MultiViT2: A Data-augmented Multimodal Neuroimaging Prediction Framework via Latent Diffusion Model

Multimodal medical imaging integrates diverse data types, such as structural and functional neuroimaging, to provide complementary insights that enhance deep learning predictions and improve outcomes. This study focuses on a neuroimaging prediction framework based on both structural and functional neuroimaging data. We propose a next-generation prediction model, \textbf{MultiViT2}, which combines a pretrained representative learning base model with a vision transformer backbone for prediction output. Additionally, we developed a data augmentation module based on the latent diffusion model that enriches input data by generating augmented neuroimaging samples, thereby enhancing predictive performance through reduced overfitting and improved generalizability. We show that MultiViT2 significantly outperforms the first-generation model in schizophrenia classification accuracy and demonstrates strong scalability and portability.

Efficient Medical VIE via Reinforcement Learning

Visual Information Extraction (VIE) converts unstructured document images into structured formats like JSON, critical for medical applications such as report analysis and online consultations. Traditional methods rely on OCR and language models, while end-to-end multimodal models offer direct JSON generation. However, domain-specific schemas and high annotation costs limit their effectiveness in medical VIE. We base our approach on the Reinforcement Learning with Verifiable Rewards (RLVR) framework to address these challenges using only 100 annotated samples. Our approach ensures dataset diversity, a balanced precision-recall reward mechanism to reduce hallucinations and improve field coverage, and innovative sampling strategies to enhance reasoning capabilities. Fine-tuning Qwen2.5-VL-7B with our RLVR method, we achieve state-of-the-art performance on medical VIE tasks, significantly improving F1, precision, and recall. While our models excel on tasks similar to medical datasets, performance drops on dissimilar tasks, highlighting the need for domain-specific optimization. Case studies further demonstrate the value of reasoning during training and inference for VIE.

GM-LDM: Latent Diffusion Model for Brain Biomarker Identification through Functional Data-Driven Gray Matter Synthesis

Generative models based on deep learning have shown significant potential in medical imaging, particularly for modality transformation and multimodal fusion in MRI-based brain imaging. This study introduces GM-LDM, a novel framework that leverages the latent diffusion model (LDM) to enhance the efficiency and precision of MRI generation tasks. GM-LDM integrates a 3D autoencoder, pre-trained on the large-scale ABCD MRI dataset, achieving statistical consistency through KL divergence loss. We employ a Vision Transformer (ViT)-based encoder-decoder as the denoising network to optimize generation quality. The framework flexibly incorporates conditional data, such as functional network connectivity (FNC) data, enabling personalized brain imaging, biomarker identification, and functional-to-structural information translation for brain diseases like schizophrenia.

Doctor Approved: Generating Medically Accurate Skin Disease Images through AI-Expert Feedback

Paucity of medical data severely limits the generalizability of diagnostic ML models, as the full spectrum of disease variability can not be represented by a small clinical dataset. To address this, diffusion models (DMs) have been considered as a promising avenue for synthetic image generation and augmentation. However, they frequently produce medically inaccurate images, deteriorating the model performance. Expert domain knowledge is critical for synthesizing images that correctly encode clinical information, especially when data is scarce and quality outweighs quantity. Existing approaches for incorporating human feedback, such as reinforcement learning (RL) and Direct Preference Optimization (DPO), rely on robust reward functions or demand labor-intensive expert evaluations. Recent progress in Multimodal Large Language Models (MLLMs) reveals their strong visual reasoning capabilities, making them adept candidates as evaluators. In this work, we propose a novel framework, coined MAGIC (Medically Accurate Generation of Images through AI-Expert Collaboration), that synthesizes clinically accurate skin disease images for data augmentation. Our method creatively translates expert-defined criteria into actionable feedback for image synthesis of DMs, significantly improving clinical accuracy while reducing the direct human workload. Experiments demonstrate that our method greatly improves the clinical quality of synthesized skin disease images, with outputs aligning with dermatologist assessments. Additionally, augmenting training data with these synthesized images improves diagnostic accuracy by +9.02% on a challenging 20-condition skin disease classification task, and by +13.89% in the few-shot setting.

CAPO: Reinforcing Consistent Reasoning in Medical Decision-Making

In medical visual question answering (Med-VQA), achieving accurate responses relies on three critical steps: precise perception of medical imaging data, logical reasoning grounded in visual input and textual questions, and coherent answer derivation from the reasoning process. Recent advances in general vision-language models (VLMs) show that large-scale reinforcement learning (RL) could significantly enhance both reasoning capabilities and overall model performance. However, their application in medical domains is hindered by two fundamental challenges: 1) misalignment between perceptual understanding and reasoning stages, and 2) inconsistency between reasoning pathways and answer generation, both compounded by the scarcity of high-quality medical datasets for effective large-scale RL. In this paper, we first introduce Med-Zero-17K, a curated dataset for pure RL-based training, encompassing over 30 medical image modalities and 24 clinical tasks. Moreover, we propose a novel large-scale RL framework for Med-VLMs, Consistency-Aware Preference Optimization (CAPO), which integrates rewards to ensure fidelity between perception and reasoning, consistency in reasoning-to-answer derivation, and rule-based accuracy for final responses. Extensive experiments on both in-domain and out-of-domain scenarios demonstrate the superiority of our method over strong VLM baselines, showcasing strong generalization capability to 3D Med-VQA benchmarks and R1-like training paradigms.

