SRU-Pix2Pix: A Fusion-Driven Generator Network for Medical Image Translation with Few-Shot Learning

Magnetic Resonance Imaging (MRI) provides detailed tissue information, but its clinical application is limited by long acquisition time, high cost, and restricted resolution. Image translation has recently gained attention as a strategy to address these limitations. Although Pix2Pix has been widely applied in medical image translation, its potential has not been fully explored. In this study, we propose an enhanced Pix2Pix framework that integrates Squeeze-and-Excitation Residual Networks (SEResNet) and U-Net++ to improve image generation quality and structural fidelity. SEResNet strengthens critical feature representation through channel attention, while U-Net++ enhances multi-scale feature fusion. A simplified PatchGAN discriminator further stabilizes training and refines local anatomical realism. Experimental results demonstrate that under few-shot conditions with fewer than 500 images, the proposed method achieves consistent structural fidelity and superior image quality across multiple intra-modality MRI translation tasks, showing strong generalization ability. These results suggest an effective extension of Pix2Pix for medical image translation.

RadDiff: Describing Differences in Radiology Image Sets with Natural Language

Understanding how two radiology image sets differ is critical for generating clinical insights and for interpreting medical AI systems. We introduce RadDiff, a multimodal agentic system that performs radiologist-style comparative reasoning to describe clinically meaningful differences between paired radiology studies. RadDiff builds on a proposer-ranker framework from VisDiff, and incorporates four innovations inspired by real diagnostic workflows: (1) medical knowledge injection through domain-adapted vision-language models; (2) multimodal reasoning that integrates images with their clinical reports; (3) iterative hypothesis refinement across multiple reasoning rounds; and (4) targeted visual search that localizes and zooms in on salient regions to capture subtle findings. To evaluate RadDiff, we construct RadDiffBench, a challenging benchmark comprising 57 expert-validated radiology study pairs with ground-truth difference descriptions. On RadDiffBench, RadDiff achieves 47% accuracy, and 50% accuracy when guided by ground-truth reports, significantly outperforming the general-domain VisDiff baseline. We further demonstrate RadDiff's versatility across diverse clinical tasks, including COVID-19 phenotype comparison, racial subgroup analysis, and discovery of survival-related imaging features. Together, RadDiff and RadDiffBench provide the first method-and-benchmark foundation for systematically uncovering meaningful differences in radiological data.

Feature-Aware One-Shot Federated Learning via Hierarchical Token Sequences

One-shot federated learning (OSFL) reduces the communication cost and privacy risks of iterative federated learning by constructing a global model with a single round of communication. However, most existing methods struggle to achieve robust performance on real-world domains such as medical imaging, or are inefficient when handling non-IID (Independent and Identically Distributed) data. To address these limitations, we introduce FALCON, a framework that enhances the effectiveness of OSFL over non-IID image data. The core idea of FALCON is to leverage the feature-aware hierarchical token sequences generation and knowledge distillation into OSFL. First, each client leverages a pretrained visual encoder with hierarchical scale encoding to compress images into hierarchical token sequences, which capture multi-scale semantics. Second, a multi-scale autoregressive transformer generator is used to model the distribution of these token sequences and generate the synthetic sequences. Third, clients upload the synthetic sequences along with the local classifier trained on the real token sequences to the server. Finally, the server incorporates knowledge distillation into global training to reduce reliance on precise distribution modeling. Experiments on medical and natural image datasets validate the effectiveness of FALCON in diverse non-IID scenarios, outperforming the best OSFL baselines by 9.58% in average accuracy.

Aligning Findings with Diagnosis: A Self-Consistent Reinforcement Learning Framework for Trustworthy Radiology Reporting

Multimodal Large Language Models (MLLMs) have shown strong potential for radiology report generation, yet their clinical translation is hindered by architectural heterogeneity and the prevalence of factual hallucinations. Standard supervised fine-tuning often fails to strictly align linguistic outputs with visual evidence, while existing reinforcement learning approaches struggle with either prohibitive computational costs or limited exploration. To address these challenges, we propose a comprehensive framework for self-consistent radiology report generation. First, we conduct a systematic evaluation to identify optimal vision encoder and LLM backbone configurations for medical imaging. Building on this foundation, we introduce a novel "Reason-then-Summarize" architecture optimized via Group Relative Policy Optimization (GRPO). This framework restructures generation into two distinct components: a think block for detailed findings and an answer block for structured disease labels. By utilizing a multi-dimensional composite reward function, we explicitly penalize logical discrepancies between the generated narrative and the final diagnosis. Extensive experiments on the MIMIC-CXR benchmark demonstrate that our method achieves state-of-the-art performance in clinical efficacy metrics and significantly reduces hallucinations compared to strong supervised baselines.

