Surg-UniWorld: A Unified Surgical World Model with Multimodal Control Experts

Controllable surgical world models can provide a generative foundation for surgical artificial intelligence and simulation by synthesizing realistic instrument--tissue interactions. However, existing methods lack a unified multimodal control paradigm, while direct fusion of heterogeneous visual conditions often causes anatomical distortion, instrument appearance drift, and temporally inconsistent interactions. In this work, we propose {Surg-UniWorld}, a unified surgical world model with multimodal control experts. Surg-UniWorld first constructs a {Hierarchical Surgical Anchor} from first-frame appearance and hierarchical semantic masks to preserve persistent scene identity, anatomical organization, and interaction boundaries. {Anchor-Relative Modality Experts} then interpret edge, depth, and optical-flow evidence relative to the shared anchor, capturing complementary boundary, geometric, and motion information. A {Multimodal Control Expert} further performs contribution-preserving stage-wise composition of the activated modality increments and generates control hints for the Wan2.2 video diffusion backbone. To support multimodal surgical world modeling, we further construct Cholec80-SurgWAM, a benchmark for controllable surgical video generation. Extensive experiments demonstrate that Surg-UniWorld consistently outperforms existing controllable video generation methods and surgical world-model baselines in generation quality, temporal consistency, and multimodal controllability.

Recurrent Contrastive Learning for Imbalanced Medical Image Classification

Medical image classification often suffers from class imbalance due to the inherent disparities in disease incidence. Existing approaches, such as class resampling and loss reweighting, mainly improve learning within the observed feature distribution, but do not explicitly enlarge the latent support region of tail classes. As a result, tail-class representations remain overly compact and are easily encroached upon by head classes, leading to biased decision boundaries. In this work, we propose Recurrent Contrastive Learning (RCL) for imbalanced medical image classification. RCL progressively expands the support region of tail classes by recurrently reusing historical feature states across training phases. Specifically, we adopt DINOv3 with LoRA adapters as the backbone to provide robust feature embeddings. We then devise a Temporal Memory Queue (TMQ) to preserve corpus-level features across training phases and provide diversified global references for contrastive learning. Based on TMQ, we construct Temporal Anchors (TARs) to form an anchor field around tail classes. This field enlarges the support region of tail classes, suppresses head-class encroachment, and improves inter-class separation. Extensive experiments on three imbalanced medical datasets demonstrate that RCL achieves consistent improvements over strong baselines. The code is available at https://github.com/dndins/RCL.

ProgFormer: Hierarchical Voxel Diffusion Transformer for Longitudinal Brain MRI Prediction

Predicting future structural MRI of a brain is challenging because longitudinal changes are often subtle and confined to specific anatomical regions, while most subject-specific brain structure remains stable over time. An effective model should therefore preserve global brain structural consistency while remaining sensitive to fine-grained disease progression. Existing latent-space-based methods improve computational efficiency, but suffer from information loss during their compression-reconstruction procedure. In contrast, direct voxel-space methods avoid latent reconstruction but commonly use a unified prediction pathway to model brain structure and progression-related changes. Subtle local changes may therefore be overshadowed by the dominant stable brain structure. To address these challenges, we propose ProgFormer, a hierarchical voxel-space Diffusion Transformer for longitudinal brain MRI prediction. ProgFormer uses a coarse pathway to perform the primary volumetric prediction from 3D patch tokens. This pathway models overall brain structure and longitudinal context. The fine pathway then uses the coarse representations as spatio-temporal grounding for voxel-level refinement within individual patches. The two pathways jointly estimate a velocity field directly in voxel space through conditional flow matching, enabling end-to-end prediction without a separately learned image autoencoder. The predicted future scan is then generated from Gaussian noise by integrating the estimated velocity field over a sequence of Euler steps. Extensive experimental results on three widely used benchmarks, ADNI, AIBL, and OASIS, under both pairwise and trajectory settings demonstrate favourable performance compared against several state-of-the-art methods.

