Radiology Report Generation for Low-Quality X-Ray Images

Vision-Language Models (VLMs) have significantly advanced automated Radiology Report Generation (RRG). However, existing methods implicitly assume high-quality inputs, overlooking the noise and artifacts prevalent in real-world clinical environments. Consequently, current models exhibit severe performance degradation when processing suboptimal images. To bridge this gap, we propose a robust report generation framework explicitly designed for image quality variations. We first introduce an Automated Quality Assessment Agent (AQAA) to identify low-quality samples within the MIMIC-CXR dataset and establish the Low-quality Radiology Report Generation (LRRG) benchmark. To tackle degradation-induced shifts, we propose a novel Dual-loop Training Strategy leveraging bi-level optimization and gradient consistency. This approach ensures the model learns quality-agnostic diagnostic features by aligning gradient directions across varying quality regimes. Extensive experiments demonstrate that our approach effectively mitigates model performance degradation caused by image quality deterioration. The code and data will be released upon acceptance.

Project Imaging-X: A Survey of 1000+ Open-Access Medical Imaging Datasets for Foundation Model Development

Foundation models have demonstrated remarkable success across diverse domains and tasks, primarily due to the thrive of large-scale, diverse, and high-quality datasets. However, in the field of medical imaging, the curation and assembling of such medical datasets are highly challenging due to the reliance on clinical expertise and strict ethical and privacy constraints, resulting in a scarcity of large-scale unified medical datasets and hindering the development of powerful medical foundation models. In this work, we present the largest survey to date of medical image datasets, covering over 1,000 open-access datasets with a systematic catalog of their modalities, tasks, anatomies, annotations, limitations, and potential for integration. Our analysis exposes a landscape that is modest in scale, fragmented across narrowly scoped tasks, and unevenly distributed across organs and modalities, which in turn limits the utility of existing medical image datasets for developing versatile and robust medical foundation models. To turn fragmentation into scale, we propose a metadata-driven fusion paradigm (MDFP) that integrates public datasets with shared modalities or tasks, thereby transforming multiple small data silos into larger, more coherent resources. Building on MDFP, we release an interactive discovery portal that enables end-to-end, automated medical image dataset integration, and compile all surveyed datasets into a unified, structured table that clearly summarizes their key characteristics and provides reference links, offering the community an accessible and comprehensive repository. By charting the current terrain and offering a principled path to dataset consolidation, our survey provides a practical roadmap for scaling medical imaging corpora, supporting faster data discovery, more principled dataset creation, and more capable medical foundation models.

FB-CLIP: Fine-Grained Zero-Shot Anomaly Detection with Foreground-Background Disentanglement

Fine-grained anomaly detection is crucial in industrial and medical applications, but labeled anomalies are often scarce, making zero-shot detection challenging. While vision-language models like CLIP offer promising solutions, they struggle with foreground-background feature entanglement and coarse textual semantics. We propose FB-CLIP, a framework that enhances anomaly localization via multi-strategy textual representations and foreground-background separation. In the textual modality, it combines End-of-Text features, global-pooled representations, and attention-weighted token features for richer semantic cues. In the visual modality, multi-view soft separation along identity, semantic, and spatial dimensions, together with background suppression, reduces interference and improves discriminability. Semantic Consistency Regularization (SCR) aligns image features with normal and abnormal textual prototypes, suppressing uncertain matches and enlarging semantic gaps. Experiments show that FB-CLIP effectively distinguishes anomalies from complex backgrounds, achieving accurate fine-grained anomaly detection and localization under zero-shot settings.

Foundation-Model Surrogates Enable Data-Efficient Active Learning for Materials Discovery

Active learning (AL) has emerged as a powerful paradigm for accelerating materials discovery by iteratively steering experiments toward promising candidates, reducing the number of costly synthesis-and-characterization cycles needed to identify optimal materials. However, current AL relies predominantly on Gaussian Process (GP) and Random Forest (RF) surrogates, which suffer from complementary limitations: GP underfits complex composition-property landscapes due to rigid kernel assumptions, while RF produces unreliable heuristic uncertainty estimates in small-data regimes. This small-data challenge is pervasive in materials science, making reliable surrogate modeling extremely difficult with models trained from scratch on each new dataset. Here we propose In-Context Active Learning (ICAL), which addresses this bottleneck by replacing conventional surrogates with TabPFN, a transformer-based foundation model (FM) pre-trained on millions of synthetic regression tasks to meta-learn a universal prior over tabular data, upon which TabPFN performs principled Bayesian inference in a single forward pass without dataset-specific retraining, delivering strong small-data regression performance and well-calibrated predictive uncertainty (required for effective AL). We benchmark ICAL against GP and RF across 10 materials datasets and TabPFN wins on 8 out of 10 datasets, achieving a mean saving of 52% in extra evaluations relative to GP and 29.77% relative to RF. Cross-validation analysis confirms that TabPFN's advantage stems from superior uncertainty calibration, achieving the lowest Negative Log-Likelihood and Area Under the Sparsification Error curve among all surrogates. These results demonstrate that pre-trained FMs can serve as effective surrogates for active learning, enabling data-efficient discovery across diverse materials systems and small-data experimental sciences.

