ALTA outperforms the best-performing counterpart by over 4% absolute points in text-to-image accuracy and approximately 6% absolute points in image-to-text retrieval accuracy. The adaptation of vision-language models during efficient alignment also promotes better vision and language understanding. Code is publicly available at https://github.com/DopamineLcy/ALTA.

Are MLMs Trapped in the Visual Room?

Can multi-modal large models (MLMs) that can ``see'' an image be said to ``understand'' it? Drawing inspiration from Searle's Chinese Room, we propose the \textbf{Visual Room} argument: a system may process and describe every detail of visual inputs by following algorithmic rules, without genuinely comprehending the underlying intention. This dilemma challenges the prevailing assumption that perceptual mastery implies genuine understanding. In implementation, we introduce a two-tier evaluation framework spanning perception and cognition. The perception component evaluates whether MLMs can accurately capture the surface-level details of visual contents, where the cognitive component examines their ability to infer sarcasm polarity. To support this framework, We further introduce a high-quality multi-modal sarcasm dataset comprising both 924 static images and 100 dynamic videos. All sarcasm labels are annotated by the original authors and verified by independent reviewers to ensure clarity and consistency. We evaluate eight state-of-the-art (SoTA) MLMs. Our results highlight three key findings: (1) MLMs perform well on perception tasks; (2) even with correct perception, models exhibit an average error rate of ~16.1\% in sarcasm understanding, revealing a significant gap between seeing and understanding; (3) error analysis attributes this gap to deficiencies in emotional reasoning, commonsense inference, and context alignment. This work provides empirical grounding for the proposed Visual Room argument and offers a new evaluation paradigm for MLMs.

CorBenchX: Large-Scale Chest X-Ray Error Dataset and Vision-Language Model Benchmark for Report Error Correction

AI-driven models have shown great promise in detecting errors in radiology reports, yet the field lacks a unified benchmark for rigorous evaluation of error detection and further correction. To address this gap, we introduce CorBenchX, a comprehensive suite for automated error detection and correction in chest X-ray reports, designed to advance AI-assisted quality control in clinical practice. We first synthesize a large-scale dataset of 26,326 chest X-ray error reports by injecting clinically common errors via prompting DeepSeek-R1, with each corrupted report paired with its original text, error type, and human-readable description. Leveraging this dataset, we benchmark both open- and closed-source vision-language models,(e.g., InternVL, Qwen-VL, GPT-4o, o4-mini, and Claude-3.7) for error detection and correction under zero-shot prompting. Among these models, o4-mini achieves the best performance, with 50.6 % detection accuracy and correction scores of BLEU 0.853, ROUGE 0.924, BERTScore 0.981, SembScore 0.865, and CheXbertF1 0.954, remaining below clinical-level accuracy, highlighting the challenge of precise report correction. To advance the state of the art, we propose a multi-step reinforcement learning (MSRL) framework that optimizes a multi-objective reward combining format compliance, error-type accuracy, and BLEU similarity. We apply MSRL to QwenVL2.5-7B, the top open-source model in our benchmark, achieving an improvement of 38.3% in single-error detection precision and 5.2% in single-error correction over the zero-shot baseline.

NurValues: Real-World Nursing Values Evaluation for Large Language Models in Clinical Context

This work introduces the first benchmark for nursing value alignment, consisting of five core value dimensions distilled from international nursing codes: Altruism, Human Dignity, Integrity, Justice, and Professionalism. The benchmark comprises 1,100 real-world nursing behavior instances collected through a five-month longitudinal field study across three hospitals of varying tiers. These instances are annotated by five clinical nurses and then augmented with LLM-generated counterfactuals with reversed ethic polarity. Each original case is paired with a value-aligned and a value-violating version, resulting in 2,200 labeled instances that constitute the Easy-Level dataset. To increase adversarial complexity, each instance is further transformed into a dialogue-based format that embeds contextual cues and subtle misleading signals, yielding a Hard-Level dataset. We evaluate 23 state-of-the-art (SoTA) LLMs on their alignment with nursing values. Our findings reveal three key insights: (1) DeepSeek-V3 achieves the highest performance on the Easy-Level dataset (94.55), where Claude 3.5 Sonnet outperforms other models on the Hard-Level dataset (89.43), significantly surpassing the medical LLMs; (2) Justice is consistently the most difficult nursing value dimension to evaluate; and (3) in-context learning significantly improves alignment. This work aims to provide a foundation for value-sensitive LLMs development in clinical settings. The dataset and the code are available at https://huggingface.co/datasets/Ben012345/NurValues.

The Application of Deep Learning for Lymph Node Segmentation: A Systematic Review

Automatic lymph node segmentation is the cornerstone for advances in computer vision tasks for early detection and staging of cancer. Traditional segmentation methods are constrained by manual delineation and variability in operator proficiency, limiting their ability to achieve high accuracy. The introduction of deep learning technologies offers new possibilities for improving the accuracy of lymph node image analysis. This study evaluates the application of deep learning in lymph node segmentation and discusses the methodologies of various deep learning architectures such as convolutional neural networks, encoder-decoder networks, and transformers in analyzing medical imaging data across different modalities. Despite the advancements, it still confronts challenges like the shape diversity of lymph nodes, the scarcity of accurately labeled datasets, and the inadequate development of methods that are robust and generalizable across different imaging modalities. To the best of our knowledge, this is the first study that provides a comprehensive overview of the application of deep learning techniques in lymph node segmentation task. Furthermore, this study also explores potential future research directions, including multimodal fusion techniques, transfer learning, and the use of large-scale pre-trained models to overcome current limitations while enhancing cancer diagnosis and treatment planning strategies.

