Daily Papers

Creating a large-scale dataset of abnormality annotation on medical images is a labor-intensive and costly task. Leveraging weak supervision from readily available data such as radiology reports can compensate lack of large-scale data for anomaly detection methods. However, most of the current methods only use image-level pathological observations, failing to utilize the relevant anatomy mentions in reports. Furthermore, Natural Language Processing (NLP)-mined weak labels are noisy due to label sparsity and linguistic ambiguity. We propose an Anatomy-Guided chest X-ray Network (AGXNet) to address these issues of weak annotation. Our framework consists of a cascade of two networks, one responsible for identifying anatomical abnormalities and the second responsible for pathological observations. The critical component in our framework is an anatomy-guided attention module that aids the downstream observation network in focusing on the relevant anatomical regions generated by the anatomy network. We use Positive Unlabeled (PU) learning to account for the fact that lack of mention does not necessarily mean a negative label. Our quantitative and qualitative results on the MIMIC-CXR dataset demonstrate the effectiveness of AGXNet in disease and anatomical abnormality localization. Experiments on the NIH Chest X-ray dataset show that the learned feature representations are transferable and can achieve the state-of-the-art performances in disease classification and competitive disease localization results. Our code is available at https://github.com/batmanlab/AGXNet

Even though convolutional neural networks (CNNs) are driving progress in medical image segmentation, standard models still have some drawbacks. First, the use of multi-scale approaches, i.e., encoder-decoder architectures, leads to a redundant use of information, where similar low-level features are extracted multiple times at multiple scales. Second, long-range feature dependencies are not efficiently modeled, resulting in non-optimal discriminative feature representations associated with each semantic class. In this paper we attempt to overcome these limitations with the proposed architecture, by capturing richer contextual dependencies based on the use of guided self-attention mechanisms. This approach is able to integrate local features with their corresponding global dependencies, as well as highlight interdependent channel maps in an adaptive manner. Further, the additional loss between different modules guides the attention mechanisms to neglect irrelevant information and focus on more discriminant regions of the image by emphasizing relevant feature associations. We evaluate the proposed model in the context of semantic segmentation on three different datasets: abdominal organs, cardiovascular structures and brain tumors. A series of ablation experiments support the importance of these attention modules in the proposed architecture. In addition, compared to other state-of-the-art segmentation networks our model yields better segmentation performance, increasing the accuracy of the predictions while reducing the standard deviation. This demonstrates the efficiency of our approach to generate precise and reliable automatic segmentations of medical images. Our code is made publicly available at https://github.com/sinAshish/Multi-Scale-Attention

Vision-grounded medical report generation aims to produce clinically accurate descriptions of medical images, anchored in explicit visual evidence to improve interpretability and facilitate integration into clinical workflows. However, existing methods often rely on separately trained detection modules that require extensive expert annotations, introducing high labeling costs and limiting generalizability due to pathology distribution bias across datasets. To address these challenges, we propose Self-Supervised Anatomical Consistency Learning (SS-ACL) -- a novel and annotation-free framework that aligns generated reports with corresponding anatomical regions using simple textual prompts. SS-ACL constructs a hierarchical anatomical graph inspired by the invariant top-down inclusion structure of human anatomy, organizing entities by spatial location. It recursively reconstructs fine-grained anatomical regions to enforce intra-sample spatial alignment, inherently guiding attention maps toward visually relevant areas prompted by text. To further enhance inter-sample semantic alignment for abnormality recognition, SS-ACL introduces a region-level contrastive learning based on anatomical consistency. These aligned embeddings serve as priors for report generation, enabling attention maps to provide interpretable visual evidence. Extensive experiments demonstrate that SS-ACL, without relying on expert annotations, (i) generates accurate and visually grounded reports -- outperforming state-of-the-art methods by 10\% in lexical accuracy and 25\% in clinical efficacy, and (ii) achieves competitive performance on various downstream visual tasks, surpassing current leading visual foundation models by 8\% in zero-shot visual grounding.

