MAP-Diff: Multi-Anchor Guided Diffusion for Progressive 3D Whole-Body Low-Dose PET Denoising

Low-dose Positron Emission Tomography (PET) reduces radiation exposure but suffers from severe noise and quantitative degradation. Diffusion-based denoising models achieve strong final reconstructions, yet their reverse trajectories are typically unconstrained and not aligned with the progressive nature of PET dose formation. We propose MAP-Diff, a multi-anchor guided diffusion framework for progressive 3D whole-body PET denoising. MAP-Diff introduces clinically observed intermediate-dose scans as trajectory anchors and enforces timestep-dependent supervision to regularize the reverse process toward dose-aligned intermediate states. Anchor timesteps are calibrated via degradation matching between simulated diffusion corruption and real multi-dose PET pairs, and a timestep-weighted anchor loss stabilizes stage-wise learning. At inference, the model requires only ultra-low-dose input while enabling progressive, dose-consistent intermediate restoration. Experiments on internal (Siemens Biograph Vision Quadra) and cross-scanner (United Imaging uEXPLORER) datasets show consistent improvements over strong CNN-, Transformer-, GAN-, and diffusion-based baselines. On the internal dataset, MAP-Diff improves PSNR from 42.48 dB to 43.71 dB (+1.23 dB), increases SSIM to 0.986, and reduces NMAE from 0.115 to 0.103 (-0.012) compared to 3D DDPM. Performance gains generalize across scanners, achieving 34.42 dB PSNR and 0.141 NMAE on the external cohort, outperforming all competing methods.

3D Wavelet-Based Structural Priors for Controlled Diffusion in Whole-Body Low-Dose PET Denoising

Low-dose Positron Emission Tomography (PET) imaging reduces patient radiation exposure but suffers from increased noise that degrades image quality and diagnostic reliability. Although diffusion models have demonstrated strong denoising capability, their stochastic nature makes it challenging to enforce anatomically consistent structures, particularly in low signal-to-noise regimes and volumetric whole-body imaging. We propose Wavelet-Conditioned ControlNet (WCC-Net), a fully 3D diffusion-based framework that introduces explicit frequency-domain structural priors via wavelet representations to guide volumetric PET denoising. By injecting wavelet-based structural guidance into a frozen pretrained diffusion backbone through a lightweight control branch, WCC-Net decouples anatomical structure from noise while preserving generative expressiveness and 3D structural continuity. Extensive experiments demonstrate that WCC-Net consistently outperforms CNN-, GAN-, and diffusion-based baselines. On the internal 1/20-dose test set, WCC-Net improves PSNR by +1.21 dB and SSIM by +0.008 over a strong diffusion baseline, while reducing structural distortion (GMSD) and intensity error (NMAE). Moreover, WCC-Net generalizes robustly to unseen dose levels (1/50 and 1/4), achieving superior quantitative performance and improved volumetric anatomical consistency.

Enabling Ultra-Fast Cardiovascular Imaging Across Heterogeneous Clinical Environments with a Generalist Foundation Model and Multimodal Database

Multimodal cardiovascular magnetic resonance (CMR) imaging provides comprehensive and non-invasive insights into cardiovascular disease (CVD) diagnosis and underlying mechanisms. Despite decades of advancements, its widespread clinical adoption remains constrained by prolonged scan times and heterogeneity across medical environments. This underscores the urgent need for a generalist reconstruction foundation model for ultra-fast CMR imaging, one capable of adapting across diverse imaging scenarios and serving as the essential substrate for all downstream analyses. To enable this goal, we curate MMCMR-427K, the largest and most comprehensive multimodal CMR k-space database to date, comprising 427,465 multi-coil k-space data paired with structured metadata across 13 international centers, 12 CMR modalities, 15 scanners, and 17 CVD categories in populations across three continents. Building on this unprecedented resource, we introduce CardioMM, a generalist reconstruction foundation model capable of dynamically adapting to heterogeneous fast CMR imaging scenarios. CardioMM unifies semantic contextual understanding with physics-informed data consistency to deliver robust reconstructions across varied scanners, protocols, and patient presentations. Comprehensive evaluations demonstrate that CardioMM achieves state-of-the-art performance in the internal centers and exhibits strong zero-shot generalization to unseen external settings. Even at imaging acceleration up to 24x, CardioMM reliably preserves key cardiac phenotypes, quantitative myocardial biomarkers, and diagnostic image quality, enabling a substantial increase in CMR examination throughput without compromising clinical integrity. Together, our open-access MMCMR-427K database and CardioMM framework establish a scalable pathway toward high-throughput, high-quality, and clinically accessible cardiovascular imaging.

