Enhancing Brain MRI Anomaly Detection and Reasoning with ROI Rethink and Synthetic Data

Medical vision-language models typically generate diagnoses through single-pass inference without indicating which image regions support their conclusions. This lack of spatial grounding limits clinical utility: outputs cannot be audited, and models may hallucinate findings on normal scans. We present BrReMark (Brain Rethink via ROI Marking), a framework that introduces explicit region marking into brain MRI diagnosis. The model first generates hypotheses about potential abnormalities and grounds them through explicit bounding box marking, then verifies conclusions by re-examining the marked evidence. Training combines supervised fine-tuning on structured reasoning trajectories with reinforcement learning using a composite reward over localization accuracy and diagnostic reasoning. Furthermore, we integrate a domain randomization-based pathology synthesis augmentation strategy to improve the model's generalizability to out-of-distribution (OOD) data. On internal benchmark, BrReMark improves mAP50 from 0.74% to 37.54% compared to the base model, while achieving 21.57% Clinical F1 and 45.26% diagnostic accuracy. On NOVA OOD benchmark, it also achieves competitive overall performance with a 45.7% reduction in false positives compared to the state-of-the-art, indicating reduced hallucination on rare pathologies. These findings suggest that explicit hypothesis-verification grounding is a practical path toward trustworthy open-ended brain MRI diagnosis across both in-distribution and OOD settings.

Causal Ensemble Agent: Hierarchical Causal Discovery with LLM-guided Expert Reweighting

Causal discovery aims to uncover causal structures from observational data, which is crucial for real-world decision-making. However, different causal discovery algorithms can produce divergent results that conflict with each other, complicating the identification of accurate causal graphs. Traditional approaches rely on numerical values and statistical assumptions, often ignoring rich domain-specific information, such as feature descriptions, which could also help structure learning. While recent works explore using Large Language Models (LLMs) to infer causal relations via direct queries, such methods can be unreliable due to a lack of alignment with the actual data. To address these limitations, we propose Causal Ensemble Agent (CEA), a novel framework that aggregates structural insights from statistical discovery experts across different graph levels via linear opinion pooling, and uses an LLM as a meta-referee to dynamically reweight experts when the aggregated confidence is close to the decision boundary, thereby composing an improved and more complete causal graph. Extensive experiments on both synthetic and real-world datasets demonstrate that CEA achieves the strongest overall performance across a wide range of causal discovery methods, highlighting the effectiveness of using LLMs for meta-analysis in causal discovery.

UniSRM: A Unified Speech Reward Model for Reasoning-Based Fine-grained Assessment

Evaluating speech generation still relies heavily on human judgments, such as Mean Opinion Score (MOS), which are expensive, subjective, and difficult to reproduce at scale. While a few recent studies have begun to explore AudioLLM-based judge models, existing efforts typically target only a narrow set of scenarios (e.g., utterance-level quality or single-turn dialogue) and provide limited coverage of diverse speech generation tasks and evaluation dimensions. In this work, we propose UniSRM, a unified speech reward model that can support multi-dimensional, interpretable reward signals with reliable reasoning. To support training and evaluation, we introduce UniSRM-Data and UniSRM-Bench, covering speech evaluation tasks from utterance-level quality to context-level coherence. Based on this dataset, we present the unified speech reward model, UniSRM, with a two-stage pipeline that enables reasoning-based fine-grained assessment. Furthermore, we introduce Reasoning-Consistent Rewards to improve the reliability of the reasoning process. Experiments show that UniSRM delivers more reliable and human-aligned judgments across a broad range of speech evaluation tasks, offering a practical foundation for scalable and unified evaluation of speech quality.