AnatomiX, an Anatomy-Aware Grounded Multimodal Large Language Model for Chest X-Ray Interpretation

Multimodal medical large language models have shown impressive progress in chest X-ray interpretation but continue to face challenges in spatial reasoning and anatomical understanding. Although existing grounding techniques improve overall performance, they often fail to establish a true anatomical correspondence, resulting in incorrect anatomical understanding in the medical domain. To address this gap, we introduce AnatomiX, a multitask multimodal large language model explicitly designed for anatomically grounded chest X-ray interpretation. Inspired by the radiological workflow, AnatomiX adopts a two stage approach: first, it identifies anatomical structures and extracts their features, and then leverages a large language model to perform diverse downstream tasks such as phrase grounding, report generation, visual question answering, and image understanding. Extensive experiments across multiple benchmarks demonstrate that AnatomiX achieves superior anatomical reasoning and delivers over 25% improvement in performance on anatomy grounding, phrase grounding, grounded diagnosis and grounded captioning tasks compared to existing approaches. Code and pretrained model are available at https://github.com/aneesurhashmi/anatomix

IBISAgent: Reinforcing Pixel-Level Visual Reasoning in MLLMs for Universal Biomedical Object Referring and Segmentation

Recent research on medical MLLMs has gradually shifted its focus from image-level understanding to fine-grained, pixel-level comprehension. Although segmentation serves as the foundation for pixel-level understanding, existing approaches face two major challenges. First, they introduce implicit segmentation tokens and require simultaneous fine-tuning of both the MLLM and external pixel decoders, which increases the risk of catastrophic forgetting and limits generalization to out-of-domain scenarios. Second, most methods rely on single-pass reasoning and lack the capability to iteratively refine segmentation results, leading to suboptimal performance. To overcome these limitations, we propose a novel agentic MLLM, named IBISAgent, that reformulates segmentation as a vision-centric, multi-step decision-making process. IBISAgent enables MLLMs to generate interleaved reasoning and text-based click actions, invoke segmentation tools, and produce high-quality masks without architectural modifications. By iteratively performing multi-step visual reasoning on masked image features, IBISAgent naturally supports mask refinement and promotes the development of pixel-level visual reasoning capabilities. We further design a two-stage training framework consisting of cold-start supervised fine-tuning and agentic reinforcement learning with tailored, fine-grained rewards, enhancing the model's robustness in complex medical referring and reasoning segmentation tasks. Extensive experiments demonstrate that IBISAgent consistently outperforms both closed-source and open-source SOTA methods. All datasets, code, and trained models will be released publicly.

Domain Adaptation of Carotid Ultrasound Images using Generative Adversarial Network

Deep learning has been extensively used in medical imaging applications, assuming that the test and training datasets belong to the same probability distribution. However, a common challenge arises when working with medical images generated by different systems or even the same system with different parameter settings. Such images contain diverse textures and reverberation noise that violate the aforementioned assumption. Consequently, models trained on data from one device or setting often struggle to perform effectively with data from other devices or settings. In addition, retraining models for each specific device or setting is labor-intensive and costly. To address these issues in ultrasound images, we propose a novel Generative Adversarial Network (GAN)-based model. We formulated the domain adaptation tasks as an image-to-image translation task, in which we modified the texture patterns and removed reverberation noise in the test data images from the source domain to align with those in the target domain images while keeping the image content unchanged. We applied the proposed method to two datasets containing carotid ultrasound images from three different domains. The experimental results demonstrate that the model successfully translated the texture pattern of images and removed reverberation noise from the ultrasound images. Furthermore, we evaluated the CycleGAN approaches for a comparative study with the proposed model. The experimental findings conclusively demonstrated that the proposed model achieved domain adaptation (histogram correlation (0.960 (0.019), & 0.920 (0.043) and bhattacharya distance (0.040 (0.020), & 0.085 (0.048)), compared to no adaptation (0.916 (0.062) & 0.890 (0.077), 0.090 (0.070) & 0.121 (0.095)) for both datasets.

