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.

SkinCLIP-VL: Consistency-Aware Vision-Language Learning for Multimodal Skin Cancer Diagnosis

The deployment of vision-language models (VLMs) in dermatology is hindered by the trilemma of high computational costs, extreme data scarcity, and the black-box nature of deep learning. To address these challenges, we present SkinCLIP-VL, a resource-efficient framework that adapts foundation models for trustworthy skin cancer diagnosis. Adopting a frozen perception, adaptive reasoning paradigm, we integrate a frozen CLIP encoder with a lightweight, quantized Qwen2.5-VL via low-rank adaptation (LoRA). To strictly align visual regions with clinical semantics under long-tailed distributions, we propose the Consistency-aware Focal Alignment (CFA) Loss. This objective synergizes focal re-weighting, semantic alignment, and calibration. On ISIC and Derm7pt benchmarks, SkinCLIP-VL surpasses 13B-parameter baselines by 4.3-6.2% in accuracy with 43% fewer parameters. Crucially, blinded expert evaluation and out-of-distribution testing confirm that our visually grounded rationales significantly enhance clinical trust compared to traditional saliency maps.

SAGE: Sustainable Agent-Guided Expert-tuning for Culturally Attuned Translation in Low-Resource Southeast Asia

The vision of an inclusive World Wide Web is impeded by a severe linguistic divide, particularly for communities in low-resource regions of Southeast Asia. While large language models (LLMs) offer a potential solution for translation, their deployment in data-poor contexts faces a dual challenge: the scarcity of high-quality, culturally relevant data and the prohibitive energy costs of training on massive, noisy web corpora. To resolve the tension between digital inclusion and environmental sustainability, we introduce Sustainable Agent-Guided Expert-tuning (SAGE). This framework pioneers an energy-aware paradigm that prioritizes the "right data" over "big data". Instead of carbon-intensive training on unfiltered datasets, SAGE employs a reinforcement learning (RL) agent, optimized via Group Relative Policy Optimization (GRPO), to autonomously curate a compact training set. The agent utilizes a semantic reward signal derived from a small, expert-constructed set of community dialogues to filter out noise and cultural misalignment. We then efficiently fine-tune open-source LLMs on this curated data using Low-Rank Adaptation (LoRA). We applied SAGE to translation tasks between English and seven low-resource languages (LRLs) in Southeast Asia. Our approach establishes new state-of-the-art performance on BLEU-4 and COMET-22 metrics, effectively capturing local linguistic nuances. Crucially, SAGE surpasses baselines trained on full datasets while reducing data usage by 97.1% and training energy consumption by 95.2%. By delivering high-performance models with a minimal environmental footprint, SAGE offers a scalable and responsible pathway to bridge the digital divide in the Global South.

DeLo: Dual Decomposed Low-Rank Experts Collaboration for Continual Missing Modality Learning

Adapting Large Multimodal Models (LMMs) to real-world scenarios poses the dual challenges of learning from sequential data streams while handling frequent modality incompleteness, a task known as Continual Missing Modality Learning (CMML). However, existing works on CMML have predominantly relied on prompt tuning, a technique that struggles with this task due to cross-task interference between its learnable prompts in their shared embedding space. A naive application of Low-Rank Adaptation (LoRA) with modality-shared module will also suffer modality interference from competing gradients. To this end, we propose DeLo, the first framework to leverage a novel dual-decomposed low-rank expert architecture for CMML. Specifically, this architecture resolves modality interference through decomposed LoRA expert, dynamically composing LoRA update matrix with rank-one factors from disentangled modality-specific factor pools. Embedded within a task-partitioned framework that structurally prevents catastrophic forgetting, this expert system is supported by two key mechanisms: a Cross-Modal Guided Routing strategy to handle incomplete data and a Task-Key Memory for efficient, task-agnostic inference. Extensive experiments on established CMML benchmarks demonstrate that our method significantly outperforms state-of-the-art approaches. This highlights the value of a principled, architecturally-aware LoRA design for real-world multimodal challenges.

ClinCoT: Clinical-Aware Visual Chain-of-Thought for Medical Vision Language Models

Medical Vision-Language Models have shown promising potential in clinical decision support, yet they remain prone to factual hallucinations due to insufficient grounding in localized pathological evidence. Existing medical alignment methods primarily operate at the response level through preference optimization, improving output correctness but leaving intermediate reasoning weakly connected to visual regions. Although chain-of-thought (CoT) enhances multimodal reasoning, it remains largely text-centric, limiting effective integration of clinical visual cues. To address this gap, we propose ClinCoT, a clinical-aware visual chain-of-thought framework that transforms preference optimization from response-level correction to visual-driven reasoning. We introduce an automatic data generation pipeline that constructs clinically grounded preference pairs through reasoning with hypotheses-driven region proposals. Multiple Med-LLMs evaluators rank and assign scores to each response, and these rankings serve as supervision to train the target model. We further introduce a scoring-based margin-aware optimization strategy that incorporates both preference ranking and score difference to refine region-level reasoning trajectories. To maintain alignment as the model's policy evolves during training, we adopt an iterative learning scheme that dynamically regenerates preference data. Extensive experiments on three medical VQA and report generation benchmarks demonstrate that ClinCoT consistently improves factual grounding and achieves superior performance compared with existing preference-based alignment methods.

