A fragile zero-watermarking method based on dual quaternion matrix decomposition

Medical images play a crucial role in assisting diagnosis, remote consultation, and academic research. However, during the transmission and sharing process, they face serious risks of copyright ownership and content tampering. Therefore, protecting medical images is of great importance. As an effective means of image copyright protection, zero-watermarking technology focuses on constructing watermarks without modifying the original carrier by extracting its stable features, which provides an ideal approach for protecting medical images. This paper aims to propose a fragile zero-watermarking model based on dual quaternion matrix decomposition, which utilizes the operational relationship between the standard part and the dual part of dual quaternions to correlate the original carrier image with the watermark image, and generates zero-watermarking information based on the characteristics of dual quaternion matrix decomposition, ultimately achieving copyright protection and content tampering detection for medical images.

PETAR: Localized Findings Generation with Mask-Aware Vision-Language Modeling for PET Automated Reporting

Recent advances in vision-language models (VLMs) have enabled impressive multimodal reasoning, yet most medical applications remain limited to 2D imaging. In this work, we extend VLMs to 3D positron emission tomography and computed tomography (PET/CT), a domain characterized by large volumetric data, small and dispersed lesions, and lengthy radiology reports. We introduce a large-scale dataset comprising over 11,000 lesion-level descriptions paired with 3D segmentations from more than 5,000 PET/CT exams, extracted via a hybrid rule-based and large language model (LLM) pipeline. Building upon this dataset, we propose PETAR-4B, a 3D mask-aware vision-language model that integrates PET, CT, and lesion contours for spatially grounded report generation. PETAR bridges global contextual reasoning with fine-grained lesion awareness, producing clinically coherent and localized findings. Comprehensive automated and human evaluations demonstrate that PETAR substantially improves PET/CT report generation quality, advancing 3D medical vision-language understanding.

MedVLSynther: Synthesizing High-Quality Visual Question Answering from Medical Documents with Generator-Verifier LMMs

Large Multimodal Models (LMMs) are increasingly capable of answering medical questions that require joint reasoning over images and text, yet training general medical VQA systems is impeded by the lack of large, openly usable, high-quality corpora. We present MedVLSynther, a rubric-guided generator-verifier framework that synthesizes high-quality multiple-choice VQA items directly from open biomedical literature by conditioning on figures, captions, and in-text references. The generator produces self-contained stems and parallel, mutually exclusive options under a machine-checkable JSON schema; a multi-stage verifier enforces essential gates (self-containment, single correct answer, clinical validity, image-text consistency), awards fine-grained positive points, and penalizes common failure modes before acceptance. Applying this pipeline to PubMed Central yields MedSynVQA: 13,087 audited questions over 14,803 images spanning 13 imaging modalities and 28 anatomical regions. Training open-weight LMMs with reinforcement learning using verifiable rewards improves accuracy across six medical VQA benchmarks, achieving averages of 55.85 (3B) and 58.15 (7B), with up to 77.57 on VQA-RAD and 67.76 on PathVQA, outperforming strong medical LMMs. A Ablations verify that both generation and verification are necessary and that more verified data consistently helps, and a targeted contamination analysis detects no leakage from evaluation suites. By operating entirely on open literature and open-weight models, MedVLSynther offers an auditable, reproducible, and privacy-preserving path to scalable medical VQA training data.

VessShape: Few-shot 2D blood vessel segmentation by leveraging shape priors from synthetic images

Semantic segmentation of blood vessels is an important task in medical image analysis, but its progress is often hindered by the scarcity of large annotated datasets and the poor generalization of models across different imaging modalities. A key aspect is the tendency of Convolutional Neural Networks (CNNs) to learn texture-based features, which limits their performance when applied to new domains with different visual characteristics. We hypothesize that leveraging geometric priors of vessel shapes, such as their tubular and branching nature, can lead to more robust and data-efficient models. To investigate this, we introduce VessShape, a methodology for generating large-scale 2D synthetic datasets designed to instill a shape bias in segmentation models. VessShape images contain procedurally generated tubular geometries combined with a wide variety of foreground and background textures, encouraging models to learn shape cues rather than textures. We demonstrate that a model pre-trained on VessShape images achieves strong few-shot segmentation performance on two real-world datasets from different domains, requiring only four to ten samples for fine-tuning. Furthermore, the model exhibits notable zero-shot capabilities, effectively segmenting vessels in unseen domains without any target-specific training. Our results indicate that pre-training with a strong shape bias can be an effective strategy to overcome data scarcity and improve model generalization in blood vessel segmentation.

