Daily Papers

Medical imaging is crucial for diagnosing a patient's health condition, and accurate segmentation of these images is essential for isolating regions of interest to ensure precise diagnosis and treatment planning. Existing methods primarily rely on bounding boxes or point-based prompts, while few have explored text-related prompts, despite clinicians often describing their observations and instructions in natural language. To address this gap, we first propose a RAG-based free-form text prompt generator, that leverages the domain corpus to generate diverse and realistic descriptions. Then, we introduce FLanS, a novel medical image segmentation model that handles various free-form text prompts, including professional anatomy-informed queries, anatomy-agnostic position-driven queries, and anatomy-agnostic size-driven queries. Additionally, our model also incorporates a symmetry-aware canonicalization module to ensure consistent, accurate segmentations across varying scan orientations and reduce confusion between the anatomical position of an organ and its appearance in the scan. FLanS is trained on a large-scale dataset of over 100k medical images from 7 public datasets. Comprehensive experiments demonstrate the model's superior language understanding and segmentation precision, along with a deep comprehension of the relationship between them, outperforming SOTA baselines on both in-domain and out-of-domain datasets.

Self-supervised learning (SSL) has recently achieved promising performance for 3D medical image analysis tasks. Most current methods follow existing SSL paradigm originally designed for photographic or natural images, which cannot explicitly and thoroughly exploit the intrinsic similar anatomical structures across varying medical images. This may in fact degrade the quality of learned deep representations by maximizing the similarity among features containing spatial misalignment information and different anatomical semantics. In this work, we propose a new self-supervised learning framework, namely Alice, that explicitly fulfills Anatomical invariance modeling and semantic alignment via elaborately combining discriminative and generative objectives. Alice introduces a new contrastive learning strategy which encourages the similarity between views that are diversely mined but with consistent high-level semantics, in order to learn invariant anatomical features. Moreover, we design a conditional anatomical feature alignment module to complement corrupted embeddings with globally matched semantics and inter-patch topology information, conditioned by the distribution of local image content, which permits to create better contrastive pairs. Our extensive quantitative experiments on three 3D medical image analysis tasks demonstrate and validate the performance superiority of Alice, surpassing the previous best SSL counterpart methods and showing promising ability for united representation learning. Codes are available at https://github.com/alibaba-damo-academy/alice.

Clinical decision-making relies heavily on understanding relative positions of anatomical structures and anomalies. Therefore, for Vision-Language Models (VLMs) to be applicable in clinical practice, the ability to accurately determine relative positions on medical images is a fundamental prerequisite. Despite its importance, this capability remains highly underexplored. To address this gap, we evaluate the ability of state-of-the-art VLMs, GPT-4o, Llama3.2, Pixtral, and JanusPro, and find that all models fail at this fundamental task. Inspired by successful approaches in computer vision, we investigate whether visual prompts, such as alphanumeric or colored markers placed on anatomical structures, can enhance performance. While these markers provide moderate improvements, results remain significantly lower on medical images compared to observations made on natural images. Our evaluations suggest that, in medical imaging, VLMs rely more on prior anatomical knowledge than on actual image content for answering relative position questions, often leading to incorrect conclusions. To facilitate further research in this area, we introduce the MIRP , Medical Imaging Relative Positioning, benchmark dataset, designed to systematically evaluate the capability to identify relative positions in medical images.

In clinical radiology reports, doctors capture important information about the patient's health status. They convey their observations from raw medical imaging data about the inner structures of a patient. As such, formulating reports requires medical experts to possess wide-ranging knowledge about anatomical regions with their normal, healthy appearance as well as the ability to recognize abnormalities. This explicit grasp on both the patient's anatomy and their appearance is missing in current medical image-processing systems as annotations are especially difficult to gather. This renders the models to be narrow experts e.g. for identifying specific diseases. In this work, we recover this missing link by adding human anatomy into the mix and enable the association of content in medical reports to their occurrence in associated imagery (medical phrase grounding). To exploit anatomical structures in this scenario, we present a sophisticated automatic pipeline to gather and integrate human bodily structures from computed tomography datasets, which we incorporate in our PAXRay: A Projected dataset for the segmentation of Anatomical structures in X-Ray data. Our evaluation shows that methods that take advantage of anatomical information benefit heavily in visually grounding radiologists' findings, as our anatomical segmentations allow for up to absolute 50% better grounding results on the OpenI dataset as compared to commonly used region proposals. The PAXRay dataset is available at https://constantinseibold.github.io/paxray/.

Developing advanced medical imaging retrieval systems is challenging due to the varying definitions of `similar images' across different medical contexts. This challenge is compounded by the lack of large-scale, high-quality medical imaging retrieval datasets and benchmarks. In this paper, we propose a novel methodology that leverages dense radiology reports to define image-wise similarity ordering at multiple granularities in a scalable and fully automatic manner. Using this approach, we construct two comprehensive medical imaging retrieval datasets: MIMIC-IR for Chest X-rays and CTRATE-IR for CT scans, providing detailed image-image ranking annotations conditioned on diverse anatomical structures. Furthermore, we develop two retrieval systems, RadIR-CXR and model-ChestCT, which demonstrate superior performance in traditional image-image and image-report retrieval tasks. These systems also enable flexible, effective image retrieval conditioned on specific anatomical structures described in text, achieving state-of-the-art results on 77 out of 78 metrics.

Recent advancements in prompt-based medical image segmentation have enabled clinicians to identify tumors using simple input like bounding boxes or text prompts. However, existing methods face challenges when doctors need to interact through natural language or when position reasoning is required - understanding spatial relationships between anatomical structures and pathologies. We present PRS-Med, a framework that integrates vision-language models with segmentation capabilities to generate both accurate segmentation masks and corresponding spatial reasoning outputs. Additionally, we introduce the MMRS dataset (Multimodal Medical in Positional Reasoning Segmentation), which provides diverse, spatially-grounded question-answer pairs to address the lack of position reasoning data in medical imaging. PRS-Med demonstrates superior performance across six imaging modalities (CT, MRI, X-ray, ultrasound, endoscopy, RGB), significantly outperforming state-of-the-art methods in both segmentation accuracy and position reasoning. Our approach enables intuitive doctor-system interaction through natural language, facilitating more efficient diagnoses. Our dataset pipeline, model, and codebase will be released to foster further research in spatially-aware multimodal reasoning for medical applications.

With over 85 million CT scans performed annually in the United States, creating tumor-related reports is a challenging and time-consuming task for radiologists. To address this need, we present RadGPT, an Anatomy-Aware Vision-Language AI Agent for generating detailed reports from CT scans. RadGPT first segments tumors, including benign cysts and malignant tumors, and their surrounding anatomical structures, then transforms this information into both structured reports and narrative reports. These reports provide tumor size, shape, location, attenuation, volume, and interactions with surrounding blood vessels and organs. Extensive evaluation on unseen hospitals shows that RadGPT can produce accurate reports, with high sensitivity/specificity for small tumor (<2 cm) detection: 80/73% for liver tumors, 92/78% for kidney tumors, and 77/77% for pancreatic tumors. For large tumors, sensitivity ranges from 89% to 97%. The results significantly surpass the state-of-the-art in abdominal CT report generation. RadGPT generated reports for 17 public datasets. Through radiologist review and refinement, we have ensured the reports' accuracy, and created the first publicly available image-text 3D medical dataset, comprising over 1.8 million text tokens and 2.7 million images from 9,262 CT scans, including 2,947 tumor scans/reports of 8,562 tumor instances. Our reports can: (1) localize tumors in eight liver sub-segments and three pancreatic sub-segments annotated per-voxel; (2) determine pancreatic tumor stage (T1-T4) in 260 reports; and (3) present individual analyses of multiple tumors--rare in human-made reports. Importantly, 948 of the reports are for early-stage tumors.

Anatomical segmentation is a fundamental task in medical image computing, generally tackled with fully convolutional neural networks which produce dense segmentation masks. These models are often trained with loss functions such as cross-entropy or Dice, which assume pixels to be independent of each other, thus ignoring topological errors and anatomical inconsistencies. We address this limitation by moving from pixel-level to graph representations, which allow to naturally incorporate anatomical constraints by construction. To this end, we introduce HybridGNet, an encoder-decoder neural architecture that leverages standard convolutions for image feature encoding and graph convolutional neural networks (GCNNs) to decode plausible representations of anatomical structures. We also propose a novel image-to-graph skip connection layer which allows localized features to flow from standard convolutional blocks to GCNN blocks, and show that it improves segmentation accuracy. The proposed architecture is extensively evaluated in a variety of domain shift and image occlusion scenarios, and audited considering different types of demographic domain shift. Our comprehensive experimental setup compares HybridGNet with other landmark and pixel-based models for anatomical segmentation in chest x-ray images, and shows that it produces anatomically plausible results in challenging scenarios where other models tend to fail.

An increasing number of public datasets have shown a marked impact on automated organ segmentation and tumor detection. However, due to the small size and partially labeled problem of each dataset, as well as a limited investigation of diverse types of tumors, the resulting models are often limited to segmenting specific organs/tumors and ignore the semantics of anatomical structures, nor can they be extended to novel domains. To address these issues, we propose the CLIP-Driven Universal Model, which incorporates text embedding learned from Contrastive Language-Image Pre-training (CLIP) to segmentation models. This CLIP-based label encoding captures anatomical relationships, enabling the model to learn a structured feature embedding and segment 25 organs and 6 types of tumors. The proposed model is developed from an assembly of 14 datasets, using a total of 3,410 CT scans for training and then evaluated on 6,162 external CT scans from 3 additional datasets. We rank first on the Medical Segmentation Decathlon (MSD) public leaderboard and achieve state-of-the-art results on Beyond The Cranial Vault (BTCV). Additionally, the Universal Model is computationally more efficient (6x faster) compared with dataset-specific models, generalized better to CT scans from varying sites, and shows stronger transfer learning performance on novel tasks.

Large Language Models (LLMs) have shown remarkable capabilities in general domains but often struggle with tasks requiring specialized knowledge. Conventional Retrieval-Augmented Generation (RAG) techniques typically retrieve external information from static knowledge bases, which can be outdated or incomplete, missing fine-grained clinical details essential for accurate medical question answering. In this work, we propose SearchRAG, a novel framework that overcomes these limitations by leveraging real-time search engines. Our method employs synthetic query generation to convert complex medical questions into search-engine-friendly queries and utilizes uncertainty-based knowledge selection to filter and incorporate the most relevant and informative medical knowledge into the LLM's input. Experimental results demonstrate that our method significantly improves response accuracy in medical question answering tasks, particularly for complex questions requiring detailed and up-to-date knowledge.

In this study, we aim to build up a model that can Segment Anything in radiology scans, driven by medical terminologies as Text prompts, termed as SAT. Our main contributions are three folds: (i) for dataset construction, we construct the first multi-modal knowledge tree on human anatomy, including 6502 anatomical terminologies; Then, we build up the largest and most comprehensive segmentation dataset for training, by collecting over 22K 3D medical image scans from72 segmentation datasets, across 497 classes, with careful standardization on both image scans and label space; (ii) for architecture design, we propose to inject medical knowledge into a text encoder via contrastive learning, and then formulate a universal segmentation model, that can be prompted by feeding in medical terminologies in text form; (iii) As a result, we have trained SAT-Nano (110M parameters) and SAT-Pro (447M parameters), demonstrating superior or comparable performance to 72 specialist models, i.e., nnU-Nets, U-Mamba or SwinUNETR, trained on each dataset/subsets. We validate SAT as a foundational segmentation model, with better generalization on external (cross-center) datasets, and can be further improved on specific tasks after fine-tuning adaptation. Comparing with state-of-the-art interactive segmentation model MedSAM, SAT demonstrate superior performance, scalability and robustness. We further compare SAT with BiomedParse, and observe SAT is significantly superior in both internal and external evaluation. Through extensive ablation study, we validate the benefit of domain knowledge on universal segmentation, especially on tail categories. As a use case, we demonstrate that SAT can act as a powerful out-of-the-box agent for large language models, enabling visual grounding in versatile application scenarios. All the data, codes, and models in this work have been released.

Real-world medical image segmentation has tremendous long-tailed complexity of objects, among which tail conditions correlate with relatively rare diseases and are clinically significant. A trustworthy medical AI algorithm should demonstrate its effectiveness on tail conditions to avoid clinically dangerous damage in these out-of-distribution (OOD) cases. In this paper, we adopt the concept of object queries in Mask Transformers to formulate semantic segmentation as a soft cluster assignment. The queries fit the feature-level cluster centers of inliers during training. Therefore, when performing inference on a medical image in real-world scenarios, the similarity between pixels and the queries detects and localizes OOD regions. We term this OOD localization as MaxQuery. Furthermore, the foregrounds of real-world medical images, whether OOD objects or inliers, are lesions. The difference between them is less than that between the foreground and background, possibly misleading the object queries to focus redundantly on the background. Thus, we propose a query-distribution (QD) loss to enforce clear boundaries between segmentation targets and other regions at the query level, improving the inlier segmentation and OOD indication. Our proposed framework is tested on two real-world segmentation tasks, i.e., segmentation of pancreatic and liver tumors, outperforming previous state-of-the-art algorithms by an average of 7.39% on AUROC, 14.69% on AUPR, and 13.79% on FPR95 for OOD localization. On the other hand, our framework improves the performance of inlier segmentation by an average of 5.27% DSC when compared with the leading baseline nnUNet.

We present Point2SSM, a novel unsupervised learning approach for constructing correspondence-based statistical shape models (SSMs) directly from raw point clouds. SSM is crucial in clinical research, enabling population-level analysis of morphological variation in bones and organs. Traditional methods of SSM construction have limitations, including the requirement of noise-free surface meshes or binary volumes, reliance on assumptions or templates, and prolonged inference times due to simultaneous optimization of the entire cohort. Point2SSM overcomes these barriers by providing a data-driven solution that infers SSMs directly from raw point clouds, reducing inference burdens and increasing applicability as point clouds are more easily acquired. While deep learning on 3D point clouds has seen success in unsupervised representation learning and shape correspondence, its application to anatomical SSM construction is largely unexplored. We conduct a benchmark of state-of-the-art point cloud deep networks on the SSM task, revealing their limited robustness to clinical challenges such as noisy, sparse, or incomplete input and limited training data. Point2SSM addresses these issues through an attention-based module, providing effective correspondence mappings from learned point features. Our results demonstrate that the proposed method significantly outperforms existing networks in terms of accurate surface sampling and correspondence, better capturing population-level statistics.

Computed Tomography (CT) scan, which produces 3D volumetric medical data that can be viewed as hundreds of cross-sectional images (a.k.a. slices), provides detailed anatomical information for diagnosis. For radiologists, creating CT radiology reports is time-consuming and error-prone. A visual question answering (VQA) system that can answer radiologists' questions about some anatomical regions on the CT scan and even automatically generate a radiology report is urgently needed. However, existing VQA systems cannot adequately handle the CT radiology question answering (CTQA) task for: (1) anatomic complexity makes CT images difficult to understand; (2) spatial relationship across hundreds slices is difficult to capture. To address these issues, this paper proposes CT-Agent, a multimodal agentic framework for CTQA. CT-Agent adopts anatomically independent tools to break down the anatomic complexity; furthermore, it efficiently captures the across-slice spatial relationship with a global-local token compression strategy. Experimental results on two 3D chest CT datasets, CT-RATE and RadGenome-ChestCT, verify the superior performance of CT-Agent.

Learning anatomical segmentation from heterogeneous labels in multi-center datasets is a common situation encountered in clinical scenarios, where certain anatomical structures are only annotated in images coming from particular medical centers, but not in the full database. Here we first show how state-of-the-art pixel-level segmentation models fail in naively learning this task due to domain memorization issues and conflicting labels. We then propose to adopt HybridGNet, a landmark-based segmentation model which learns the available anatomical structures using graph-based representations. By analyzing the latent space learned by both models, we show that HybridGNet naturally learns more domain-invariant feature representations, and provide empirical evidence in the context of chest X-ray multiclass segmentation. We hope these insights will shed light on the training of deep learning models with heterogeneous labels from public and multi-center datasets.

The accelerating development of general medical artificial intelligence (GMAI), powered by multimodal large language models (MLLMs), offers transformative potential for addressing persistent healthcare challenges, including workforce deficits and escalating costs. The parallel development of systematic evaluation benchmarks emerges as a critical imperative to enable performance assessment and provide technological guidance. Meanwhile, as an invaluable knowledge source, the potential of medical textbooks for benchmark development remains underexploited. Here, we present MedBookVQA, a systematic and comprehensive multimodal benchmark derived from open-access medical textbooks. To curate this benchmark, we propose a standardized pipeline for automated extraction of medical figures while contextually aligning them with corresponding medical narratives. Based on this curated data, we generate 5,000 clinically relevant questions spanning modality recognition, disease classification, anatomical identification, symptom diagnosis, and surgical procedures. A multi-tier annotation system categorizes queries through hierarchical taxonomies encompassing medical imaging modalities (42 categories), body anatomies (125 structures), and clinical specialties (31 departments), enabling nuanced analysis across medical subdomains. We evaluate a wide array of MLLMs, including proprietary, open-sourced, medical, and reasoning models, revealing significant performance disparities across task types and model categories. Our findings highlight critical capability gaps in current GMAI systems while establishing textbook-derived multimodal benchmarks as essential evaluation tools. MedBookVQA establishes textbook-derived benchmarking as a critical paradigm for advancing clinical AI, exposing limitations in GMAI systems while providing anatomically structured performance metrics across specialties.

Human readers or radiologists routinely perform full-body multi-organ multi-disease detection and diagnosis in clinical practice, while most medical AI systems are built to focus on single organs with a narrow list of a few diseases. This might severely limit AI's clinical adoption. A certain number of AI models need to be assembled non-trivially to match the diagnostic process of a human reading a CT scan. In this paper, we construct a Unified Tumor Transformer (UniT) model to detect (tumor existence and location) and diagnose (tumor characteristics) eight major cancer-prevalent organs in CT scans. UniT is a query-based Mask Transformer model with the output of multi-organ and multi-tumor semantic segmentation. We decouple the object queries into organ queries, detection queries and diagnosis queries, and further establish hierarchical relationships among the three groups. This clinically-inspired architecture effectively assists inter- and intra-organ representation learning of tumors and facilitates the resolution of these complex, anatomically related multi-organ cancer image reading tasks. UniT is trained end-to-end using a curated large-scale CT images of 10,042 patients including eight major types of cancers and occurring non-cancer tumors (all are pathology-confirmed with 3D tumor masks annotated by radiologists). On the test set of 631 patients, UniT has demonstrated strong performance under a set of clinically relevant evaluation metrics, substantially outperforming both multi-organ segmentation methods and an assembly of eight single-organ expert models in tumor detection, segmentation, and diagnosis. Such a unified multi-cancer image reading model (UniT) can significantly reduce the number of false positives produced by combined multi-system models. This moves one step closer towards a universal high-performance cancer screening tool.

Current medical retrieval benchmarks primarily emphasize lexical or shallow semantic similarity, overlooking the reasoning-intensive demands that are central to clinical decision-making. In practice, physicians often retrieve authoritative medical evidence to support diagnostic hypotheses. Such evidence typically aligns with an inferred diagnosis rather than the surface form of a patient's symptoms, leading to low lexical or semantic overlap between queries and relevant documents. To address this gap, we introduce R2MED, the first benchmark explicitly designed for reasoning-driven medical retrieval. It comprises 876 queries spanning three tasks: Q&A reference retrieval, clinical evidence retrieval, and clinical case retrieval. These tasks are drawn from five representative medical scenarios and twelve body systems, capturing the complexity and diversity of real-world medical information needs. We evaluate 15 widely-used retrieval systems on R2MED and find that even the best model achieves only 31.4 nDCG@10, demonstrating the benchmark's difficulty. Classical re-ranking and generation-augmented retrieval methods offer only modest improvements. Although large reasoning models improve performance via intermediate inference generation, the best results still peak at 41.4 nDCG@10. These findings underscore a substantial gap between current retrieval techniques and the reasoning demands of real clinical tasks. We release R2MED as a challenging benchmark to foster the development of next-generation medical retrieval systems with enhanced reasoning capabilities. Data and code are available at https://github.com/R2MED/R2MED

Perception-enhanced pre-training, particularly through grounding techniques, is widely adopted to enhance the performance of graphical user interface (GUI) agents. However, in resource-constrained scenarios, the format discrepancy between coordinate-oriented grounding and action-oriented reasoning limits the effectiveness of grounding for reasoning tasks. To address this challenge, we propose a query-oriented pivot approach called query inference, which serves as a bridge between GUI grounding and reasoning. By inferring potential user queries from a screenshot and its associated element coordinates, query inference improves the understanding of coordinates while aligning more closely with reasoning tasks. Experimental results show that query inference outperforms previous grounding techniques under the same training data scale. Notably, query inference achieves comparable or even better performance to large-scale grounding-enhanced OS-Atlas with less than 0.1% of training data. Furthermore, we explore the impact of reasoning formats and demonstrate that integrating additional semantic information into the input further boosts reasoning performance. The code is publicly available at https://github.com/ZrW00/GUIPivot.

The emergent abilities of large language models (LLMs) have demonstrated great potential in solving medical questions. They can possess considerable medical knowledge, but may still hallucinate and are inflexible in the knowledge updates. While Retrieval-Augmented Generation (RAG) has been proposed to enhance the medical question-answering capabilities of LLMs with external knowledge bases, it may still fail in complex cases where multiple rounds of information-seeking are required. To address such an issue, we propose iterative RAG for medicine (i-MedRAG), where LLMs can iteratively ask follow-up queries based on previous information-seeking attempts. In each iteration of i-MedRAG, the follow-up queries will be answered by a vanilla RAG system and they will be further used to guide the query generation in the next iteration. Our experiments show the improved performance of various LLMs brought by i-MedRAG compared with vanilla RAG on complex questions from clinical vignettes in the United States Medical Licensing Examination (USMLE), as well as various knowledge tests in the Massive Multitask Language Understanding (MMLU) dataset. Notably, our zero-shot i-MedRAG outperforms all existing prompt engineering and fine-tuning methods on GPT-3.5, achieving an accuracy of 69.68\% on the MedQA dataset. In addition, we characterize the scaling properties of i-MedRAG with different iterations of follow-up queries and different numbers of queries per iteration. Our case studies show that i-MedRAG can flexibly ask follow-up queries to form reasoning chains, providing an in-depth analysis of medical questions. To the best of our knowledge, this is the first-of-its-kind study on incorporating follow-up queries into medical RAG.

Self-Supervised Learning (SSL) has demonstrated promising results in 3D medical image analysis. However, the lack of high-level semantics in pre-training still heavily hinders the performance of downstream tasks. We observe that 3D medical images contain relatively consistent contextual position information, i.e., consistent geometric relations between different organs, which leads to a potential way for us to learn consistent semantic representations in pre-training. In this paper, we propose a simple-yet-effective Volume Contrast (VoCo) framework to leverage the contextual position priors for pre-training. Specifically, we first generate a group of base crops from different regions while enforcing feature discrepancy among them, where we employ them as class assignments of different regions. Then, we randomly crop sub-volumes and predict them belonging to which class (located at which region) by contrasting their similarity to different base crops, which can be seen as predicting contextual positions of different sub-volumes. Through this pretext task, VoCo implicitly encodes the contextual position priors into model representations without the guidance of annotations, enabling us to effectively improve the performance of downstream tasks that require high-level semantics. Extensive experimental results on six downstream tasks demonstrate the superior effectiveness of VoCo. Code will be available at https://github.com/Luffy03/VoCo.

Radiology reporting generative AI holds significant potential to alleviate clinical workloads and streamline medical care. However, achieving high clinical accuracy is challenging, as radiological images often feature subtle lesions and intricate structures. Existing systems often fall short, largely due to their reliance on fixed size, patch-level image features and insufficient incorporation of pathological information. This can result in the neglect of such subtle patterns and inconsistent descriptions of crucial pathologies. To address these challenges, we propose an innovative approach that leverages pathology-aware regional prompts to explicitly integrate anatomical and pathological information of various scales, significantly enhancing the precision and clinical relevance of generated reports. We develop an anatomical region detector that extracts features from distinct anatomical areas, coupled with a novel multi-label lesion detector that identifies global pathologies. Our approach emulates the diagnostic process of radiologists, producing clinically accurate reports with comprehensive diagnostic capabilities. Experimental results show that our model outperforms previous state-of-the-art methods on most natural language generation and clinical efficacy metrics, with formal expert evaluations affirming its potential to enhance radiology practice.