ShapeSpeak: Body Shape-Aware Textual Alignment for Visible-Infrared Person Re-Identification

Visible-Infrared Person Re-identification (VIReID) aims to match visible and infrared pedestrian images, but the modality differences and the complexity of identity features make it challenging. Existing methods rely solely on identity label supervision, which makes it difficult to fully extract high-level semantic information. Recently, vision-language pre-trained models have been introduced to VIReID, enhancing semantic information modeling by generating textual descriptions. However, such methods do not explicitly model body shape features, which are crucial for cross-modal matching. To address this, we propose an effective Body Shape-aware Textual Alignment (BSaTa) framework that explicitly models and utilizes body shape information to improve VIReID performance. Specifically, we design a Body Shape Textual Alignment (BSTA) module that extracts body shape information using a human parsing model and converts it into structured text representations via CLIP. We also design a Text-Visual Consistency Regularizer (TVCR) to ensure alignment between body shape textual representations and visual body shape features. Furthermore, we introduce a Shape-aware Representation Learning (SRL) mechanism that combines Multi-text Supervision and Distribution Consistency Constraints to guide the visual encoder to learn modality-invariant and discriminative identity features, thus enhancing modality invariance. Experimental results demonstrate that our method achieves superior performance on the SYSU-MM01 and RegDB datasets, validating its effectiveness.

Landmark-Free Preoperative-to-Intraoperative Registration in Laparoscopic Liver Resection

Liver registration by overlaying preoperative 3D models onto intraoperative 2D frames can assist surgeons in perceiving the spatial anatomy of the liver clearly for a higher surgical success rate. Existing registration methods rely heavily on anatomical landmark-based workflows, which encounter two major limitations: 1) ambiguous landmark definitions fail to provide efficient markers for registration; 2) insufficient integration of intraoperative liver visual information in shape deformation modeling. To address these challenges, in this paper, we propose a landmark-free preoperative-to-intraoperative registration framework utilizing effective self-supervised learning, termed \ourmodel. This framework transforms the conventional 3D-2D workflow into a 3D-3D registration pipeline, which is then decoupled into rigid and non-rigid registration subtasks. \ourmodel~first introduces a feature-disentangled transformer to learn robust correspondences for recovering rigid transformations. Further, a structure-regularized deformation network is designed to adjust the preoperative model to align with the intraoperative liver surface. This network captures structural correlations through geometry similarity modeling in a low-rank transformer network. To facilitate the validation of the registration performance, we also construct an in-vivo registration dataset containing liver resection videos of 21 patients, called \emph{P2I-LReg}, which contains 346 keyframes that provide a global view of the liver together with liver mask annotations and calibrated camera intrinsic parameters. Extensive experiments and user studies on both synthetic and in-vivo datasets demonstrate the superiority and potential clinical applicability of our method.

Beyond Single-Sentence Prompts: Upgrading Value Alignment Benchmarks with Dialogues and Stories

Evaluating the value alignment of large language models (LLMs) has traditionally relied on single-sentence adversarial prompts, which directly probe models with ethically sensitive or controversial questions. However, with the rapid advancements in AI safety techniques, models have become increasingly adept at circumventing these straightforward tests, limiting their effectiveness in revealing underlying biases and ethical stances. To address this limitation, we propose an upgraded value alignment benchmark that moves beyond single-sentence prompts by incorporating multi-turn dialogues and narrative-based scenarios. This approach enhances the stealth and adversarial nature of the evaluation, making it more robust against superficial safeguards implemented in modern LLMs. We design and implement a dataset that includes conversational traps and ethically ambiguous storytelling, systematically assessing LLMs' responses in more nuanced and context-rich settings. Experimental results demonstrate that this enhanced methodology can effectively expose latent biases that remain undetected in traditional single-shot evaluations. Our findings highlight the necessity of contextual and dynamic testing for value alignment in LLMs, paving the way for more sophisticated and realistic assessments of AI ethics and safety.

Synergistic Bleeding Region and Point Detection in Surgical Videos

Intraoperative bleeding in laparoscopic surgery causes rapid obscuration of the operative field to hinder the surgical process. Intelligent detection of bleeding regions can quantify the blood loss to assist decision-making, while locating the bleeding point helps surgeons quickly identify the source of bleeding and achieve hemostasis in time. In this study, we first construct a real-world surgical bleeding detection dataset, named SurgBlood, comprising 5,330 frames from 95 surgical video clips with bleeding region and point annotations. Accordingly, we develop a dual-task synergistic online detector called BlooDet, designed to perform simultaneous detection of bleeding regions and points in surgical videos. Our framework embraces a dual-branch bidirectional guidance design based on Segment Anything Model 2 (SAM 2). The mask branch detects bleeding regions through adaptive edge and point prompt embeddings, while the point branch leverages mask memory to induce bleeding point memory modeling and captures the direction of bleed point movement through inter-frame optical flow. By interactive guidance and prompts, the two branches explore potential spatial-temporal relationships while leveraging memory modeling from previous frames to infer the current bleeding condition. Extensive experiments demonstrate that our approach outperforms other counterparts on SurgBlood in both bleeding region and point detection tasks, e.g., achieving 64.88% IoU for bleeding region detection and 83.69% PCK-10% for bleeding point detection.