Reinforcement Learning for Follow-the-Leader Robotic Endoscopic Navigation via Synthetic Data

Autonomous navigation is crucial for both medical and industrial endoscopic robots, enabling safe and efficient exploration of narrow tubular environments without continuous human intervention, where avoiding contact with the inner walls has been a longstanding challenge for prior approaches. We present a follow-the-leader endoscopic robot based on a flexible continuum structure designed to minimize contact between the endoscope body and intestinal walls, thereby reducing patient discomfort. To achieve this objective, we propose a vision-based deep reinforcement learning framework guided by monocular depth estimation. A realistic intestinal simulation environment was constructed in \textit{NVIDIA Omniverse} to train and evaluate autonomous navigation strategies. Furthermore, thousands of synthetic intraluminal images were generated using NVIDIA Replicator to fine-tune the Depth Anything model, enabling dense three-dimensional perception of the intestinal environment with a single monocular camera. Subsequently, we introduce a geometry-aware reward and penalty mechanism to enable accurate lumen tracking. Compared with the original Depth Anything model, our method improves $δ_{1}$ depth accuracy by 39.2% and reduces the navigation J-index by 0.67 relative to the second-best method, demonstrating the robustness and effectiveness of the proposed approach.

Evaluating the Diagnostic Classification Ability of Multimodal Large Language Models: Insights from the Osteoarthritis Initiative

Multimodal large language models (MLLMs) show promising performance on medical visual question answering (VQA) and report generation, but these generation and explanation abilities do not reliably transfer to disease-specific classification. We evaluated MLLM architectures on knee osteoarthritis (OA) radiograph classification, which remains underrepresented in existing medical MLLM benchmarks, even though knee OA affects an estimated 300 to 400 million people worldwide. Through systematic ablation studies manipulating the vision encoder, the connector, and the large language model (LLM) across diverse training strategies, we measured each component's contribution to diagnostic accuracy. In our classification task, a trained vision encoder alone could outperform full MLLM pipelines in classification accuracy and fine-tuning the LLM provided no meaningful improvement over prompt-based guidance. And LoRA fine-tuning on a small, class-balanced dataset (500 images) gave better results than training on a much larger but class-imbalanced set (5,778 images), indicating that data balance and quality can matter more than raw scale for this task. These findings suggest that for domain-specific medical classification, LLMs are more effective as interpreters and report generators rather than as primary classifiers. Therefore, the MLLM architecture appears less suitable for medical image diagnostic classification tasks that demand high certainty. We recommend prioritizing vision encoder optimization and careful dataset curation when developing clinically applicable systems.

CT Scans As Video: Efficient Intracranial Hemorrhage Detection Using Multi-Object Tracking

Automated analysis of volumetric medical imaging on edge devices is severely constrained by the high memory and computational demands of 3D Convolutional Neural Networks (CNNs). This paper develops a lightweight computer vision framework that reconciles the efficiency of 2D detection with the necessity of 3D context by reformulating volumetric Computer Tomography (CT) data as sequential video streams. This video-viewpoint paradigm is applied to the time-sensitive task of Intracranial Hemorrhage (ICH) detection using the Hemorica dataset. To ensure operational efficiency, we benchmarked multiple generations of the YOLO architecture (v8, v10, v11 and v12) in their Nano configurations, selecting the version with the highest mAP@50 to serve as the slice-level backbone. A ByteTrack algorithm is then introduced to enforce anatomical consistency across the $z$-axis. To address the initialization lag inherent in video trackers, a hybrid inference strategy and a spatiotemporal consistency filter are proposed to distinguish true pathology from transient prediction noise. Experimental results on independent test data demonstrate that the proposed framework serves as a rigorous temporal validator, increasing detection Precision from 0.703 to 0.779 compared to the baseline 2D detector, while maintaining high sensitivity. By approximating 3D contextual reasoning at a fraction of the computational cost, this method provides a scalable solution for real-time patient prioritization in resource-constrained environments, such as mobile stroke units and IoT-enabled remote clinics.