Agentic AI-powered flexible fiber-bundle endoscopy for high-resolution NIR-II fluorescence imaging in vivo

Fiber-bundle endoscopy offers a compact and flexible route for clinical fluorescence imaging through natural human orifices, but since its first report in the 1950s, it has remained limited by low spatial resolution, honeycomb artifacts, and inter-core crosstalk. The crosstalk becomes more pronounced at near-infrared-II wavelengths (NIR-II, 1000-3000 nm), a spectral window that offers superior contrast, resolution, and tissue penetration depth for biomedical imaging. Here, we present an AI-powered flexible endoscopy platform that overcomes these constraints through optical-computational co-design: optimizing ultrathin fiber bundles to mitigate crosstalk-induced image blur and enable high-fidelity image transmission across the visible-to-NIR-II spectral range, and developing an Agent-Guided Mixture-of-Experts (GAME) pipeline for honeycomb-artifact removal and image restoration. GAME provides a single restoration entry point for diverse biomedical images acquired with our endoscope, spanning cell, mouse and human samples. It dynamically routes each input to suitable restoration experts via a vision-language model, facilitating image reconstruction with a fourfold resolution improvement beyond the NyquistShannon sampling limit. The utility of our endoscope is demonstrated through in vivo NIR-II imaging of anatomical structures in mice, as well as imaging of the digital micromirror device (DMD)-projected human gastric tube and lymphatic system, paving the way for future clinical translation.

HSENet: Hybrid Spatial Encoding Network for 3D Medical Vision-Language Understanding

Automated 3D CT diagnosis empowers clinicians to make timely, evidence-based decisions by enhancing diagnostic accuracy and workflow efficiency. While multimodal large language models (MLLMs) exhibit promising performance in visual-language understanding, existing methods mainly focus on 2D medical images, which fundamentally limits their ability to capture complex 3D anatomical structures. This limitation often leads to misinterpretation of subtle pathologies and causes diagnostic hallucinations. In this paper, we present Hybrid Spatial Encoding Network (HSENet), a framework that exploits enriched 3D medical visual cues by effective visual perception and projection for accurate and robust vision-language understanding. Specifically, HSENet employs dual-3D vision encoders to perceive both global volumetric contexts and fine-grained anatomical details, which are pre-trained by dual-stage alignment with diagnostic reports. Furthermore, we propose Spatial Packer, an efficient multimodal projector that condenses high-resolution 3D spatial regions into a compact set of informative visual tokens via centroid-based compression. By assigning spatial packers with dual-3D vision encoders, HSENet can seamlessly perceive and transfer hybrid visual representations to LLM's semantic space, facilitating accurate diagnostic text generation. Experimental results demonstrate that our method achieves state-of-the-art performance in 3D language-visual retrieval (39.85% of R@100, +5.96% gain), 3D medical report generation (24.01% of BLEU-4, +8.01% gain), and 3D visual question answering (73.60% of Major Class Accuracy, +1.99% gain), confirming its effectiveness. Our code is available at https://github.com/YanzhaoShi/HSENet.

See Detail Say Clear: Towards Brain CT Report Generation via Pathological Clue-driven Representation Learning

Brain CT report generation is significant to aid physicians in diagnosing cranial diseases. Recent studies concentrate on handling the consistency between visual and textual pathological features to improve the coherence of report. However, there exist some challenges: 1) Redundant visual representing: Massive irrelevant areas in 3D scans distract models from representing salient visual contexts. 2) Shifted semantic representing: Limited medical corpus causes difficulties for models to transfer the learned textual representations to generative layers. This study introduces a Pathological Clue-driven Representation Learning (PCRL) model to build cross-modal representations based on pathological clues and naturally adapt them for accurate report generation. Specifically, we construct pathological clues from perspectives of segmented regions, pathological entities, and report themes, to fully grasp visual pathological patterns and learn cross-modal feature representations. To adapt the representations for the text generation task, we bridge the gap between representation learning and report generation by using a unified large language model (LLM) with task-tailored instructions. These crafted instructions enable the LLM to be flexibly fine-tuned across tasks and smoothly transfer the semantic representation for report generation. Experiments demonstrate that our method outperforms previous methods and achieves SoTA performance. Our code is available at https://github.com/Chauncey-Jheng/PCRL-MRG.