Attention mechanisms are a central property of cognitive systems allowing them to selectively deploy cognitive resources in a flexible manner. Attention has been long studied in the neurosciences and there are numerous phenomenological models that try to capture its core properties. Recently attentional mechanisms have become a dominating architectural choice of machine learning and are the central innovation of Transformers. The dominant intuition and formalism underlying their development has drawn on ideas of keys and queries in database management systems. In this work, we propose an alternative Bayesian foundation for attentional mechanisms and show how this unifies different attentional architectures in machine learning. This formulation allows to to identify commonality across different attention ML architectures as well as suggest a bridge to those developed in neuroscience. We hope this work will guide more sophisticated intuitions into the key properties of attention architectures and suggest new ones.

Medical image analysis continues to hold interesting challenges given the subtle characteristics of certain diseases and the significant overlap in appearance between diseases. In this work, we explore the concept of self-attention for tackling such subtleties in and between diseases. To this end, we introduce MEDUSA, a multi-scale encoder-decoder self-attention mechanism tailored for medical image analysis. While self-attention deep convolutional neural network architectures in existing literature center around the notion of multiple isolated lightweight attention mechanisms with limited individual capacities being incorporated at different points in the network architecture, MEDUSA takes a significant departure from this notion by possessing a single, unified self-attention mechanism with significantly higher capacity with multiple attention heads feeding into different scales in the network architecture. To the best of the authors' knowledge, this is the first "single body, multi-scale heads" realization of self-attention and enables explicit global context amongst selective attention at different levels of representational abstractions while still enabling differing local attention context at individual levels of abstractions. With MEDUSA, we obtain state-of-the-art performance on multiple challenging medical image analysis benchmarks including COVIDx, RSNA RICORD, and RSNA Pneumonia Challenge when compared to previous work. Our MEDUSA model is publicly available.

We propose a novel method for unsupervised image-to-image translation, which incorporates a new attention module and a new learnable normalization function in an end-to-end manner. The attention module guides our model to focus on more important regions distinguishing between source and target domains based on the attention map obtained by the auxiliary classifier. Unlike previous attention-based method which cannot handle the geometric changes between domains, our model can translate both images requiring holistic changes and images requiring large shape changes. Moreover, our new AdaLIN (Adaptive Layer-Instance Normalization) function helps our attention-guided model to flexibly control the amount of change in shape and texture by learned parameters depending on datasets. Experimental results show the superiority of the proposed method compared to the existing state-of-the-art models with a fixed network architecture and hyper-parameters. Our code and datasets are available at https://github.com/taki0112/UGATIT or https://github.com/znxlwm/UGATIT-pytorch.

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.

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.

The Transformer architecture processes sequences by implementing a form of neural message-passing that consists of iterative information retrieval (attention), followed by local processing (position-wise MLP). Two types of information are essential under this general computational paradigm: "sensory" information about individual objects, and "relational" information describing the relationships between objects. Standard attention naturally encodes the former, but does not explicitly encode the latter. In this paper, we present an extension of Transformers where multi-head attention is augmented with two distinct types of attention heads, each routing information of a different type. The first type is the standard attention mechanism of Transformers, which captures object-level features, while the second type is a novel attention mechanism we propose to explicitly capture relational information. The two types of attention heads each possess different inductive biases, giving the resulting architecture greater efficiency and versatility. The promise of this approach is demonstrated empirically across a range of tasks.