Recently, deep learning-based language models have significantly enhanced text-to-SQL tasks, with promising applications in retrieving patient records within the medical domain. One notable challenge in such applications is discerning unanswerable queries. Through fine-tuning model, we demonstrate the feasibility of converting medical record inquiries into SQL queries. Additionally, we introduce an entropy-based method to identify and filter out unanswerable results. We further enhance result quality by filtering low-confidence SQL through log probability-based distribution, while grammatical and schema errors are mitigated by executing queries on the actual database. We experimentally verified that our method can filter unanswerable questions, which can be widely utilized even when the parameters of the model are not accessible, and that it can be effectively utilized in practice.

This paper addresses the challenge of localization of anatomical landmarks in knee X-ray images at different stages of osteoarthritis (OA). Landmark localization can be viewed as regression problem, where the landmark position is directly predicted by using the region of interest or even full-size images leading to large memory footprint, especially in case of high resolution medical images. In this work, we propose an efficient deep neural networks framework with an hourglass architecture utilizing a soft-argmax layer to directly predict normalized coordinates of the landmark points. We provide an extensive evaluation of different regularization techniques and various loss functions to understand their influence on the localization performance. Furthermore, we introduce the concept of transfer learning from low-budget annotations, and experimentally demonstrate that such approach is improving the accuracy of landmark localization. Compared to the prior methods, we validate our model on two datasets that are independent from the train data and assess the performance of the method for different stages of OA severity. The proposed approach demonstrates better generalization performance compared to the current state-of-the-art.

Radiography imaging protocols focus on particular body regions, therefore producing images of great similarity and yielding recurrent anatomical structures across patients. To exploit this structured information, we propose the use of Space-aware Memory Queues for In-painting and Detecting anomalies from radiography images (abbreviated as SQUID). We show that SQUID can taxonomize the ingrained anatomical structures into recurrent patterns; and in the inference, it can identify anomalies (unseen/modified patterns) in the image. SQUID surpasses 13 state-of-the-art methods in unsupervised anomaly detection by at least 5 points on two chest X-ray benchmark datasets measured by the Area Under the Curve (AUC). Additionally, we have created a new dataset (DigitAnatomy), which synthesizes the spatial correlation and consistent shape in chest anatomy. We hope DigitAnatomy can prompt the development, evaluation, and interpretability of anomaly detection methods.

Despite the progress in automatic detection of radiologic findings from chest X-ray (CXR) images in recent years, a quantitative evaluation of the explainability of these models is hampered by the lack of locally labeled datasets for different findings. With the exception of a few expert-labeled small-scale datasets for specific findings, such as pneumonia and pneumothorax, most of the CXR deep learning models to date are trained on global "weak" labels extracted from text reports, or trained via a joint image and unstructured text learning strategy. Inspired by the Visual Genome effort in the computer vision community, we constructed the first Chest ImaGenome dataset with a scene graph data structure to describe 242,072 images. Local annotations are automatically produced using a joint rule-based natural language processing (NLP) and atlas-based bounding box detection pipeline. Through a radiologist constructed CXR ontology, the annotations for each CXR are connected as an anatomy-centered scene graph, useful for image-level reasoning and multimodal fusion applications. Overall, we provide: i) 1,256 combinations of relation annotations between 29 CXR anatomical locations (objects with bounding box coordinates) and their attributes, structured as a scene graph per image, ii) over 670,000 localized comparison relations (for improved, worsened, or no change) between the anatomical locations across sequential exams, as well as ii) a manually annotated gold standard scene graph dataset from 500 unique patients.

In this work we address the problem of landmark-based segmentation for anatomical structures. We propose HybridGNet, an encoder-decoder neural architecture which combines standard convolutions for image feature encoding, with graph convolutional neural networks to decode plausible representations of anatomical structures. We benchmark the proposed architecture considering other standard landmark and pixel-based models for anatomical segmentation in chest x-ray images, and found that HybridGNet is more robust to image occlusions. We also show that it can be used to construct landmark-based segmentations from pixel level annotations. Our experimental results suggest that HybridGNet produces accurate and anatomically plausible landmark-based segmentations, by naturally incorporating shape constraints within the decoding process via spectral convolutions.

Retrieval-Augmented Generation (RAG) systems typically rely on a single fixed retriever, despite growing evidence that no single retriever performs optimally across all query types. In this paper, we explore a query routing approach that dynamically selects from a pool of retrievers based on the query, using both train-free heuristics and learned routing models. We frame routing as a learning-to-rank (LTR) problem and introduce LTRR, a framework that learns to rank retrievers by their expected utility gain to downstream LLM performance. Our experiments, conducted on synthetic QA data with controlled query type variations, show that routing-based RAG systems can outperform the best single-retriever-based systems. Performance gains are especially pronounced in models trained with the Answer Correctness (AC) metric and with pairwise learning approaches, especially with XGBoost. We also observe improvements in generalization to out-of-distribution queries. As part of the SIGIR 2025 LiveRAG challenge, our submitted system demonstrated the practical viability of our approach, achieving competitive performance in both answer correctness and faithfulness. These findings highlight the importance of both training methodology and metric selection in query routing for RAG systems.

Clinical routine and retrospective cohorts commonly include multi-parametric Magnetic Resonance Imaging; however, they are mostly acquired in different anisotropic 2D views due to signal-to-noise-ratio and scan-time constraints. Thus acquired views suffer from poor out-of-plane resolution and affect downstream volumetric image analysis that typically requires isotropic 3D scans. Combining different views of multi-contrast scans into high-resolution isotropic 3D scans is challenging due to the lack of a large training cohort, which calls for a subject-specific framework. This work proposes a novel solution to this problem leveraging Implicit Neural Representations (INR). Our proposed INR jointly learns two different contrasts of complementary views in a continuous spatial function and benefits from exchanging anatomical information between them. Trained within minutes on a single commodity GPU, our model provides realistic super-resolution across different pairs of contrasts in our experiments with three datasets. Using Mutual Information (MI) as a metric, we find that our model converges to an optimum MI amongst sequences, achieving anatomically faithful reconstruction. Code is available at: https://github.com/jqmcginnis/multi_contrast_inr/

In this work, we address the problem of grounding abnormalities in medical images, where the goal is to localize clinical findings based on textual descriptions. While generalist Vision-Language Models (VLMs) excel in natural grounding tasks, they often struggle in the medical domain due to rare, compositional, and domain-specific terms that are poorly aligned with visual patterns. Specialized medical VLMs address this challenge via large-scale domain pretraining, but at the cost of substantial annotation and computational resources. To overcome these limitations, we propose Knowledge to Sight (K2Sight), a framework that introduces structured semantic supervision by decomposing clinical concepts into interpretable visual attributes, such as shape, density, and anatomical location. These attributes are distilled from domain ontologies and encoded into concise instruction-style prompts, which guide region-text alignment during training. Unlike conventional report-level supervision, our approach explicitly bridges domain knowledge and spatial structure, enabling data-efficient training of compact models. We train compact models with 0.23B and 2B parameters using only 1.5\% of the data required by state-of-the-art medical VLMs. Despite their small size and limited training data, these models achieve performance on par with or better than 7B+ medical VLMs, with up to 9.82\% improvement in mAP_{50}. Code and models: https://lijunrio.github.io/K2Sight/{SOTAPink{https://lijunrio.github.io/K2Sight/}}.

Accurate and generalizable object segmentation in ultrasound imaging remains a significant challenge due to anatomical variability, diverse imaging protocols, and limited annotated data. In this study, we propose a prompt-driven vision-language model (VLM) that integrates Grounding DINO with SAM2 to enable object segmentation across multiple ultrasound organs. A total of 18 public ultrasound datasets, encompassing the breast, thyroid, liver, prostate, kidney, and paraspinal muscle, were utilized. These datasets were divided into 15 for fine-tuning and validation of Grounding DINO using Low Rank Adaptation (LoRA) to the ultrasound domain, and 3 were held out entirely for testing to evaluate performance in unseen distributions. Comprehensive experiments demonstrate that our approach outperforms state-of-the-art segmentation methods, including UniverSeg, MedSAM, MedCLIP-SAM, BiomedParse, and SAMUS on most seen datasets while maintaining strong performance on unseen datasets without additional fine-tuning. These results underscore the promise of VLMs in scalable and robust ultrasound image analysis, reducing dependence on large, organ-specific annotated datasets. We will publish our code on code.sonography.ai after acceptance.

Recent AI-based scoliosis screening methods primarily rely on large-scale silhouette datasets, often neglecting clinically relevant postural asymmetries-key indicators in traditional screening. In contrast, pose data provide an intuitive skeletal representation, enhancing clinical interpretability across various medical applications. However, pose-based scoliosis screening remains underexplored due to two main challenges: (1) the scarcity of large-scale, annotated pose datasets; and (2) the discrete and noise-sensitive nature of raw pose coordinates, which hinders the modeling of subtle asymmetries. To address these limitations, we introduce Scoliosis1K-Pose, a 2D human pose annotation set that extends the original Scoliosis1K dataset, comprising 447,900 frames of 2D keypoints from 1,050 adolescents. Building on this dataset, we introduce the Dual Representation Framework (DRF), which integrates a continuous skeleton map to preserve spatial structure with a discrete Postural Asymmetry Vector (PAV) that encodes clinically relevant asymmetry descriptors. A novel PAV-Guided Attention (PGA) module further uses the PAV as clinical prior to direct feature extraction from the skeleton map, focusing on clinically meaningful asymmetries. Extensive experiments demonstrate that DRF achieves state-of-the-art performance. Visualizations further confirm that the model leverages clinical asymmetry cues to guide feature extraction and promote synergy between its dual representations. The dataset and code are publicly available at https://zhouzi180.github.io/Scoliosis1K/.

Despite the widespread exploration of Retrieval-Augmented Generation (RAG), its deployment in enterprises for domain-specific datasets remains limited due to poor answer accuracy. These corpora, often shielded behind firewalls in private enterprise knowledge bases, having complex, domain-specific terminology, rarely seen by LLMs during pre-training; exhibit significant semantic variability across domains (like networking, military, or legal, etc.), or even within a single domain like medicine, and thus result in poor context precision for RAG systems. Currently, in such situations, fine-tuning or RAG with fine-tuning is attempted, but these approaches are slow, expensive, and lack generalization for accuracy as the new domain-specific data emerges. We propose an approach for Enterprise Search that focuses on enhancing the retriever for a domain-specific corpus through hybrid query indexes and metadata enrichment. This 'MetaGen Blended RAG' method constructs a metadata generation pipeline using key concepts, topics, and acronyms, and then creates a metadata-enriched hybrid index with boosted search queries. This approach avoids overfitting and generalizes effectively across domains. On the PubMedQA benchmark for the biomedical domain, the proposed method achieves 82% retrieval accuracy and 77% RAG accuracy, surpassing all previous RAG accuracy results without fine-tuning and sets a new benchmark for zero-shot results while outperforming much larger models like GPT3.5. The results are even comparable to the best fine-tuned models on this dataset, and we further demonstrate the robustness and scalability of the approach by evaluating it on other Q&A datasets like SQuAD, NQ etc.

We introduce a novel graph-based Retrieval-Augmented Generation (RAG) framework specifically designed for the medical domain, called MedGraphRAG, aimed at enhancing Large Language Model (LLM) capabilities and generating evidence-based results, thereby improving safety and reliability when handling private medical data. Our comprehensive pipeline begins with a hybrid static-semantic approach to document chunking, significantly improving context capture over traditional methods. Extracted entities are used to create a three-tier hierarchical graph structure, linking entities to foundational medical knowledge sourced from medical papers and dictionaries. These entities are then interconnected to form meta-graphs, which are merged based on semantic similarities to develop a comprehensive global graph. This structure supports precise information retrieval and response generation. The retrieval process employs a U-retrieve method to balance global awareness and indexing efficiency of the LLM. Our approach is validated through a comprehensive ablation study comparing various methods for document chunking, graph construction, and information retrieval. The results not only demonstrate that our hierarchical graph construction method consistently outperforms state-of-the-art models on multiple medical Q\&A benchmarks, but also confirms that the responses generated include source documentation, significantly enhancing the reliability of medical LLMs in practical applications. Code will be at: https://github.com/MedicineToken/Medical-Graph-RAG/tree/main

The integration of artificial intelligence in image-guided interventions holds transformative potential, promising to extract 3D geometric and quantitative information from conventional 2D imaging modalities during complex procedures. Achieving this requires the rapid and precise alignment of 2D intraoperative images (e.g., X-ray) with 3D preoperative volumes (e.g., CT, MRI). However, current 2D/3D registration methods fail across the broad spectrum of procedures dependent on X-ray guidance: traditional optimization techniques require custom parameter tuning for each subject, whereas neural networks trained on small datasets do not generalize to new patients or require labor-intensive manual annotations, increasing clinical burden and precluding application to new anatomical targets. To address these challenges, we present xvr, a fully automated framework for training patient-specific neural networks for 2D/3D registration. xvr uses physics-based simulation to generate abundant high-quality training data from a patient's own preoperative volumetric imaging, thereby overcoming the inherently limited ability of supervised models to generalize to new patients and procedures. Furthermore, xvr requires only 5 minutes of training per patient, making it suitable for emergency interventions as well as planned procedures. We perform the largest evaluation of a 2D/3D registration algorithm on real X-ray data to date and find that xvr robustly generalizes across a diverse dataset comprising multiple anatomical structures, imaging modalities, and hospitals. Across surgical tasks, xvr achieves submillimeter-accurate registration at intraoperative speeds, improving upon existing methods by an order of magnitude. xvr is released as open-source software freely available at https://github.com/eigenvivek/xvr.

In this paper, we present a practical approach to improve anatomical shape accuracy in whole-body medical segmentation. Our analysis shows that a shape-focused toolkit can enhance segmentation performance by over 8%, without the need for model re-training or fine-tuning. In comparison, modifications to model architecture typically lead to marginal gains of less than 3%. Motivated by this observation, we introduce ShapeKit, a flexible and easy-to-integrate toolkit designed to refine anatomical shapes. This work highlights the underappreciated value of shape-based tools and calls attention to their potential impact within the medical segmentation community.

Widely adopted evaluation metrics for sparse-view CT reconstruction--such as Structural Similarity Index Measure and Peak Signal-to-Noise Ratio--prioritize pixel-wise fidelity but often fail to capture the completeness of critical anatomical structures, particularly small or thin regions that are easily missed. To address this limitation, we propose a suite of novel anatomy-aware evaluation metrics designed to assess structural completeness across anatomical structures, including large organs, small organs, intestines, and vessels. Building on these metrics, we introduce CARE, a Completeness-Aware Reconstruction Enhancement framework that incorporates structural penalties during training to encourage anatomical preservation of significant structures. CARE is model-agnostic and can be seamlessly integrated into analytical, implicit, and generative methods. When applied to these methods, CARE substantially improves structural completeness in CT reconstructions, achieving up to +32% improvement for large organs, +22% for small organs, +40% for intestines, and +36% for vessels.

Humans effortlessly interpret images by parsing them into part-whole hierarchies; deep learning excels in learning multi-level feature spaces, but they often lack explicit coding of part-whole relations, a prominent property of medical imaging. To overcome this limitation, we introduce Adam-v2, a new self-supervised learning framework extending Adam [79] by explicitly incorporating part-whole hierarchies into its learning objectives through three key branches: (1) Localizability, acquiring discriminative representations to distinguish different anatomical patterns; (2) Composability, learning each anatomical structure in a parts-to-whole manner; and (3) Decomposability, comprehending each anatomical structure in a whole-to-parts manner. Experimental results across 10 tasks, compared to 11 baselines in zero-shot, few-shot transfer, and full fine-tuning settings, showcase Adam-v2's superior performance over large-scale medical models and existing SSL methods across diverse downstream tasks. The higher generality and robustness of Adam-v2's representations originate from its explicit construction of hierarchies for distinct anatomical structures from unlabeled medical images. Adam-v2 preserves a semantic balance of anatomical diversity and harmony in its embedding, yielding representations that are both generic and semantically meaningful, yet overlooked in existing SSL methods. All code and pretrained models are available at https://github.com/JLiangLab/Eden.

In this paper we study how to effectively exploit implicit feedback in Dense Retrievers (DRs). We consider the specific case in which click data from a historic click log is available as implicit feedback. We then exploit such historic implicit interactions to improve the effectiveness of a DR. A key challenge that we study is the effect that biases in the click signal, such as position bias, have on the DRs. To overcome the problems associated with the presence of such bias, we propose the Counterfactual Rocchio (CoRocchio) algorithm for exploiting implicit feedback in Dense Retrievers. We demonstrate both theoretically and empirically that dense query representations learnt with CoRocchio are unbiased with respect to position bias and lead to higher retrieval effectiveness. We make available the implementations of the proposed methods and the experimental framework, along with all results at https://github.com/ielab/Counterfactual-DR.

This study investigates a specific form of positional bias, termed the Myopic Trap, where retrieval models disproportionately attend to the early parts of documents while overlooking relevant information that appears later. To systematically quantify this phenomenon, we propose a semantics-preserving evaluation framework that repurposes the existing NLP datasets into position-aware retrieval benchmarks. By evaluating the SOTA models of full retrieval pipeline, including BM25, embedding models, ColBERT-style late-interaction models, and reranker models, we offer a broader empirical perspective on positional bias than prior work. Experimental results show that embedding models and ColBERT-style models exhibit significant performance degradation when query-related content is shifted toward later positions, indicating a pronounced head bias. Notably, under the same training configuration, ColBERT-style approach show greater potential for mitigating positional bias compared to the traditional single-vector approach. In contrast, BM25 and reranker models remain largely unaffected by such perturbations, underscoring their robustness to positional bias. Code and data are publicly available at: www.github.com/NovaSearch-Team/RAG-Retrieval.

Accurate delineation of anatomical structures in volumetric CT scans is crucial for diagnosis and treatment planning. While AI has advanced automated segmentation, current approaches typically target individual structures, creating a fragmented landscape of incompatible models with varying performance and disparate evaluation protocols. Foundational segmentation models address these limitations by providing a holistic anatomical view through a single model. Yet, robust clinical deployment demands comprehensive training data, which is lacking in existing whole-body approaches, both in terms of data heterogeneity and, more importantly, anatomical coverage. In this work, rather than pursuing incremental optimizations in model architecture, we present CADS, an open-source framework that prioritizes the systematic integration, standardization, and labeling of heterogeneous data sources for whole-body CT segmentation. At its core is a large-scale dataset of 22,022 CT volumes with complete annotations for 167 anatomical structures, representing a significant advancement in both scale and coverage, with 18 times more scans than existing collections and 60% more distinct anatomical targets. Building on this diverse dataset, we develop the CADS-model using established architectures for accessible and automated full-body CT segmentation. Through comprehensive evaluation across 18 public datasets and an independent real-world hospital cohort, we demonstrate advantages over SoTA approaches. Notably, thorough testing of the model's performance in segmentation tasks from radiation oncology validates its direct utility for clinical interventions. By making our large-scale dataset, our segmentation models, and our clinical software tool publicly available, we aim to advance robust AI solutions in radiology and make comprehensive anatomical analysis accessible to clinicians and researchers alike.

Identifying disease phenotypes from electronic health records (EHRs) is critical for numerous secondary uses. Manually encoding physician knowledge into rules is particularly challenging for rare diseases due to inadequate EHR coding, necessitating review of clinical notes. Large language models (LLMs) offer promise in text understanding but may not efficiently handle real-world clinical documentation. We propose a zero-shot LLM-based method enriched by retrieval-augmented generation and MapReduce, which pre-identifies disease-related text snippets to be used in parallel as queries for the LLM to establish diagnosis. We show that this method as applied to pulmonary hypertension (PH), a rare disease characterized by elevated arterial pressures in the lungs, significantly outperforms physician logic rules (F_1 score of 0.62 vs. 0.75). This method has the potential to enhance rare disease cohort identification, expanding the scope of robust clinical research and care gap identification.

Conventional 2D pose estimation models are constrained by their design to specific object categories. This limits their applicability to predefined objects. To overcome these limitations, category-agnostic pose estimation (CAPE) emerged as a solution. CAPE aims to facilitate keypoint localization for diverse object categories using a unified model, which can generalize from minimal annotated support images. Recent CAPE works have produced object poses based on arbitrary keypoint definitions annotated on a user-provided support image. Our work departs from conventional CAPE methods, which require a support image, by adopting a text-based approach instead of the support image. Specifically, we use a pose-graph, where nodes represent keypoints that are described with text. This representation takes advantage of the abstraction of text descriptions and the structure imposed by the graph. Our approach effectively breaks symmetry, preserves structure, and improves occlusion handling. We validate our novel approach using the MP-100 benchmark, a comprehensive dataset spanning over 100 categories and 18,000 images. Under a 1-shot setting, our solution achieves a notable performance boost of 1.07\%, establishing a new state-of-the-art for CAPE. Additionally, we enrich the dataset by providing text description annotations, further enhancing its utility for future research.

Active learning promises to improve annotation efficiency by iteratively selecting the most important data to be annotated first. However, we uncover a striking contradiction to this promise: active learning fails to select data as efficiently as random selection at the first few choices. We identify this as the cold start problem in vision active learning, caused by a biased and outlier initial query. This paper seeks to address the cold start problem by exploiting the three advantages of contrastive learning: (1) no annotation is required; (2) label diversity is ensured by pseudo-labels to mitigate bias; (3) typical data is determined by contrastive features to reduce outliers. Experiments are conducted on CIFAR-10-LT and three medical imaging datasets (i.e. Colon Pathology, Abdominal CT, and Blood Cell Microscope). Our initial query not only significantly outperforms existing active querying strategies but also surpasses random selection by a large margin. We foresee our solution to the cold start problem as a simple yet strong baseline to choose the initial query for vision active learning. Code is available: https://github.com/c-liangyu/CSVAL

Deep learning-based point cloud modeling has been widely investigated as an indispensable component of general shape analysis. Recently, transformer and state space model (SSM) have shown promising capacities in point cloud learning. However, limited research has been conducted on medical point clouds, which have great potential in disease diagnosis and treatment. This paper presents an SSM-based hierarchical feature learning framework for medical point cloud understanding. Specifically, we down-sample input into multiple levels through the farthest point sampling. At each level, we perform a series of k-nearest neighbor (KNN) queries to aggregate multi-scale structural information. To assist SSM in processing point clouds, we introduce coordinate-order and inside-out scanning strategies for efficient serialization of irregular points. Point features are calculated progressively from short neighbor sequences and long point sequences through vanilla and group Point SSM blocks, to capture both local patterns and long-range dependencies. To evaluate the proposed method, we build a large-scale medical point cloud dataset named MedPointS for anatomy classification, completion, and segmentation. Extensive experiments conducted on MedPointS demonstrate that our method achieves superior performance across all tasks. The dataset is available at https://flemme-docs.readthedocs.io/en/latest/medpoints.html. Code is merged to a public medical imaging platform: https://github.com/wlsdzyzl/flemme.

3D Reconstruction of moving articulated objects without additional information about object structure is a challenging problem. Current methods overcome such challenges by employing category-specific skeletal models. Consequently, they do not generalize well to articulated objects in the wild. We treat an articulated object as an unknown, semi-rigid skeletal structure surrounded by nonrigid material (e.g., skin). Our method simultaneously estimates the visible (explicit) representation (3D shapes, colors, camera parameters) and the implicit skeletal representation, from motion cues in the object video without 3D supervision. Our implicit representation consists of four parts. (1) Skeleton, which specifies how semi-rigid parts are connected. (2) black{Skinning Weights}, which associates each surface vertex with semi-rigid parts with probability. (3) Rigidity Coefficients, specifying the articulation of the local surface. (4) Time-Varying Transformations, which specify the skeletal motion and surface deformation parameters. We introduce an algorithm that uses physical constraints as regularization terms and iteratively estimates both implicit and explicit representations. Our method is category-agnostic, thus eliminating the need for category-specific skeletons, we show that our method outperforms state-of-the-art across standard video datasets.