Seeing What Matters: Lesion-Aware High-Resolution Patch Discovery and Fusion for Chest X-ray Report Generation

Despite rapid advances in chest X-ray (CXR) foundation models, most radiology report generation (RRG) systems still rely on heavily downsampled inputs (e.g., 256x256) due to the fixed visual token budgets of pretrained vision encoders, suppressing subtle yet clinically important cues present in native-resolution images. However, enabling high-resolution (high-res) perception remains challenging: naive tiling causes prohibitive token inflation, while global compression suppresses subtle lesions and degrades diagnostic fidelity. Inspired by radiologists' workflow, localizing suspicious regions before detailed high-res assessment. We propose Lesion-Aware High-Resolution Patch Discovery and Fusion for Chest X-ray Reporting (LePaX), the first RRG framework that enables efficient high-res CXR perception (up to 1920x1920) without increasing the vision-token count. LePaX formulates high-res perception as a constrained spatial resolution allocation problem under a fixed token budget and introduces two key components: Learnable Spatial Resolution Allocation (LSRA), which learns a spatial utility map that adaptively allocates limited high-res capacity to diagnostically relevant regions, enabling targeted extraction of high-res patches from native CXRs; and Global-Regional Fusion (GRF), which performs token-preserving region-to-global refinement by projecting high-resolution regional evidence back onto the global feature grid through spatially aligned resolution write-back, avoiding token inflation. Experiments on multiple CXR benchmarks demonstrate that LePaX consistently improves both clinical and linguistic metrics while enabling native-resolution CXR perception with over 10x fewer visual tokens than naive high-res tiling.

Hierarchical Text-Guided Brain Tumor Segmentation via Sub-Region-Aware Prompts

Brain tumor segmentation remains challenging because the three standard sub-regions, i.e., whole tumor (WT), tumor core (TC), and enhancing tumor (ET), often exhibit ambiguous visual boundaries. Integrating radiological description texts with imaging has shown promise. However, most multimodal approaches typically compress a report into a single global text embedding shared across all sub-regions, overlooking their distinct clinical characteristics. We propose TextCSP (text-modulated soft cascade architecture), a hierarchical text-guided framework that builds on the TextBraTS baseline with three novel components: (1) a text-modulated soft cascade decoder that predicts WT->TC->ET in a coarse-to-fine manner consistent with their anatomical containment hierarchy. (2) sub-region-aware prompt tuning, which uses learnable soft prompts with a LoRA-adapted BioBERT encoder to generate specialized text representations tailored for each sub-region; (3) text-semantic channel modulators that convert the aforementioned representations into channel-wise refinement signals, enabling the decoder to emphasize features aligned with clinically described patterns. Experiments on the TextBraTS dataset demonstrate consistent improvements across all sub-regions against state-of-the-art methods by 1.7% and 6% on the main metrics Dice and HD95.

EndoIR: Degradation-Agnostic All-in-One Endoscopic Image Restoration via Noise-Aware Routing Diffusion

Endoscopic images often suffer from diverse and co-occurring degradations such as low lighting, smoke, and bleeding, which obscure critical clinical details. Existing restoration methods are typically task-specific and often require prior knowledge of the degradation type, limiting their robustness in real-world clinical use. We propose EndoIR, an all-in-one, degradation-agnostic diffusion-based framework that restores multiple degradation types using a single model. EndoIR introduces a Dual-Domain Prompter that extracts joint spatial-frequency features, coupled with an adaptive embedding that encodes both shared and task-specific cues as conditioning for denoising. To mitigate feature confusion in conventional concatenation-based conditioning, we design a Dual-Stream Diffusion architecture that processes clean and degraded inputs separately, with a Rectified Fusion Block integrating them in a structured, degradation-aware manner. Furthermore, Noise-Aware Routing Block improves efficiency by dynamically selecting only noise-relevant features during denoising. Experiments on SegSTRONG-C and CEC datasets demonstrate that EndoIR achieves state-of-the-art performance across multiple degradation scenarios while using fewer parameters than strong baselines, and downstream segmentation experiments confirm its clinical utility.