Accurate disease interpretation from radiology remains challenging due to imaging heterogeneity. Achieving expert-level diagnostic decisions requires integration of subtle image features with clinical knowledge. Yet major vision-language models (VLMs) treat images as holistic entities and overlook fine-grained image details that are vital for disease diagnosis. Clinicians analyze images by utilizing their prior medical knowledge and identify anatomical structures as important region of interests (ROIs). Inspired from this human-centric workflow, we introduce Anatomy-VLM, a fine-grained, vision-language model that incorporates multi-scale information. First, we design a model encoder to localize key anatomical features from entire medical images. Second, these regions are enriched with structured knowledge for contextually-aware interpretation. Finally, the model encoder aligns multi-scale medical information to generate clinically-interpretable disease prediction. Anatomy-VLM achieves outstanding performance on both in- and out-of-distribution datasets. We also validate the performance of Anatomy-VLM on downstream image segmentation tasks, suggesting that its fine-grained alignment captures anatomical and pathology-related knowledge. Furthermore, the Anatomy-VLM's encoder facilitates zero-shot anatomy-wise interpretation, providing its strong expert-level clinical interpretation capabilities.

Transformers are increasingly dominating multi-modal reasoning tasks, such as visual question answering, achieving state-of-the-art results thanks to their ability to contextualize information using the self-attention and co-attention mechanisms. These attention modules also play a role in other computer vision tasks including object detection and image segmentation. Unlike Transformers that only use self-attention, Transformers with co-attention require to consider multiple attention maps in parallel in order to highlight the information that is relevant to the prediction in the model's input. In this work, we propose the first method to explain prediction by any Transformer-based architecture, including bi-modal Transformers and Transformers with co-attentions. We provide generic solutions and apply these to the three most commonly used of these architectures: (i) pure self-attention, (ii) self-attention combined with co-attention, and (iii) encoder-decoder attention. We show that our method is superior to all existing methods which are adapted from single modality explainability.

We propose Convolutional Block Attention Module (CBAM), a simple yet effective attention module for feed-forward convolutional neural networks. Given an intermediate feature map, our module sequentially infers attention maps along two separate dimensions, channel and spatial, then the attention maps are multiplied to the input feature map for adaptive feature refinement. Because CBAM is a lightweight and general module, it can be integrated into any CNN architectures seamlessly with negligible overheads and is end-to-end trainable along with base CNNs. We validate our CBAM through extensive experiments on ImageNet-1K, MS~COCO detection, and VOC~2007 detection datasets. Our experiments show consistent improvements in classification and detection performances with various models, demonstrating the wide applicability of CBAM. The code and models will be publicly available.

Convolutional neural networks have allowed remarkable advances in single image super-resolution (SISR) over the last decade. Among recent advances in SISR, attention mechanisms are crucial for high-performance SR models. However, the attention mechanism remains unclear on why and how it works in SISR. In this work, we attempt to quantify and visualize attention mechanisms in SISR and show that not all attention modules are equally beneficial. We then propose attention in attention network (A^2N) for more efficient and accurate SISR. Specifically, A^2N consists of a non-attention branch and a coupling attention branch. A dynamic attention module is proposed to generate weights for these two branches to suppress unwanted attention adjustments dynamically, where the weights change adaptively according to the input features. This allows attention modules to specialize to beneficial examples without otherwise penalties and thus greatly improve the capacity of the attention network with few parameters overhead. Experimental results demonstrate that our final model A^2N could achieve superior trade-off performances comparing with state-of-the-art networks of similar sizes. Codes are available at https://github.com/haoyuc/A2N.

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.

Vision-language models (VLMs) pretrained on large-scale image-text pairs demonstrate strong image-level understanding, but are primarily optimized for global alignment and do not explicitly encode fine-grained anatomical structure, limiting their suitability for spatially precise tasks such as segmentation. We introduce CheXanatomy, a framework that integrates explicit anatomical knowledge into a pretrained VLM through autoregressive token-space supervision. Instead of adding task-specific decoder heads, the model is trained to generate anatomical segmentation masks via next-token prediction. To enable scalable supervision, we synthesize realistic chest radiographs from CT volumes and forward-project CT segmentation labels to obtain anatomically consistent 2D masks. We evaluate the approach on synthetic and real chest radiographs against a U-Net baseline, including ablations on model scale, input resolution, and vision encoder fine-tuning. Autoregressive anatomical supervision achieves performance comparable to specialized convolutional models in-distribution and demonstrates improved geometric robustness under domain shift to real CXR data. In addition, anatomy-pretrained models exhibit improved sample efficiency when adapting to novel localization tasks under limited supervision. Larger models and higher input image resolution improve performance, while vision encoder fine-tuning has limited effect. These results show that embedding anatomical structure directly into the generative objective promotes spatially grounded representations and supports anatomy-aware medical vision-language modeling.