The objective of Radiology Report Generation (RRG) is to automatically generate coherent textual analyses of diseases based on radiological images, thereby alleviating the workload of radiologists. Current AI-based methods for RRG primarily focus on modifications to the encoder-decoder model architecture. To advance these approaches, this paper introduces an Organ-Regional Information Driven (ORID) framework which can effectively integrate multi-modal information and reduce the influence of noise from unrelated organs. Specifically, based on the LLaVA-Med, we first construct an RRG-related instruction dataset to improve organ-regional diagnosis description ability and get the LLaVA-Med-RRG. After that, we propose an organ-based cross-modal fusion module to effectively combine the information from the organ-regional diagnosis description and radiology image. To further reduce the influence of noise from unrelated organs on the radiology report generation, we introduce an organ importance coefficient analysis module, which leverages Graph Neural Network (GNN) to examine the interconnections of the cross-modal information of each organ region. Extensive experiments an1d comparisons with state-of-the-art methods across various evaluation metrics demonstrate the superior performance of our proposed method.

Semi-supervised learning relaxes the need of large pixel-wise labeled datasets for image segmentation by leveraging unlabeled data. A prominent way to exploit unlabeled data is to regularize model predictions. Since the predictions of unlabeled data can be unreliable, uncertainty-aware schemes are typically employed to gradually learn from meaningful and reliable predictions. Uncertainty estimation methods, however, rely on multiple inferences from the model predictions that must be computed for each training step, which is computationally expensive. Moreover, these uncertainty maps capture pixel-wise disparities and do not consider global information. This work proposes a novel method to estimate segmentation uncertainty by leveraging global information from the segmentation masks. More precisely, an anatomically-aware representation is first learnt to model the available segmentation masks. The learnt representation thereupon maps the prediction of a new segmentation into an anatomically-plausible segmentation. The deviation from the plausible segmentation aids in estimating the underlying pixel-level uncertainty in order to further guide the segmentation network. The proposed method consequently estimates the uncertainty using a single inference from our representation, thereby reducing the total computation. We evaluate our method on two publicly available segmentation datasets of left atria in cardiac MRIs and of multiple organs in abdominal CTs. Our anatomically-aware method improves the segmentation accuracy over the state-of-the-art semi-supervised methods in terms of two commonly used evaluation metrics.

Formulating selective information needs results in queries that implicitly specify set operations, such as intersection, union, and difference. For instance, one might search for "shorebirds that are not sandpipers" or "science-fiction films shot in England". To study the ability of retrieval systems to meet such information needs, we construct QUEST, a dataset of 3357 natural language queries with implicit set operations, that map to a set of entities corresponding to Wikipedia documents. The dataset challenges models to match multiple constraints mentioned in queries with corresponding evidence in documents and correctly perform various set operations. The dataset is constructed semi-automatically using Wikipedia category names. Queries are automatically composed from individual categories, then paraphrased and further validated for naturalness and fluency by crowdworkers. Crowdworkers also assess the relevance of entities based on their documents and highlight attribution of query constraints to spans of document text. We analyze several modern retrieval systems, finding that they often struggle on such queries. Queries involving negation and conjunction are particularly challenging and systems are further challenged with combinations of these operations.

We present ReXGroundingCT, the first publicly available dataset to link free-text radiology findings with pixel-level segmentations in 3D chest CT scans that is manually annotated. While prior datasets have relied on structured labels or predefined categories, ReXGroundingCT captures the full expressiveness of clinical language represented in free text and grounds it to spatially localized 3D segmentation annotations in volumetric imaging. This addresses a critical gap in medical AI: the ability to connect complex, descriptive text, such as "3 mm nodule in the left lower lobe", to its precise anatomical location in three-dimensional space, a capability essential for grounded radiology report generation systems. The dataset comprises 3,142 non-contrast chest CT scans paired with standardized radiology reports from the CT-RATE dataset. Using a systematic three-stage pipeline, GPT-4 was used to extract positive lung and pleural findings, which were then manually segmented by expert annotators. A total of 8,028 findings across 16,301 entities were annotated, with quality control performed by board-certified radiologists. Approximately 79% of findings are focal abnormalities, while 21% are non-focal. The training set includes up to three representative segmentations per finding, while the validation and test sets contain exhaustive labels for each finding entity. ReXGroundingCT establishes a new benchmark for developing and evaluating sentence-level grounding and free-text medical segmentation models in chest CT. The dataset can be accessed at https://huggingface.co/datasets/rajpurkarlab/ReXGroundingCT.

Vector similarity search presents significant challenges in terms of scalability for large and high-dimensional datasets, as well as in providing native support for hybrid queries. Serverless computing and cloud functions offer attractive benefits such as elasticity and cost-effectiveness, but are difficult to apply to data-intensive workloads. Jointly addressing these two main challenges, we present SQUASH, the first fully serverless vector search solution with rich support for hybrid queries. It features OSQ, an optimized and highly parallelizable quantization-based approach for vectors and attributes. Its segment-based storage mechanism enables significant compression in resource-constrained settings and offers efficient dimensional extraction operations. SQUASH performs a single distributed pass to guarantee the return of sufficiently many vectors satisfying the filter predicate, achieving high accuracy and avoiding redundant computation for vectors which fail the predicate. A multi-level search workflow is introduced to prune most vectors early to minimize the load on Function-as-a-Service (FaaS) instances. SQUASH is designed to identify and utilize retention of relevant data in re-used runtime containers, which eliminates redundant I/O and reduces costs. Finally, we demonstrate a new tree-based method for rapid FaaS invocation, enabling the bi-directional flow of data via request/response payloads. Experiments comparing SQUASH with state-of-the-art serverless vector search solutions and server-based baselines on vector search benchmarks confirm significant performance improvements at a lower cost.

With increasing demands for efficiency, information retrieval has developed a branch of sparse retrieval, further advancing towards inference-free retrieval where the documents are encoded during indexing time and there is no model-inference for queries. Existing sparse retrieval models rely on FLOPS regularization for sparsification, while this mechanism was originally designed for Siamese encoders, it is considered to be suboptimal in inference-free scenarios which is asymmetric. Previous attempts to adapt FLOPS for inference-free scenarios have been limited to rule-based methods, leaving the potential of sparsification approaches for inference-free retrieval models largely unexplored. In this paper, we explore ell_0 inspired sparsification manner for inference-free retrievers. Through comprehensive out-of-domain evaluation on the BEIR benchmark, our method achieves state-of-the-art performance among inference-free sparse retrieval models and is comparable to leading Siamese sparse retrieval models. Furthermore, we provide insights into the trade-off between retrieval effectiveness and computational efficiency, demonstrating practical value for real-world applications.

Question Answering on Electronic Health Records (EHR-QA) has a significant impact on the healthcare domain, and it is being actively studied. Previous research on structured EHR-QA focuses on converting natural language queries into query language such as SQL or SPARQL (NLQ2Query), so the problem scope is limited to pre-defined data types by the specific query language. In order to expand the EHR-QA task beyond this limitation to handle multi-modal medical data and solve complex inference in the future, more primitive systemic language is needed. In this paper, we design the program-based model (NLQ2Program) for EHR-QA as the first step towards the future direction. We tackle MIMICSPARQL*, the graph-based EHR-QA dataset, via a program-based approach in a semi-supervised manner in order to overcome the absence of gold programs. Without the gold program, our proposed model shows comparable performance to the previous state-of-the-art model, which is an NLQ2Query model (0.9% gain). In addition, for a reliable EHR-QA model, we apply the uncertainty decomposition method to measure the ambiguity in the input question. We empirically confirmed data uncertainty is most indicative of the ambiguity in the input question.

Deep learning methods for Visual Place Recognition (VPR) have advanced significantly, largely driven by large-scale datasets. However, most existing approaches are trained on a single dataset, which can introduce dataset-specific inductive biases and limit model generalization. While multi-dataset joint training offers a promising solution for developing universal VPR models, divergences among training datasets can saturate limited information capacity in feature aggregation layers, leading to suboptimal performance. To address these challenges, we propose Query-based Adaptive Aggregation (QAA), a novel feature aggregation technique that leverages learned queries as reference codebooks to effectively enhance information capacity without significant computational or parameter complexity. We show that computing the Cross-query Similarity (CS) between query-level image features and reference codebooks provides a simple yet effective way to generate robust descriptors. Our results demonstrate that QAA outperforms state-of-the-art models, achieving balanced generalization across diverse datasets while maintaining peak performance comparable to dataset-specific models. Ablation studies further explore QAA's mechanisms and scalability. Visualizations reveal that the learned queries exhibit diverse attention patterns across datasets. Code will be publicly released.

Retrieval-Augmented Generation (RAG) has shown substantial promise in improving factual accuracy by grounding model responses with external knowledge relevant to queries. However, most existing RAG approaches are limited to a text-only corpus, and while recent efforts have extended RAG to other modalities such as images and videos, they typically operate over a single modality-specific corpus. In contrast, real-world queries vary widely in the type of knowledge they require, which a single type of knowledge source cannot address. To address this, we introduce UniversalRAG, a novel RAG framework designed to retrieve and integrate knowledge from heterogeneous sources with diverse modalities and granularities. Specifically, motivated by the observation that forcing all modalities into a unified representation space derived from a single combined corpus causes a modality gap, where the retrieval tends to favor items from the same modality as the query, we propose a modality-aware routing mechanism that dynamically identifies the most appropriate modality-specific corpus and performs targeted retrieval within it. Also, beyond modality, we organize each modality into multiple granularity levels, enabling fine-tuned retrieval tailored to the complexity and scope of the query. We validate UniversalRAG on 8 benchmarks spanning multiple modalities, showing its superiority over modality-specific and unified baselines.

Domain adaptation (DA) has drawn high interest for its capacity to adapt a model trained on labeled source data to perform well on unlabeled or weakly labeled target data from a different domain. Most common DA techniques require concurrent access to the input images of both the source and target domains. However, in practice, privacy concerns often impede the availability of source images in the adaptation phase. This is a very frequent DA scenario in medical imaging, where, for instance, the source and target images could come from different clinical sites. We introduce a source-free domain adaptation for image segmentation. Our formulation is based on minimizing a label-free entropy loss defined over target-domain data, which we further guide with a domain-invariant prior on the segmentation regions. Many priors can be derived from anatomical information. Here, a class ratio prior is estimated from anatomical knowledge and integrated in the form of a Kullback Leibler (KL) divergence in our overall loss function. Furthermore, we motivate our overall loss with an interesting link to maximizing the mutual information between the target images and their label predictions. We show the effectiveness of our prior aware entropy minimization in a variety of domain-adaptation scenarios, with different modalities and applications, including spine, prostate, and cardiac segmentation. Our method yields comparable results to several state of the art adaptation techniques, despite having access to much less information, as the source images are entirely absent in our adaptation phase. Our straightforward adaptation strategy uses only one network, contrary to popular adversarial techniques, which are not applicable to a source-free DA setting. Our framework can be readily used in a breadth of segmentation problems, and our code is publicly available: https://github.com/mathilde-b/SFDA

Humans can develop internal world models that encode common sense knowledge, telling them how the world works and predicting the consequences of their actions. This concept has emerged as a promising direction for establishing general-purpose machine-learning models in recent preliminary works, e.g., for visual representation learning. In this paper, we present CheXWorld, the first effort towards a self-supervised world model for radiographic images. Specifically, our work develops a unified framework that simultaneously models three aspects of medical knowledge essential for qualified radiologists, including 1) local anatomical structures describing the fine-grained characteristics of local tissues (e.g., architectures, shapes, and textures); 2) global anatomical layouts describing the global organization of the human body (e.g., layouts of organs and skeletons); and 3) domain variations that encourage CheXWorld to model the transitions across different appearance domains of radiographs (e.g., varying clarity, contrast, and exposure caused by collecting radiographs from different hospitals, devices, or patients). Empirically, we design tailored qualitative and quantitative analyses, revealing that CheXWorld successfully captures these three dimensions of medical knowledge. Furthermore, transfer learning experiments across eight medical image classification and segmentation benchmarks showcase that CheXWorld significantly outperforms existing SSL methods and large-scale medical foundation models. Code & pre-trained models are available at https://github.com/LeapLabTHU/CheXWorld.

Active Learning (AL) is a well-known standard method for efficiently obtaining annotated data by first labeling the samples that contain the most information based on a query strategy. In the past, a large variety of such query strategies has been proposed, with each generation of new strategies increasing the runtime and adding more complexity. However, to the best of our our knowledge, none of these strategies excels consistently over a large number of datasets from different application domains. Basically, most of the the existing AL strategies are a combination of the two simple heuristics informativeness and representativeness, and the big differences lie in the combination of the often conflicting heuristics. Within this paper, we propose ImitAL, a domain-independent novel query strategy, which encodes AL as a learning-to-rank problem and learns an optimal combination between both heuristics. We train ImitAL on large-scale simulated AL runs on purely synthetic datasets. To show that ImitAL was successfully trained, we perform an extensive evaluation comparing our strategy on 13 different datasets, from a wide range of domains, with 7 other query strategies.

Retrieval-Augmented Generation (RAG) plays a crucial role in grounding Large Language Models by leveraging external knowledge, whereas the effectiveness is often compromised by the retrieval of contextually flawed or incomplete information. To address this, knowledge graph-based RAG methods have evolved towards hierarchical structures, organizing knowledge into multi-level summaries. However, these approaches still suffer from two critical, unaddressed challenges: high-level conceptual summaries exist as disconnected ``semantic islands'', lacking the explicit relations needed for cross-community reasoning; and the retrieval process itself remains structurally unaware, often degenerating into an inefficient flat search that fails to exploit the graph's rich topology. To overcome these limitations, we introduce LeanRAG, a framework that features a deeply collaborative design combining knowledge aggregation and retrieval strategies. LeanRAG first employs a novel semantic aggregation algorithm that forms entity clusters and constructs new explicit relations among aggregation-level summaries, creating a fully navigable semantic network. Then, a bottom-up, structure-guided retrieval strategy anchors queries to the most relevant fine-grained entities and then systematically traverses the graph's semantic pathways to gather concise yet contextually comprehensive evidence sets. The LeanRAG can mitigate the substantial overhead associated with path retrieval on graphs and minimizes redundant information retrieval. Extensive experiments on four challenging QA benchmarks with different domains demonstrate that LeanRAG significantly outperforming existing methods in response quality while reducing 46\% retrieval redundancy. Code is available at: https://github.com/RaZzzyz/LeanRAG

Retrieval-augmented generation (RAG) has emerged as a promising approach to enhance the performance of large language models (LLMs) in knowledge-intensive tasks such as those from medical domain. However, the sensitive nature of the medical domain necessitates a completely accurate and trustworthy system. While existing RAG benchmarks primarily focus on the standard retrieve-answer setting, they overlook many practical scenarios that measure crucial aspects of a reliable medical system. This paper addresses this gap by providing a comprehensive evaluation framework for medical question-answering (QA) systems in a RAG setting for these situations, including sufficiency, integration, and robustness. We introduce Medical Retrieval-Augmented Generation Benchmark (MedRGB) that provides various supplementary elements to four medical QA datasets for testing LLMs' ability to handle these specific scenarios. Utilizing MedRGB, we conduct extensive evaluations of both state-of-the-art commercial LLMs and open-source models across multiple retrieval conditions. Our experimental results reveals current models' limited ability to handle noise and misinformation in the retrieved documents. We further analyze the LLMs' reasoning processes to provides valuable insights and future directions for developing RAG systems in this critical medical domain.

Medical report generation from X-ray images is a challenging task, particularly in an unpaired setting where paired image-report data is unavailable for training. To address this challenge, we propose a novel model that leverages the available information in two distinct datasets, one comprising reports and the other consisting of images. The core idea of our model revolves around the notion that combining auto-encoding report generation with multi-modal (report-image) alignment can offer a solution. However, the challenge persists regarding how to achieve this alignment when pair correspondence is absent. Our proposed solution involves the use of auxiliary tasks, particularly contrastive learning and classification, to position related images and reports in close proximity to each other. This approach differs from previous methods that rely on pre-processing steps, such as using external information stored in a knowledge graph. Our model, named MedRAT, surpasses previous state-of-the-art methods, demonstrating the feasibility of generating comprehensive medical reports without the need for paired data or external tools.

Electronic Health Records (EHRs), which contain patients' medical histories in various multi-modal formats, often overlook the potential for joint reasoning across imaging and table modalities underexplored in current EHR Question Answering (QA) systems. In this paper, we introduce EHRXQA, a novel multi-modal question answering dataset combining structured EHRs and chest X-ray images. To develop our dataset, we first construct two uni-modal resources: 1) The MIMIC- CXR-VQA dataset, our newly created medical visual question answering (VQA) benchmark, specifically designed to augment the imaging modality in EHR QA, and 2) EHRSQL (MIMIC-IV), a refashioned version of a previously established table-based EHR QA dataset. By integrating these two uni-modal resources, we successfully construct a multi-modal EHR QA dataset that necessitates both uni-modal and cross-modal reasoning. To address the unique challenges of multi-modal questions within EHRs, we propose a NeuralSQL-based strategy equipped with an external VQA API. This pioneering endeavor enhances engagement with multi-modal EHR sources and we believe that our dataset can catalyze advances in real-world medical scenarios such as clinical decision-making and research. EHRXQA is available at https://github.com/baeseongsu/ehrxqa.

Modern operating room is becoming increasingly complex, requiring innovative intra-operative support systems. While the focus of surgical data science has largely been on video analysis, integrating surgical computer vision with language capabilities is emerging as a necessity. Our work aims to advance Visual Question Answering (VQA) in the surgical context with scene graph knowledge, addressing two main challenges in the current surgical VQA systems: removing question-condition bias in the surgical VQA dataset and incorporating scene-aware reasoning in the surgical VQA model design. First, we propose a Surgical Scene Graph-based dataset, SSG-QA, generated by employing segmentation and detection models on publicly available datasets. We build surgical scene graphs using spatial and action information of instruments and anatomies. These graphs are fed into a question engine, generating diverse QA pairs. Our SSG-QA dataset provides a more complex, diverse, geometrically grounded, unbiased, and surgical action-oriented dataset compared to existing surgical VQA datasets. We then propose SSG-QA-Net, a novel surgical VQA model incorporating a lightweight Scene-embedded Interaction Module (SIM), which integrates geometric scene knowledge in the VQA model design by employing cross-attention between the textual and the scene features. Our comprehensive analysis of the SSG-QA dataset shows that SSG-QA-Net outperforms existing methods across different question types and complexities. We highlight that the primary limitation in the current surgical VQA systems is the lack of scene knowledge to answer complex queries. We present a novel surgical VQA dataset and model and show that results can be significantly improved by incorporating geometric scene features in the VQA model design. The source code and the dataset will be made publicly available at: https://github.com/CAMMA-public/SSG-QA

Domain adaptation methods for 2D human pose estimation typically require continuous access to the source data during adaptation, which can be challenging due to privacy, memory, or computational constraints. To address this limitation, we focus on the task of source-free domain adaptation for pose estimation, where a source model must adapt to a new target domain using only unlabeled target data. Although recent advances have introduced source-free methods for classification tasks, extending them to the regression task of pose estimation is non-trivial. In this paper, we present Prior-guided Self-training (POST), a pseudo-labeling approach that builds on the popular Mean Teacher framework to compensate for the distribution shift. POST leverages prediction-level and feature-level consistency between a student and teacher model against certain image transformations. In the absence of source data, POST utilizes a human pose prior that regularizes the adaptation process by directing the model to generate more accurate and anatomically plausible pose pseudo-labels. Despite being simple and intuitive, our framework can deliver significant performance gains compared to applying the source model directly to the target data, as demonstrated in our extensive experiments and ablation studies. In fact, our approach achieves comparable performance to recent state-of-the-art methods that use source data for adaptation.

Answering real-world user queries, such as product search, often requires accurate retrieval of information from semi-structured knowledge bases or databases that involve blend of unstructured (e.g., textual descriptions of products) and structured (e.g., entity relations of products) information. However, previous works have mostly studied textual and relational retrieval tasks as separate topics. To address the gap, we develop STARK, a large-scale Semi-structure retrieval benchmark on Textual and Relational Knowledge Bases. We design a novel pipeline to synthesize natural and realistic user queries that integrate diverse relational information and complex textual properties, as well as their ground-truth answers. Moreover, we rigorously conduct human evaluation to validate the quality of our benchmark, which covers a variety of practical applications, including product recommendations, academic paper searches, and precision medicine inquiries. Our benchmark serves as a comprehensive testbed for evaluating the performance of retrieval systems, with an emphasis on retrieval approaches driven by large language models (LLMs). Our experiments suggest that the STARK datasets present significant challenges to the current retrieval and LLM systems, indicating the demand for building more capable retrieval systems that can handle both textual and relational aspects.

Biomedical researchers increasingly rely on large-scale structured databases for complex analytical tasks. However, current text-to-SQL systems often struggle to map qualitative scientific questions into executable SQL, particularly when implicit domain reasoning is required. We introduce BiomedSQL, the first benchmark explicitly designed to evaluate scientific reasoning in text-to-SQL generation over a real-world biomedical knowledge base. BiomedSQL comprises 68,000 question/SQL query/answer triples grounded in a harmonized BigQuery knowledge base that integrates gene-disease associations, causal inference from omics data, and drug approval records. Each question requires models to infer domain-specific criteria, such as genome-wide significance thresholds, effect directionality, or trial phase filtering, rather than rely on syntactic translation alone. We evaluate a range of open- and closed-source LLMs across prompting strategies and interaction paradigms. Our results reveal a substantial performance gap: GPT-o3-mini achieves 59.0% execution accuracy, while our custom multi-step agent, BMSQL, reaches 62.6%, both well below the expert baseline of 90.0%. BiomedSQL provides a new foundation for advancing text-to-SQL systems capable of supporting scientific discovery through robust reasoning over structured biomedical knowledge bases. Our dataset is publicly available at https://huggingface.co/datasets/NIH-CARD/BiomedSQL, and our code is open-source at https://github.com/NIH-CARD/biomedsql.

Recent advances in deep learning-based point cloud registration have improved generalization, yet most methods still require retraining or manual parameter tuning for each new environment. In this paper, we identify three key factors limiting generalization: (a) reliance on environment-specific voxel size and search radius, (b) poor out-of-domain robustness of learning-based keypoint detectors, and (c) raw coordinate usage, which exacerbates scale discrepancies. To address these issues, we present a zero-shot registration pipeline called BUFFER-X by (a) adaptively determining voxel size/search radii, (b) using farthest point sampling to bypass learned detectors, and (c) leveraging patch-wise scale normalization for consistent coordinate bounds. In particular, we present a multi-scale patch-based descriptor generation and a hierarchical inlier search across scales to improve robustness in diverse scenes. We also propose a novel generalizability benchmark using 11 datasets that cover various indoor/outdoor scenarios and sensor modalities, demonstrating that BUFFER-X achieves substantial generalization without prior information or manual parameter tuning for the test datasets. Our code is available at https://github.com/MIT-SPARK/BUFFER-X.

This paper presents a comprehensive evaluation of GPT-4V's capabilities across diverse medical imaging tasks, including Radiology Report Generation, Medical Visual Question Answering (VQA), and Visual Grounding. While prior efforts have explored GPT-4V's performance in medical image analysis, to the best of our knowledge, our study represents the first quantitative evaluation on publicly available benchmarks. Our findings highlight GPT-4V's potential in generating descriptive reports for chest X-ray images, particularly when guided by well-structured prompts. Meanwhile, its performance on the MIMIC-CXR dataset benchmark reveals areas for improvement in certain evaluation metrics, such as CIDEr. In the domain of Medical VQA, GPT-4V demonstrates proficiency in distinguishing between question types but falls short of the VQA-RAD benchmark in terms of accuracy. Furthermore, our analysis finds the limitations of conventional evaluation metrics like the BLEU scores, advocating for the development of more semantically robust assessment methods. In the field of Visual Grounding, GPT-4V exhibits preliminary promise in recognizing bounding boxes, but its precision is lacking, especially in identifying specific medical organs and signs. Our evaluation underscores the significant potential of GPT-4V in the medical imaging domain, while also emphasizing the need for targeted refinements to fully unlock its capabilities.

The detection of human parts (e.g., hands, face) and their correct association with individuals is an essential task, e.g., for ubiquitous human-machine interfaces and action recognition. Traditional methods often employ multi-stage processes, rely on cumbersome anchor-based systems, or do not scale well to larger part sets. This paper presents PBADet, a novel one-stage, anchor-free approach for part-body association detection. Building upon the anchor-free object representation across multi-scale feature maps, we introduce a singular part-to-body center offset that effectively encapsulates the relationship between parts and their parent bodies. Our design is inherently versatile and capable of managing multiple parts-to-body associations without compromising on detection accuracy or robustness. Comprehensive experiments on various datasets underscore the efficacy of our approach, which not only outperforms existing state-of-the-art techniques but also offers a more streamlined and efficient solution to the part-body association challenge.