Thinking in Uncertainty: Mitigating Hallucinations in MLRMs with Latent Entropy-Aware Decoding

Recent advancements in multimodal large reasoning models (MLRMs) have significantly improved performance in visual question answering. However, we observe that transition words (e.g., because, however, and wait) are closely associated with hallucinations and tend to exhibit high-entropy states. We argue that adequate contextual reasoning information can be directly extracted from the token probability distribution. Inspired by superposed representation theory, we propose leveraging latent superposed reasoning to integrate multiple candidate semantics and maintain latent reasoning trajectories. The hypothesis is that reliance on discrete textual inputs may drive the model toward sequential explicit reasoning, underutilizing dense contextual cues during high-entropy reasoning stages. Therefore, we propose constructing rich semantic representations from the token probability distributions to enhance in-context reasoning. With this goal, we present Latent Entropy-Aware Decoding (LEAD), an efficient plug-and-play decoding strategy that leverages semantic context to achieve reliable reasoning. The heart of our method lies in entropy-aware reasoning mode switching. The model employs probability-weighted continuous embeddings under high-entropy states and transitions back to discrete token embeddings as entropy decreases. Moreover, we propose a prior-guided visual anchor injection strategy that encourages the model to focus on visual information. Extensive experiments show that LEAD effectively mitigates hallucinations across various MLRMs on multiple benchmarks.

OPGAgent: An Agent for Auditable Dental Panoramic X-ray Interpretation

Orthopantomograms (OPGs) are the standard panoramic radiograph in dentistry, used for full-arch screening across multiple diagnostic tasks. While Vision Language Models (VLMs) now allow multi-task OPG analysis through natural language, they underperform task-specific models on most individual tasks. Agentic systems that orchestrate specialized tools offer a path to both versatility and accuracy, this approach remains unexplored in the field of dental imaging. To address this gap, we propose OPGAgent, a multi-tool agentic system for auditable OPG interpretation. OPGAgent coordinates specialized perception modules with a consensus mechanism through three components: (1) a Hierarchical Evidence Gathering module that decomposes OPG analysis into global, quadrant, and tooth-level phases with dynamically invoking tools, (2) a Specialized Toolbox encapsulating spatial, detection, utility, and expert zoos, and (3) a Consensus Subagent that resolves conflicts through anatomical constraints. We further propose OPG-Bench, a structured-report protocol based on (Location, Field, Value) triples derived from real clinical reports, which enables a comprehensive review of findings and hallucinations, extending beyond the limitations of VQA indicators. On our OPG-Bench and the public MMOral-OPG benchmark, OPGAgent outperforms current dental VLMs and medical agent frameworks across both structured-report and VQA evaluation. Code will be released upon acceptance.

Training-Free Acceleration for Document Parsing Vision-Language Model with Hierarchical Speculative Decoding

Document parsing is a fundamental task in multimodal understanding, supporting a wide range of downstream applications such as information extraction and intelligent document analysis. Benefiting from strong semantic modeling and robust generalization, VLM-based end-to-end approaches have emerged as the mainstream paradigm in recent years. However, these models often suffer from substantial inference latency, as they must auto-regressively generate long token sequences when processing long-form documents. In this work, motivated by the extremely long outputs and complex layout structures commonly found in document parsing, we propose a training-free and highly efficient acceleration method. Inspired by speculative decoding, we employ a lightweight document parsing pipeline as a draft model to predict batches of future tokens, while the more accurate VLM verifies these draft predictions in parallel. Moreover, we further exploit the layout-structured nature of documents by partitioning each page into independent regions, enabling parallel decoding of each region using the same draft-verify strategy. The final predictions are then assembled according to the natural reading order. Experimental results demonstrate the effectiveness of our approach: on the general-purpose OmniDocBench, our method provides a 2.42x lossless acceleration for the dots.ocr model, and achieves up to 4.89x acceleration on long-document parsing tasks. We will release our code to facilitate reproducibility and future research.