Exploring the Effectiveness of Deep Features from Domain-Specific Foundation Models in Retinal Image Synthesis

The adoption of neural network models in medical imaging has been constrained by strict privacy regulations, limited data availability, high acquisition costs, and demographic biases. Deep generative models offer a promising solution by generating synthetic data that bypasses privacy concerns and addresses fairness by producing samples for under-represented groups. However, unlike natural images, medical imaging requires validation not only for fidelity (e.g., Fr\'echet Inception Score) but also for morphological and clinical accuracy. This is particularly true for colour fundus retinal imaging, which requires precise replication of the retinal vascular network, including vessel topology, continuity, and thickness. In this study, we in-vestigated whether a distance-based loss function based on deep activation layers of a large foundational model trained on large corpus of domain data, colour fundus imaging, offers advantages over a perceptual loss and edge-detection based loss functions. Our extensive validation pipeline, based on both domain-free and domain specific tasks, suggests that domain-specific deep features do not improve autoen-coder image generation. Conversely, our findings highlight the effectiveness of con-ventional edge detection filters in improving the sharpness of vascular structures in synthetic samples.

MedSeg-R: Reasoning Segmentation in Medical Images with Multimodal Large Language Models

Medical image segmentation is crucial for clinical diagnosis, yet existing models are limited by their reliance on explicit human instructions and lack the active reasoning capabilities to understand complex clinical questions. While recent advancements in multimodal large language models (MLLMs) have improved medical question-answering (QA) tasks, most methods struggle to generate precise segmentation masks, limiting their application in automatic medical diagnosis. In this paper, we introduce medical image reasoning segmentation, a novel task that aims to generate segmentation masks based on complex and implicit medical instructions. To address this, we propose MedSeg-R, an end-to-end framework that leverages the reasoning abilities of MLLMs to interpret clinical questions while also capable of producing corresponding precise segmentation masks for medical images. It is built on two core components: 1) a global context understanding module that interprets images and comprehends complex medical instructions to generate multi-modal intermediate tokens, and 2) a pixel-level grounding module that decodes these tokens to produce precise segmentation masks and textual responses. Furthermore, we introduce MedSeg-QA, a large-scale dataset tailored for the medical image reasoning segmentation task. It includes over 10,000 image-mask pairs and multi-turn conversations, automatically annotated using large language models and refined through physician reviews. Experiments show MedSeg-R's superior performance across several benchmarks, achieving high segmentation accuracy and enabling interpretable textual analysis of medical images.

Adapting Vision-Language Foundation Model for Next Generation Medical Ultrasound Image Analysis

Medical ultrasonography is an essential imaging technique for examining superficial organs and tissues, including lymph nodes, breast, and thyroid. It employs high-frequency ultrasound waves to generate detailed images of the internal structures of the human body. However, manually contouring regions of interest in these images is a labor-intensive task that demands expertise and often results in inconsistent interpretations among individuals. Vision-language foundation models, which have excelled in various computer vision applications, present new opportunities for enhancing ultrasound image analysis. Yet, their performance is hindered by the significant differences between natural and medical imaging domains. This research seeks to overcome these challenges by developing domain adaptation methods for vision-language foundation models. In this study, we explore the fine-tuning pipeline for vision-language foundation models by utilizing large language model as text refiner with special-designed adaptation strategies and task-driven heads. Our approach has been extensively evaluated on six ultrasound datasets and two tasks: segmentation and classification. The experimental results show that our method can effectively improve the performance of vision-language foundation models for ultrasound image analysis, and outperform the existing state-of-the-art vision-language and pure foundation models. The source code of this study is available at https://github.com/jinggqu/NextGen-UIA.

Taming Stable Diffusion for Computed Tomography Blind Super-Resolution

High-resolution computed tomography (CT) imaging is essential for medical diagnosis but requires increased radiation exposure, creating a critical trade-off between image quality and patient safety. While deep learning methods have shown promise in CT super-resolution, they face challenges with complex degradations and limited medical training data. Meanwhile, large-scale pre-trained diffusion models, particularly Stable Diffusion, have demonstrated remarkable capabilities in synthesizing fine details across various vision tasks. Motivated by this, we propose a novel framework that adapts Stable Diffusion for CT blind super-resolution. We employ a practical degradation model to synthesize realistic low-quality images and leverage a pre-trained vision-language model to generate corresponding descriptions. Subsequently, we perform super-resolution using Stable Diffusion with a specialized controlling strategy, conditioned on both low-resolution inputs and the generated text descriptions. Extensive experiments show that our method outperforms existing approaches, demonstrating its potential for achieving high-quality CT imaging at reduced radiation doses. Our code will be made publicly available.

Test-Time-Scaling for Zero-Shot Diagnosis with Visual-Language Reasoning

As a cornerstone of patient care, clinical decision-making significantly influences patient outcomes and can be enhanced by large language models (LLMs). Although LLMs have demonstrated remarkable performance, their application to visual question answering in medical imaging, particularly for reasoning-based diagnosis, remains largely unexplored. Furthermore, supervised fine-tuning for reasoning tasks is largely impractical due to limited data availability and high annotation costs. In this work, we introduce a zero-shot framework for reliable medical image diagnosis that enhances the reasoning capabilities of LLMs in clinical settings through test-time scaling. Given a medical image and a textual prompt, a vision-language model processes a medical image along with a corresponding textual prompt to generate multiple descriptions or interpretations of visual features. These interpretations are then fed to an LLM, where a test-time scaling strategy consolidates multiple candidate outputs into a reliable final diagnosis. We evaluate our approach across various medical imaging modalities -- including radiology, ophthalmology, and histopathology -- and demonstrate that the proposed test-time scaling strategy enhances diagnostic accuracy for both our and baseline methods. Additionally, we provide an empirical analysis showing that the proposed approach, which allows unbiased prompting in the first stage, improves the reliability of LLM-generated diagnoses and enhances classification accuracy.