F^2TTA: Free-Form Test-Time Adaptation on Cross-Domain Medical Image Classification via Image-Level Disentangled Prompt Tuning

Test-Time Adaptation (TTA) has emerged as a promising solution for adapting a source model to unseen medical sites using unlabeled test data, due to the high cost of data annotation. Existing TTA methods consider scenarios where data from one or multiple domains arrives in complete domain units. However, in clinical practice, data usually arrives in domain fragments of arbitrary lengths and in random arrival orders, due to resource constraints and patient variability. This paper investigates a practical Free-Form Test-Time Adaptation (F$^{2}$TTA) task, where a source model is adapted to such free-form domain fragments, with shifts occurring between fragments unpredictably. In this setting, these shifts could distort the adaptation process. To address this problem, we propose a novel Image-level Disentangled Prompt Tuning (I-DiPT) framework. I-DiPT employs an image-invariant prompt to explore domain-invariant representations for mitigating the unpredictable shifts, and an image-specific prompt to adapt the source model to each test image from the incoming fragments. The prompts may suffer from insufficient knowledge representation since only one image is available for training. To overcome this limitation, we first introduce Uncertainty-oriented Masking (UoM), which encourages the prompts to extract sufficient information from the incoming image via masked consistency learning driven by the uncertainty of the source model representations. Then, we further propose a Parallel Graph Distillation (PGD) method that reuses knowledge from historical image-specific and image-invariant prompts through parallel graph networks. Experiments on breast cancer and glaucoma classification demonstrate the superiority of our method over existing TTA approaches in F$^{2}$TTA. Code is available at https://github.com/mar-cry/F2TTA.

ADAgent: LLM Agent for Alzheimer's Disease Analysis with Collaborative Coordinator

Alzheimer's disease (AD) is a progressive and irreversible neurodegenerative disease. Early and precise diagnosis of AD is crucial for timely intervention and treatment planning to alleviate the progressive neurodegeneration. However, most existing methods rely on single-modality data, which contrasts with the multifaceted approach used by medical experts. While some deep learning approaches process multi-modal data, they are limited to specific tasks with a small set of input modalities and cannot handle arbitrary combinations. This highlights the need for a system that can address diverse AD-related tasks, process multi-modal or missing input, and integrate multiple advanced methods for improved performance. In this paper, we propose ADAgent, the first specialized AI agent for AD analysis, built on a large language model (LLM) to address user queries and support decision-making. ADAgent integrates a reasoning engine, specialized medical tools, and a collaborative outcome coordinator to facilitate multi-modal diagnosis and prognosis tasks in AD. Extensive experiments demonstrate that ADAgent outperforms SOTA methods, achieving significant improvements in accuracy, including a 2.7% increase in multi-modal diagnosis, a 0.7% improvement in multi-modal prognosis, and enhancements in MRI and PET diagnosis tasks.

Astra: Toward General-Purpose Mobile Robots via Hierarchical Multimodal Learning

Modern robot navigation systems encounter difficulties in diverse and complex indoor environments. Traditional approaches rely on multiple modules with small models or rule-based systems and thus lack adaptability to new environments. To address this, we developed Astra, a comprehensive dual-model architecture, Astra-Global and Astra-Local, for mobile robot navigation. Astra-Global, a multimodal LLM, processes vision and language inputs to perform self and goal localization using a hybrid topological-semantic graph as the global map, and outperforms traditional visual place recognition methods. Astra-Local, a multitask network, handles local path planning and odometry estimation. Its 4D spatial-temporal encoder, trained through self-supervised learning, generates robust 4D features for downstream tasks. The planning head utilizes flow matching and a novel masked ESDF loss to minimize collision risks for generating local trajectories, and the odometry head integrates multi-sensor inputs via a transformer encoder to predict the relative pose of the robot. Deployed on real in-house mobile robots, Astra achieves high end-to-end mission success rate across diverse indoor environments.

Silence is Not Consensus: Disrupting Agreement Bias in Multi-Agent LLMs via Catfish Agent for Clinical Decision Making

Large language models (LLMs) have demonstrated strong potential in clinical question answering, with recent multi-agent frameworks further improving diagnostic accuracy via collaborative reasoning. However, we identify a recurring issue of Silent Agreement, where agents prematurely converge on diagnoses without sufficient critical analysis, particularly in complex or ambiguous cases. We present a new concept called Catfish Agent, a role-specialized LLM designed to inject structured dissent and counter silent agreement. Inspired by the ``catfish effect'' in organizational psychology, the Catfish Agent is designed to challenge emerging consensus to stimulate deeper reasoning. We formulate two mechanisms to encourage effective and context-aware interventions: (i) a complexity-aware intervention that modulates agent engagement based on case difficulty, and (ii) a tone-calibrated intervention articulated to balance critique and collaboration. Evaluations on nine medical Q&A and three medical VQA benchmarks show that our approach consistently outperforms both single- and multi-agent LLMs frameworks, including leading commercial models such as GPT-4o and DeepSeek-R1.