Large language models (LLMs) have become a disruptive force in the industry, introducing unprecedented capabilities in natural language processing, logical reasoning and so on. However, the challenges of knowledge updates and hallucination issues have limited the application of LLMs in medical scenarios, where retrieval-augmented generation (RAG) can offer significant assistance. Nevertheless, existing retrieve-then-read approaches generally digest the retrieved documents, without considering the timeliness, authoritativeness and commonality of retrieval. We argue that these approaches can be suboptimal, especially in real-world applications where information from different sources might conflict with each other and even information from the same source in different time scale might be different, and totally relying on this would deteriorate the performance of RAG approaches. We propose PolyRAG that carefully incorporate judges from different perspectives and finally integrate the polyviews for retrieval augmented generation in medical applications. Due to the scarcity of real-world benchmarks for evaluation, to bridge the gap we propose PolyEVAL, a benchmark consists of queries and documents collected from real-world medical scenarios (including medical policy, hospital & doctor inquiry and healthcare) with multiple tagging (e.g., timeliness, authoritativeness) on them. Extensive experiments and analysis on PolyEVAL have demonstrated the superiority of PolyRAG.

Generating Natural Language Explanations (NLEs) for model predictions on medical images, particularly those depicting thoracic pathologies, remains a critical and challenging task. Existing methodologies often struggle due to general models' insufficient domain-specific medical knowledge and privacy concerns associated with retrieval-based augmentation techniques. To address these issues, we propose a novel Vision-Language framework augmented with a Knowledge Graph (KG)-based datastore, which enhances the model's understanding by incorporating additional domain-specific medical knowledge essential for generating accurate and informative NLEs. Our framework employs a KG-based retrieval mechanism that not only improves the precision of the generated explanations but also preserves data privacy by avoiding direct data retrieval. The KG datastore is designed as a plug-and-play module, allowing for seamless integration with various model architectures. We introduce and evaluate three distinct frameworks within this paradigm: KG-LLaVA, which integrates the pre-trained LLaVA model with KG-RAG; Med-XPT, a custom framework combining MedCLIP, a transformer-based projector, and GPT-2; and Bio-LLaVA, which adapts LLaVA by incorporating the Bio-ViT-L vision model. These frameworks are validated on the MIMIC-NLE dataset, where they achieve state-of-the-art results, underscoring the effectiveness of KG augmentation in generating high-quality NLEs for thoracic pathologies.

In medical scenarios, effectively retrieving external knowledge and leveraging it for rigorous logical reasoning is of significant importance. Despite their potential, existing work has predominantly focused on enhancing either retrieval or reasoning capabilities of the models in isolation, with little attention given to their joint optimization, which leads to limited coordination between the two processes. Additionally, current methods rely heavily on supervised fine-tuning (SFT), which can cause models to memorize existing problem-solving pathways, thereby restricting their generalization ability when confronted with novel problem contexts. Furthermore, while some studies have explored to improve retrieval-augmented reasoning in general domains via reinforcement learning, their reward function designs do not adequately capture the specific demands of the medical domain. To address these challenges, we introduce **Med-R^3**, a **Med**ical **R**etrieval-augmented **R**easoning framework driven by progressive **R**einforcement learning. In this framework, we first develop the model's ability to perform logical reasoning over medical problems. Subsequently, on the basis of this foundation, we adaptively optimize the retrieval capability to better align with the characteristics of knowledge corpus and external information utilization throughout the reasoning process. Finally, we conduct joint optimization of the model's retrieval and reasoning coordination. Extensive experiments indicate that **Med-R^3** could achieve state-of-the-art performances, with LLaMA3.1-8B-Instruct + Med-R^3 surpassing closed-sourced GPT-4o-mini by 3.93\% at a comparable parameter scale, while Qwen2.5-14B augmented with Med-R^3 shows a more substantial gain of 13.53\%.

Identifying patient cohorts is fundamental to numerous healthcare tasks, including clinical trial recruitment and retrospective studies. Current cohort retrieval methods in healthcare organizations rely on automated queries of structured data combined with manual curation, which are time-consuming, labor-intensive, and often yield low-quality results. Recent advancements in large language models (LLMs) and information retrieval (IR) offer promising avenues to revolutionize these systems. Major challenges include managing extensive eligibility criteria and handling the longitudinal nature of unstructured Electronic Medical Records (EMRs) while ensuring that the solution remains cost-effective for real-world application. This paper introduces a new task, Automatic Cohort Retrieval (ACR), and evaluates the performance of LLMs and commercial, domain-specific neuro-symbolic approaches. We provide a benchmark task, a query dataset, an EMR dataset, and an evaluation framework. Our findings underscore the necessity for efficient, high-quality ACR systems capable of longitudinal reasoning across extensive patient databases.

In many applications, retrieval-augmented generation (RAG) drives tool use and function calling by embedding the (user) queries and matching them to pre-specified tool/function descriptions. In this paper, we address an embedding misalignment issue that often arises in practical applications due to imperfect embedding models or noisy descriptions; such misalignment may lead to incorrect retrieval and task failure. We introduce Online-Optimized RAG, a deployment-time framework that continually adapts retrieval embeddings from live interactions using minimal feedback (e.g., task success). Online-Optimized RAG applies lightweight online gradient updates with negligible per-query latency and requires no changes to the underlying LLM. The method is plug-and-play: it supports both single- and multi-hop tool use, dynamic tool inventories, and K-retrieval with re-ranking. We provide a problem-dependent theoretical analysis that quantifies how the method's performance depends on the initialization quality of the embeddings and other related quantities. Across diverse tool-use and document-retrieval scenarios, our Online-Optimized RAG consistently improves tool selection accuracy and end-task success, thus providing a simple, practical path to robust, self-improving RAG systems.

Recent studies show that paddings in convolutional neural networks encode absolute position information which can negatively affect the model performance for certain tasks. However, existing metrics for quantifying the strength of positional information remain unreliable and frequently lead to erroneous results. To address this issue, we propose novel metrics for measuring (and visualizing) the encoded positional information. We formally define the encoded information as PPP (Position-information Pattern from Padding) and conduct a series of experiments to study its properties as well as its formation. The proposed metrics measure the presence of positional information more reliably than the existing metrics based on PosENet and a test in F-Conv. We also demonstrate that for any extant (and proposed) padding schemes, PPP is primarily a learning artifact and is less dependent on the characteristics of the underlying padding schemes.

Question answering over visually rich documents (VRDs) requires reasoning not only over isolated content but also over documents' structural organization and cross-page dependencies. However, conventional retrieval-augmented generation (RAG) methods encode content in isolated chunks during ingestion, losing structural and cross-page dependencies, and retrieve a fixed number of pages at inference, regardless of the specific demands of the question or context. This often results in incomplete evidence retrieval and degraded answer quality for multi-page reasoning tasks. To address these limitations, we propose LAD-RAG, a novel Layout-Aware Dynamic RAG framework. During ingestion, LAD-RAG constructs a symbolic document graph that captures layout structure and cross-page dependencies, adding it alongside standard neural embeddings to yield a more holistic representation of the document. During inference, an LLM agent dynamically interacts with the neural and symbolic indices to adaptively retrieve the necessary evidence based on the query. Experiments on MMLongBench-Doc, LongDocURL, DUDE, and MP-DocVQA demonstrate that LAD-RAG improves retrieval, achieving over 90% perfect recall on average without any top-k tuning, and outperforming baseline retrievers by up to 20% in recall at comparable noise levels, yielding higher QA accuracy with minimal latency.

The scarcity of annotations poses a significant challenge in medical image analysis. Large-scale pre-training has emerged as a promising label-efficient solution, owing to the utilization of large-scale data, large models, and advanced pre-training techniques. However, its development in medical images remains underexplored. The primary challenge lies in harnessing large-scale unlabeled data and learning high-level semantics without annotations. We observe that 3D medical images exhibit consistent geometric context, i.e., consistent geometric relations between different organs, which leads to a promising way for learning consistent representations. Motivated by this, we introduce a simple-yet-effective Volume Contrast (VoCo) framework to leverage geometric context priors for self-supervision. Given an input volume, we extract base crops from different regions to construct positive and negative pairs for contrastive learning. Then we predict the contextual position of a random crop by contrasting its similarity to the base crops. In this way, VoCo encodes the inherent geometric context into model representations, facilitating high-level semantic learning without annotations. Specifically, we (1) introduce the largest medical pre-training dataset PreCT-160K; (2) investigate scaling laws and propose guidelines for tailoring different model sizes to various medical tasks; (3) build a benchmark encompassing 48 medical tasks. Extensive experiments highlight the superiority of VoCo. Codes at https://github.com/Luffy03/Large-Scale-Medical.

We present SpineTrack, the first comprehensive dataset for 2D spine pose estimation in unconstrained settings, addressing a crucial need in sports analytics, healthcare, and realistic animation. Existing pose datasets often simplify the spine to a single rigid segment, overlooking the nuanced articulation required for accurate motion analysis. In contrast, SpineTrack annotates nine detailed spinal keypoints across two complementary subsets: a synthetic set comprising 25k annotations created using Unreal Engine with biomechanical alignment through OpenSim, and a real-world set comprising over 33k annotations curated via an active learning pipeline that iteratively refines automated annotations with human feedback. This integrated approach ensures anatomically consistent labels at scale, even for challenging, in-the-wild images. We further introduce SpinePose, extending state-of-the-art body pose estimators using knowledge distillation and an anatomical regularization strategy to jointly predict body and spine keypoints. Our experiments in both general and sports-specific contexts validate the effectiveness of SpineTrack for precise spine pose estimation, establishing a robust foundation for future research in advanced biomechanical analysis and 3D spine reconstruction in the wild.

Existing medical VQA benchmarks mostly focus on single-image analysis, yet clinicians almost always compare a series of images before reaching a diagnosis. To better approximate this workflow, we introduce MedFrameQA -- the first benchmark that explicitly evaluates multi-image reasoning in medical VQA. To build MedFrameQA both at scale and in high-quality, we develop 1) an automated pipeline that extracts temporally coherent frames from medical videos and constructs VQA items whose content evolves logically across images, and 2) a multiple-stage filtering strategy, including model-based and manual review, to preserve data clarity, difficulty, and medical relevance. The resulting dataset comprises 2,851 VQA pairs (gathered from 9,237 high-quality frames in 3,420 videos), covering nine human body systems and 43 organs; every question is accompanied by two to five images. We comprehensively benchmark ten advanced Multimodal LLMs -- both proprietary and open source, with and without explicit reasoning modules -- on MedFrameQA. The evaluation challengingly reveals that all models perform poorly, with most accuracies below 50%, and accuracy fluctuates as the number of images per question increases. Error analysis further shows that models frequently ignore salient findings, mis-aggregate evidence across images, and propagate early mistakes through their reasoning chains; results also vary substantially across body systems, organs, and modalities. We hope this work can catalyze research on clinically grounded, multi-image reasoning and accelerate progress toward more capable diagnostic AI systems.

The burgeoning integration of 3D medical imaging into healthcare has led to a substantial increase in the workload of medical professionals. To assist clinicians in their diagnostic processes and alleviate their workload, the development of a robust system for retrieving similar case studies presents a viable solution. While the concept holds great promise, the field of 3D medical text-image retrieval is currently limited by the absence of robust evaluation benchmarks and curated datasets. To remedy this, our study presents a groundbreaking dataset, BIMCV-R (This dataset will be released upon acceptance.), which includes an extensive collection of 8,069 3D CT volumes, encompassing over 2 million slices, paired with their respective radiological reports. Expanding upon the foundational work of our dataset, we craft a retrieval strategy, MedFinder. This approach employs a dual-stream network architecture, harnessing the potential of large language models to advance the field of medical image retrieval beyond existing text-image retrieval solutions. It marks our preliminary step towards developing a system capable of facilitating text-to-image, image-to-text, and keyword-based retrieval tasks.

Positron emission tomography (PET) is a cornerstone of modern oncologic and neurologic imaging, distinguished by its unique ability to illuminate dynamic metabolic processes that transcend the anatomical focus of traditional imaging technologies. Radiology reports are essential for clinical decision making, yet their manual creation is labor-intensive and time-consuming. Recent advancements of vision-language models (VLMs) have shown strong potential in medical applications, presenting a promising avenue for automating report generation. However, existing applications of VLMs in the medical domain have predominantly focused on structural imaging modalities, while the unique characteristics of molecular PET imaging have largely been overlooked. To bridge the gap, we introduce PET2Rep, a large-scale comprehensive benchmark for evaluation of general and medical VLMs for radiology report generation for PET images. PET2Rep stands out as the first dedicated dataset for PET report generation with metabolic information, uniquely capturing whole-body image-report pairs that cover dozens of organs to fill the critical gap in existing benchmarks and mirror real-world clinical comprehensiveness. In addition to widely recognized natural language generation metrics, we introduce a series of clinical efficiency metrics to evaluate the quality of radiotracer uptake pattern description in key organs in generated reports. We conduct a head-to-head comparison of 30 cutting-edge general-purpose and medical-specialized VLMs. The results show that the current state-of-the-art VLMs perform poorly on PET report generation task, falling considerably short of fulfilling practical needs. Moreover, we identify several key insufficiency that need to be addressed to advance the development in medical applications.

Medical open-domain question answering demands substantial access to specialized knowledge. Recent efforts have sought to decouple knowledge from model parameters, counteracting architectural scaling and allowing for training on common low-resource hardware. The retrieve-then-read paradigm has become ubiquitous, with model predictions grounded on relevant knowledge pieces from external repositories such as PubMed, textbooks, and UMLS. An alternative path, still under-explored but made possible by the advent of domain-specific large language models, entails constructing artificial contexts through prompting. As a result, "to generate or to retrieve" is the modern equivalent of Hamlet's dilemma. This paper presents MedGENIE, the first generate-then-read framework for multiple-choice question answering in medicine. We conduct extensive experiments on MedQA-USMLE, MedMCQA, and MMLU, incorporating a practical perspective by assuming a maximum of 24GB VRAM. MedGENIE sets a new state-of-the-art (SOTA) in the open-book setting of each testbed, even allowing a small-scale reader to outcompete zero-shot closed-book 175B baselines while using up to 706times fewer parameters. Overall, our findings reveal that generated passages are more effective than retrieved counterparts in attaining higher accuracy.

Medical image segmentation poses challenges due to domain gaps, data modality variations, and dependency on domain knowledge or experts, especially for low- and middle-income countries (LMICs). Whereas for humans, given a few exemplars (with corresponding labels), we are able to segment different medical images even without exten-sive domain-specific clinical training. In addition, current SAM-based medical segmentation models use fine-grained visual prompts, such as the bounding rectangle generated from manually annotated target segmentation mask, as the bounding box (bbox) prompt during the testing phase. However, in actual clinical scenarios, no such precise prior knowledge is available. Our experimental results also reveal that previous models nearly fail to predict when given coarser bbox prompts. Considering these issues, in this paper, we introduce a domain-aware selective adaptation approach to adapt the general knowledge learned from a large model trained with natural images to the corresponding medical domains/modalities, with access to only a few (e.g. less than 5) exemplars. Our method mitigates the aforementioned limitations, providing an efficient and LMICs-friendly solution. Extensive experimental analysis showcases the effectiveness of our approach, offering potential advancements in healthcare diagnostics and clinical applications in LMICs.

Methods and datasets for human pose estimation focus predominantly on side- and front-view scenarios. We overcome the limitation by leveraging synthetic data and introduce RePoGen (RarE POses GENerator), an SMPL-based method for generating synthetic humans with comprehensive control over pose and view. Experiments on top-view datasets and a new dataset of real images with diverse poses show that adding the RePoGen data to the COCO dataset outperforms previous approaches to top- and bottom-view pose estimation without harming performance on common views. An ablation study shows that anatomical plausibility, a property prior research focused on, is not a prerequisite for effective performance. The introduced dataset and the corresponding code are available on https://mirapurkrabek.github.io/RePoGen-paper/ .

Recent proprietary large language models (LLMs), such as GPT-4, have achieved a milestone in tackling diverse challenges in the biomedical domain, ranging from multiple-choice questions to long-form generations. To address challenges that still cannot be handled with the encoded knowledge of LLMs, various retrieval-augmented generation (RAG) methods have been developed by searching documents from the knowledge corpus and appending them unconditionally or selectively to the input of LLMs for generation. However, when applying existing methods to different domain-specific problems, poor generalization becomes apparent, leading to fetching incorrect documents or making inaccurate judgments. In this paper, we introduce Self-BioRAG, a framework reliable for biomedical text that specializes in generating explanations, retrieving domain-specific documents, and self-reflecting generated responses. We utilize 84k filtered biomedical instruction sets to train Self-BioRAG that can assess its generated explanations with customized reflective tokens. Our work proves that domain-specific components, such as a retriever, domain-related document corpus, and instruction sets are necessary for adhering to domain-related instructions. Using three major medical question-answering benchmark datasets, experimental results of Self-BioRAG demonstrate significant performance gains by achieving a 7.2% absolute improvement on average over the state-of-the-art open-foundation model with a parameter size of 7B or less. Overall, we analyze that Self-BioRAG finds the clues in the question, retrieves relevant documents if needed, and understands how to answer with information from retrieved documents and encoded knowledge as a medical expert does. We release our data and code for training our framework components and model weights (7B and 13B) to enhance capabilities in biomedical and clinical domains.

Recent advances in natural language processing, primarily propelled by Large Language Models (LLMs), have showcased their remarkable capabilities grounded in in-context learning. A promising avenue for guiding LLMs in intricate reasoning tasks involves the utilization of intermediate reasoning steps within the Chain-of-Thought (CoT) paradigm. Nevertheless, the central challenge lies in the effective selection of exemplars for facilitating in-context learning. In this study, we introduce a framework that leverages Dual Queries and Low-rank approximation Re-ranking (DQ-LoRe) to automatically select exemplars for in-context learning. Dual Queries first query LLM to obtain LLM-generated knowledge such as CoT, then query the retriever to obtain the final exemplars via both question and the knowledge. Moreover, for the second query, LoRe employs dimensionality reduction techniques to refine exemplar selection, ensuring close alignment with the input question's knowledge. Through extensive experiments, we demonstrate that DQ-LoRe significantly outperforms prior state-of-the-art methods in the automatic selection of exemplars for GPT-4, enhancing performance from 92.5% to 94.2%. Our comprehensive analysis further reveals that DQ-LoRe consistently outperforms retrieval-based approaches in terms of both performance and adaptability, especially in scenarios characterized by distribution shifts. DQ-LoRe pushes the boundary of in-context learning and opens up new avenues for addressing complex reasoning challenges. Our code is released at https://github.com/AI4fun/DQ-LoRe}{https://github.com/AI4fun/DQ-LoRe.

We address the problem of fitting a parametric human body model (SMPL) to point cloud data. Optimization-based methods require careful initialization and are prone to becoming trapped in local optima. Learning-based methods address this but do not generalize well when the input pose is far from those seen during training. For rigid point clouds, remarkable generalization has been achieved by leveraging SE(3)-equivariant networks, but these methods do not work on articulated objects. In this work we extend this idea to human bodies and propose ArtEq, a novel part-based SE(3)-equivariant neural architecture for SMPL model estimation from point clouds. Specifically, we learn a part detection network by leveraging local SO(3) invariance, and regress shape and pose using articulated SE(3) shape-invariant and pose-equivariant networks, all trained end-to-end. Our novel pose regression module leverages the permutation-equivariant property of self-attention layers to preserve rotational equivariance. Experimental results show that ArtEq generalizes to poses not seen during training, outperforming state-of-the-art methods by ~44% in terms of body reconstruction accuracy, without requiring an optimization refinement step. Furthermore, ArtEq is three orders of magnitude faster during inference than prior work and has 97.3% fewer parameters. The code and model are available for research purposes at https://arteq.is.tue.mpg.de.

Self-supervised learning (SSL) approaches have recently shown substantial success in learning visual representations from unannotated images. Compared with photographic images, medical images acquired with the same imaging protocol exhibit high consistency in anatomy. To exploit this anatomical consistency, this paper introduces a novel SSL approach, called PEAC (patch embedding of anatomical consistency), for medical image analysis. Specifically, in this paper, we propose to learn global and local consistencies via stable grid-based matching, transfer pre-trained PEAC models to diverse downstream tasks, and extensively demonstrate that (1) PEAC achieves significantly better performance than the existing state-of-the-art fully/self-supervised methods, and (2) PEAC captures the anatomical structure consistency across views of the same patient and across patients of different genders, weights, and healthy statuses, which enhances the interpretability of our method for medical image analysis.

Recently, the retrieval models based on dense representations have been gradually applied in the first stage of the document retrieval tasks, showing better performance than traditional sparse vector space models. To obtain high efficiency, the basic structure of these models is Bi-encoder in most cases. However, this simple structure may cause serious information loss during the encoding of documents since the queries are agnostic. To address this problem, we design a method to mimic the queries on each of the documents by an iterative clustering process and represent the documents by multiple pseudo queries (i.e., the cluster centroids). To boost the retrieval process using approximate nearest neighbor search library, we also optimize the matching function with a two-step score calculation procedure. Experimental results on several popular ranking and QA datasets show that our model can achieve state-of-the-art results.

Longitudinal multimodal data, including electronic health records (EHR) and sequential chest X-rays (CXRs), is critical for modeling disease progression, yet remains underutilized due to two key challenges: (1) redundancy in consecutive CXR sequences, where static anatomical regions dominate over clinically-meaningful dynamics, and (2) temporal misalignment between sparse, irregular imaging and continuous EHR data. We introduce DiPro, a novel framework that addresses these challenges through region-aware disentanglement and multi-timescale alignment. First, we disentangle static (anatomy) and dynamic (pathology progression) features in sequential CXRs, prioritizing disease-relevant changes. Second, we hierarchically align these static and dynamic CXR features with asynchronous EHR data via local (pairwise interval-level) and global (full-sequence) synchronization to model coherent progression pathways. Extensive experiments on the MIMIC dataset demonstrate that DiPro could effectively extract temporal clinical dynamics and achieve state-of-the-art performance on both disease progression identification and general ICU prediction tasks.

Large-scale visual localization systems continue to rely on 3D point clouds built from image collections using structure-from-motion. While the 3D points in these models are represented using local image features, directly matching a query image's local features against the point cloud is challenging due to the scale of the nearest-neighbor search problem. Many recent approaches to visual localization have thus proposed a hybrid method, where first a global (per image) embedding is used to retrieve a small subset of database images, and local features of the query are matched only against those. It seems to have become common belief that global embeddings are critical for said image-retrieval in visual localization, despite the significant downside of having to compute two feature types for each query image. In this paper, we take a step back from this assumption and propose Constrained Approximate Nearest Neighbors (CANN), a joint solution of k-nearest-neighbors across both the geometry and appearance space using only local features. We first derive the theoretical foundation for k-nearest-neighbor retrieval across multiple metrics and then showcase how CANN improves visual localization. Our experiments on public localization benchmarks demonstrate that our method significantly outperforms both state-of-the-art global feature-based retrieval and approaches using local feature aggregation schemes. Moreover, it is an order of magnitude faster in both index and query time than feature aggregation schemes for these datasets. Code will be released.

Vision-and-language models (VLMs) have been increasingly explored in the medical domain, particularly following the success of CLIP in general domain. However, unlike the relatively straightforward pairing of 2D images and text, curating large-scale paired data in the medical field for volumetric modalities such as CT scans remains a challenging and time-intensive process. This difficulty often limits the performance on downstream tasks. To address these challenges, we propose a novel vision-language pre-training (VLP) framework, termed as VELVET-Med, specifically designed for limited volumetric data such as 3D CT and associated radiology reports. Instead of relying on large-scale data collection, our method focuses on the development of effective pre-training objectives and model architectures. The key contributions are: 1) We incorporate uni-modal self-supervised learning into VLP framework, which are often underexplored in the existing literature. 2) We propose a novel language encoder, termed as TriBERT, for learning multi-level textual semantics. 3) We devise the hierarchical contrastive learning to capture multi-level vision-language correspondence. Using only 38,875 scan-report pairs, our approach seeks to uncover rich spatial and semantic relationships embedded in volumetric medical images and corresponding clinical narratives, thereby enhancing the generalization ability of the learned encoders. The resulting encoders exhibit strong transferability, achieving state-of-the-art performance across a wide range of downstream tasks, including 3D segmentation, cross-modal retrieval, visual question answering, and report generation.