Defining Robust Ultrasound Quality Metrics via an Ultrasound Foundation Model

Clinicians lack a principled framework to quantify diagnostic utility in ultrasound reconstructions. Existing standards like PSNR and VGG-LPIPS are inadequate, failing to account for modality-specific physics or the structural nuances of acoustic imaging. We close this gap with a TinyUSFM-based evaluation framework featuring two distinct metrics: TinyUSFM-uLPIPS, a full-reference perceptual distance based on multi-layer token relations, and TinyUSFM-NRQ, a deployable no-reference quality score utilizing clean-manifold modeling and worst-region aggregation to detect localized harmful artifacts. We demonstrate that the presented metrics have four unique advantages: 1) Task-linked quality, where TinyUSFM-uLPIPS achieves superior calibration with semantic task damage, accurately reflecting Dice-score drops in segmentation where VGG-based metrics fail; 2) Cross-organ comparability, maintaining stable scoring scales and consistent severity rankings across diverse anatomical sites and domain-shifted data; 3) PSNR-consistent sensitivity, with TinyUSFM-NRQ providing a reliable quality score without ground-truth images that remains consistent with traditional fidelity benchmarks (i.e. PSNR); and 4) Clinical utility, improving the prediction of expert preference from 47.2$\%$ to 72.8$\%$ accuracy and producing super-resolution reconstructions preferred by sonographers. By integrating these advantages into a unified assessment and optimization loop, this work establishes a modality-aligned standard that finally bridges the gap between algorithmic performance and diagnostic utility. https://github.com/sextant-fable/US-Metrics

EchoAgent: Towards Reliable Echocardiography Interpretation with "Eyes","Hands" and "Minds"

Reliable interpretation of echocardiography (Echo) is crucial for assessing cardiac function, which demands clinicians to synchronously orchestrate multiple capabilities, including visual observation (eyes), manual measurement (hands), and expert knowledge learning and reasoning (minds). While current task-specific deep-learning approaches and multimodal large language models have demonstrated promise in assisting Echo analysis through automated segmentation or reasoning, they remain focused on restricted skills, i.e., eyes-hands or eyes-minds, thereby limiting clinical reliability and utility. To address these issues, we propose EchoAgent, an agentic system tailored for end-to-end Echo interpretation, which achieves a fully coordinated eyes-hands-minds workflow that learns, observes, operates, and reasons like a cardiac sonographer. First, we introduce an expertise-driven cognition engine where our agent can automatically assimilate credible Echo guidelines into a structured knowledge base, thus constructing an Echo-customized mind. Second, we devise a hierarchical collaboration toolkit to endow EchoAgent with eyes-hands, which can automatically parse Echo video streams, identify cardiac views, perform anatomical segmentation, and quantitative measurement. Third, we integrate the perceived multimodal evidence with the exclusive knowledge base into an orchestrated reasoning hub to conduct explainable inferences. We evaluate EchoAgent on CAMUS and MIMIC-EchoQA datasets, which cover 48 distinct echocardiographic views spanning 14 cardiac anatomical regions. Experimental results show that EchoAgent achieves optimal performance across diverse structure analyses, yielding overall accuracy of up to 80.00%. Importantly, EchoAgent empowers a single system with abilities to learn, observe, operate and reason like an echocardiologist, which holds great promise for reliable Echo interpretation.

Ran Score: a LLM-based Evaluation Score for Radiology Report Generation

Chest X-ray report generation and automated evaluation are limited by poor recognition of low-prevalence abnormalities and inadequate handling of clinically important language, including negation and ambiguity. We develop a clinician-guided framework combining human expertise and large language models for multi-label finding extraction from free-text chest X-ray reports and use it to define Ran Score, a finding-level metric for report evaluation. Using three non-overlapping MIMIC-CXR-EN cohorts from a public chest X-ray dataset and an independent ChestX-CN validation cohort, we optimize prompts, establish radiologist-derived reference labels and evaluate report generation models. The optimized framework improves the macro-averaged score from 0.753 to 0.956 on the MIMIC-CXR-EN development cohort, exceeds the CheXbert benchmark by 15.7 percentage points on directly comparable labels, and shows robust generalization on the ChestX-CN validation cohort. Here we show that clinician-guided prompt optimization improves agreement with a radiologist-derived reference standard and that Ran Score enables finding-level evaluation of report fidelity, particularly for low-prevalence abnormalities.

MADCrowner: Margin Aware Dental Crown Design with Template Deformation and Refinement

Dental crown restoration is one of the most common treatment modalities for tooth defect, where personalized dental crown design is critical. While computer-aided design (CAD) systems have notably enhanced the efficiency of dental crown design, extensive manual adjustments are still required in the clinic workflow. Recent studies have explored the application of learning-based methods for the automated generation of restorative dental crowns. Nevertheless, these approaches were challenged by inadequate spatial resolution, noisy outputs, and overextension of surface reconstruction. To address these limitations, we propose \totalframework, a margin-aware mesh generation framework comprising CrownDeformR and CrownSegger. Inspired by the clinic manual workflow of dental crown design, we designed CrownDeformR to deform an initial template to the target crown based on anatomical context, which is extracted by a multi-scale intraoral scan encoder. Additionally, we introduced \marginseg, a novel margin segmentation network, to extract the cervical margin of the target tooth. The performance of CrownDeformR improved with the cervical margin as an extra constraint. And it was also utilized as the boundary condition for the tailored postprocessing method, which removed the overextended area of the reconstructed surface. We constructed a large-scale intraoral scan dataset and performed extensive experiments. The proposed method significantly outperformed existing approaches in both geometric accuracy and clinical feasibility.