Dynamic Dual Buffer with Divide-and-Conquer Strategy for Online Continual Learning

Online Continual Learning (OCL) presents a complex learning environment in which new data arrives in a batch-to-batch online format, and the risk of catastrophic forgetting can significantly impair model efficacy. In this study, we address OCL by introducing an innovative memory framework that incorporates a short-term memory system to retain dynamic information and a long-term memory system to archive enduring knowledge. Specifically, the long-term memory system comprises a collection of sub-memory buffers, each linked to a cluster prototype and designed to retain data samples from distinct categories. We propose a novel $K$-means-based sample selection method to identify cluster prototypes for each encountered category. To safeguard essential and critical samples, we introduce a novel memory optimisation strategy that selectively retains samples in the appropriate sub-memory buffer by evaluating each cluster prototype against incoming samples through an optimal transportation mechanism. This approach specifically promotes each sub-memory buffer to retain data samples that exhibit significant discrepancies from the corresponding cluster prototype, thereby ensuring the preservation of semantically rich information. In addition, we propose a novel Divide-and-Conquer (DAC) approach that formulates the memory updating as an optimisation problem and divides it into several subproblems. As a result, the proposed DAC approach can solve these subproblems separately and thus can significantly reduce computations of the proposed memory updating process. We conduct a series of experiments across standard and imbalanced learning settings, and the empirical findings indicate that the proposed memory framework achieves state-of-the-art performance in both learning contexts.

Reason Like a Radiologist: Chain-of-Thought and Reinforcement Learning for Verifiable Report Generation

Radiology report generation is critical for efficiency but current models lack the structured reasoning of experts, hindering clinical trust and explainability by failing to link visual findings to precise anatomical locations. This paper introduces BoxMed-RL, a groundbreaking unified training framework for generating spatially verifiable and explainable radiology reports. Built on a large vision-language model, BoxMed-RL revolutionizes report generation through two integrated phases: (1) In the Pretraining Phase, we refine the model via medical concept learning, using Chain-of-Thought supervision to internalize the radiologist-like workflow, followed by spatially verifiable reinforcement, which applies reinforcement learning to align medical findings with bounding boxes. (2) In the Downstream Adapter Phase, we freeze the pretrained weights and train a downstream adapter to ensure fluent and clinically credible reports. This framework precisely mimics radiologists' workflow, compelling the model to connect high-level medical concepts with definitive anatomical evidence. Extensive experiments on public datasets demonstrate that BoxMed-RL achieves an average 7% improvement in both METEOR and ROUGE-L metrics compared to state-of-the-art methods. An average 5% improvement in large language model-based metrics further underscores BoxMed-RL's robustness in generating high-quality radiology reports.

Task-oriented Uncertainty Collaborative Learning for Label-Efficient Brain Tumor Segmentation

Multi-contrast magnetic resonance imaging (MRI) plays a vital role in brain tumor segmentation and diagnosis by leveraging complementary information from different contrasts. Each contrast highlights specific tumor characteristics, enabling a comprehensive understanding of tumor morphology, edema, and pathological heterogeneity. However, existing methods still face the challenges of multi-level specificity perception across different contrasts, especially with limited annotations. These challenges include data heterogeneity, granularity differences, and interference from redundant information. To address these limitations, we propose a Task-oriented Uncertainty Collaborative Learning (TUCL) framework for multi-contrast MRI segmentation. TUCL introduces a task-oriented prompt attention (TPA) module with intra-prompt and cross-prompt attention mechanisms to dynamically model feature interactions across contrasts and tasks. Additionally, a cyclic process is designed to map the predictions back to the prompt to ensure that the prompts are effectively utilized. In the decoding stage, the TUCL framework proposes a dual-path uncertainty refinement (DUR) strategy which ensures robust segmentation by refining predictions iteratively. Extensive experimental results on limited labeled data demonstrate that TUCL significantly improves segmentation accuracy (88.2\% in Dice and 10.853 mm in HD95). It shows that TUCL has the potential to extract multi-contrast information and reduce the reliance on extensive annotations. The code is available at: https://github.com/Zhenxuan-Zhang/TUCL_BrainSeg.

