ESP-MedSAM: Efficient Self-Prompting SAM for Universal Domain-Generalized Medical Image Segmentation

The Segment Anything Model (SAM) has demonstrated outstanding adaptation to medical image segmentation but still faces three major challenges. Firstly, the huge computational costs of SAM limit its real-world applicability. Secondly, SAM depends on manual annotations (e.g., points, boxes) as prompts, which are laborious and impractical in clinical scenarios. Thirdly, SAM handles all segmentation targets equally, which is suboptimal for diverse medical modalities with inherent heterogeneity. To address these issues, we propose an Efficient Self-Prompting SAM for universal medical image segmentation, named ESP-MedSAM. We devise a Multi-Modal Decoupled Knowledge Distillation (MMDKD) strategy to distil common image knowledge and domain-specific medical knowledge from the foundation model to train a lightweight image encoder and a modality controller. Further, they combine with the additionally introduced Self-Patch Prompt Generator (SPPG) and Query-Decoupled Modality Decoder (QDMD) to construct ESP-MedSAM. Specifically, SPPG aims to generate a set of patch prompts automatically and QDMD leverages a one-to-one strategy to provide an independent decoding channel for every modality. Extensive experiments indicate that ESP-MedSAM outperforms state-of-the-arts in diverse medical imaging segmentation takes, displaying superior zero-shot learning and modality transfer ability. Especially, our framework uses only 31.4% parameters compared to SAM-Base.

PANS: Probabilistic Airway Navigation System for Real-time Robust Bronchoscope Localization

Accurate bronchoscope localization is essential for pulmonary interventions, by providing six degrees of freedom (DOF) in airway navigation. However, the robustness of current vision-based methods is often compromised in clinical practice, and they struggle to perform in real-time and to generalize across cases unseen during training. To overcome these challenges, we propose a novel Probabilistic Airway Navigation System (PANS), leveraging Monte-Carlo method with pose hypotheses and likelihoods to achieve robust and real-time bronchoscope localization. Specifically, our PANS incorporates diverse visual representations (\textit{e.g.}, odometry and landmarks) by leveraging two key modules, including the Depth-based Motion Inference (DMI) and the Bronchial Semantic Analysis (BSA). To generate the pose hypotheses of bronchoscope for PANS, we devise the DMI to accurately propagate the estimation of pose hypotheses over time. Moreover, to estimate the accurate pose likelihood, we devise the BSA module by effectively distinguishing between similar bronchial regions in endoscopic images, along with a novel metric to assess the congruence between estimated depth maps and the segmented airway structure. Under this probabilistic formulation, our PANS is capable of achieving the 6-DOF bronchoscope localization with superior accuracy and robustness. Extensive experiments on the collected pulmonary intervention dataset comprising 10 clinical cases confirm the advantage of our PANS over state-of-the-arts, in terms of both robustness and generalization in localizing deeper airway branches and the efficiency of real-time inference. The proposed PANS reveals its potential to be a reliable tool in the operating room, promising to enhance the quality and safety of pulmonary interventions.

CuDA2: An approach for Incorporating Traitor Agents into Cooperative Multi-Agent Systems

Cooperative Multi-Agent Reinforcement Learning (CMARL) strategies are well known to be vulnerable to adversarial perturbations. Previous works on adversarial attacks have primarily focused on white-box attacks that directly perturb the states or actions of victim agents, often in scenarios with a limited number of attacks. However, gaining complete access to victim agents in real-world environments is exceedingly difficult. To create more realistic adversarial attacks, we introduce a novel method that involves injecting traitor agents into the CMARL system. We model this problem as a Traitor Markov Decision Process (TMDP), where traitors cannot directly attack the victim agents but can influence their formation or positioning through collisions. In TMDP, traitors are trained using the same MARL algorithm as the victim agents, with their reward function set as the negative of the victim agents' reward. Despite this, the training efficiency for traitors remains low because it is challenging for them to directly associate their actions with the victim agents' rewards. To address this issue, we propose the Curiosity-Driven Adversarial Attack (CuDA2) framework. CuDA2 enhances the efficiency and aggressiveness of attacks on the specified victim agents' policies while maintaining the optimal policy invariance of the traitors. Specifically, we employ a pre-trained Random Network Distillation (RND) module, where the extra reward generated by the RND module encourages traitors to explore states unencountered by the victim agents. Extensive experiments on various scenarios from SMAC demonstrate that our CuDA2 framework offers comparable or superior adversarial attack capabilities compared to other baselines.