A CT examination captures multiple organs, but many biomedical questions concern abnormalities, prognosis, or longitudinal change in a specific organ. These questions require a separate representation for each organ within the same CT volume. Existing CT foundation models commonly produce a single volume-level representation, while recent anatomy-aware methods either encode pre-separated organ volumes or explicitly disentangle images into organ token groups. The former may remove clinically relevant surrounding context, while the latter does not condition a shared encoder on a selected organ before its features are formed. We introduce OrganLens for organ-specific representation learning through self-supervision. An organ identity conditions a shared CT encoder, while organ-specific distillation and anatomy-mask supervision shape features for anatomy-weighted pooling into organ-specific representations. At inference, the shared model produces 11 organ-specific representations without external segmentation masks. We evaluate OrganLens on CT-RATE, RAD-ChestCT, INSPECT, and NLST across diverse acquisitions and downstream evaluations. Relative to CT-pretrained DINOv2, heart representations raise CT-RATE cardiomegaly AUROC from 0.910 to 0.953, while lung representations improve the Harrell C-index for NLST lung-cancer mortality by 14.2\%. The global representation reaches INSPECT Recall@10 of 33.09\% and 32.04\% for text-to-image and image-to-text retrieval, respectively. Across organ-related tasks, anatomically matched representations provide stronger task-relevant signal, while the global representation retains broad utility. OrganLens offers a scalable approach to organ-specific CT representation learning with a shared encoder. More broadly, it provides the medical research community with a reusable framework for studying organ-specific disease across cohorts and clinical endpoints.

How a vision-language model internally solves the task of describing an image is far from obvious. We find that the model develops a specific mechanism for this: a small set of attention heads in its language-model backbone, which we call gaze heads, whose attention tracks the image region the model is currently describing. We find them with a simple correlation score from a few forward passes, using comic strips as a controlled testbed where narrative order is laid out spatially. These gaze heads do not just track the image tokens being described: redirecting their attention to a chosen region forces the VLM to describe that region instead. A single attention-mask intervention on the top-100 gaze heads, fewer than 9% of all heads, steers the model's answer to any chosen comic panel at 83.1% accuracy, while the same intervention on random heads fails to redirect the answer, and intervening on all heads destroys generation. The same lever also extends to continuous control: switching the gaze target mid-generation makes the model wrap up its current panel description and move to the new one within a few tokens. Beyond comics, the same intervention redirects answers to chosen regions in natural COCO images. The mechanism further recurs across model sizes from 2B to 32B parameters and across other VLM architectures, although some frozen-encoder families show no comparable head set. More broadly, this shows that targeted edits identified through mechanistic analysis can serve as practical inference-time levers for steering multimodal model behavior, without any retraining. Our code, interactive demo, and datasets are available at https://gaze.baulab.info/

The rapid increase in the number of Computed Tomography (CT) scan examinations has created an urgent need for automated tools, such as organ segmentation, anomaly classification, and report generation, to assist radiologists with their growing workload. Multi-label classification of Three-Dimensional (3D) CT scans is a challenging task due to the volumetric nature of the data and the variety of anomalies to be detected. Existing deep learning methods based on Convolutional Neural Networks (CNNs) struggle to capture long-range dependencies effectively, while Vision Transformers require extensive pre-training, posing challenges for practical use. Additionally, these existing methods do not explicitly model the radiologist's navigational behavior while scrolling through CT scan slices, which requires both global context understanding and local detail awareness. In this study, we present CT-Scroll, a novel global-local attention model specifically designed to emulate the scrolling behavior of radiologists during the analysis of 3D CT scans. Our approach is evaluated on two public datasets, demonstrating its efficacy through comprehensive experiments and an ablation study that highlights the contribution of each model component.