EEG-Driven Image Reconstruction with Saliency-Guided Diffusion Models

Existing EEG-driven image reconstruction methods often overlook spatial attention mechanisms, limiting fidelity and semantic coherence. To address this, we propose a dual-conditioning framework that combines EEG embeddings with spatial saliency maps to enhance image generation. Our approach leverages the Adaptive Thinking Mapper (ATM) for EEG feature extraction and fine-tunes Stable Diffusion 2.1 via Low-Rank Adaptation (LoRA) to align neural signals with visual semantics, while a ControlNet branch conditions generation on saliency maps for spatial control. Evaluated on THINGS-EEG, our method achieves a significant improvement in the quality of low- and high-level image features over existing approaches. Simultaneously, strongly aligning with human visual attention. The results demonstrate that attentional priors resolve EEG ambiguities, enabling high-fidelity reconstructions with applications in medical diagnostics and neuroadaptive interfaces, advancing neural decoding through efficient adaptation of pre-trained diffusion models.

Nirvana: A Specialized Generalist Model With Task-Aware Memory Mechanism

Specialized Generalist Models (SGMs) aim to preserve broad capabilities while achieving expert-level performance in target domains. However, traditional LLM structures including Transformer, Linear Attention, and hybrid models do not employ specialized memory mechanism guided by task information. In this paper, we present Nirvana, an SGM with specialized memory mechanism, linear time complexity, and test-time task information extraction. Besides, we propose the Task-Aware Memory Trigger ($\textit{Trigger}$) that flexibly adjusts memory mechanism based on the current task's requirements. In Trigger, each incoming sample is treated as a self-supervised fine-tuning task, enabling Nirvana to adapt its task-related parameters on the fly to domain shifts. We also design the Specialized Memory Updater ($\textit{Updater}$) that dynamically memorizes the context guided by Trigger. We conduct experiments on both general language tasks and specialized medical tasks. On a variety of natural language modeling benchmarks, Nirvana achieves competitive or superior results compared to the existing LLM structures. To prove the effectiveness of Trigger on specialized tasks, we test Nirvana's performance on a challenging medical task, i.e., Magnetic Resonance Imaging (MRI). We post-train frozen Nirvana backbone with lightweight codecs on paired electromagnetic signals and MRI images. Despite the frozen Nirvana backbone, Trigger guides the model to adapt to the MRI domain with the change of task-related parameters. Nirvana achieves higher-quality MRI reconstruction compared to conventional MRI models as well as the models with traditional LLMs' backbone, and can also generate accurate preliminary clinical reports accordingly.

MedXplain-VQA: Multi-Component Explainable Medical Visual Question Answering

Explainability is critical for the clinical adoption of medical visual question answering (VQA) systems, as physicians require transparent reasoning to trust AI-generated diagnoses. We present MedXplain-VQA, a comprehensive framework integrating five explainable AI components to deliver interpretable medical image analysis. The framework leverages a fine-tuned BLIP-2 backbone, medical query reformulation, enhanced Grad-CAM attention, precise region extraction, and structured chain-of-thought reasoning via multi-modal language models. To evaluate the system, we introduce a medical-domain-specific framework replacing traditional NLP metrics with clinically relevant assessments, including terminology coverage, clinical structure quality, and attention region relevance. Experiments on 500 PathVQA histopathology samples demonstrate substantial improvements, with the enhanced system achieving a composite score of 0.683 compared to 0.378 for baseline methods, while maintaining high reasoning confidence (0.890). Our system identifies 3-5 diagnostically relevant regions per sample and generates structured explanations averaging 57 words with appropriate clinical terminology. Ablation studies reveal that query reformulation provides the most significant initial improvement, while chain-of-thought reasoning enables systematic diagnostic processes. These findings underscore the potential of MedXplain-VQA as a robust, explainable medical VQA system. Future work will focus on validation with medical experts and large-scale clinical datasets to ensure clinical readiness.