EndoUIC: Promptable Diffusion Transformer for Unified Illumination Correction in Capsule Endoscopy

Wireless Capsule Endoscopy (WCE) is highly valued for its non-invasive and painless approach, though its effectiveness is compromised by uneven illumination from hardware constraints and complex internal dynamics, leading to overexposed or underexposed images. While researchers have discussed the challenges of low-light enhancement in WCE, the issue of correcting for different exposure levels remains underexplored. To tackle this, we introduce EndoUIC, a WCE unified illumination correction solution using an end-to-end promptable diffusion transformer (DFT) model. In our work, the illumination prompt module shall navigate the model to adapt to different exposure levels and perform targeted image enhancement, in which the Adaptive Prompt Integration (API) and Global Prompt Scanner (GPS) modules shall further boost the concurrent representation learning between the prompt parameters and features. Besides, the U-shaped restoration DFT model shall capture the long-range dependencies and contextual information for unified illumination restoration. Moreover, we present a novel Capsule-endoscopy Exposure Correction (CEC) dataset, including ground-truth and corrupted image pairs annotated by expert photographers. Extensive experiments against a variety of state-of-the-art (SOTA) methods on four datasets showcase the effectiveness of our proposed method and components in WCE illumination restoration, and the additional downstream experiments further demonstrate its utility for clinical diagnosis and surgical assistance.

Transforming Surgical Interventions with Embodied Intelligence for Ultrasound Robotics

Ultrasonography has revolutionized non-invasive diagnostic methodologies, significantly enhancing patient outcomes across various medical domains. Despite its advancements, integrating ultrasound technology with robotic systems for automated scans presents challenges, including limited command understanding and dynamic execution capabilities. To address these challenges, this paper introduces a novel Ultrasound Embodied Intelligence system that synergistically combines ultrasound robots with large language models (LLMs) and domain-specific knowledge augmentation, enhancing ultrasound robots' intelligence and operational efficiency. Our approach employs a dual strategy: firstly, integrating LLMs with ultrasound robots to interpret doctors' verbal instructions into precise motion planning through a comprehensive understanding of ultrasound domain knowledge, including APIs and operational manuals; secondly, incorporating a dynamic execution mechanism, allowing for real-time adjustments to scanning plans based on patient movements or procedural errors. We demonstrate the effectiveness of our system through extensive experiments, including ablation studies and comparisons across various models, showcasing significant improvements in executing medical procedures from verbal commands. Our findings suggest that the proposed system improves the efficiency and quality of ultrasound scans and paves the way for further advancements in autonomous medical scanning technologies, with the potential to transform non-invasive diagnostics and streamline medical workflows.

A Practice-Friendly Two-Stage LLM-Enhanced Paradigm in Sequential Recommendation

The training paradigm integrating large language models (LLM) is gradually reshaping sequential recommender systems (SRS) and has shown promising results. However, most existing LLM-enhanced methods rely on rich textual information on the item side and instance-level supervised fine-tuning (SFT) to inject collaborative information into LLM, which is inefficient and limited in many applications. To alleviate these problems, this paper proposes a novel practice-friendly two-stage LLM-enhanced paradigm (TSLRec) for SRS. Specifically, in the information reconstruction stage, we design a new user-level SFT task for collaborative information injection with the assistance of a pre-trained SRS model, which is more efficient and compatible with limited text information. We aim to let LLM try to infer the latent category of each item and reconstruct the corresponding user's preference distribution for all categories from the user's interaction sequence. In the information augmentation stage, we feed each item into LLM to obtain a set of enhanced embeddings that combine collaborative information and LLM inference capabilities. These embeddings can then be used to help train various future SRS models. Finally, we verify the effectiveness and efficiency of our TSLRec on three SRS benchmark datasets.