Understanding how humans process visual information is one of the crucial steps for unraveling the underlying mechanism of brain activity. Recently, this curiosity has motivated the fMRI-to-image reconstruction task; given the fMRI data from visual stimuli, it aims to reconstruct the corresponding visual stimuli. Surprisingly, leveraging powerful generative models such as the Latent Diffusion Model (LDM) has shown promising results in reconstructing complex visual stimuli such as high-resolution natural images from vision datasets. Despite the impressive structural fidelity of these reconstructions, they often lack details of small objects, ambiguous shapes, and semantic nuances. Consequently, the incorporation of additional semantic knowledge, beyond mere visuals, becomes imperative. In light of this, we exploit how modern LDMs effectively incorporate multi-modal guidance (text guidance, visual guidance, and image layout) for structurally and semantically plausible image generations. Specifically, inspired by the two-streams hypothesis suggesting that perceptual and semantic information are processed in different brain regions, our framework, Brain-Streams, maps fMRI signals from these brain regions to appropriate embeddings. That is, by extracting textual guidance from semantic information regions and visual guidance from perceptual information regions, Brain-Streams provides accurate multi-modal guidance to LDMs. We validate the reconstruction ability of Brain-Streams both quantitatively and qualitatively on a real fMRI dataset comprising natural image stimuli and fMRI data.

Training convolutional neural networks (CNNs) for segmentation of pulmonary airway, artery, and vein is challenging due to sparse supervisory signals caused by the severe class imbalance between tubular targets and background. We present a CNNs-based method for accurate airway and artery-vein segmentation in non-contrast computed tomography. It enjoys superior sensitivity to tenuous peripheral bronchioles, arterioles, and venules. The method first uses a feature recalibration module to make the best use of features learned from the neural networks. Spatial information of features is properly integrated to retain relative priority of activated regions, which benefits the subsequent channel-wise recalibration. Then, attention distillation module is introduced to reinforce representation learning of tubular objects. Fine-grained details in high-resolution attention maps are passing down from one layer to its previous layer recursively to enrich context. Anatomy prior of lung context map and distance transform map is designed and incorporated for better artery-vein differentiation capacity. Extensive experiments demonstrated considerable performance gains brought by these components. Compared with state-of-the-art methods, our method extracted much more branches while maintaining competitive overall segmentation performance. Codes and models are available at http://www.pami.sjtu.edu.cn/News/56

Understanding the mechanisms underlying human attention is a fundamental challenge for both vision science and artificial intelligence. While numerous computational models of free-viewing have been proposed, less is known about the mechanisms underlying task-driven image exploration. To address this gap, we present CapMIT1003, a database of captions and click-contingent image explorations collected during captioning tasks. CapMIT1003 is based on the same stimuli from the well-known MIT1003 benchmark, for which eye-tracking data under free-viewing conditions is available, which offers a promising opportunity to concurrently study human attention under both tasks. We make this dataset publicly available to facilitate future research in this field. In addition, we introduce NevaClip, a novel zero-shot method for predicting visual scanpaths that combines contrastive language-image pretrained (CLIP) models with biologically-inspired neural visual attention (NeVA) algorithms. NevaClip simulates human scanpaths by aligning the representation of the foveated visual stimulus and the representation of the associated caption, employing gradient-driven visual exploration to generate scanpaths. Our experimental results demonstrate that NevaClip outperforms existing unsupervised computational models of human visual attention in terms of scanpath plausibility, for both captioning and free-viewing tasks. Furthermore, we show that conditioning NevaClip with incorrect or misleading captions leads to random behavior, highlighting the significant impact of caption guidance in the decision-making process. These findings contribute to a better understanding of mechanisms that guide human attention and pave the way for more sophisticated computational approaches to scanpath prediction that can integrate direct top-down guidance of downstream tasks.