DoAtlas-1: A Causal Compilation Paradigm for Clinical AI

Medical foundation models generate narrative explanations but cannot quantify intervention effects, detect evidence conflicts, or validate literature claims, limiting clinical auditability. We propose causal compilation, a paradigm that transforms medical evidence from narrative text into executable code. The paradigm standardizes heterogeneous research evidence into structured estimand objects, each explicitly specifying intervention contrast, effect scale, time horizon, and target population, supporting six executable causal queries: do-calculus, counterfactual reasoning, temporal trajectories, heterogeneous effects, mechanistic decomposition, and joint interventions. We instantiate this paradigm in DoAtlas-1, compiling 1,445 effect kernels from 754 studies through effect standardization, conflict-aware graph construction, and real-world validation (Human Phenotype Project, 10,000 participants). The system achieves 98.5% canonicalization accuracy and 80.5% query executability. This paradigm shifts medical AI from text generation to executable, auditable, and verifiable causal reasoning.

FloorplanVLM: A Vision-Language Model for Floorplan Vectorization

Converting raster floorplans into engineering-grade vector graphics is challenging due to complex topology and strict geometric constraints. To address this, we present FloorplanVLM, a unified framework that reformulates floorplan vectorization as an image-conditioned sequence modeling task. Unlike pixel-based methods that rely on fragile heuristics or query-based transformers that generate fragmented rooms, our model directly outputs structured JSON sequences representing the global topology. This 'pixels-to-sequence' paradigm enables the precise and holistic constraint satisfaction of complex geometries, such as slanted walls and curved arcs. To support this data-hungry approach, we introduce a scalable data engine: we construct a large-scale dataset (Floorplan-2M) and a high-fidelity subset (Floorplan-HQ-300K) to balance geometric diversity and pixel-level precision. We then employ a progressive training strategy, using Supervised Fine-Tuning (SFT) for structural grounding and quality annealing, followed by Group Relative Policy Optimization (GRPO) for strict geometric alignment. To standardize evaluation on complex layouts, we establish and open-source FPBench-2K. Evaluated on this rigorous benchmark, FloorplanVLM demonstrates exceptional structural validity, achieving $\textbf{92.52%}$ external-wall IoU and robust generalization across non-Manhattan architectures.

DreamHome-Pano: Design-Aware and Conflict-Free Panoramic Interior Generation

In modern interior design, the generation of personalized spaces frequently necessitates a delicate balance between rigid architectural structural constraints and specific stylistic preferences. However, existing multi-condition generative frameworks often struggle to harmonize these inputs, leading to "condition conflicts" where stylistic attributes inadvertently compromise the geometric precision of the layout. To address this challenge, we present DreamHome-Pano, a controllable panoramic generation framework designed for high-fidelity interior synthesis. Our approach introduces a Prompt-LLM that serves as a semantic bridge, effectively translating layout constraints and style references into professional descriptive prompts to achieve precise cross-modal alignment. To safeguard architectural integrity during the generative process, we develop a Conflict-Free Control architecture that incorporates structural-aware geometric priors and a multi-condition decoupling strategy, effectively suppressing stylistic interference from eroding the spatial layout. Furthermore, we establish a comprehensive panoramic interior benchmark alongside a multi-stage training pipeline, encompassing progressive Supervised Fine-Tuning (SFT) and Reinforcement Learning (RL). Experimental results demonstrate that DreamHome-Pano achieves a superior balance between aesthetic quality and structural consistency, offering a robust and professional-grade solution for panoramic interior visualization.

LMK > CLS: Landmark Pooling for Dense Embeddings

Representation learning is central to many downstream tasks such as search, clustering, classification, and reranking. State-of-the-art sequence encoders typically collapse a variable-length token sequence to a single vector using a pooling operator, most commonly a special [CLS] token or mean pooling over token embeddings. In this paper, we identify systematic weaknesses of these pooling strategies: [CLS] tends to concentrate information toward the initial positions of the sequence and can under-represent distributed evidence, while mean pooling can dilute salient local signals, sometimes leading to worse short-context performance. To address these issues, we introduce Landmark (LMK) pooling, which partitions a sequence into chunks, inserts landmark tokens between chunks, and forms the final representation by mean-pooling the landmark token embeddings. This simple mechanism improves long-context extrapolation without sacrificing local salient features, at the cost of introducing a small number of special tokens. We empirically demonstrate that LMK pooling matches existing methods on short-context retrieval tasks and yields substantial improvements on long-context tasks, making it a practical and scalable alternative to existing pooling methods.

Influence Guided Sampling for Domain Adaptation of Text Retrievers

General-purpose open-domain dense retrieval systems are usually trained with a large, eclectic mix of corpora and search tasks. How should these diverse corpora and tasks be sampled for training? Conventional approaches sample them uniformly, proportional to their instance population sizes, or depend on human-level expert supervision. It is well known that the training data sampling strategy can greatly impact model performance. However, how to find the optimal strategy has not been adequately studied in the context of embedding models. We propose Inf-DDS, a novel reinforcement learning driven sampling framework that adaptively reweighs training datasets guided by influence-based reward signals and is much more lightweight with respect to GPU consumption. Our technique iteratively refines the sampling policy, prioritizing datasets that maximize model performance on a target development set. We evaluate the efficacy of our sampling strategy on a wide range of text retrieval tasks, demonstrating strong improvements in retrieval performance and better adaptation compared to existing gradient-based sampling methods, while also being 1.5x to 4x cheaper in GPU compute. Our sampling strategy achieves a 5.03 absolute NDCG@10 improvement while training a multilingual bge-m3 model and an absolute NDCG@10 improvement of 0.94 while training all-MiniLM-L6-v2, even when starting from expert-assigned weights on a large pool of training datasets.