Medical Referring Image Segmentation via Next-Token Mask Prediction

Medical Referring Image Segmentation (MRIS) involves segmenting target regions in medical images based on natural language descriptions. While achieving promising results, recent approaches usually involve complex design of multimodal fusion or multi-stage decoders. In this work, we propose NTP-MRISeg, a novel framework that reformulates MRIS as an autoregressive next-token prediction task over a unified multimodal sequence of tokenized image, text, and mask representations. This formulation streamlines model design by eliminating the need for modality-specific fusion and external segmentation models, supports a unified architecture for end-to-end training. It also enables the use of pretrained tokenizers from emerging large-scale multimodal models, enhancing generalization and adaptability. More importantly, to address challenges under this formulation-such as exposure bias, long-tail token distributions, and fine-grained lesion edges-we propose three novel strategies: (1) a Next-k Token Prediction (NkTP) scheme to reduce cumulative prediction errors, (2) Token-level Contrastive Learning (TCL) to enhance boundary sensitivity and mitigate long-tail distribution effects, and (3) a memory-based Hard Error Token (HET) optimization strategy that emphasizes difficult tokens during training. Extensive experiments on the QaTa-COV19 and MosMedData+ datasets demonstrate that NTP-MRISeg achieves new state-of-the-art performance, offering a streamlined and effective alternative to traditional MRIS pipelines.

A Review of Longitudinal Radiology Report Generation: Dataset Composition, Methods, and Performance Evaluation

Chest Xray imaging is a widely used diagnostic tool in modern medicine, and its high utilization creates substantial workloads for radiologists. To alleviate this burden, vision language models are increasingly applied to automate Chest Xray radiology report generation (CXRRRG), aiming for clinically accurate descriptions while reducing manual effort. Conventional approaches, however, typically rely on single images, failing to capture the longitudinal context necessary for producing clinically faithful comparison statements. Recently, growing attention has been directed toward incorporating longitudinal data into CXR RRG, enabling models to leverage historical studies in ways that mirror radiologists diagnostic workflows. Nevertheless, existing surveys primarily address single image CXRRRG and offer limited guidance for longitudinal settings, leaving researchers without a systematic framework for model design. To address this gap, this survey provides the first comprehensive review of longitudinal radiology report generation (LRRG). Specifically, we examine dataset construction strategies, report generation architectures alongside longitudinally tailored designs, and evaluation protocols encompassing both longitudinal specific measures and widely used benchmarks. We further summarize LRRG methods performance, alongside analyses of different ablation studies, which collectively highlight the critical role of longitudinal information and architectural design choices in improving model performance. Finally, we summarize five major limitations of current research and outline promising directions for future development, aiming to lay a foundation for advancing this emerging field.

Understand Before You Generate: Self-Guided Training for Autoregressive Image Generation

Recent studies have demonstrated the importance of high-quality visual representations in image generation and have highlighted the limitations of generative models in image understanding. As a generative paradigm originally designed for natural language, autoregressive models face similar challenges. In this work, we present the first systematic investigation into the mechanisms of applying the next-token prediction paradigm to the visual domain. We identify three key properties that hinder the learning of high-level visual semantics: local and conditional dependence, inter-step semantic inconsistency, and spatial invariance deficiency. We show that these issues can be effectively addressed by introducing self-supervised objectives during training, leading to a novel training framework, Self-guided Training for AutoRegressive models (ST-AR). Without relying on pre-trained representation models, ST-AR significantly enhances the image understanding ability of autoregressive models and leads to improved generation quality. Specifically, ST-AR brings approximately 42% FID improvement for LlamaGen-L and 49% FID improvement for LlamaGen-XL, while maintaining the same sampling strategy.

Dense Video Captioning using Graph-based Sentence Summarization

Recently, dense video captioning has made attractive progress in detecting and captioning all events in a long untrimmed video. Despite promising results were achieved, most existing methods do not sufficiently explore the scene evolution within an event temporal proposal for captioning, and therefore perform less satisfactorily when the scenes and objects change over a relatively long proposal. To address this problem, we propose a graph-based partition-and-summarization (GPaS) framework for dense video captioning within two stages. For the ``partition" stage, a whole event proposal is split into short video segments for captioning at a finer level. For the ``summarization" stage, the generated sentences carrying rich description information for each segment are summarized into one sentence to describe the whole event. We particularly focus on the ``summarization" stage, and propose a framework that effectively exploits the relationship between semantic words for summarization. We achieve this goal by treating semantic words as nodes in a graph and learning their interactions by coupling Graph Convolutional Network (GCN) and Long Short Term Memory (LSTM), with the aid of visual cues. Two schemes of GCN-LSTM Interaction (GLI) modules are proposed for seamless integration of GCN and LSTM. The effectiveness of our approach is demonstrated via an extensive comparison with the state-of-the-arts methods on the two benchmarks ActivityNet Captions dataset and YouCook II dataset.