Generating Reports or Repeating Templates? Measuring and Mitigating Template Collapse in 3D CT Report Generation

Modern 3D medical vision-language models (VLMs) can generate fluent radiology-style text while exhibit critically low pathology detection and output diversity, collapsing to generic templates that under-report rare yet critical findings. We identify this failure mode as Template Collapse. This failure stems from the unique constraints of 3D medical imaging, e.g., limited data, severe label imbalance, and weak signals from volumetric encoders. Under these constraints, text-generation objectives encourage shortcut learning and fluent but weakly grounded reports. We systematically diagnose the Template Collapse through clinical fidelity, output diversity, normal-template bias, and rare-finding survival. To mitigate it, we propose CLarGen, a decoupled framework that separates what to say (clinical detection) from how to say it (language synthesis). CLarGen uses (i) a Latent Query Transformer for multi-label pathology detection, (ii) pathology-guided retrieval for clinically matched exemplars, and (iii) a medical language model to synthesize the final report from detected findings and retrieved context. Across state-of-the-art 3D CT report generation baselines, CLarGen mitigates Template Collapse and substantially improves clinical accuracy (macro-F1 0.487 vs. 0.189; CRG 0.472 vs. 0.368) while maintaining fluent reporting. Our results suggest that explicit, measurable clinical grounding is essential for template-collapse-resistant 3D CT report generation. Code will be released upon acceptance.

FP4 Explore, BF16 Train: Diffusion Reinforcement Learning via Efficient Rollout Scaling

Reinforcement-Learning-based post-training has recently emerged as a promising paradigm for aligning text-to-image diffusion models with human preferences. In recent studies, increasing the rollout group size yields pronounced performance improvements, indicating substantial room for further alignment gains. However, scaling rollouts on large-scale foundational diffusion models (e.g., FLUX.1-12B) imposes a heavy computational burden. To alleviate this bottleneck, we explore the integration of FP4 quantization into Diffusion RL rollouts. Yet, we identify that naive quantized pipelines inherently introduce risks of performance degradation. To overcome this dilemma between efficiency and training integrity, we propose Sol-RL (Speed-of-light RL), a novel FP4-empowered Two-stage Reinforcement Learning framework. First, we utilize high-throughput NVFP4 rollouts to generate a massive candidate pool and extract a highly contrastive subset. Second, we regenerate these selected samples in BF16 precision and optimize the policy exclusively on them. By decoupling candidate exploration from policy optimization, Sol-RL integrates the algorithmic mechanisms of rollout scaling with the system-level throughput gains of NVFP4. This synergistic algorithm-hardware design effectively accelerates the rollout phase while reserving high-fidelity samples for optimization. We empirically demonstrate that our framework maintains the training integrity of BF16 precision pipeline while fully exploiting the throughput gains enabled by FP4 arithmetic. Extensive experiments across SANA, FLUX.1, and SD3.5-L substantiate that our approach delivers superior alignment performance across multiple metrics while accelerating training convergence by up to $4.64\times$, unlocking the power of massive rollout scaling at a fraction of the cost.

Conditional Diffusion for 3D CT Volume Reconstruction from 2D X-rays

Computed tomography (CT) provides rich 3D anatomical details but is often constrained by high radiation exposure, substantial costs, and limited availability. While standard chest X-rays are cost-effective and widely accessible, they only provide 2D projections with limited pathological information. Reconstructing 3D CT volumes from 2D X-rays offers a transformative solution to increase diagnostic accessibility, yet existing methods predominantly rely on synthetic X-ray projections, limiting clinical generalization. In this work, we propose AXON, a multi-stage diffusion-based framework that reconstructs high-fidelity 3D CT volumes directly from real X-rays. AXON employs a coarse-to-fine strategy, with a Brownian Bridge diffusion model-based initial stage for global structural synthesis, followed by a ControlNet-based refinement stage for local intensity optimization. It also supports bi-planar X-ray input to mitigate depth ambiguities inherent in 2D-to-3D reconstruction. A super-resolution network is integrated to upscale the generated volumes to achieve diagnostic-grade resolution. Evaluations on both public and external datasets demonstrate that AXON significantly outperforms state-of-the-art baselines, achieving a 11.9% improvement in PSNR and a 11.0% increase in SSIM with robust generalizability across disparate clinical distributions. Our code is available at https://github.com/ai-med/AXON.