TraceTrans: Translation and Spatial Tracing for Surgical Prediction

Image-to-image translation models have achieved notable success in converting images across visual domains and are increasingly used for medical tasks such as predicting post-operative outcomes and modeling disease progression. However, most existing methods primarily aim to match the target distribution and often neglect spatial correspondences between the source and translated images. This limitation can lead to structural inconsistencies and hallucinations, undermining the reliability and interpretability of the predictions. These challenges are accentuated in clinical applications by the stringent requirement for anatomical accuracy. In this work, we present TraceTrans, a novel deformable image translation model designed for post-operative prediction that generates images aligned with the target distribution while explicitly revealing spatial correspondences with the pre-operative input. The framework employs an encoder for feature extraction and dual decoders for predicting spatial deformations and synthesizing the translated image. The predicted deformation field imposes spatial constraints on the generated output, ensuring anatomical consistency with the source. Extensive experiments on medical cosmetology and brain MRI datasets demonstrate that TraceTrans delivers accurate and interpretable post-operative predictions, highlighting its potential for reliable clinical deployment.

LoMix: Learnable Weighted Multi-Scale Logits Mixing for Medical Image Segmentation

U-shaped networks output logits at multiple spatial scales, each capturing a different blend of coarse context and fine detail. Yet, training still treats these logits in isolation - either supervising only the final, highest-resolution logits or applying deep supervision with identical loss weights at every scale - without exploring mixed-scale combinations. Consequently, the decoder output misses the complementary cues that arise only when coarse and fine predictions are fused. To address this issue, we introduce LoMix (Logits Mixing), a NAS-inspired, differentiable plug-and-play module that generates new mixed-scale outputs and learns how exactly each of them should guide the training process. More precisely, LoMix mixes the multi-scale decoder logits with four lightweight fusion operators: addition, multiplication, concatenation, and attention-based weighted fusion, yielding a rich set of synthetic mutant maps. Every original or mutant map is given a softplus loss weight that is co-optimized with network parameters, mimicking a one-step architecture search that automatically discovers the most useful scales, mixtures, and operators. Plugging LoMix into recent U-shaped architectures (i.e., PVT-V2-B2 backbone with EMCAD decoder) on Synapse 8-organ dataset improves DICE by +4.2% over single-output supervision, +2.2% over deep supervision, and +1.5% over equally weighted additive fusion, all with zero inference overhead. When training data are scarce (e.g., one or two labeled scans), the advantage grows to +9.23%, underscoring LoMix's data efficiency. Across four benchmarks and diverse U-shaped networks, LoMiX improves DICE by up to +13.5% over single-output supervision, confirming that learnable weighted mixed-scale fusion generalizes broadly while remaining data efficient, fully interpretable, and overhead-free at inference. Our code is available at https://github.com/SLDGroup/LoMix.

S-Chain: Structured Visual Chain-of-Thought For Medicine

Faithful reasoning in medical vision-language models (VLMs) requires not only accurate predictions but also transparent alignment between textual rationales and visual evidence. While Chain-of-Thought (CoT) prompting has shown promise in medical visual question answering (VQA), no large-scale expert-level dataset has captured stepwise reasoning with precise visual grounding. We introduce S-Chain, the first large-scale dataset of 12,000 expert-annotated medical images with bounding boxes and structured visual CoT (SV-CoT), explicitly linking visual regions to reasoning steps. The dataset further supports 16 languages, totaling over 700k VQA pairs for broad multilingual applicability. Using S-Chain, we benchmark state-of-the-art medical VLMs (ExGra-Med, LLaVA-Med) and general-purpose VLMs (Qwen2.5-VL, InternVL2.5), showing that SV-CoT supervision significantly improves interpretability, grounding fidelity, and robustness. Beyond benchmarking, we study its synergy with retrieval-augmented generation, revealing how domain knowledge and visual grounding interact during autoregressive reasoning. Finally, we propose a new mechanism that strengthens the alignment between visual evidence and reasoning, improving both reliability and efficiency. S-Chain establishes a new benchmark for grounded medical reasoning and paves the way toward more trustworthy and explainable medical VLMs.