MedITok: A Unified Tokenizer for Medical Image Synthesis and Interpretation

Advanced autoregressive models have reshaped multimodal AI. However, their transformative potential in medical imaging remains largely untapped due to the absence of a unified visual tokenizer -- one capable of capturing fine-grained visual structures for faithful image reconstruction and realistic image synthesis, as well as rich semantics for accurate diagnosis and image interpretation. To this end, we present MedITok, the first unified tokenizer tailored for medical images, encoding both low-level structural details and high-level clinical semantics within a unified latent space. To balance these competing objectives, we introduce a novel two-stage training framework: a visual representation alignment stage that cold-starts the tokenizer reconstruction learning with a visual semantic constraint, followed by a textual semantic representation alignment stage that infuses detailed clinical semantics into the latent space. Trained on the meticulously collected large-scale dataset with over 30 million medical images and 2 million image-caption pairs, MedITok achieves state-of-the-art performance on more than 30 datasets across 9 imaging modalities and 4 different tasks. By providing a unified token space for autoregressive modeling, MedITok supports a wide range of tasks in clinical diagnostics and generative healthcare applications. Model and code will be made publicly available at: https://github.com/Masaaki-75/meditok.

RetinaLogos: Fine-Grained Synthesis of High-Resolution Retinal Images Through Captions

The scarcity of high-quality, labelled retinal imaging data, which presents a significant challenge in the development of machine learning models for ophthalmology, hinders progress in the field. To synthesise Colour Fundus Photographs (CFPs), existing methods primarily relying on predefined disease labels face significant limitations. However, current methods remain limited, thus failing to generate images for broader categories with diverse and fine-grained anatomical structures. To overcome these challenges, we first introduce an innovative pipeline that creates a large-scale, synthetic Caption-CFP dataset comprising 1.4 million entries, called RetinaLogos-1400k. Specifically, RetinaLogos-1400k uses large language models (LLMs) to describe retinal conditions and key structures, such as optic disc configuration, vascular distribution, nerve fibre layers, and pathological features. Furthermore, based on this dataset, we employ a novel three-step training framework, called RetinaLogos, which enables fine-grained semantic control over retinal images and accurately captures different stages of disease progression, subtle anatomical variations, and specific lesion types. Extensive experiments demonstrate state-of-the-art performance across multiple datasets, with 62.07% of text-driven synthetic images indistinguishable from real ones by ophthalmologists. Moreover, the synthetic data improves accuracy by 10%-25% in diabetic retinopathy grading and glaucoma detection, thereby providing a scalable solution to augment ophthalmic datasets.

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.

Ophora: A Large-Scale Data-Driven Text-Guided Ophthalmic Surgical Video Generation Model

In ophthalmic surgery, developing an AI system capable of interpreting surgical videos and predicting subsequent operations requires numerous ophthalmic surgical videos with high-quality annotations, which are difficult to collect due to privacy concerns and labor consumption. Text-guided video generation (T2V) emerges as a promising solution to overcome this issue by generating ophthalmic surgical videos based on surgeon instructions. In this paper, we present Ophora, a pioneering model that can generate ophthalmic surgical videos following natural language instructions. To construct Ophora, we first propose a Comprehensive Data Curation pipeline to convert narrative ophthalmic surgical videos into a large-scale, high-quality dataset comprising over 160K video-instruction pairs, Ophora-160K. Then, we propose a Progressive Video-Instruction Tuning scheme to transfer rich spatial-temporal knowledge from a T2V model pre-trained on natural video-text datasets for privacy-preserved ophthalmic surgical video generation based on Ophora-160K. Experiments on video quality evaluation via quantitative analysis and ophthalmologist feedback demonstrate that Ophora can generate realistic and reliable ophthalmic surgical videos based on surgeon instructions. We also validate the capability of Ophora for empowering downstream tasks of ophthalmic surgical workflow understanding. Code is available at https://github.com/mar-cry/Ophora.

Building a Human-Verified Clinical Reasoning Dataset via a Human LLM Hybrid Pipeline for Trustworthy Medical AI

Despite strong performance in medical question-answering, the clinical adoption of Large Language Models (LLMs) is critically hampered by their opaque 'black-box' reasoning, limiting clinician trust. This challenge is compounded by the predominant reliance of current medical LLMs on corpora from scientific literature or synthetic data, which often lack the granular expert validation and high clinical relevance essential for advancing their specialized medical capabilities. To address these critical gaps, we introduce a highly clinically relevant dataset with 31,247 medical question-answer pairs, each accompanied by expert-validated chain-of-thought (CoT) explanations. This resource, spanning multiple clinical domains, was curated via a scalable human-LLM hybrid pipeline: LLM-generated rationales were iteratively reviewed, scored, and refined by medical experts against a structured rubric, with substandard outputs revised through human effort or guided LLM regeneration until expert consensus. This publicly available dataset provides a vital source for the development of medical LLMs that capable of transparent and verifiable reasoning, thereby advancing safer and more interpretable AI in medicine.

GMAI-VL-R1: Harnessing Reinforcement Learning for Multimodal Medical Reasoning

Recent advances in general medical AI have made significant strides, but existing models often lack the reasoning capabilities needed for complex medical decision-making. This paper presents GMAI-VL-R1, a multimodal medical reasoning model enhanced by reinforcement learning (RL) to improve its reasoning abilities. Through iterative training, GMAI-VL-R1 optimizes decision-making, significantly boosting diagnostic accuracy and clinical support. We also develop a reasoning data synthesis method, generating step-by-step reasoning data via rejection sampling, which further enhances the model's generalization. Experimental results show that after RL training, GMAI-VL-R1 excels in tasks such as medical image diagnosis and visual question answering. While the model demonstrates basic memorization with supervised fine-tuning, RL is crucial for true generalization. Our work establishes new evaluation benchmarks and paves the way for future advancements in medical reasoning models. Code, data, and model will be released at \href{https://github.com/uni-medical/GMAI-VL-R1}{this link}.