Translating MRI to PET through Conditional Diffusion Models with Enhanced Pathology Awareness

Positron emission tomography (PET) is a widely recognized technique for diagnosing neurodegenerative diseases, offering critical functional insights. However, its high costs and radiation exposure hinder its widespread use. In contrast, magnetic resonance imaging (MRI) does not involve such limitations. While MRI also detects neurodegenerative changes, it is less sensitive for diagnosis compared to PET. To overcome such limitations, one approach is to generate synthetic PET from MRI. Recent advances in generative models have paved the way for cross-modality medical image translation; however, existing methods largely emphasize structural preservation while neglecting the critical need for pathology awareness. To address this gap, we propose PASTA, a novel image translation framework built on conditional diffusion models with enhanced pathology awareness. PASTA surpasses state-of-the-art methods by preserving both structural and pathological details through its highly interactive dual-arm architecture and multi-modal condition integration. Additionally, we introduce a novel cycle exchange consistency and volumetric generation strategy that significantly enhances PASTA's ability to produce high-quality 3D PET images. Our qualitative and quantitative results demonstrate the high quality and pathology awareness of the synthesized PET scans. For Alzheimer's diagnosis, the performance of these synthesized scans improves over MRI by 4%, almost reaching the performance of actual PET. Our code is available at https://github.com/ai-med/PASTA.

Cortex-Grounded Diffusion Models for Brain Image Generation

Synthetic neuroimaging data can mitigate critical limitations of real-world datasets, including the scarcity of rare phenotypes, domain shifts across scanners, and insufficient longitudinal coverage. However, existing generative models largely rely on weak conditioning signals, such as labels or text, which lack anatomical grounding and often produce biologically implausible outputs. To this end, we introduce Cor2Vox, a cortex-grounded generative framework for brain magnetic resonance image (MRI) synthesis that ties image generation to continuous structural priors of the cerebral cortex. It leverages high-resolution cortical surfaces to guide a 3D shape-to-image Brownian bridge diffusion process, enabling topologically faithful synthesis and precise control over underlying anatomies. To support the generation of new, realistic brain shapes, we developed a large-scale statistical shape model of cortical morphology derived from over 33,000 UK Biobank scans. We validated the fidelity of Cor2Vox based on traditional image quality metrics, advanced cortical surface reconstruction, and whole-brain segmentation quality, outperforming many baseline methods. Across three applications, namely (i) anatomically consistent synthesis, (ii) simulation of progressive gray matter atrophy, and (iii) harmonization of in-house frontotemporal dementia scans with public datasets, Cor2Vox preserved fine-grained cortical morphology at the sub-voxel level, exhibiting remarkable robustness to variations in cortical geometry and disease phenotype without retraining.

TreeAdv: Tree-Structured Advantage Redistribution for Group-Based RL

Reinforcement learning with group-based objectives, such as Group Relative Policy Optimization (GRPO), is a common framework for aligning large language models on complex reasoning tasks. However, standard GRPO treats each rollout trajectory as an independent flat sequence and assigns a single sequence-level advantage to all tokens, which leads to sample inefficiency and a length bias toward verbose, redundant chains of thought without improving logical depth. We introduce TreeAdv (Tree-Structured Advantage Redistribution for Group-Based RL), which makes the tree structure of group rollouts explicit for both exploration and advantage assignment. Specifically, TreeAdv builds a group of trees (a forest) based on an entropy-driven sampling method where each tree branches at high-uncertainty decisions while sharing low-uncertainty tokens across rollouts. Then, TreeAdv aggregates token-level advantages for internal tree segments by redistributing the advantages of complete rollouts (all leaf nodes), and TreeAdv can easily apply to group-based objectives such as GRPO or GSPO. Across 10 math reasoning benchmarks, TreeAdv consistently outperforms GRPO and GSPO, while using substantially fewer generated tokens under identical supervision, data, and decoding budgets.