Pretext Task Adversarial Learning for Unpaired Low-field to Ultra High-field MRI Synthesis

Given the scarcity and cost of high-field MRI, the synthesis of high-field MRI from low-field MRI holds significant potential when there is limited data for training downstream tasks (e.g. segmentation). Low-field MRI often suffers from a reduced signal-to-noise ratio (SNR) and spatial resolution compared to high-field MRI. However, synthesizing high-field MRI data presents challenges. These involve aligning image features across domains while preserving anatomical accuracy and enhancing fine details. To address these challenges, we propose a Pretext Task Adversarial (PTA) learning framework for high-field MRI synthesis from low-field MRI data. The framework comprises three processes: (1) The slice-wise gap perception (SGP) network aligns the slice inconsistencies of low-field and high-field datasets based on contrastive learning. (2) The local structure correction (LSC) network extracts local structures by restoring the locally rotated and masked images. (3) The pretext task-guided adversarial training process introduces additional supervision and incorporates a discriminator to improve image realism. Extensive experiments on low-field to ultra high-field task demonstrate the effectiveness of our method, achieving state-of-the-art performance (16.892 in FID, 1.933 in IS, and 0.324 in MS-SSIM). This enables the generation of high-quality high-field-like MRI data from low-field MRI data to augment training datasets for downstream tasks. The code is available at: https://github.com/Zhenxuan-Zhang/PTA4Unpaired_HF_MRI_SYN.

Lightweight Hypercomplex MRI Reconstruction: A Generalized Kronecker-Parameterized Approach

Magnetic Resonance Imaging (MRI) is crucial for clinical diagnostics but is hindered by prolonged scan times. Current deep learning models enhance MRI reconstruction but are often memory-intensive and unsuitable for resource-limited systems. This paper introduces a lightweight MRI reconstruction model leveraging Kronecker-Parameterized Hypercomplex Neural Networks to achieve high performance with reduced parameters. By integrating Kronecker-based modules, including Kronecker MLP, Kronecker Window Attention, and Kronecker Convolution, the proposed model efficiently extracts spatial features while preserving representational power. We introduce Kronecker U-Net and Kronecker SwinMR, which maintain high reconstruction quality with approximately 50% fewer parameters compared to existing models. Experimental evaluation on the FastMRI dataset demonstrates competitive PSNR, SSIM, and LPIPS metrics, even at high acceleration factors (8x and 16x), with no significant performance drop. Additionally, Kronecker variants exhibit superior generalization and reduced overfitting on limited datasets, facilitating efficient MRI reconstruction on hardware-constrained systems. This approach sets a new benchmark for parameter-efficient medical imaging models.

GEMA-Score: Granular Explainable Multi-Agent Score for Radiology Report Evaluation

Automatic medical report generation supports clinical diagnosis, reduces the workload of radiologists, and holds the promise of improving diagnosis consistency. However, existing evaluation metrics primarily assess the accuracy of key medical information coverage in generated reports compared to human-written reports, while overlooking crucial details such as the location and certainty of reported abnormalities. These limitations hinder the comprehensive assessment of the reliability of generated reports and pose risks in their selection for clinical use. Therefore, we propose a Granular Explainable Multi-Agent Score (GEMA-Score) in this paper, which conducts both objective quantification and subjective evaluation through a large language model-based multi-agent workflow. Our GEMA-Score parses structured reports and employs NER-F1 calculations through interactive exchanges of information among agents to assess disease diagnosis, location, severity, and uncertainty. Additionally, an LLM-based scoring agent evaluates completeness, readability, and clinical terminology while providing explanatory feedback. Extensive experiments validate that GEMA-Score achieves the highest correlation with human expert evaluations on a public dataset, demonstrating its effectiveness in clinical scoring (Kendall coefficient = 0.70 for Rexval dataset and Kendall coefficient = 0.54 for RadEvalX dataset). The anonymous project demo is available at: https://github.com/Zhenxuan-Zhang/GEMA_score.

RuozhiBench: Evaluating LLMs with Logical Fallacies and Misleading Premises

Recent advances in large language models (LLMs) have shown that they can answer questions requiring complex reasoning. However, their ability to identify and respond to text containing logical fallacies or deliberately misleading premises remains less studied. To address this gap, we introduce RuozhiBench, a bilingual dataset comprising 677 carefully curated questions that contain various forms of deceptive reasoning, meticulously crafted through extensive human effort and expert review. In a comprehensive evaluation of 17 LLMs from 5 Series over RuozhiBench using both open-ended and two-choice formats, we conduct extensive analyses on evaluation protocols and result patterns. Despite their high scores on conventional benchmarks, these models showed limited ability to detect and reason correctly about logical fallacies, with even the best-performing model, Claude-3-haiku, achieving only 62% accuracy compared to the human of more than 90%.