This paper presents the technical solution developed by team CRUISE for the KDD Cup 2025 Meta Comprehensive RAG Benchmark for Multi-modal, Multi-turn (CRAG-MM) challenge. The challenge aims to address a critical limitation of modern Vision Language Models (VLMs): their propensity to hallucinate, especially when faced with egocentric imagery, long-tail entities, and complex, multi-hop questions. This issue is particularly problematic in real-world applications where users pose fact-seeking queries that demand high factual accuracy across diverse modalities. To tackle this, we propose a robust, multi-stage framework that prioritizes factual accuracy and truthfulness over completeness. Our solution integrates a lightweight query router for efficiency, a query-aware retrieval and summarization pipeline, a dual-pathways generation and a post-hoc verification. This conservative strategy is designed to minimize hallucinations, which incur a severe penalty in the competition's scoring metric. Our approach achieved 3rd place in Task 1, demonstrating the effectiveness of prioritizing answer reliability in complex multi-modal RAG systems. Our implementation is available at https://github.com/Breezelled/KDD-Cup-2025-Meta-CRAG-MM .

Interactions with large language models (LLMs) often yield long and detailed responses, leveraging both parametric knowledge and retrieval-augmented generation (RAG). While these responses can provide rich insights, they often include redundant or less engaging content not aligned with user interests. This issue becomes apparent when users specify particular subtopics to include or exclude -- termed coverage-conditioned (C^2) queries -- as LLMs often struggle to provide tailored responses. To address this challenge, we investigate the role of query outlines, sequences of subqueries designed to guide LLMs in generating responses that meet specific user requirements. To systematically create and evaluate these outlines, we introduce QTree, a dataset of 10K hierarchical sets of information-seeking subqueries that define structured boundaries for outline creation and evaluation in C^2 scenarios. Additionally, we develop QPlanner, a 7B language model trained to generate customized outlines within boundaries of QTree. We evaluate the effectiveness of the generated outlines through automatic and human judgements, focusing on their impact within retrieval-augmented generation (RAG) systems. Experimental results demonstrate that QPlanner, especially when trained with alignment techniques like DPO, generates higher-quality outlines that better fulfill diverse user needs.

Scaling dense retrievers to larger large language model (LLM) backbones has been a dominant strategy for improving their retrieval effectiveness. However, this has substantial cost implications: larger backbones require more expensive hardware (e.g. GPUs with more memory) and lead to higher indexing and querying costs (latency, energy consumption). In this paper, we challenge this paradigm by introducing PromptPRF, a feature-based pseudo-relevance feedback (PRF) framework that enables small LLM-based dense retrievers to achieve effectiveness comparable to much larger models. PromptPRF uses LLMs to extract query-independent, structured and unstructured features (e.g., entities, summaries, chain-of-thought keywords, essay) from top-ranked documents. These features are generated offline and integrated into dense query representations via prompting, enabling efficient retrieval without additional training. Unlike prior methods such as GRF, which rely on online, query-specific generation and sparse retrieval, PromptPRF decouples feedback generation from query processing and supports dense retrievers in a fully zero-shot setting. Experiments on TREC DL and BEIR benchmarks demonstrate that PromptPRF consistently improves retrieval effectiveness and offers favourable cost-effectiveness trade-offs. We further present ablation studies to understand the role of positional feedback and analyse the interplay between feature extractor size, PRF depth, and model performance. Our findings demonstrate that with effective PRF design, scaling the retriever is not always necessary, narrowing the gap between small and large models while reducing inference cost.

Retrieval-augmented learning based on radiology reports has emerged as a promising direction to improve performance on long-tail medical imaging tasks, such as rare disease detection in chest X-rays. Most existing methods rely on comparing high-dimensional text embeddings from models like CLIP or CXR-BERT, which are often difficult to interpret, computationally expensive, and not well-aligned with the structured nature of medical knowledge. We propose a novel, ontology-driven alternative for comparing radiology report texts based on clinically grounded concepts from the Unified Medical Language System (UMLS). Our method extracts standardised medical entities from free-text reports using an enhanced pipeline built on RadGraph-XL and SapBERT. These entities are linked to UMLS concepts (CUIs), enabling a transparent, interpretable set-based representation of each report. We then define a task-adaptive similarity measure based on a modified and weighted version of the Tversky Index that accounts for synonymy, negation, and hierarchical relationships between medical entities. This allows efficient and semantically meaningful similarity comparisons between reports. We demonstrate that our approach outperforms state-of-the-art embedding-based retrieval methods in a radiograph classification task on MIMIC-CXR, particularly in long-tail settings. Additionally, we use our pipeline to generate ontology-backed disease labels for MIMIC-CXR, offering a valuable new resource for downstream learning tasks. Our work provides more explainable, reliable, and task-specific retrieval strategies in clinical AI systems, especially when interpretability and domain knowledge integration are essential. Our code is available at https://github.com/Felix-012/ontology-concept-distillation

Vector embeddings have been tasked with an ever-increasing set of retrieval tasks over the years, with a nascent rise in using them for reasoning, instruction-following, coding, and more. These new benchmarks push embeddings to work for any query and any notion of relevance that could be given. While prior works have pointed out theoretical limitations of vector embeddings, there is a common assumption that these difficulties are exclusively due to unrealistic queries, and those that are not can be overcome with better training data and larger models. In this work, we demonstrate that we may encounter these theoretical limitations in realistic settings with extremely simple queries. We connect known results in learning theory, showing that the number of top-k subsets of documents capable of being returned as the result of some query is limited by the dimension of the embedding. We empirically show that this holds true even if we restrict to k=2, and directly optimize on the test set with free parameterized embeddings. We then create a realistic dataset called LIMIT that stress tests models based on these theoretical results, and observe that even state-of-the-art models fail on this dataset despite the simple nature of the task. Our work shows the limits of embedding models under the existing single vector paradigm and calls for future research to develop methods that can resolve this fundamental limitation.

The question-answering system for Life science research, which is characterized by the rapid pace of discovery, evolving insights, and complex interactions among knowledge entities, presents unique challenges in maintaining a comprehensive knowledge warehouse and accurate information retrieval. To address these issues, we introduce BioRAG, a novel Retrieval-Augmented Generation (RAG) with the Large Language Models (LLMs) framework. Our approach starts with parsing, indexing, and segmenting an extensive collection of 22 million scientific papers as the basic knowledge, followed by training a specialized embedding model tailored to this domain. Additionally, we enhance the vector retrieval process by incorporating a domain-specific knowledge hierarchy, which aids in modeling the intricate interrelationships among each query and context. For queries requiring the most current information, BioRAG deconstructs the question and employs an iterative retrieval process incorporated with the search engine for step-by-step reasoning. Rigorous experiments have demonstrated that our model outperforms fine-tuned LLM, LLM with search engines, and other scientific RAG frameworks across multiple life science question-answering tasks.

Large Language Models (LLMs) have demonstrated remarkable capabilities in natural language processing, and yet, their factual inaccuracies and hallucinations limits their application, particularly in critical domains like healthcare. Context retrieval methods, by introducing relevant information as input, have emerged as a crucial approach for enhancing LLM factuality and reliability. This study explores the boundaries of context retrieval methods within the healthcare domain, optimizing their components and benchmarking their performance against open and closed alternatives. Our findings reveal how open LLMs, when augmented with an optimized retrieval system, can achieve performance comparable to the biggest private solutions on established healthcare benchmarks (multiple-choice question answering). Recognizing the lack of realism of including the possible answers within the question (a setup only found in medical exams), and after assessing a strong LLM performance degradation in the absence of those options, we extend the context retrieval system in that direction. In particular, we propose OpenMedPrompt a pipeline that improves the generation of more reliable open-ended answers, moving this technology closer to practical application.

This paper considers Pseudo-Relevance Feedback (PRF) methods for dense retrievers in a resource constrained environment such as that of cheap cloud instances or embedded systems (e.g., smartphones and smartwatches), where memory and CPU are limited and GPUs are not present. For this, we propose a transformer-based PRF method (TPRF), which has a much smaller memory footprint and faster inference time compared to other deep language models that employ PRF mechanisms, with a marginal effectiveness loss. TPRF learns how to effectively combine the relevance feedback signals from dense passage representations. Specifically, TPRF provides a mechanism for modelling relationships and weights between the query and the relevance feedback signals. The method is agnostic to the specific dense representation used and thus can be generally applied to any dense retriever.

Large reasoning models (LRMs) have demonstrated strong performance in complex, multi-step reasoning tasks. Existing methods enhance LRMs by sequentially integrating external knowledge retrieval; models iteratively generate queries, retrieve external information, and progressively reason over this information. However, purely sequential querying increases inference latency and context length, diminishing coherence and potentially reducing accuracy. To address these limitations, we introduce HDS-QA (Hybrid Deep Search QA), a synthetic dataset automatically generated from Natural Questions, explicitly designed to train LRMs to distinguish parallelizable from sequential queries. HDS-QA comprises hybrid-hop questions that combine parallelizable independent subqueries (executable simultaneously) and sequentially dependent subqueries (requiring step-by-step resolution), along with synthetic reasoning-querying-retrieval paths involving parallel queries. We fine-tune an LRM using HDS-QA, naming the model HybridDeepSearcher, which outperforms state-of-the-art baselines across multiple benchmarks, notably achieving +15.9 and +11.5 F1 on FanOutQA and a subset of BrowseComp, respectively, both requiring comprehensive and exhaustive search. Experimental results highlight two key advantages: HybridDeepSearcher reaches comparable accuracy with fewer search turns, significantly reducing inference latency, and it effectively scales as more turns are permitted. These results demonstrate the efficiency, scalability, and effectiveness of explicitly training LRMs to leverage hybrid parallel and sequential querying.

Zero-shot medical detection can further improve detection performance without relying on annotated medical images even upon the fine-tuned model, showing great clinical value. Recent studies leverage grounded vision-language models (GLIP) to achieve this by using detailed disease descriptions as prompts for the target disease name during the inference phase. However, these methods typically treat prompts as equivalent context to the target name, making it difficult to assign specific disease knowledge based on visual information, leading to a coarse alignment between images and target descriptions. In this paper, we propose StructuralGLIP, which introduces an auxiliary branch to encode prompts into a latent knowledge bank layer-by-layer, enabling more context-aware and fine-grained alignment. Specifically, in each layer, we select highly similar features from both the image representation and the knowledge bank, forming structural representations that capture nuanced relationships between image patches and target descriptions. These features are then fused across modalities to further enhance detection performance. Extensive experiments demonstrate that StructuralGLIP achieves a +4.1\% AP improvement over prior state-of-the-art methods across seven zero-shot medical detection benchmarks, and consistently improves fine-tuned models by +3.2\% AP on endoscopy image datasets.

Few-shot fine-grained classification and person search appear as distinct tasks and literature has treated them separately. But a closer look unveils important similarities: both tasks target categories that can only be discriminated by specific object details; and the relevant models should generalize to new categories, not seen during training. We propose a novel unified Query-Guided Network (QGN) applicable to both tasks. QGN consists of a Query-guided Siamese-Squeeze-and-Excitation subnetwork which re-weights both the query and gallery features across all network layers, a Query-guided Region Proposal subnetwork for query-specific localisation, and a Query-guided Similarity subnetwork for metric learning. QGN improves on a few recent few-shot fine-grained datasets, outperforming other techniques on CUB by a large margin. QGN also performs competitively on the person search CUHK-SYSU and PRW datasets, where we perform in-depth analysis.

Large language models (LLMs) are increasingly envisioned as decision-support tools in clinical practice, yet safe clinical reasoning demands integrating heterogeneous knowledge bases -- trials, primary studies, regulatory documents, and cost data -- under strict accuracy constraints. Existing evaluations often rely on synthetic prompts, reduce the task to single-hop factoid queries, or conflate reasoning with open-ended generation, leaving their real-world utility unclear. To close this gap, we present MedBrowseComp, the first benchmark that systematically tests an agent's ability to reliably retrieve and synthesize multi-hop medical facts from live, domain-specific knowledge bases. MedBrowseComp contains more than 1,000 human-curated questions that mirror clinical scenarios where practitioners must reconcile fragmented or conflicting information to reach an up-to-date conclusion. Applying MedBrowseComp to frontier agentic systems reveals performance shortfalls as low as ten percent, exposing a critical gap between current LLM capabilities and the rigor demanded in clinical settings. MedBrowseComp therefore offers a clear testbed for reliable medical information seeking and sets concrete goals for future model and toolchain upgrades. You can visit our project page at: https://moreirap12.github.io/mbc-browse-app/

Traditional 2D pose estimation models are limited by their category-specific design, making them suitable only for predefined object categories. This restriction becomes particularly challenging when dealing with novel objects due to the lack of relevant training data. To address this limitation, category-agnostic pose estimation (CAPE) was introduced. CAPE aims to enable keypoint localization for arbitrary object categories using a single model, requiring minimal support images with annotated keypoints. This approach not only enables object pose generation based on arbitrary keypoint definitions but also significantly reduces the associated costs, paving the way for versatile and adaptable pose estimation applications. We present a novel approach to CAPE that leverages the inherent geometrical relations between keypoints through a newly designed Graph Transformer Decoder. By capturing and incorporating this crucial structural information, our method enhances the accuracy of keypoint localization, marking a significant departure from conventional CAPE techniques that treat keypoints as isolated entities. We validate our approach on the MP-100 benchmark, a comprehensive dataset comprising over 20,000 images spanning more than 100 categories. Our method outperforms the prior state-of-the-art by substantial margins, achieving remarkable improvements of 2.16% and 1.82% under 1-shot and 5-shot settings, respectively. Furthermore, our method's end-to-end training demonstrates both scalability and efficiency compared to previous CAPE approaches.

Existing volumetric medical image segmentation models are typically task-specific, excelling at specific target but struggling to generalize across anatomical structures or modalities. This limitation restricts their broader clinical use. In this paper, we introduce SAM-Med3D for general-purpose segmentation on volumetric medical images. Given only a few 3D prompt points, SAM-Med3D can accurately segment diverse anatomical structures and lesions across various modalities. To achieve this, we gather and process a large-scale 3D medical image dataset, SA-Med3D-140K, from a blend of public sources and licensed private datasets. This dataset includes 22K 3D images and 143K corresponding 3D masks. Then SAM-Med3D, a promptable segmentation model characterized by the fully learnable 3D structure, is trained on this dataset using a two-stage procedure and exhibits impressive performance on both seen and unseen segmentation targets. We comprehensively evaluate SAM-Med3D on 16 datasets covering diverse medical scenarios, including different anatomical structures, modalities, targets, and zero-shot transferability to new/unseen tasks. The evaluation shows the efficiency and efficacy of SAM-Med3D, as well as its promising application to diverse downstream tasks as a pre-trained model. Our approach demonstrates that substantial medical resources can be utilized to develop a general-purpose medical AI for various potential applications. Our dataset, code, and models are available at https://github.com/uni-medical/SAM-Med3D.

Incorporating domain-specific priors in search and navigation tasks has shown promising results in improving generalization and sample complexity over end-to-end trained policies. In this work, we study how object embeddings that capture spatial semantic priors can guide search and navigation tasks in a structured environment. We know that humans can search for an object like a book, or a plate in an unseen house, based on the spatial semantics of bigger objects detected. For example, a book is likely to be on a bookshelf or a table, whereas a plate is likely to be in a cupboard or dishwasher. We propose a method to incorporate such spatial semantic awareness in robots by leveraging pre-trained language models and multi-relational knowledge bases as object embeddings. We demonstrate using these object embeddings to search a query object in an unseen indoor environment. We measure the performance of these embeddings in an indoor simulator (AI2Thor). We further evaluate different pre-trained embedding onSuccess Rate(SR) and success weighted by Path Length(SPL).

The fine-grained localization of clinicians in the operating room (OR) is a key component to design the new generation of OR support systems. Computer vision models for person pixel-based segmentation and body-keypoints detection are needed to better understand the clinical activities and the spatial layout of the OR. This is challenging, not only because OR images are very different from traditional vision datasets, but also because data and annotations are hard to collect and generate in the OR due to privacy concerns. To address these concerns, we first study how joint person pose estimation and instance segmentation can be performed on low resolutions images with downsampling factors from 1x to 12x. Second, to address the domain shift and the lack of annotations, we propose a novel unsupervised domain adaptation method, called AdaptOR, to adapt a model from an in-the-wild labeled source domain to a statistically different unlabeled target domain. We propose to exploit explicit geometric constraints on the different augmentations of the unlabeled target domain image to generate accurate pseudo labels and use these pseudo labels to train the model on high- and low-resolution OR images in a self-training framework. Furthermore, we propose disentangled feature normalization to handle the statistically different source and target domain data. Extensive experimental results with detailed ablation studies on the two OR datasets MVOR+ and TUM-OR-test show the effectiveness of our approach against strongly constructed baselines, especially on the low-resolution privacy-preserving OR images. Finally, we show the generality of our method as a semi-supervised learning (SSL) method on the large-scale COCO dataset, where we achieve comparable results with as few as 1% of labeled supervision against a model trained with 100% labeled supervision.

Statistical shape modeling (SSM) enables population-based quantitative analysis of anatomical shapes, informing clinical diagnosis. Deep learning approaches predict correspondence-based SSM directly from unsegmented 3D images but require calibrated uncertainty quantification, motivating Bayesian formulations. Variational information bottleneck DeepSSM (VIB-DeepSSM) is an effective, principled framework for predicting probabilistic shapes of anatomy from images with aleatoric uncertainty quantification. However, VIB is only half-Bayesian and lacks epistemic uncertainty inference. We derive a fully Bayesian VIB formulation and demonstrate the efficacy of two scalable implementation approaches: concrete dropout and batch ensemble. Additionally, we introduce a novel combination of the two that further enhances uncertainty calibration via multimodal marginalization. Experiments on synthetic shapes and left atrium data demonstrate that the fully Bayesian VIB network predicts SSM from images with improved uncertainty reasoning without sacrificing accuracy.

Although the preservation of shape continuity and physiological anatomy is a natural assumption in the segmentation of medical images, it is often neglected by deep learning methods that mostly aim for the statistical modeling of input data as pixels rather than interconnected structures. In biological structures, however, organs are not separate entities; for example, in reality, a severed vessel is an indication of an underlying problem, but traditional segmentation models are not designed to strictly enforce the continuity of anatomy, potentially leading to inaccurate medical diagnoses. To address this issue, we propose a graph-based approach that enforces the continuity and connectivity of anatomical topology in medical images. Our method encodes the continuity of shapes as a graph constraint, ensuring that the network's predictions maintain this continuity. We evaluate our method on two public benchmarks on retinal vessel segmentation, showing significant improvements in connectivity metrics compared to traditional methods while getting better or on-par performance on segmentation metrics.

The field of medical image segmentation is hindered by the scarcity of large, publicly available annotated datasets. Not all datasets are made public for privacy reasons, and creating annotations for a large dataset is time-consuming and expensive, as it requires specialized expertise to accurately identify regions of interest (ROIs) within the images. To address these challenges, we evaluate the performance of the Segment Anything Model (SAM) as an annotation tool for medical data by using it to produce so-called "pseudo labels" on the Medical Segmentation Decathlon (MSD) computed tomography (CT) tasks. The pseudo labels are then used in place of ground truth labels to train a UNet model in a weakly-supervised manner. We experiment with different prompt types on SAM and find that the bounding box prompt is a simple yet effective method for generating pseudo labels. This method allows us to develop a weakly-supervised model that performs comparably to a fully supervised model.

Medical information retrieval (MIR) is essential for retrieving relevant medical knowledge from diverse sources, including electronic health records, scientific literature, and medical databases. However, achieving effective zero-shot dense retrieval in the medical domain poses substantial challenges due to the lack of relevance-labeled data. In this paper, we introduce a novel approach called Self-Learning Hypothetical Document Embeddings (SL-HyDE) to tackle this issue. SL-HyDE leverages large language models (LLMs) as generators to generate hypothetical documents based on a given query. These generated documents encapsulate key medical context, guiding a dense retriever in identifying the most relevant documents. The self-learning framework progressively refines both pseudo-document generation and retrieval, utilizing unlabeled medical corpora without requiring any relevance-labeled data. Additionally, we present the Chinese Medical Information Retrieval Benchmark (CMIRB), a comprehensive evaluation framework grounded in real-world medical scenarios, encompassing five tasks and ten datasets. By benchmarking ten models on CMIRB, we establish a rigorous standard for evaluating medical information retrieval systems. Experimental results demonstrate that SL-HyDE significantly surpasses existing methods in retrieval accuracy while showcasing strong generalization and scalability across various LLM and retriever configurations. CMIRB data and evaluation code are publicly available at: https://github.com/CMIRB-benchmark/CMIRB.

Interactive medical questioning is essential in real-world clinical consultations, where physicians must actively gather information from patients. While medical Large Language Models (LLMs) have shown impressive capabilities in static medical question answering, they predominantly operate under a reactive paradigm: generating answers directly without seeking additional information, which risks incorrect diagnoses in such interactive settings. To address this limitation, we propose ProMed, a reinforcement learning (RL) framework that transitions medical LLMs toward a proactive paradigm, equipping them with the ability to ask clinically valuable questions before decision-making. At the core of ProMed is the Shapley Information Gain (SIG) reward, which quantifies the clinical utility of each question by combining the amount of newly acquired information with its contextual importance, estimated via Shapley values. We integrate SIG into a two-stage training pipeline: (1) SIG-Guided Model Initialization uses Monte Carlo Tree Search (MCTS) to construct high-reward interaction trajectories to supervise the model, and (2) SIG-Augmented Policy Optimization, which integrates SIG and enhances RL with a novel SIG-guided Reward Distribution Mechanism that assigns higher rewards to informative questions for targeted optimization. Extensive experiments on two newly curated partial-information medical benchmarks demonstrate that ProMed significantly outperforms state-of-the-art methods by an average of 6.29% and delivers a 54.45% gain over the reactive paradigm, while also generalizing robustly to out-of-domain cases.

High-quality medical systematic reviews require comprehensive literature searches to ensure the recommendations and outcomes are sufficiently reliable. Indeed, searching for relevant medical literature is a key phase in constructing systematic reviews and often involves domain (medical researchers) and search (information specialists) experts in developing the search queries. Queries in this context are highly complex, based on Boolean logic, include free-text terms and index terms from standardised terminologies (e.g., MeSH), and are difficult and time-consuming to build. The use of MeSH terms, in particular, has been shown to improve the quality of the search results. However, identifying the correct MeSH terms to include in a query is difficult: information experts are often unfamiliar with the MeSH database and unsure about the appropriateness of MeSH terms for a query. Naturally, the full value of the MeSH terminology is often not fully exploited. This paper investigates methods to suggest MeSH terms based on an initial Boolean query that includes only free-text terms. These methods promise to automatically identify highly effective MeSH terms for inclusion in a systematic review query. Our study contributes an empirical evaluation of several MeSH term suggestion methods. We perform an extensive analysis of the retrieval, ranking, and refinement of MeSH term suggestions for each method and how these suggestions impact the effectiveness of Boolean queries.

Vector databases typically rely on approximate nearest neighbor (ANN) search to retrieve the top-k closest vectors to a query in embedding space. While effective, this approach often yields semantically redundant results, missing the diversity and contextual richness required by applications such as retrieval-augmented generation (RAG), multi-hop QA, and memory-augmented agents. We introduce a new retrieval paradigm: semantic compression, which aims to select a compact, representative set of vectors that captures the broader semantic structure around a query. We formalize this objective using principles from submodular optimization and information geometry, and show that it generalizes traditional top-k retrieval by prioritizing coverage and diversity. To operationalize this idea, we propose graph-augmented vector retrieval, which overlays semantic graphs (e.g., kNN or knowledge-based links) atop vector spaces to enable multi-hop, context-aware search. We theoretically analyze the limitations of proximity-based retrieval under high-dimensional concentration and highlight how graph structures can improve semantic coverage. Our work outlines a foundation for meaning-centric vector search systems, emphasizing hybrid indexing, diversity-aware querying, and structured semantic retrieval. We make our implementation publicly available to foster future research in this area.

