Medical Image Understanding Improves Survival Prediction via Visual Instruction Tuning

Accurate prognostication and risk estimation are essential for guiding clinical decision-making and optimizing patient management. While radiologist-assessed features from CT scans provide valuable indicators of disease severity and outcomes, interpreting such images requires expert knowledge, and translating rich visual information into textual summaries inevitably leads to information loss. In this work, we propose a vision-language framework for 3D CT image understanding that leverages large-scale open-sourced CT images paired with radiology reports through visual instruction tuning. This pre-training enables the model to learn clinically meaningful visual-textual representations, which can then be adapted to downstream survival prediction tasks. By incorporating a survival prediction head on top of the pre-trained model, our approach improves survival prediction from CT images and clinical data while generating clinically meaningful language responses to predefined questions. Experimental results demonstrate that our method outperforms baseline methods in survival prediction, particularly, when clinical data alone is less predictive. The code will be released upon acceptance.

Energy-Guided Decoding for Object Hallucination Mitigation

Mitigating object hallucination in large vision-language models (LVLMs) is critical to their safe deployment. Existing methods either are restricted to specific decoding methods, or demand sophisticated modifications to visual inputs, or rely on knowledge from external models. In this work, we first reveal the phenomenon that VLMs exhibit significant imbalance in the ``Yes'' ratio ( \ie, the fraction of ``Yes'' answers among the total number of questions) across three different visual question answering (VQA) datasets. Furthermore, we propose an energy-based decoding method, which dynamically selects the hidden states from the layer with minimal energy score. It is simple yet effective in reducing the bias for the yes ratio while boosting performance across three benchmarks (POPE, MME, and MMVP). Our method consistently improves accuracy and F1 score on three VQA datasets across three commonly used VLMs over several baseline methods. The average accuracy improvement is 4.82% compared to greedy decoding. Moreover, the average yes-ratio gap reduction is 8.81%, meaning the proposed method is less biased as shown in Figure 1.