Real Garment Benchmark (RGBench): A Comprehensive Benchmark for Robotic Garment Manipulation featuring a High-Fidelity Scalable Simulator

While there has been significant progress to use simulated data to learn robotic manipulation of rigid objects, applying its success to deformable objects has been hindered by the lack of both deformable object models and realistic non-rigid body simulators. In this paper, we present Real Garment Benchmark (RGBench), a comprehensive benchmark for robotic manipulation of garments. It features a diverse set of over 6000 garment mesh models, a new high-performance simulator, and a comprehensive protocol to evaluate garment simulation quality with carefully measured real garment dynamics. Our experiments demonstrate that our simulator outperforms currently available cloth simulators by a large margin, reducing simulation error by 20% while maintaining a speed of 3 times faster. We will publicly release RGBench to accelerate future research in robotic garment manipulation. Website: https://rgbench.github.io/

HardcoreLogic: Challenging Large Reasoning Models with Long-tail Logic Puzzle Games

Large Reasoning Models (LRMs) have demonstrated impressive performance on complex tasks, including logical puzzle games that require deriving solutions satisfying all constraints. However, whether they can flexibly apply appropriate rules to varying conditions, particularly when faced with non-canonical game variants, remains an open question. Existing corpora focus on popular puzzles like 9x9 Sudoku, risking overfitting to canonical formats and memorization of solution patterns, which can mask deficiencies in understanding novel rules or adapting strategies to new variants. To address this, we introduce HardcoreLogic, a challenging benchmark of over 5,000 puzzles across 10 games, designed to test the robustness of LRMs on the "long-tail" of logical games. HardcoreLogic systematically transforms canonical puzzles through three dimensions: Increased Complexity (IC), Uncommon Elements (UE), and Unsolvable Puzzles (UP), reducing reliance on shortcut memorization. Evaluations on a diverse set of LRMs reveal significant performance drops, even for models achieving top scores on existing benchmarks, indicating heavy reliance on memorized stereotypes. While increased complexity is the dominant source of difficulty, models also struggle with subtle rule variations that do not necessarily increase puzzle difficulty. Our systematic error analysis on solvable and unsolvable puzzles further highlights gaps in genuine reasoning. Overall, HardcoreLogic exposes the limitations of current LRMs and establishes a benchmark for advancing high-level logical reasoning.

Vision-Language-Vision Auto-Encoder: Scalable Knowledge Distillation from Diffusion Models

Building state-of-the-art Vision-Language Models (VLMs) with strong captioning capabilities typically necessitates training on billions of high-quality image-text pairs, requiring millions of GPU hours. This paper introduces the Vision-Language-Vision (VLV) auto-encoder framework, which strategically leverages key pretrained components: a vision encoder, the decoder of a Text-to-Image (T2I) diffusion model, and subsequently, a Large Language Model (LLM). Specifically, we establish an information bottleneck by regularizing the language representation space, achieved through freezing the pretrained T2I diffusion decoder. Our VLV pipeline effectively distills knowledge from the text-conditioned diffusion model using continuous embeddings, demonstrating comprehensive semantic understanding via high-quality reconstructions. Furthermore, by fine-tuning a pretrained LLM to decode the intermediate language representations into detailed descriptions, we construct a state-of-the-art (SoTA) captioner comparable to leading models like GPT-4o and Gemini 2.0 Flash. Our method demonstrates exceptional cost-efficiency and significantly reduces data requirements; by primarily utilizing single-modal images for training and maximizing the utility of existing pretrained models (image encoder, T2I diffusion model, and LLM), it circumvents the need for massive paired image-text datasets, keeping the total training expenditure under $1,000 USD.

MedBridge: Bridging Foundation Vision-Language Models to Medical Image Diagnosis

Recent vision-language foundation models deliver state-of-the-art results on natural image classification but falter on medical images due to pronounced domain shifts. At the same time, training a medical foundation model requires substantial resources, including extensive annotated data and high computational capacity. To bridge this gap with minimal overhead, we introduce MedBridge, a lightweight multimodal adaptation framework that re-purposes pretrained VLMs for accurate medical image diagnosis. MedBridge comprises three key components. First, a Focal Sampling module that extracts high-resolution local regions to capture subtle pathological features and compensate for the limited input resolution of general-purpose VLMs. Second, a Query Encoder (QEncoder) injects a small set of learnable queries that attend to the frozen feature maps of VLM, aligning them with medical semantics without retraining the entire backbone. Third, a Mixture of Experts mechanism, driven by learnable queries, harnesses the complementary strength of diverse VLMs to maximize diagnostic performance. We evaluate MedBridge on five medical imaging benchmarks across three key adaptation tasks, demonstrating its superior performance in both cross-domain and in-domain adaptation settings, even under varying levels of training data availability. Notably, MedBridge achieved over 6-15% improvement in AUC compared to state-of-the-art VLM adaptation methods in multi-label thoracic disease diagnosis, underscoring its effectiveness in leveraging foundation models for accurate and data-efficient medical diagnosis. Our code is available at https://github.com/ai-med/MedBridge.