This paper presents the RMIT--ADM+S participation in the SIGIR 2025 LiveRAG Challenge. Our Generation-Retrieval-Augmented Generation (GRAG) approach relies on generating a hypothetical answer that is used in the retrieval phase, alongside the original question. GRAG also incorporates a pointwise large language model (LLM)-based re-ranking step prior to final answer generation. We describe the system architecture and the rationale behind our design choices. In particular, a systematic evaluation using the Grid of Points (GoP) framework and N-way ANOVA enabled comparison across multiple configurations, including query variant generation, question decomposition, rank fusion strategies, and prompting techniques for answer generation. Our system achieved a Relevance score of 1.199 and a Faithfulness score of 0.477 on the private leaderboard, placing among the top four finalists in the LiveRAG 2025 Challenge.

Large Vision-Language Models (LVLMs) have demonstrated remarkable capabilities in various multimodal tasks. However, their potential in the medical domain remains largely unexplored. A significant challenge arises from the scarcity of diverse medical images spanning various modalities and anatomical regions, which is essential in real-world medical applications. To solve this problem, in this paper, we introduce OmniMedVQA, a novel comprehensive medical Visual Question Answering (VQA) benchmark. This benchmark is collected from 75 different medical datasets, including 12 different modalities and covering more than 20 distinct anatomical regions. Importantly, all images in this benchmark are sourced from authentic medical scenarios, ensuring alignment with the requirements of the medical field and suitability for evaluating LVLMs. Through our extensive experiments, we have found that existing LVLMs struggle to address these medical VQA problems effectively. Moreover, what surprises us is that medical-specialized LVLMs even exhibit inferior performance to those general-domain models, calling for a more versatile and robust LVLM in the biomedical field. The evaluation results not only reveal the current limitations of LVLM in understanding real medical images but also highlight our dataset's significance. Our dataset will be made publicly available.

Medical image retrieval is essential for clinical decision-making and translational research, relying on discriminative visual representations. Yet, current methods remain fragmented, relying on separate architectures and training strategies for 2D, 3D, and video-based medical data. This modality-specific design hampers scalability and inhibits the development of unified representations. To enable unified learning, we curate a large-scale hybrid-modality dataset comprising 867,653 medical imaging samples, including 2D X-rays and ultrasounds, RGB endoscopy videos, and 3D CT scans. Leveraging this dataset, we train M3Ret, a unified visual encoder without any modality-specific customization. It successfully learns transferable representations using both generative (MAE) and contrastive (SimDINO) self-supervised learning (SSL) paradigms. Our approach sets a new state-of-the-art in zero-shot image-to-image retrieval across all individual modalities, surpassing strong baselines such as DINOv3 and the text-supervised BMC-CLIP. More remarkably, strong cross-modal alignment emerges without paired data, and the model generalizes to unseen MRI tasks, despite never observing MRI during pretraining, demonstrating the generalizability of purely visual self-supervision to unseen modalities. Comprehensive analyses further validate the scalability of our framework across model and data sizes. These findings deliver a promising signal to the medical imaging community, positioning M3Ret as a step toward foundation models for visual SSL in multimodal medical image understanding.

Retrieval-augmented models have proven to be effective in natural language processing tasks, yet there remains a lack of research on their optimization using variational inference. We introduce the Variational Open-Domain (VOD) framework for end-to-end training and evaluation of retrieval-augmented models, focusing on open-domain question answering and language modelling. The VOD objective, a self-normalized estimate of the R\'enyi variational bound, approximates the task marginal likelihood and is evaluated under samples drawn from an auxiliary sampling distribution (cached retriever and/or approximate posterior). It remains tractable, even for retriever distributions defined on large corpora. We demonstrate VOD's versatility by training reader-retriever BERT-sized models on multiple-choice medical exam questions. On the MedMCQA dataset, we outperform the domain-tuned Med-PaLM by +5.3% despite using 2.500times fewer parameters. Our retrieval-augmented BioLinkBERT model scored 62.9% on the MedMCQA and 55.0% on the MedQA-USMLE. Last, we show the effectiveness of our learned retriever component in the context of medical semantic search.

Learned sparse retrieval systems aim to combine the effectiveness of contextualized language models with the scalability of conventional data structures such as inverted indexes. Nevertheless, the indexes generated by these systems exhibit significant deviations from the ones that use traditional retrieval models, leading to a discrepancy in the performance of existing query optimizations that were specifically developed for traditional structures. These disparities arise from structural variations in query and document statistics, including sub-word tokenization, leading to longer queries, smaller vocabularies, and different score distributions within posting lists. This paper introduces Block-Max Pruning (BMP), an innovative dynamic pruning strategy tailored for indexes arising in learned sparse retrieval environments. BMP employs a block filtering mechanism to divide the document space into small, consecutive document ranges, which are then aggregated and sorted on the fly, and fully processed only as necessary, guided by a defined safe early termination criterion or based on approximate retrieval requirements. Through rigorous experimentation, we show that BMP substantially outperforms existing dynamic pruning strategies, offering unparalleled efficiency in safe retrieval contexts and improved tradeoffs between precision and efficiency in approximate retrieval tasks.

All tables can be represented as grids. Based on this observation, we propose GridFormer, a novel approach for interpreting unconstrained table structures by predicting the vertex and edge of a grid. First, we propose a flexible table representation in the form of an MXN grid. In this representation, the vertexes and edges of the grid store the localization and adjacency information of the table. Then, we introduce a DETR-style table structure recognizer to efficiently predict this multi-objective information of the grid in a single shot. Specifically, given a set of learned row and column queries, the recognizer directly outputs the vertexes and edges information of the corresponding rows and columns. Extensive experiments on five challenging benchmarks which include wired, wireless, multi-merge-cell, oriented, and distorted tables demonstrate the competitive performance of our model over other methods.

Self-supervised learning (SSL) has potential for effective representation learning in medical imaging, but the choice of data augmentation is critical and domain-specific. It remains uncertain if general augmentation policies suit surgical applications. In this work, we automate the search for suitable augmentation policies through a new method called Dimensionality Driven Augmentation Search (DDA). DDA leverages the local dimensionality of deep representations as a proxy target, and differentiably searches for suitable data augmentation policies in contrastive learning. We demonstrate the effectiveness and efficiency of DDA in navigating a large search space and successfully identifying an appropriate data augmentation policy for laparoscopic surgery. We systematically evaluate DDA across three laparoscopic image classification and segmentation tasks, where it significantly improves over existing baselines. Furthermore, DDA's optimised set of augmentations provides insight into domain-specific dependencies when applying contrastive learning in medical applications. For example, while hue is an effective augmentation for natural images, it is not advantageous for laparoscopic images.

Self-supervised learning has emerged as a powerful paradigm for training deep neural networks, particularly in medical imaging where labeled data is scarce. While current approaches typically rely on synthetic augmentations of single images, we propose VET-DINO, a framework that leverages a unique characteristic of medical imaging: the availability of multiple standardized views from the same study. Using a series of clinical veterinary radiographs from the same patient study, we enable models to learn view-invariant anatomical structures and develop an implied 3D understanding from 2D projections. We demonstrate our approach on a dataset of 5 million veterinary radiographs from 668,000 canine studies. Through extensive experimentation, including view synthesis and downstream task performance, we show that learning from real multi-view pairs leads to superior anatomical understanding compared to purely synthetic augmentations. VET-DINO achieves state-of-the-art performance on various veterinary imaging tasks. Our work establishes a new paradigm for self-supervised learning in medical imaging that leverages domain-specific properties rather than merely adapting natural image techniques.

Precision medicine, such as patient-adaptive treatments assisted by medical image analysis, poses new challenges for segmentation algorithms in adapting to new patients, due to the large variability across different patients and the limited availability of annotated data for each patient. In this work, we propose a data-efficient segmentation algorithm, namely Part-aware Prompted Segment Anything Model (P^2SAM). Without any model fine-tuning, P^2SAM enables seamless adaptation to any new patients relying only on one-shot patient-specific data. We introduce a novel part-aware prompt mechanism to select multiple-point prompts based on the part-level features of the one-shot data, which can be extensively integrated into different promptable segmentation models, such as SAM and SAM 2. Moreover, to determine the optimal number of parts for each specific case, we propose a distribution-guided retrieval approach that further enhances the robustness of the part-aware prompt mechanism. P^2SAM improves the performance by +8.0% and +2.0% mean Dice score for two different patient-adaptive segmentation applications, respectively. In addition, P^2SAM also exhibits impressive generalizability in other adaptive segmentation tasks in the natural image domain, e.g., +6.4% mIoU within personalized object segmentation task. The code is available at: https://github.com/Zch0414/p2sam

UV map estimation is used in computer vision for detailed analysis of human posture or activity. Previous methods assign pixels to body model vertices by comparing pixel descriptors independently, without enforcing global coherence or plausibility in the UV map. We propose Pose-Constrained Continuous Surface Embeddings (PC-CSE), which integrates estimated 2D human pose into the pixel-to-vertex assignment process. The pose provides global anatomical constraints, ensuring that UV maps remain coherent while preserving local precision. Evaluation on DensePose COCO demonstrates consistent improvement, regardless of the chosen 2D human pose model. Whole-body poses offer better constraints by incorporating additional details about the hands and feet. Conditioning UV maps with human pose reduces invalid mappings and enhances anatomical plausibility. In addition, we highlight inconsistencies in the ground-truth annotations.

Retrieval-augmented Generation (RAG) has primarily been studied in limited settings, such as factoid question answering; more challenging, reasoning-intensive benchmarks have seen limited success from minimal RAG. In this work, we challenge this prevailing view on established, reasoning-intensive benchmarks: MMLU, MMLU Pro, AGI Eval, GPQA, and MATH. We identify a key missing component in prior work: a usable, web-scale datastore aligned with the breadth of pretraining data. To this end, we introduce CompactDS: a diverse, high-quality, web-scale datastore that achieves high retrieval accuracy and subsecond latency on a single-node. The key insights are (1) most web content can be filtered out without sacrificing coverage, and a compact, high-quality subset is sufficient; and (2) combining in-memory approximate nearest neighbor (ANN) retrieval and on-disk exact search balances speed and recall. Using CompactDS, we show that a minimal RAG pipeline achieves consistent accuracy improvements across all benchmarks and model sizes (8B--70B), with relative gains of 10% on MMLU, 33% on MMLU Pro, 14% on GPQA, and 19% on MATH. No single data source suffices alone, highlighting the importance of diversity of sources (web crawls, curated math, academic papers, textbooks). Finally, we show that our carefully designed in-house datastore matches or outperforms web search engines such as Google Search, as well as recently proposed, complex agent-based RAG systems--all while maintaining simplicity, reproducibility, and self-containment. We release CompactDS and our retrieval pipeline, supporting future research exploring retrieval-based AI systems.

Powerful priors allow us to perform inference with insufficient information. In this paper, we propose an autoregressive prior for 3D shapes to solve multimodal 3D tasks such as shape completion, reconstruction, and generation. We model the distribution over 3D shapes as a non-sequential autoregressive distribution over a discretized, low-dimensional, symbolic grid-like latent representation of 3D shapes. This enables us to represent distributions over 3D shapes conditioned on information from an arbitrary set of spatially anchored query locations and thus perform shape completion in such arbitrary settings (e.g., generating a complete chair given only a view of the back leg). We also show that the learned autoregressive prior can be leveraged for conditional tasks such as single-view reconstruction and language-based generation. This is achieved by learning task-specific naive conditionals which can be approximated by light-weight models trained on minimal paired data. We validate the effectiveness of the proposed method using both quantitative and qualitative evaluation and show that the proposed method outperforms the specialized state-of-the-art methods trained for individual tasks. The project page with code and video visualizations can be found at https://yccyenchicheng.github.io/AutoSDF/.

Image segmentation plays an essential role in medicine for both diagnostic and interventional tasks. Segmentation approaches are either manual, semi-automated or fully-automated. Manual segmentation offers full control over the quality of the results, but is tedious, time consuming and prone to operator bias. Fully automated methods require no human effort, but often deliver sub-optimal results without providing users with the means to make corrections. Semi-automated approaches keep users in control of the results by providing means for interaction, but the main challenge is to offer a good trade-off between precision and required interaction. In this paper we present a deep learning (DL) based semi-automated segmentation approach that aims to be a "smart" interactive tool for region of interest delineation in medical images. We demonstrate its use for segmenting multiple organs on computed tomography (CT) of the abdomen. Our approach solves some of the most pressing clinical challenges: (i) it requires only one to a few user clicks to deliver excellent 2D segmentations in a fast and reliable fashion; (ii) it can generalize to previously unseen structures and "corner cases"; (iii) it delivers results that can be corrected quickly in a smart and intuitive way up to an arbitrary degree of precision chosen by the user and (iv) ensures high accuracy. We present our approach and compare it to other techniques and previous work to show the advantages brought by our method.

Instance segmentation is critical in biomedical imaging to accurately distinguish individual objects like cells, which often overlap and vary in size. Recent query-based methods, where object queries guide segmentation, have shown strong performance. While U-Net has been a go-to architecture in medical image segmentation, its potential in query-based approaches remains largely unexplored. In this work, we present IAUNet, a novel query-based U-Net architecture. The core design features a full U-Net architecture, enhanced by a novel lightweight convolutional Pixel decoder, making the model more efficient and reducing the number of parameters. Additionally, we propose a Transformer decoder that refines object-specific features across multiple scales. Finally, we introduce the 2025 Revvity Full Cell Segmentation Dataset, a unique resource with detailed annotations of overlapping cell cytoplasm in brightfield images, setting a new benchmark for biomedical instance segmentation. Experiments on multiple public datasets and our own show that IAUNet outperforms most state-of-the-art fully convolutional, transformer-based, and query-based models and cell segmentation-specific models, setting a strong baseline for cell instance segmentation tasks. Code is available at https://github.com/SlavkoPrytula/IAUNet

Large language models (LLMs) have achieved remarkable success and demonstrated superior performance across various tasks, including natural language processing (NLP), weather forecasting, biological protein folding, text generation, and solving mathematical problems. However, many real-world data exhibit highly non-Euclidean latent hierarchical anatomy, such as protein networks, transportation networks, financial networks, brain networks, and linguistic structures or syntactic trees in natural languages. Effectively learning intrinsic semantic entailment and hierarchical relationships from these raw, unstructured input data using LLMs remains an underexplored area. Due to its effectiveness in modeling tree-like hierarchical structures, hyperbolic geometry -- a non-Euclidean space -- has rapidly gained popularity as an expressive latent representation space for complex data modeling across domains such as graphs, images, languages, and multi-modal data. Here, we provide a comprehensive and contextual exposition of recent advancements in LLMs that leverage hyperbolic geometry as a representation space to enhance semantic representation learning and multi-scale reasoning. Specifically, the paper presents a taxonomy of the principal techniques of Hyperbolic LLMs (HypLLMs) in terms of four main categories: (1) hyperbolic LLMs through exp/log maps; (2) hyperbolic fine-tuned models; (3) fully hyperbolic LLMs, and (4) hyperbolic state-space models. We also explore crucial potential applications and outline future research directions. A repository of key papers, models, datasets, and code implementations is available at https://github.com/sarangp2402/Hyperbolic-LLM-Models/tree/main.

Current volumetric biomedical foundation models struggle to generalize as public 3D datasets are small and do not cover the broad diversity of medical procedures, conditions, anatomical regions, and imaging protocols. We address this by creating a representation learning method that instead anticipates strong domain shifts at training time itself. We first propose a data engine that synthesizes highly variable training samples that would enable generalization to new biomedical contexts. To then train a single 3D network for any voxel-level task, we develop a contrastive learning method that pretrains the network to be stable against nuisance imaging variation simulated by the data engine, a key inductive bias for generalization. This network's features can be used as robust representations of input images for downstream tasks and its weights provide a strong, dataset-agnostic initialization for finetuning on new datasets. As a result, we set new standards across both multimodality registration and few-shot segmentation, a first for any 3D biomedical vision model, all without (pre-)training on any existing dataset of real images.

Retrieval-Augmented Generation (RAG) has demonstrated considerable effectiveness in open-domain question answering. However, when applied to heterogeneous documents, comprising both textual and tabular components, existing RAG approaches exhibit critical limitations. The prevailing practice of flattening tables and chunking strategies disrupts the intrinsic tabular structure, leads to information loss, and undermines the reasoning capabilities of LLMs in multi-hop, global queries. To address these challenges, we propose TableRAG, an hybrid framework that unifies textual understanding and complex manipulations over tabular data. TableRAG iteratively operates in four steps: context-sensitive query decomposition, text retrieval, SQL programming and execution, and compositional intermediate answer generation. We also develop HeteQA, a novel benchmark designed to evaluate the multi-hop heterogeneous reasoning capabilities. Experimental results demonstrate that TableRAG consistently outperforms existing baselines on both public datasets and our HeteQA, establishing a new state-of-the-art for heterogeneous document question answering. We release TableRAG at https://github.com/yxh-y/TableRAG/tree/main.

One of the recent best attempts at Text-to-SQL is the pre-trained language model. Due to the structural property of the SQL queries, the seq2seq model takes the responsibility of parsing both the schema items (i.e., tables and columns) and the skeleton (i.e., SQL keywords). Such coupled targets increase the difficulty of parsing the correct SQL queries especially when they involve many schema items and logic operators. This paper proposes a ranking-enhanced encoding and skeleton-aware decoding framework to decouple the schema linking and the skeleton parsing. Specifically, for a seq2seq encoder-decode model, its encoder is injected by the most relevant schema items instead of the whole unordered ones, which could alleviate the schema linking effort during SQL parsing, and its decoder first generates the skeleton and then the actual SQL query, which could implicitly constrain the SQL parsing. We evaluate our proposed framework on Spider and its three robustness variants: Spider-DK, Spider-Syn, and Spider-Realistic. The experimental results show that our framework delivers promising performance and robustness. Our code is available at https://github.com/RUCKBReasoning/RESDSQL.

Large language models achieve high task performance yet often hallucinate or rely on outdated knowledge. Retrieval-augmented generation (RAG) addresses these gaps by coupling generation with external search. We analyse how hyperparameters influence speed and quality in RAG systems, covering Chroma and Faiss vector stores, chunking policies, cross-encoder re-ranking, and temperature, and we evaluate six metrics: faithfulness, answer correctness, answer relevancy, context precision, context recall, and answer similarity. Chroma processes queries 13% faster, whereas Faiss yields higher retrieval precision, revealing a clear speed-accuracy trade-off. Naive fixed-length chunking with small windows and minimal overlap outperforms semantic segmentation while remaining the quickest option. Re-ranking provides modest gains in retrieval quality yet increases runtime by roughly a factor of 5, so its usefulness depends on latency constraints. These results help practitioners balance computational cost and accuracy when tuning RAG systems for transparent, up-to-date responses. Finally, we re-evaluate the top configurations with a corrective RAG workflow and show that their advantages persist when the model can iteratively request additional evidence. We obtain a near-perfect context precision (99%), which demonstrates that RAG systems can achieve extremely high retrieval accuracy with the right combination of hyperparameters, with significant implications for applications where retrieval quality directly impacts downstream task performance, such as clinical decision support in healthcare.

Text-to-SQL aims to map natural language questions to SQL queries. The sketch-based method combined with execution-guided (EG) decoding strategy has shown a strong performance on the WikiSQL benchmark. However, execution-guided decoding relies on database execution, which significantly slows down the inference process and is hence unsatisfactory for many real-world applications. In this paper, we present the Schema Dependency guided multi-task Text-to-SQL model (SDSQL) to guide the network to effectively capture the interactions between questions and schemas. The proposed model outperforms all existing methods in both the settings with or without EG. We show the schema dependency learning partially cover the benefit from EG and alleviates the need for it. SDSQL without EG significantly reduces time consumption during inference, sacrificing only a small amount of performance and provides more flexibility for downstream applications.

For the immanent challenge of insufficiently annotated samples in the medical field, semi-supervised medical image segmentation (SSMIS) offers a promising solution. Despite achieving impressive results in delineating primary target areas, most current methodologies struggle to precisely capture the subtle details of boundaries. This deficiency often leads to significant diagnostic inaccuracies. To tackle this issue, we introduce C3S3, a novel semi-supervised segmentation model that synergistically integrates complementary competition and contrastive selection. This design significantly sharpens boundary delineation and enhances overall precision. Specifically, we develop an Outcome-Driven Contrastive Learning module dedicated to refining boundary localization. Additionally, we incorporate a Dynamic Complementary Competition module that leverages two high-performing sub-networks to generate pseudo-labels, thereby further improving segmentation quality. The proposed C3S3 undergoes rigorous validation on two publicly accessible datasets, encompassing the practices of both MRI and CT scans. The results demonstrate that our method achieves superior performance compared to previous cutting-edge competitors. Especially, on the 95HD and ASD metrics, our approach achieves a notable improvement of at least 6%, highlighting the significant advancements. The code is available at https://github.com/Y-TARL/C3S3.

Large reasoning models (LRMs) have shown significant progress in test-time scaling through chain-of-thought prompting. Current approaches like search-o1 integrate retrieval augmented generation (RAG) into multi-step reasoning processes but rely on a single, linear reasoning chain while incorporating unstructured textual information in a flat, context-agnostic manner. As a result, these approaches can lead to error accumulation throughout the reasoning chain, which significantly limits its effectiveness in medical question-answering (QA) tasks where both accuracy and traceability are critical requirements. To address these challenges, we propose MIRAGE (Multi-chain Inference with Retrieval-Augmented Graph Exploration), a novel test-time scalable reasoning framework that performs dynamic multi-chain inference over structured medical knowledge graphs. Specifically, MIRAGE 1) decomposes complex queries into entity-grounded sub-questions, 2) executes parallel inference chains, 3) retrieves evidence adaptively via neighbor expansion and multi-hop traversal, and 4) integrates answers using cross-chain verification to resolve contradictions. Experiments on three medical QA benchmarks (GenMedGPT-5k, CMCQA, and ExplainCPE) show that MIRAGE consistently outperforms GPT-4o, Tree-of-Thought variants, and other retrieval-augmented baselines in both automatic and human evaluations. Additionally, MIRAGE improves interpretability by generating explicit reasoning chains that trace each factual claim to concrete chains within the knowledge graph, making it well-suited for complex medical reasoning scenarios. The code will be available for further research.

Clinical diagnosis is a highly specialized discipline requiring both domain expertise and strict adherence to rigorous guidelines. While current AI-driven medical research predominantly focuses on knowledge graphs or natural text pretraining paradigms to incorporate medical knowledge, these approaches primarily rely on implicitly encoded knowledge within model parameters, neglecting task-specific knowledge required by diverse downstream tasks. To address this limitation, we propose Retrieval-Augmented Diagnosis (RAD), a novel framework that explicitly injects external knowledge into multimodal models directly on downstream tasks. Specifically, RAD operates through three key mechanisms: retrieval and refinement of disease-centered knowledge from multiple medical sources, a guideline-enhanced contrastive loss that constrains the latent distance between multi-modal features and guideline knowledge, and the dual transformer decoder that employs guidelines as queries to steer cross-modal fusion, aligning the models with clinical diagnostic workflows from guideline acquisition to feature extraction and decision-making. Moreover, recognizing the lack of quantitative evaluation of interpretability for multimodal diagnostic models, we introduce a set of criteria to assess the interpretability from both image and text perspectives. Extensive evaluations across four datasets with different anatomies demonstrate RAD's generalizability, achieving state-of-the-art performance. Furthermore, RAD enables the model to concentrate more precisely on abnormal regions and critical indicators, ensuring evidence-based, trustworthy diagnosis. Our code is available at https://github.com/tdlhl/RAD.

Medicine is inherently multimodal, with rich data modalities spanning text, imaging, genomics, and more. Generalist biomedical artificial intelligence (AI) systems that flexibly encode, integrate, and interpret this data at scale can potentially enable impactful applications ranging from scientific discovery to care delivery. To enable the development of these models, we first curate MultiMedBench, a new multimodal biomedical benchmark. MultiMedBench encompasses 14 diverse tasks such as medical question answering, mammography and dermatology image interpretation, radiology report generation and summarization, and genomic variant calling. We then introduce Med-PaLM Multimodal (Med-PaLM M), our proof of concept for a generalist biomedical AI system. Med-PaLM M is a large multimodal generative model that flexibly encodes and interprets biomedical data including clinical language, imaging, and genomics with the same set of model weights. Med-PaLM M reaches performance competitive with or exceeding the state of the art on all MultiMedBench tasks, often surpassing specialist models by a wide margin. We also report examples of zero-shot generalization to novel medical concepts and tasks, positive transfer learning across tasks, and emergent zero-shot medical reasoning. To further probe the capabilities and limitations of Med-PaLM M, we conduct a radiologist evaluation of model-generated (and human) chest X-ray reports and observe encouraging performance across model scales. In a side-by-side ranking on 246 retrospective chest X-rays, clinicians express a pairwise preference for Med-PaLM M reports over those produced by radiologists in up to 40.50% of cases, suggesting potential clinical utility. While considerable work is needed to validate these models in real-world use cases, our results represent a milestone towards the development of generalist biomedical AI systems.