A Vision-Language Foundation Model for Zero-shot Clinical Collaboration and Automated Concept Discovery in Dermatology

Medical foundation models have shown promise in controlled benchmarks, yet widespread deployment remains hindered by reliance on task-specific fine-tuning. Here, we introduce DermFM-Zero, a dermatology vision-language foundation model trained via masked latent modelling and contrastive learning on over 4 million multimodal data points. We evaluated DermFM-Zero across 20 benchmarks spanning zero-shot diagnosis and multimodal retrieval, achieving state-of-the-art performance without task-specific adaptation. We further evaluated its zero-shot capabilities in three multinational reader studies involving over 1,100 clinicians. In primary care settings, AI assistance enabled general practitioners to nearly double their differential diagnostic accuracy across 98 skin conditions. In specialist settings, the model significantly outperformed board-certified dermatologists in multimodal skin cancer assessment. In collaborative workflows, AI assistance enabled non-experts to surpass unassisted experts while improving management appropriateness. Finally, we show that DermFM-Zero's latent representations are interpretable: sparse autoencoders unsupervisedly disentangle clinically meaningful concepts that outperform predefined-vocabulary approaches and enable targeted suppression of artifact-induced biases, enhancing robustness without retraining. These findings demonstrate that a foundation model can provide effective, safe, and transparent zero-shot clinical decision support.

MedScope: Incentivizing "Think with Videos" for Clinical Reasoning via Coarse-to-Fine Tool Calling

Long-form clinical videos are central to visual evidence-based decision-making, with growing importance for applications such as surgical robotics and related settings. However, current multimodal large language models typically process videos with passive sampling or weakly grounded inspection, which limits their ability to iteratively locate, verify, and justify predictions with temporally targeted evidence. To close this gap, we propose MedScope, a tool-using clinical video reasoning model that performs coarse-to-fine evidence seeking over long-form procedures. By interleaving intermediate reasoning with targeted tool calls and verification on retrieved observations, MedScope produces more accurate and trustworthy predictions that are explicitly grounded in temporally localized visual evidence. To address the lack of high-fidelity supervision, we build ClinVideoSuite, an evidence-centric, fine-grained clinical video suite. We then optimize MedScope with Grounding-Aware Group Relative Policy Optimization (GA-GRPO), which directly reinforces tool use with grounding-aligned rewards and evidence-weighted advantages. On full and fine-grained video understanding benchmarks, MedScope achieves state-of-the-art performance in both in-domain and out-of-domain evaluations. Our approach illuminates a path toward medical AI agents that can genuinely "think with videos" through tool-integrated reasoning. We will release our code, models, and data.

OneVision-Encoder: Codec-Aligned Sparsity as a Foundational Principle for Multimodal Intelligence

Hypothesis. Artificial general intelligence is, at its core, a compression problem. Effective compression demands resonance: deep learning scales best when its architecture aligns with the fundamental structure of the data. These are the fundamental principles. Yet, modern vision architectures have strayed from these truths: visual signals are highly redundant, while discriminative information, the surprise, is sparse. Current models process dense pixel grids uniformly, wasting vast compute on static background rather than focusing on the predictive residuals that define motion and meaning. We argue that to solve visual understanding, we must align our architectures with the information-theoretic principles of video, i.e., Codecs. Method. OneVision-Encoder encodes video by compressing predictive visual structure into semantic meaning. By adopting Codec Patchification, OV-Encoder abandons uniform computation to focus exclusively on the 3.1%-25% of regions rich in signal entropy. To unify spatial and temporal reasoning under irregular token layouts, OneVision-Encoder employs a shared 3D RoPE and is trained with a large-scale cluster discrimination objective over more than one million semantic concepts, jointly capturing object permanence and motion dynamics. Evidence. The results validate our core hypothesis: efficiency and accuracy are not a trade-off; they are positively correlated. When integrated into LLM, it consistently outperforms strong vision backbones such as Qwen3-ViT and SigLIP2 across 16 image, video, and document understanding benchmarks, despite using substantially fewer visual tokens and pretraining data. Notably, on video understanding tasks, OV-Encoder achieves an average improvement of 4.1% over Qwen3-ViT. Codec-aligned, patch-level sparsity is a foundational principle, enabling OV-Encoder as a scalable engine for next-generation visual generalists.