ColoDiff: Integrating Dynamic Consistency With Content Awareness for Colonoscopy Video Generation

Colonoscopy video generation delivers dynamic, information-rich data critical for diagnosing intestinal diseases, particularly in data-scarce scenarios. High-quality video generation demands temporal consistency and precise control over clinical attributes, but faces challenges from irregular intestinal structures, diverse disease representations, and various imaging modalities. To this end, we propose ColoDiff, a diffusion-based framework that generates dynamic-consistent and content-aware colonoscopy videos, aiming to alleviate data shortage and assist clinical analysis. At the inter-frame level, our TimeStream module decouples temporal dependency from video sequences through a cross-frame tokenization mechanism, enabling intricate dynamic modeling despite irregular intestinal structures. At the intra-frame level, our Content-Aware module incorporates noise-injected embeddings and learnable prototypes to realize precise control over clinical attributes, breaking through the coarse guidance of diffusion models. Additionally, ColoDiff employs a non-Markovian sampling strategy that cuts steps by over 90% for real-time generation. ColoDiff is evaluated across three public datasets and one hospital database, based on both generation metrics and downstream tasks including disease diagnosis, modality discrimination, bowel preparation scoring, and lesion segmentation. Extensive experiments show ColoDiff generates videos with smooth transitions and rich dynamics. ColoDiff presents an effort in controllable colonoscopy video generation, revealing the potential of synthetic videos in complementing authentic representation and mitigating data scarcity in clinical settings.

Mirage2Matter: A Physically Grounded Gaussian World Model from Video

The scalability of embodied intelligence is fundamentally constrained by the scarcity of real-world interaction data. While simulation platforms provide a promising alternative, existing approaches often suffer from a substantial visual and physical gap to real environments and rely on expensive sensors, precise robot calibration, or depth measurements, limiting their practicality at scale. We present Simulate Anything, a graphics-driven world modeling and simulation framework that enables efficient generation of high-fidelity embodied training data using only multi-view environment videos and off-the-shelf assets. Our approach reconstructs real-world environments into a photorealistic scene representation using 3D Gaussian Splatting (3DGS), seamlessly capturing fine-grained geometry and appearance from video. We then leverage generative models to recover a physically realistic representation and integrate it into a simulation environment via a precision calibration target, enabling accurate scale alignment between the reconstructed scene and the real world. Together, these components provide a unified, editable, and physically grounded world model. Vision Language Action (VLA) models trained on our simulated data achieve strong zero-shot performance on downstream tasks, matching or even surpassing results obtained with real-world data, highlighting the potential of reconstruction-driven world modeling for scalable and practical embodied intelligence training.

Reconstructing Building Height from Spaceborne TomoSAR Point Clouds Using a Dual-Topology Network

Reliable building height estimation is essential for various urban applications. Spaceborne SAR tomography (TomoSAR) provides weather-independent, side-looking observations that capture facade-level structure, offering a promising alternative to conventional optical methods. However, TomoSAR point clouds often suffer from noise, anisotropic point distributions, and data voids on incoherent surfaces, all of which hinder accurate height reconstruction. To address these challenges, we introduce a learning-based framework for converting raw TomoSAR points into high-resolution building height maps. Our dual-topology network alternates between a point branch that models irregular scatterer features and a grid branch that enforces spatial consistency. By jointly processing these representations, the network denoises the input points and inpaints missing regions to produce continuous height estimates. To our knowledge, this is the first proof of concept for large-scale urban height mapping directly from TomoSAR point clouds. Extensive experiments on data from Munich and Berlin validate the effectiveness of our approach. Moreover, we demonstrate that our framework can be extended to incorporate optical satellite imagery, further enhancing reconstruction quality. The source code is available at https://github.com/zhu-xlab/tomosar2height.