The Segment Anything Model (SAM) represents a state-of-the-art research advancement in natural image segmentation, achieving impressive results with input prompts such as points and bounding boxes. However, our evaluation and recent research indicate that directly applying the pretrained SAM to medical image segmentation does not yield satisfactory performance. This limitation primarily arises from significant domain gap between natural images and medical images. To bridge this gap, we introduce SAM-Med2D, the most comprehensive studies on applying SAM to medical 2D images. Specifically, we first collect and curate approximately 4.6M images and 19.7M masks from public and private datasets, constructing a large-scale medical image segmentation dataset encompassing various modalities and objects. Then, we comprehensively fine-tune SAM on this dataset and turn it into SAM-Med2D. Unlike previous methods that only adopt bounding box or point prompts as interactive segmentation approach, we adapt SAM to medical image segmentation through more comprehensive prompts involving bounding boxes, points, and masks. We additionally fine-tune the encoder and decoder of the original SAM to obtain a well-performed SAM-Med2D, leading to the most comprehensive fine-tuning strategies to date. Finally, we conducted a comprehensive evaluation and analysis to investigate the performance of SAM-Med2D in medical image segmentation across various modalities, anatomical structures, and organs. Concurrently, we validated the generalization capability of SAM-Med2D on 9 datasets from MICCAI 2023 challenge. Overall, our approach demonstrated significantly superior performance and generalization capability compared to SAM.

Recent developments in Large Language Model (LLM)-based agents have shown impressive capabilities spanning multiple domains, exemplified by deep research systems that demonstrate superior performance on complex information-seeking and synthesis tasks. While general-purpose deep research agents have shown impressive capabilities, they struggle significantly with medical domain challenges, as evidenced by leading proprietary systems achieving limited accuracy on complex medical benchmarks. The key limitations are: (1) the model lacks sufficient dense medical knowledge for clinical reasoning, and (2) the framework is constrained by the absence of specialized retrieval tools tailored for medical contexts.We present a medical deep research agent that addresses these challenges through two core innovations. First, we develop a novel data synthesis framework using medical knowledge graphs, extracting the longest chains from subgraphs around rare medical entities to generate complex multi-hop question-answer pairs. Second, we integrate a custom-built private medical retrieval engine alongside general-purpose tools, enabling accurate medical information synthesis. Our approach generates 2100+ diverse trajectories across 12 medical specialties, each averaging 4.2 tool interactions.Through a two-stage training paradigm combining supervised fine-tuning and online reinforcement learning with composite rewards, our MedResearcher-R1-32B model demonstrates exceptional performance, establishing new state-of-the-art results on medical benchmarks while maintaining competitive performance on general deep research tasks. Our work demonstrates that strategic domain-specific innovations in architecture, tool design, and training data construction can enable smaller open-source models to outperform much larger proprietary systems in specialized domains.

Contrastive pretraining on parallel image-text data has attained great success in vision-language processing (VLP), as exemplified by CLIP and related methods. However, prior explorations tend to focus on general domains in the web. Biomedical images and text are rather different, but publicly available datasets are small and skew toward chest X-ray, thus severely limiting progress. In this paper, we conducted by far the largest study on biomedical VLP, using 15 million figure-caption pairs extracted from biomedical research articles in PubMed Central. Our dataset (PMC-15M) is two orders of magnitude larger than existing biomedical image-text datasets such as MIMIC-CXR, and spans a diverse range of biomedical images. The standard CLIP method is suboptimal for the biomedical domain. We propose BiomedCLIP with domain-specific adaptations tailored to biomedical VLP. We conducted extensive experiments and ablation studies on standard biomedical imaging tasks from retrieval to classification to visual question-answering (VQA). BiomedCLIP established new state of the art in a wide range of standard datasets, substantially outperformed prior VLP approaches. Surprisingly, BiomedCLIP even outperformed radiology-specific state-of-the-art models such as BioViL on radiology-specific tasks such as RSNA pneumonia detection, thus highlighting the utility in large-scale pretraining across all biomedical image types. We will release our models at https://aka.ms/biomedclip to facilitate future research in biomedical VLP.

The ability to generate SPARQL queries from natural language questions is crucial for ensuring efficient and accurate retrieval of structured data from knowledge graphs (KG). While large language models (LLMs) have been widely adopted for SPARQL query generation, they are often susceptible to hallucinations and out-of-distribution errors when producing KG elements like Uniform Resource Identifiers (URIs) based on internal parametric knowledge. This often results in content that appears plausible but is factually incorrect, posing significant challenges for their use in real-world information retrieval (IR) applications. This has led to increased research aimed at detecting and mitigating such errors. In this paper, we introduce PGMR (Post-Generation Memory Retrieval), a modular framework that incorporates a non-parametric memory module to retrieve KG elements and enhance LLM-based SPARQL query generation. Our experimental results indicate that PGMR consistently delivers strong performance across diverse datasets, data distributions, and LLMs. Notably, PGMR significantly mitigates URI hallucinations, nearly eliminating the problem in several scenarios.

As lung cancer evolves, the presence of enlarged and potentially malignant lymph nodes must be assessed to properly estimate disease progression and select the best treatment strategy. Following the clinical guidelines, estimation of short-axis diameter and mediastinum station are paramount for correct diagnosis. A method for accurate and automatic segmentation is hence decisive for quantitatively describing lymph nodes. In this study, the use of 3D convolutional neural networks, either through slab-wise schemes or the leveraging of downsampled entire volumes, is investigated. Furthermore, the potential impact from simple ensemble strategies is considered. As lymph nodes have similar attenuation values to nearby anatomical structures, we suggest using the knowledge of other organs as prior information to guide the segmentation task. To assess the segmentation and instance detection performances, a 5-fold cross-validation strategy was followed over a dataset of 120 contrast-enhanced CT volumes. For the 1178 lymph nodes with a short-axis diameter geq10 mm, our best performing approach reached a patient-wise recall of 92%, a false positive per patient ratio of 5, and a segmentation overlap of 80.5%. The method performs similarly well across all stations. Fusing a slab-wise and a full volume approach within an ensemble scheme generated the best performances. The anatomical priors guiding strategy is promising, yet a larger set than four organs appears needed to generate an optimal benefit. A larger dataset is also mandatory, given the wide range of expressions a lymph node can exhibit (i.e., shape, location, and attenuation), and contrast uptake variations.

Achieving meticulous segmentation of tooth point clouds from intra-oral scans stands as an indispensable prerequisite for various orthodontic applications. Given the labor-intensive nature of dental annotation, a significant amount of data remains unlabeled, driving increasing interest in semi-supervised approaches. One primary challenge of existing semi-supervised medical segmentation methods lies in noisy pseudo labels generated for unlabeled data. To address this challenge, we propose GeoT, the first framework that employs instance-dependent transition matrix (IDTM) to explicitly model noise in pseudo labels for semi-supervised dental segmentation. Specifically, to handle the extensive solution space of IDTM arising from tens of thousands of dental points, we introduce tooth geometric priors through two key components: point-level geometric regularization (PLGR) to enhance consistency between point adjacency relationships in 3D and IDTM spaces, and class-level geometric smoothing (CLGS) to leverage the fixed spatial distribution of tooth categories for optimal IDTM estimation. Extensive experiments performed on the public Teeth3DS dataset and private dataset demonstrate that our method can make full utilization of unlabeled data to facilitate segmentation, achieving performance comparable to fully supervised methods with only 20% of the labeled data.

Learning implicit representations has been a widely used solution for surface reconstruction from 3D point clouds. The latest methods infer a distance or occupancy field by overfitting a neural network on a single point cloud. However, these methods suffer from a slow inference due to the slow convergence of neural networks and the extensive calculation of distances to surface points, which limits them to small scale points. To resolve the scalability issue in surface reconstruction, we propose GridPull to improve the efficiency of learning implicit representations from large scale point clouds. Our novelty lies in the fast inference of a discrete distance field defined on grids without using any neural components. To remedy the lack of continuousness brought by neural networks, we introduce a loss function to encourage continuous distances and consistent gradients in the field during pulling queries onto the surface in grids near to the surface. We use uniform grids for a fast grid search to localize sampled queries, and organize surface points in a tree structure to speed up the calculation of distances to the surface. We do not rely on learning priors or normal supervision during optimization, and achieve superiority over the latest methods in terms of complexity and accuracy. We evaluate our method on shape and scene benchmarks, and report numerical and visual comparisons with the latest methods to justify our effectiveness and superiority. The code is available at https://github.com/chenchao15/GridPull.

Radiologic diagnostic errors-under-reading errors, inattentional blindness, and communication failures-remain prevalent in clinical practice. These issues often stem from missed localized abnormalities, limited global context, and variability in report language. These challenges are amplified in 3D imaging, where clinicians must examine hundreds of slices per scan. Addressing them requires systems with precise localized detection, global volume-level reasoning, and semantically consistent natural language reporting. However, existing 3D vision-language models are unable to meet all three needs jointly, lacking local-global understanding for spatial reasoning and struggling with the variability and noise of uncurated radiology reports. We present MedVista3D, a multi-scale semantic-enriched vision-language pretraining framework for 3D CT analysis. To enable joint disease detection and holistic interpretation, MedVista3D performs local and global image-text alignment for fine-grained representation learning within full-volume context. To address report variability, we apply language model rewrites and introduce a Radiology Semantic Matching Bank for semantics-aware alignment. MedVista3D achieves state-of-the-art performance on zero-shot disease classification, report retrieval, and medical visual question answering, while transferring well to organ segmentation and prognosis prediction. Code and datasets will be released.

The scaling laws and extraordinary performance of large foundation models motivate the development and utilization of such models in biomedicine. However, despite early promising results on some biomedical benchmarks, there are still major challenges that need to be addressed before these models can be used in real-world clinics. Frontier general-domain models such as GPT-4V still have significant performance gaps in multimodal biomedical applications. More importantly, less-acknowledged pragmatic issues, including accessibility, model cost, and tedious manual evaluation make it hard for clinicians to use state-of-the-art large models directly on private patient data. Here, we explore training open-source small multimodal models (SMMs) to bridge competency gaps for unmet clinical needs in radiology. To maximize data efficiency, we adopt a modular approach by incorporating state-of-the-art pre-trained models for image and text modalities, and focusing on training a lightweight adapter to ground each modality to the text embedding space, as exemplified by LLaVA-Med. For training, we assemble a large dataset of over 697 thousand radiology image-text pairs. For evaluation, we propose CheXprompt, a GPT-4-based metric for factuality evaluation, and demonstrate its parity with expert evaluation. For best practice, we conduct a systematic ablation study on various choices in data engineering and multimodal training. The resulting LlaVA-Rad (7B) model attains state-of-the-art results on standard radiology tasks such as report generation and cross-modal retrieval, even outperforming much larger models such as GPT-4V and Med-PaLM M (84B). The inference of LlaVA-Rad is fast and can be performed on a single V100 GPU in private settings, offering a promising state-of-the-art tool for real-world clinical applications.

We introduce an unsupervised feature learning approach that embeds 3D shape information into a single-view image representation. The main idea is a self-supervised training objective that, given only a single 2D image, requires all unseen views of the object to be predictable from learned features. We implement this idea as an encoder-decoder convolutional neural network. The network maps an input image of an unknown category and unknown viewpoint to a latent space, from which a deconvolutional decoder can best "lift" the image to its complete viewgrid showing the object from all viewing angles. Our class-agnostic training procedure encourages the representation to capture fundamental shape primitives and semantic regularities in a data-driven manner---without manual semantic labels. Our results on two widely-used shape datasets show 1) our approach successfully learns to perform "mental rotation" even for objects unseen during training, and 2) the learned latent space is a powerful representation for object recognition, outperforming several existing unsupervised feature learning methods.

Deep research systems represent an emerging class of agentic information retrieval methods that generate comprehensive and well-supported reports to complex queries. However, most existing frameworks rely on dynamic commercial search APIs, which pose reproducibility and transparency challenges in addition to their cost. To address these limitations, we introduce DeepResearchGym, an open-source sandbox that combines a reproducible search API with a rigorous evaluation protocol for benchmarking deep research systems. The API indexes large-scale public web corpora, namely ClueWeb22 and FineWeb, using a state-of-the-art dense retriever and approximate nearest neighbor search via DiskANN. It achieves lower latency than popular commercial APIs while ensuring stable document rankings across runs, and is freely available for research use. To evaluate deep research systems' outputs, we extend the Researchy Questions benchmark with automatic metrics through LLM-as-a-judge assessments to measure alignment with users' information needs, retrieval faithfulness, and report quality. Experimental results show that systems integrated with DeepResearchGym achieve performance comparable to those using commercial APIs, with performance rankings remaining consistent across evaluation metrics. A human evaluation study further confirms that our automatic protocol aligns with human preferences, validating the framework's ability to help support controlled assessment of deep research systems. Our code and API documentation are available at https://www.deepresearchgym.ai.

We introduce eCLIP, an enhanced version of the CLIP model that integrates expert annotations in the form of radiologist eye-gaze heatmaps. It tackles key challenges in contrastive multi-modal medical imaging analysis, notably data scarcity and the "modality gap" -- a significant disparity between image and text embeddings that diminishes the quality of representations and hampers cross-modal interoperability. eCLIP integrates a heatmap processor and leverages mixup augmentation to efficiently utilize the scarce expert annotations, thus boosting the model's learning effectiveness. eCLIP is designed to be generally applicable to any variant of CLIP without requiring any modifications of the core architecture. Through detailed evaluations across several tasks, including zero-shot inference, linear probing, cross-modal retrieval, and Retrieval Augmented Generation (RAG) of radiology reports using a frozen Large Language Model, eCLIP showcases consistent improvements in embedding quality. The outcomes reveal enhanced alignment and uniformity, affirming eCLIP's capability to harness high-quality annotations for enriched multi-modal analysis in the medical imaging domain.

We present an automated and efficient approach for retrieving high-quality CAD models of objects and their poses in a scene captured by a moving RGB-D camera. We first investigate various objective functions to measure similarity between a candidate CAD object model and the available data, and the best objective function appears to be a "render-and-compare" method comparing depth and mask rendering. We thus introduce a fast-search method that approximates an exhaustive search based on this objective function for simultaneously retrieving the object category, a CAD model, and the pose of an object given an approximate 3D bounding box. This method involves a search tree that organizes the CAD models and object properties including object category and pose for fast retrieval and an algorithm inspired by Monte Carlo Tree Search, that efficiently searches this tree. We show that this method retrieves CAD models that fit the real objects very well, with a speed-up factor of 10x to 120x compared to exhaustive search.

Every day, countless surgeries are performed worldwide, each within the distinct settings of operating rooms (ORs) that vary not only in their setups but also in the personnel, tools, and equipment used. This inherent diversity poses a substantial challenge for achieving a holistic understanding of the OR, as it requires models to generalize beyond their initial training datasets. To reduce this gap, we introduce ORacle, an advanced vision-language model designed for holistic OR domain modeling, which incorporates multi-view and temporal capabilities and can leverage external knowledge during inference, enabling it to adapt to previously unseen surgical scenarios. This capability is further enhanced by our novel data augmentation framework, which significantly diversifies the training dataset, ensuring ORacle's proficiency in applying the provided knowledge effectively. In rigorous testing, in scene graph generation, and downstream tasks on the 4D-OR dataset, ORacle not only demonstrates state-of-the-art performance but does so requiring less data than existing models. Furthermore, its adaptability is displayed through its ability to interpret unseen views, actions, and appearances of tools and equipment. This demonstrates ORacle's potential to significantly enhance the scalability and affordability of OR domain modeling and opens a pathway for future advancements in surgical data science. We will release our code and data upon acceptance.

Query expansion, pivotal in search engines, enhances the representation of user information needs with additional terms. While existing methods expand queries using retrieved or generated contextual documents, each approach has notable limitations. Retrieval-based methods often fail to accurately capture search intent, particularly with brief or ambiguous queries. Generation-based methods, utilizing large language models (LLMs), generally lack corpus-specific knowledge and entail high fine-tuning costs. To address these gaps, we propose a novel zero-shot query expansion framework utilizing LLMs for mutual verification. Specifically, we first design a query-query-document generation method, leveraging LLMs' zero-shot reasoning ability to produce diverse sub-queries and corresponding documents. Then, a mutual verification process synergizes generated and retrieved documents for optimal expansion. Our proposed method is fully zero-shot, and extensive experiments on three public benchmark datasets are conducted to demonstrate its effectiveness over existing methods. Our code is available online at https://github.com/Applied-Machine-Learning-Lab/MILL to ease reproduction.

Recent studies have explored graph-based approaches to retrieval-augmented generation, leveraging structured or semi-structured information -- such as entities and their relations extracted from documents -- to enhance retrieval. However, these methods are typically designed to address specific tasks, such as multi-hop question answering and query-focused summarisation, and therefore, there is limited evidence of their general applicability across broader datasets. In this paper, we aim to adapt a state-of-the-art graph-based RAG solution: GeAR and explore its performance and limitations on the SIGIR 2025 LiveRAG Challenge.

We introduce MRMR, the first expert-level multidisciplinary multimodal retrieval benchmark requiring intensive reasoning. MRMR contains 1,502 queries spanning 23 domains, with positive documents carefully verified by human experts. Compared to prior benchmarks, MRMR introduces three key advancements. First, it challenges retrieval systems across diverse areas of expertise, enabling fine-grained model comparison across domains. Second, queries are reasoning-intensive, with images requiring deeper interpretation such as diagnosing microscopic slides. We further introduce Contradiction Retrieval, a novel task requiring models to identify conflicting concepts. Finally, queries and documents are constructed as image-text interleaved sequences. Unlike earlier benchmarks restricted to single images or unimodal documents, MRMR offers a realistic setting with multi-image queries and mixed-modality corpus documents. We conduct an extensive evaluation of 4 categories of multimodal retrieval systems and 14 frontier models on MRMR. The text embedding model Qwen3-Embedding with LLM-generated image captions achieves the highest performance, highlighting substantial room for improving multimodal retrieval models. Although latest multimodal models such as Ops-MM-Embedding perform competitively on expert-domain queries, they fall short on reasoning-intensive tasks. We believe that MRMR paves the way for advancing multimodal retrieval in more realistic and challenging scenarios.

Automated interpretation of CT images-particularly localizing and describing abnormal findings across multi-plane and whole-body scans-remains a significant challenge in clinical radiology. This work aims to address this challenge through four key contributions: (i) On taxonomy, we collaborate with senior radiologists to propose a comprehensive hierarchical classification system, with 404 representative abnormal findings across all body regions; (ii) On data, we contribute a dataset containing over 14.5K CT images from multiple planes and all human body regions, and meticulously provide grounding annotations for over 19K abnormalities, each linked to the detailed description and cast into the taxonomy; (iii) On model development, we propose OminiAbnorm-CT, which can automatically ground and describe abnormal findings on multi-plane and whole-body CT images based on text queries, while also allowing flexible interaction through visual prompts; (iv) On benchmarks, we establish three representative evaluation tasks based on real clinical scenarios. Through extensive experiments, we show that OminiAbnorm-CT can significantly outperform existing methods on all the tasks and metrics.

In recent years, 3D scene graphs have emerged as a powerful world representation, offering both geometric accuracy and semantic richness. Combining 3D scene graphs with large language models enables robots to reason, plan, and navigate in complex human-centered environments. However, current approaches for constructing 3D scene graphs are semantically limited to a predefined set of relationships, and their serialization in large environments can easily exceed an LLM's context window. We introduce KeySG, a framework that represents 3D scenes as a hierarchical graph consisting of floors, rooms, objects, and functional elements, where nodes are augmented with multi-modal information extracted from keyframes selected to optimize geometric and visual coverage. The keyframes allow us to efficiently leverage VLM to extract scene information, alleviating the need to explicitly model relationship edges between objects, enabling more general, task-agnostic reasoning and planning. Our approach can process complex and ambiguous queries while mitigating the scalability issues associated with large scene graphs by utilizing a hierarchical retrieval-augmented generation (RAG) pipeline to extract relevant context from the graph. Evaluated across four distinct benchmarks -- including 3D object segmentation and complex query retrieval -- KeySG outperforms prior approaches on most metrics, demonstrating its superior semantic richness and efficiency.

We propose a new localized inference algorithm for answering marginalization queries in large graphical models with the correlation decay property. Given a query variable and a large graphical model, we define a much smaller model in a local region around the query variable in the target model so that the marginal distribution of the query variable can be accurately approximated. We introduce two approximation error bounds based on the Dobrushin's comparison theorem and apply our bounds to derive a greedy expansion algorithm that efficiently guides the selection of neighbor nodes for localized inference. We verify our theoretical bounds on various datasets and demonstrate that our localized inference algorithm can provide fast and accurate approximation for large graphical models.

Prior to the deep learning era, shape was commonly used to describe the objects. Nowadays, state-of-the-art (SOTA) algorithms in medical imaging are predominantly diverging from computer vision, where voxel grids, meshes, point clouds, and implicit surface models are used. This is seen from numerous shape-related publications in premier vision conferences as well as the growing popularity of ShapeNet (about 51,300 models) and Princeton ModelNet (127,915 models). For the medical domain, we present a large collection of anatomical shapes (e.g., bones, organs, vessels) and 3D models of surgical instrument, called MedShapeNet, created to facilitate the translation of data-driven vision algorithms to medical applications and to adapt SOTA vision algorithms to medical problems. As a unique feature, we directly model the majority of shapes on the imaging data of real patients. As of today, MedShapeNet includes 23 dataset with more than 100,000 shapes that are paired with annotations (ground truth). Our data is freely accessible via a web interface and a Python application programming interface (API) and can be used for discriminative, reconstructive, and variational benchmarks as well as various applications in virtual, augmented, or mixed reality, and 3D printing. Exemplary, we present use cases in the fields of classification of brain tumors, facial and skull reconstructions, multi-class anatomy completion, education, and 3D printing. In future, we will extend the data and improve the interfaces. The project pages are: https://medshapenet.ikim.nrw/ and https://github.com/Jianningli/medshapenet-feedback

This paper presents OG-RAG, an Ontology-Grounded Retrieval Augmented Generation method designed to enhance LLM-generated responses by anchoring retrieval processes in domain-specific ontologies. While LLMs are widely used for tasks like question answering and search, they struggle to adapt to specialized knowledge, such as industrial workflows or knowledge work, without expensive fine-tuning or sub-optimal retrieval methods. Existing retrieval-augmented models, such as RAG, offer improvements but fail to account for structured domain knowledge, leading to suboptimal context generation. Ontologies, which conceptually organize domain knowledge by defining entities and their interrelationships, offer a structured representation to address this gap. OG-RAG constructs a hypergraph representation of domain documents, where each hyperedge encapsulates clusters of factual knowledge grounded using domain-specific ontology. An optimization algorithm then retrieves the minimal set of hyperedges that constructs a precise, conceptually grounded context for the LLM. This method enables efficient retrieval while preserving the complex relationships between entities. OG-RAG applies to domains where fact-based reasoning is essential, particularly in tasks that require workflows or decision-making steps to follow predefined rules and procedures. These include industrial workflows in healthcare, legal, and agricultural sectors, as well as knowledge-driven tasks such as news journalism, investigative research, consulting and more. Our evaluations demonstrate that OG-RAG increases the recall of accurate facts by 55% and improves response correctness by 40% across four different LLMs. Additionally, OG-RAG enables 30% faster attribution of responses to context and boosts fact-based reasoning accuracy by 27% compared to baseline methods.

Existing Text-to-SQL generators require the entire schema to be encoded with the user text. This is expensive or impractical for large databases with tens of thousands of columns. Standard dense retrieval techniques are inadequate for schema subsetting of a large structured database, where the correct semantics of retrieval demands that we rank sets of schema elements rather than individual elements. In response, we propose a two-stage process for effective coverage during retrieval. First, we instruct an LLM to hallucinate a minimal DB schema deemed adequate to answer the query. We use the hallucinated schema to retrieve a subset of the actual schema, by composing the results from multiple dense retrievals. Remarkably, hallucination x2013 generally considered a nuisance x2013 turns out to be actually useful as a bridging mechanism. Since no existing benchmarks exist for schema subsetting on large databases, we introduce three benchmarks. Two semi-synthetic datasets are derived from the union of schemas in two well-known datasets, SPIDER and BIRD, resulting in 4502 and 798 schema elements respectively. A real-life benchmark called SocialDB is sourced from an actual large data warehouse comprising 17844 schema elements. We show that our method1 leads to significantly higher recall than SOTA retrieval-based augmentation methods.