E$^3$-Net: Efficient E-Equivariant Normal Estimation Network

Point cloud normal estimation is a fundamental task in 3D geometry processing. While recent learning-based methods achieve notable advancements in normal prediction, they often overlook the critical aspect of equivariance. This results in inefficient learning of symmetric patterns. To address this issue, we propose E3-Net to achieve equivariance for normal estimation. We introduce an efficient random frame method, which significantly reduces the training resources required for this task to just 1/8 of previous work and improves the accuracy. Further, we design a Gaussian-weighted loss function and a receptive-aware inference strategy that effectively utilizes the local properties of point clouds. Our method achieves superior results on both synthetic and real-world datasets, and outperforms current state-of-the-art techniques by a substantial margin. We improve RMSE by 4% on the PCPNet dataset, 2.67% on the SceneNN dataset, and 2.44% on the FamousShape dataset.

VS-Assistant: Versatile Surgery Assistant on the Demand of Surgeons

The surgical intervention is crucial to patient healthcare, and many studies have developed advanced algorithms to provide understanding and decision-making assistance for surgeons. Despite great progress, these algorithms are developed for a single specific task and scenario, and in practice require the manual combination of different functions, thus limiting the applicability. Thus, an intelligent and versatile surgical assistant is expected to accurately understand the surgeon's intentions and accordingly conduct the specific tasks to support the surgical process. In this work, by leveraging advanced multimodal large language models (MLLMs), we propose a Versatile Surgery Assistant (VS-Assistant) that can accurately understand the surgeon's intention and complete a series of surgical understanding tasks, e.g., surgical scene analysis, surgical instrument detection, and segmentation on demand. Specifically, to achieve superior surgical multimodal understanding, we devise a mixture of projectors (MOP) module to align the surgical MLLM in VS-Assistant to balance the natural and surgical knowledge. Moreover, we devise a surgical Function-Calling Tuning strategy to enable the VS-Assistant to understand surgical intentions, and thus make a series of surgical function calls on demand to meet the needs of the surgeons. Extensive experiments on neurosurgery data confirm that our VS-Assistant can understand the surgeon's intention more accurately than the existing MLLM, resulting in overwhelming performance in textual analysis and visual tasks. Source code and models will be made public.

Enhancing Surgical Robots with Embodied Intelligence for Autonomous Ultrasound Scanning

Ultrasound robots are increasingly used in medical diagnostics and early disease screening. However, current ultrasound robots lack the intelligence to understand human intentions and instructions, hindering autonomous ultrasound scanning. To solve this problem, we propose a novel Ultrasound Embodied Intelligence system that equips ultrasound robots with the large language model (LLM) and domain knowledge, thereby improving the efficiency of ultrasound robots. Specifically, we first design an ultrasound operation knowledge database to add expertise in ultrasound scanning to the LLM, enabling the LLM to perform precise motion planning. Furthermore, we devise a dynamic ultrasound scanning strategy based on a \textit{think-observe-execute} prompt engineering, allowing LLMs to dynamically adjust motion planning strategies during the scanning procedures. Extensive experiments demonstrate that our system significantly improves ultrasound scan efficiency and quality from verbal commands. This advancement in autonomous medical scanning technology contributes to non-invasive diagnostics and streamlined medical workflows.

Transitive Vision-Language Prompt Learning for Domain Generalization

The vision-language pre-training has enabled deep models to make a huge step forward in generalizing across unseen domains. The recent learning method based on the vision-language pre-training model is a great tool for domain generalization and can solve this problem to a large extent. However, there are still some issues that an advancement still suffers from trading-off between domain invariance and class separability, which are crucial in current DG problems. However, there are still some issues that an advancement still suffers from trading-off between domain invariance and class separability, which are crucial in current DG problems. In this paper, we introduce a novel prompt learning strategy that leverages deep vision prompts to address domain invariance while utilizing language prompts to ensure class separability, coupled with adaptive weighting mechanisms to balance domain invariance and class separability. Extensive experiments demonstrate that deep vision prompts effectively extract domain-invariant features, significantly improving the generalization ability of deep models and achieving state-of-the-art performance on three datasets.