In this paper, we delve into the intricate dynamics of Fine-Grained Sketch-Based Image Retrieval (FG-SBIR) by addressing a critical yet overlooked aspect -- the choice of viewpoint during sketch creation. Unlike photo systems that seamlessly handle diverse views through extensive datasets, sketch systems, with limited data collected from fixed perspectives, face challenges. Our pilot study, employing a pre-trained FG-SBIR model, highlights the system's struggle when query-sketches differ in viewpoint from target instances. Interestingly, a questionnaire however shows users desire autonomy, with a significant percentage favouring view-specific retrieval. To reconcile this, we advocate for a view-aware system, seamlessly accommodating both view-agnostic and view-specific tasks. Overcoming dataset limitations, our first contribution leverages multi-view 2D projections of 3D objects, instilling cross-modal view awareness. The second contribution introduces a customisable cross-modal feature through disentanglement, allowing effortless mode switching. Extensive experiments on standard datasets validate the effectiveness of our method.

While deep networks have achieved broad success in analyzing natural images, when applied to medical scans, they often fail in unexcepted situations. We investigate this challenge and focus on model sensitivity to domain shifts, such as data sampled from different hospitals or data confounded by demographic variables such as sex, race, etc, in the context of chest X-rays and skin lesion images. A key finding we show empirically is that existing visual backbones lack an appropriate prior from the architecture for reliable generalization in these settings. Taking inspiration from medical training, we propose giving deep networks a prior grounded in explicit medical knowledge communicated in natural language. To this end, we introduce Knowledge-enhanced Bottlenecks (KnoBo), a class of concept bottleneck models that incorporates knowledge priors that constrain it to reason with clinically relevant factors found in medical textbooks or PubMed. KnoBo uses retrieval-augmented language models to design an appropriate concept space paired with an automatic training procedure for recognizing the concept. We evaluate different resources of knowledge and recognition architectures on a broad range of domain shifts across 20 datasets. In our comprehensive evaluation with two imaging modalities, KnoBo outperforms fine-tuned models on confounded datasets by 32.4% on average. Finally, evaluations reveal that PubMed is a promising resource for making medical models less sensitive to domain shift, outperforming other resources on both diversity of information and final prediction performance.

Retrieval-augmented generation (RAG) has become a dominant paradigm for mitigating knowledge hallucination and staleness in large language models (LLMs) while preserving data security. By retrieving relevant evidence from private, domain-specific corpora and injecting it into carefully engineered prompts, RAG delivers trustworthy responses without the prohibitive cost of fine-tuning. Traditional retrieval-augmented generation (RAG) systems are text-only and often rely on a single storage backend, most commonly a vector database. In practice, this monolithic design suffers from unavoidable trade-offs: vector search captures semantic similarity yet loses global context; knowledge graphs excel at relational precision but struggle with recall; full-text indexes are fast and exact yet semantically blind; and relational engines such as MySQL provide strong transactional guarantees but no semantic understanding. We argue that these heterogeneous retrieval paradigms are complementary, and propose a principled fusion scheme to orchestrate them synergistically, mitigating the weaknesses of any single modality. In this work we introduce HetaRAG, a hybrid, deep-retrieval augmented generation framework that orchestrates cross-modal evidence from heterogeneous data stores. We plan to design a system that unifies vector indices, knowledge graphs, full-text engines, and structured databases into a single retrieval plane, dynamically routing and fusing evidence to maximize recall, precision, and contextual fidelity. To achieve this design goal, we carried out preliminary explorations and constructed an initial RAG pipeline; this technical report provides a brief overview. The partial code is available at https://github.com/KnowledgeXLab/HetaRAG.

One of the biggest challenges that complicates applied supervised machine learning is the need for huge amounts of labeled data. Active Learning (AL) is a well-known standard method for efficiently obtaining labeled data by first labeling the samples that contain the most information based on a query strategy. Although many methods for query strategies have been proposed in the past, no clear superior method that works well in general for all domains has been found yet. Additionally, many strategies are computationally expensive which further hinders the widespread use of AL for large-scale annotation projects. We, therefore, propose ImitAL, a novel query strategy, which encodes AL as a learning-to-rank problem. For training the underlying neural network we chose Imitation Learning. The required demonstrative expert experience for training is generated from purely synthetic data. To show the general and superior applicability of , we perform an extensive evaluation comparing our strategy on 15 different datasets, from a wide range of domains, with 10 different state-of-the-art query strategies. We also show that our approach is more runtime performant than most other strategies, especially on very large datasets.

We propose a novel method for discovering shape regions that strongly correlate with user-prescribed tags. For example, given a collection of chairs tagged as either "has armrest" or "lacks armrest", our system correctly highlights the armrest regions as the main distinctive parts between the two chair types. To obtain point-wise predictions from shape-wise tags we develop a novel neural network architecture that is trained with tag classification loss, but is designed to rely on segmentation to predict the tag. Our network is inspired by U-Net, but we replicate shallow U structures several times with new skip connections and pooling layers, and call the resulting architecture "WU-Net". We test our method on segmentation benchmarks and show that even with weak supervision of whole shape tags, our method can infer meaningful semantic regions, without ever observing shape segmentations. Further, once trained, the model can process shapes for which the tag is entirely unknown. As a bonus, our architecture is directly operational under full supervision and performs strongly on standard benchmarks. We validate our method through experiments with many variant architectures and prior baselines, and demonstrate several applications.

Radiologists play a crucial role by translating medical images into medical reports. However, the field faces staffing shortages and increasing workloads. While automated approaches using vision-language models (VLMs) show promise as assistants, they require exceptionally high accuracy. Most current VLMs in radiology rely solely on supervised fine-tuning (SFT). Meanwhile, in the general domain, additional preference fine-tuning has become standard practice. The challenge in radiology lies in the prohibitive cost of obtaining radiologist feedback. We propose a scalable automated preference alignment technique for VLMs in radiology, focusing on chest X-ray (CXR) report generation. Our method leverages publicly available datasets with an LLM-as-a-Judge mechanism, eliminating the need for additional expert radiologist feedback. We evaluate and benchmark five direct alignment algorithms (DAAs). Our results show up to a 57.4% improvement in average GREEN scores, a LLM-based metric for evaluating CXR reports, and a 9.2% increase in an average across six metrics (domain specific and general), compared to the SFT baseline. We study reward overoptimization via length exploitation, with reports lengthening by up to 3.2x. To assess a potential alignment tax, we benchmark on six additional diverse tasks, finding no significant degradations. A reader study involving four board-certified radiologists indicates win rates of up to 0.62 over the SFT baseline, while significantly penalizing verbosity. Our analysis provides actionable insights for the development of VLMs in high-stakes fields like radiology.

Landmark detection plays a crucial role in medical imaging tasks that rely on precise spatial localization, including specific applications in diagnosis, treatment planning, image registration, and surgical navigation. However, manual annotation is labor-intensive and requires expert knowledge. While deep learning shows promise in automating this task, progress is hindered by limited public datasets, inconsistent benchmarks, and non-standardized baselines, restricting reproducibility, fair comparisons, and model generalizability. This work introduces nnLandmark, a self-configuring deep learning framework for 3D medical landmark detection, adapting nnU-Net to perform heatmap-based regression. By leveraging nnU-Net's automated configuration, nnLandmark eliminates the need for manual parameter tuning, offering out-of-the-box usability. It achieves state-of-the-art accuracy across two public datasets, with a mean radial error (MRE) of 1.5 mm on the Mandibular Molar Landmark (MML) dental CT dataset and 1.2 mm for anatomical fiducials on a brain MRI dataset (AFIDs), where nnLandmark aligns with the inter-rater variability of 1.5 mm. With its strong generalization, reproducibility, and ease of deployment, nnLandmark establishes a reliable baseline for 3D landmark detection, supporting research in anatomical localization and clinical workflows that depend on precise landmark identification. The code will be available soon.

Despite the recent successes of deep learning, such models are still far from some human abilities like learning from few examples, reasoning and explaining decisions. In this paper, we focus on organ annotation in medical images and we introduce a reasoning framework that is based on learning fuzzy relations on a small dataset for generating explanations. Given a catalogue of relations, it efficiently induces the most relevant relations and combines them for building constraints in order to both solve the organ annotation task and generate explanations. We test our approach on a publicly available dataset of medical images where several organs are already segmented. A demonstration of our model is proposed with an example of explained annotations. It was trained on a small training set containing as few as a couple of examples.

Precise spatial modeling in the operating room (OR) is foundational to many clinical tasks, supporting intraoperative awareness, hazard avoidance, and surgical decision-making. While existing approaches leverage large-scale multimodal datasets for latent-space alignment to implicitly learn spatial relationships, they overlook the 3D capabilities of MLLMs. However, this approach raises two issues: (1) Operating rooms typically lack multiple video and audio sensors, making multimodal 3D data difficult to obtain; (2) Training solely on readily available 2D data fails to capture fine-grained details in complex scenes. To address this gap, we introduce Spatial-ORMLLM, the first large vision-language model for 3D spatial reasoning in operating rooms using only RGB modality to infer volumetric and semantic cues, enabling downstream medical tasks with detailed and holistic spatial context. Spatial-ORMLLM incorporates a Spatial-Enhanced Feature Fusion Block, which integrates 2D modality inputs with rich 3D spatial knowledge extracted by the estimation algorithm and then feeds the combined features into the visual tower. By employing a unified end-to-end MLLM framework, it combines powerful spatial features with textual features to deliver robust 3D scene reasoning without any additional expert annotations or sensor inputs. Experiments on multiple benchmark clinical datasets demonstrate that Spatial-ORMLLM achieves state-of-the-art performance and generalizes robustly to previously unseen surgical scenarios and downstream tasks.

Representing complex objects with basic geometric primitives has long been a topic in computer vision. Primitive-based representations have the merits of compactness and computational efficiency in higher-level tasks such as physics simulation, collision checking, and robotic manipulation. Unlike previous works which extract polygonal meshes from a signed distance function (SDF), in this paper, we present a novel method, named Marching-Primitives, to obtain a primitive-based abstraction directly from an SDF. Our method grows geometric primitives (such as superquadrics) iteratively by analyzing the connectivity of voxels while marching at different levels of signed distance. For each valid connected volume of interest, we march on the scope of voxels from which a primitive is able to be extracted in a probabilistic sense and simultaneously solve for the parameters of the primitive to capture the underlying local geometry. We evaluate the performance of our method on both synthetic and real-world datasets. The results show that the proposed method outperforms the state-of-the-art in terms of accuracy, and is directly generalizable among different categories and scales. The code is open-sourced at https://github.com/ChirikjianLab/Marching-Primitives.git.

The skeleton of a digital image is a compact representation of its topology, geometry, and scale. It has utility in many computer vision applications, such as image description, segmentation, and registration. However, skeletonization has only seen limited use in contemporary deep learning solutions. Most existing skeletonization algorithms are not differentiable, making it impossible to integrate them with gradient-based optimization. Compatible algorithms based on morphological operations and neural networks have been proposed, but their results often deviate from the geometry and topology of the true medial axis. This work introduces the first three-dimensional skeletonization algorithm that is both compatible with gradient-based optimization and preserves an object's topology. Our method is exclusively based on matrix additions and multiplications, convolutional operations, basic non-linear functions, and sampling from a uniform probability distribution, allowing it to be easily implemented in any major deep learning library. In benchmarking experiments, we prove the advantages of our skeletonization algorithm compared to non-differentiable, morphological, and neural-network-based baselines. Finally, we demonstrate the utility of our algorithm by integrating it with two medical image processing applications that use gradient-based optimization: deep-learning-based blood vessel segmentation, and multimodal registration of the mandible in computed tomography and magnetic resonance images.

Agentic search, as a more autonomous and adaptive paradigm of retrieval augmentation, is driving the evolution of intelligent search systems. However, existing evaluation frameworks fail to align well with the goals of agentic search. First, the complex queries commonly used in current benchmarks often deviate from realistic user search scenarios. Second, prior approaches tend to introduce noise when extracting ground truth for end-to-end evaluations, leading to distorted assessments at a fine-grained level. Third, most current frameworks focus solely on the quality of final answers, neglecting the evaluation of the iterative process inherent to agentic search. To address these limitations, we propose RAVine -- a Reality-Aligned eValuation framework for agentic LLMs with search. RAVine targets multi-point queries and long-form answers that better reflect user intents, and introduces an attributable ground truth construction strategy to enhance the accuracy of fine-grained evaluation. Moreover, RAVine examines model's interaction with search tools throughout the iterative process, and accounts for factors of efficiency. We benchmark a series of models using RAVine and derive several insights, which we hope will contribute to advancing the development of agentic search systems. The code and datasets are available at https://github.com/SwordFaith/RAVine.

Vision-Language Models (VLMs), such as Flamingo and GPT-4V, have shown immense potential by integrating large language models with vision systems. Nevertheless, these models face challenges in the fundamental computer vision task of object localisation, due to their training on multimodal data containing mostly captions without explicit spatial grounding. While it is possible to construct custom, supervised training pipelines with bounding box annotations that integrate with VLMs, these result in specialized and hard-to-scale models. In this paper, we aim to explore the limits of caption-based VLMs and instead propose to tackle the challenge in a simpler manner by i) keeping the weights of a caption-based VLM frozen and ii) not using any supervised detection data. To this end, we introduce an input-agnostic Positional Insert (PIN), a learnable spatial prompt, containing a minimal set of parameters that are slid inside the frozen VLM, unlocking object localisation capabilities. Our PIN module is trained with a simple next-token prediction task on synthetic data without requiring the introduction of new output heads. Our experiments demonstrate strong zero-shot localisation performances on a variety of images, including Pascal VOC, COCO, LVIS, and diverse images like paintings or cartoons.

Biomedical question-answering (QA) systems require effective retrieval and generation components to ensure accuracy, efficiency, and scalability. This study systematically examines a Retrieval-Augmented Generation (RAG) system for biomedical QA, evaluating retrieval strategies and response time trade-offs. We first assess state-of-the-art retrieval methods, including BM25, BioBERT, MedCPT, and a hybrid approach, alongside common data stores such as Elasticsearch, MongoDB, and FAISS, on a ~10% subset of PubMed (2.4M documents) to measure indexing efficiency, retrieval latency, and retriever performance in the end-to-end RAG system. Based on these insights, we deploy the final RAG system on the full 24M PubMed corpus, comparing different retrievers' impact on overall performance. Evaluations of the retrieval depth show that retrieving 50 documents with BM25 before reranking with MedCPT optimally balances accuracy (0.90), recall (0.90), and response time (1.91s). BM25 retrieval time remains stable (82ms), while MedCPT incurs the main computational cost. These results highlight previously not well-known trade-offs in retrieval depth, efficiency, and scalability for biomedical QA. With open-source code, the system is fully reproducible and extensible.

Recent progress in Large Vision-Language Models (LVLMs) has enabled promising applications in medical tasks, such as report generation and visual question answering. However, existing benchmarks focus mainly on the final diagnostic answer, offering limited insight into whether models engage in clinically meaningful reasoning. To address this, we present CheXStruct and CXReasonBench, a structured pipeline and benchmark built on the publicly available MIMIC-CXR-JPG dataset. CheXStruct automatically derives a sequence of intermediate reasoning steps directly from chest X-rays, such as segmenting anatomical regions, deriving anatomical landmarks and diagnostic measurements, computing diagnostic indices, and applying clinical thresholds. CXReasonBench leverages this pipeline to evaluate whether models can perform clinically valid reasoning steps and to what extent they can learn from structured guidance, enabling fine-grained and transparent assessment of diagnostic reasoning. The benchmark comprises 18,988 QA pairs across 12 diagnostic tasks and 1,200 cases, each paired with up to 4 visual inputs, and supports multi-path, multi-stage evaluation including visual grounding via anatomical region selection and diagnostic measurements. Even the strongest of 10 evaluated LVLMs struggle with structured reasoning and generalization, often failing to link abstract knowledge with anatomically grounded visual interpretation. The code is available at https://github.com/ttumyche/CXReasonBench

The growing demand for efficient and lightweight Retrieval-Augmented Generation (RAG) systems has highlighted significant challenges when deploying Small Language Models (SLMs) in existing RAG frameworks. Current approaches face severe performance degradation due to SLMs' limited semantic understanding and text processing capabilities, creating barriers for widespread adoption in resource-constrained scenarios. To address these fundamental limitations, we present MiniRAG, a novel RAG system designed for extreme simplicity and efficiency. MiniRAG introduces two key technical innovations: (1) a semantic-aware heterogeneous graph indexing mechanism that combines text chunks and named entities in a unified structure, reducing reliance on complex semantic understanding, and (2) a lightweight topology-enhanced retrieval approach that leverages graph structures for efficient knowledge discovery without requiring advanced language capabilities. Our extensive experiments demonstrate that MiniRAG achieves comparable performance to LLM-based methods even when using SLMs while requiring only 25\% of the storage space. Additionally, we contribute a comprehensive benchmark dataset for evaluating lightweight RAG systems under realistic on-device scenarios with complex queries. We fully open-source our implementation and datasets at: https://github.com/HKUDS/MiniRAG.

Retrieval augmented generation (RAG) has shown great power in improving Large Language Models (LLMs). However, most existing RAG-based LLMs are dedicated to retrieving single modality information, mainly text; while for many real-world problems, such as healthcare, information relevant to queries can manifest in various modalities such as knowledge graph, text (clinical notes), and complex molecular structure. Thus, being able to retrieve relevant multi-modality domain-specific information, and reason and synthesize diverse knowledge to generate an accurate response is important. To address the gap, we present BioMol-MQA, a new question-answering (QA) dataset on polypharmacy, which is composed of two parts (i) a multimodal knowledge graph (KG) with text and molecular structure for information retrieval; and (ii) challenging questions that designed to test LLM capabilities in retrieving and reasoning over multimodal KG to answer questions. Our benchmarks indicate that existing LLMs struggle to answer these questions and do well only when given the necessary background data, signaling the necessity for strong RAG frameworks.

The choice of representation for geographic location significantly impacts the accuracy of models for a broad range of geospatial tasks, including fine-grained species classification, population density estimation, and biome classification. Recent works like SatCLIP and GeoCLIP learn such representations by contrastively aligning geolocation with co-located images. While these methods work exceptionally well, in this paper, we posit that the current training strategies fail to fully capture the important visual features. We provide an information-theoretic perspective on why the resulting embeddings from these methods discard crucial visual information that is important for many downstream tasks. To solve this problem, we propose a novel retrieval-augmented strategy called RANGE. We build our method on the intuition that the visual features of a location can be estimated by combining the visual features from multiple similar-looking locations. We evaluate our method across a wide variety of tasks. Our results show that RANGE outperforms the existing state-of-the-art models with significant margins in most tasks. We show gains of up to 13.1% on classification tasks and 0.145 R^2 on regression tasks. All our code and models will be made available at: https://github.com/mvrl/RANGE.

Modern deep learning models have the ability to generate high-dimensional vectors whose similarity reflects semantic resemblance. Thus, similarity search, i.e., the operation of retrieving those vectors in a large collection that are similar to a given query, has become a critical component of a wide range of applications that demand highly accurate and timely answers. In this setting, the high vector dimensionality puts similarity search systems under compute and memory pressure, leading to subpar performance. Additionally, cross-modal retrieval tasks have become increasingly common, e.g., where a user inputs a text query to find the most relevant images for that query. However, these queries often have different distributions than the database embeddings, making it challenging to achieve high accuracy. In this work, we present LeanVec, a framework that combines linear dimensionality reduction with vector quantization to accelerate similarity search on high-dimensional vectors while maintaining accuracy. We present LeanVec variants for in-distribution (ID) and out-of-distribution (OOD) queries. LeanVec-ID yields accuracies on par with those from recently introduced deep learning alternatives whose computational overhead precludes their usage in practice. LeanVec-OOD uses a novel technique for dimensionality reduction that considers the query and database distributions to simultaneously boost the accuracy and the performance of the framework even further (even presenting competitive results when the query and database distributions match). All in all, our extensive and varied experimental results show that LeanVec produces state-of-the-art results, with up to 3.7x improvement in search throughput and up to 4.9x faster index build time over the state of the art.

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.

This paper presents a systematic study on enabling medical reasoning models (MRMs) to generate ranked lists of answers for open-ended questions. Clinical decision-making rarely relies on a single answer but instead considers multiple options, reducing the risks of narrow perspectives. Yet current MRMs are typically trained to produce only one answer, even in open-ended settings. We propose an alternative format: ranked lists and investigate two approaches: prompting and fine-tuning. While prompting is a cost-effective way to steer an MRM's response, not all MRMs generalize well across different answer formats: choice, short text, and list answers. Based on our prompting findings, we train and evaluate MRMs using supervised fine-tuning (SFT) and reinforcement fine-tuning (RFT). SFT teaches a model to imitate annotated responses, and RFT incentivizes exploration through the responses that maximize a reward. We propose new reward functions targeted at ranked-list answer formats, and conduct ablation studies for RFT. Our results show that while some SFT models generalize to certain answer formats, models trained with RFT are more robust across multiple formats. We also present a case study on a modified MedQA with multiple valid answers, finding that although MRMs might fail to select the benchmark's preferred ground truth, they can recognize valid answers. To the best of our knowledge, this is the first systematic investigation of approaches for enabling MRMs to generate answers as ranked lists. We hope this work provides a first step toward developing alternative answer formats that are beneficial beyond single answers in medical domains.

We propose a novel attention gate (AG) model for medical imaging that automatically learns to focus on target structures of varying shapes and sizes. Models trained with AGs implicitly learn to suppress irrelevant regions in an input image while highlighting salient features useful for a specific task. This enables us to eliminate the necessity of using explicit external tissue/organ localisation modules of cascaded convolutional neural networks (CNNs). AGs can be easily integrated into standard CNN architectures such as the U-Net model with minimal computational overhead while increasing the model sensitivity and prediction accuracy. The proposed Attention U-Net architecture is evaluated on two large CT abdominal datasets for multi-class image segmentation. Experimental results show that AGs consistently improve the prediction performance of U-Net across different datasets and training sizes while preserving computational efficiency. The code for the proposed architecture is publicly available.

This paper introduces a cost-efficient active learning (AL) framework for classification, featuring a novel query design called candidate set query. Unlike traditional AL queries requiring the oracle to examine all possible classes, our method narrows down the set of candidate classes likely to include the ground-truth class, significantly reducing the search space and labeling cost. Moreover, we leverage conformal prediction to dynamically generate small yet reliable candidate sets, adapting to model enhancement over successive AL rounds. To this end, we introduce an acquisition function designed to prioritize data points that offer high information gain at lower cost. Empirical evaluations on CIFAR-10, CIFAR-100, and ImageNet64x64 demonstrate the effectiveness and scalability of our framework. Notably, it reduces labeling cost by 42% on ImageNet64x64.

Large-scale language models (LLMs) have achieved remarkable success across various language tasks but suffer from hallucinations and temporal misalignment. To mitigate these shortcomings, Retrieval-augmented generation (RAG) has been utilized to provide external knowledge to facilitate the answer generation. However, applying such models to the medical domain faces several challenges due to the lack of domain-specific knowledge and the intricacy of real-world scenarios. In this study, we explore LLMs with RAG framework for knowledge-intensive tasks in the medical field. To evaluate the capabilities of LLMs, we introduce MedicineQA, a multi-round dialogue benchmark that simulates the real-world medication consultation scenario and requires LLMs to answer with retrieved evidence from the medicine database. MedicineQA contains 300 multi-round question-answering pairs, each embedded within a detailed dialogue history, highlighting the challenge posed by this knowledge-intensive task to current LLMs. We further propose a new Distill-Retrieve-Read framework instead of the previous Retrieve-then-Read. Specifically, the distillation and retrieval process utilizes a tool calling mechanism to formulate search queries that emulate the keyword-based inquiries used by search engines. With experimental results, we show that our framework brings notable performance improvements and surpasses the previous counterparts in the evidence retrieval process in terms of evidence retrieval accuracy. This advancement sheds light on applying RAG to the medical domain.