Multimodal large language models (MLLMs) recently showed strong capacity in integrating data among multiple modalities, empowered by a generalizable attention architecture. Advanced methods predominantly focus on language-centric tuning while less exploring multimodal tokens mixed through attention, posing challenges in high-level tasks that require fine-grained cognition and emotion understanding. In this work, we identify the attention deficit disorder problem in multimodal learning, caused by inconsistent cross-modal attention and layer-by-layer decayed attention activation. To address this, we propose a novel attention mechanism, termed MOdular Duplex Attention (MODA), simultaneously conducting the inner-modal refinement and inter-modal interaction. MODA employs a correct-after-align strategy to effectively decouple modality alignment from cross-layer token mixing. In the alignment phase, tokens are mapped to duplex modality spaces based on the basis vectors, enabling the interaction between visual and language modality. Further, the correctness of attention scores is ensured through adaptive masked attention, which enhances the model's flexibility by allowing customizable masking patterns for different modalities. Extensive experiments on 21 benchmark datasets verify the effectiveness of MODA in perception, cognition, and emotion tasks. Source code and demo are available in https://zzcheng.top/MODA.

The analysis of 3D medical images is crucial for modern healthcare, yet traditional task-specific models are becoming increasingly inadequate due to limited generalizability across diverse clinical scenarios. Multimodal large language models (MLLMs) offer a promising solution to these challenges. However, existing MLLMs have limitations in fully leveraging the rich, hierarchical information embedded in 3D medical images. Inspired by clinical practice, where radiologists focus on both 3D spatial structure and 2D planar content, we propose Med-2E3, a novel MLLM for 3D medical image analysis that integrates 3D and 2D encoders. To aggregate 2D features more effectively, we design a Text-Guided Inter-Slice (TG-IS) scoring module, which scores the attention of each 2D slice based on slice contents and task instructions. To the best of our knowledge, Med-2E3 is the first MLLM to integrate both 3D and 2D features for 3D medical image analysis. Experiments on a large-scale, open-source 3D medical multimodal benchmark demonstrate that Med-2E3 exhibits task-specific attention distribution and significantly outperforms current state-of-the-art models, with a 14% improvement in report generation and a 5% gain in medical visual question answering (VQA), highlighting the model's potential in addressing complex multimodal clinical tasks. The code will be released upon acceptance.

Learning similarity is a key aspect in medical image analysis, particularly in recommendation systems or in uncovering the interpretation of anatomical data in images. Most existing methods learn such similarities in the embedding space over image sets using a single metric learner. Images, however, have a variety of object attributes such as color, shape, or artifacts. Encoding such attributes using a single metric learner is inadequate and may fail to generalize. Instead, multiple learners could focus on separate aspects of these attributes in subspaces of an overarching embedding. This, however, implies the number of learners to be found empirically for each new dataset. This work, Dynamic Subspace Learners, proposes to dynamically exploit multiple learners by removing the need of knowing apriori the number of learners and aggregating new subspace learners during training. Furthermore, the visual interpretability of such subspace learning is enforced by integrating an attention module into our method. This integrated attention mechanism provides a visual insight of discriminative image features that contribute to the clustering of image sets and a visual explanation of the embedding features. The benefits of our attention-based dynamic subspace learners are evaluated in the application of image clustering, image retrieval, and weakly supervised segmentation. Our method achieves competitive results with the performances of multiple learners baselines and significantly outperforms the classification network in terms of clustering and retrieval scores on three different public benchmark datasets. Moreover, our attention maps offer a proxy-labels, which improves the segmentation accuracy up to 15% in Dice scores when compared to state-of-the-art interpretation techniques.

In this work, we propose a training-free method to inject visual prompts into Multimodal Large Language Models (MLLMs) through test-time optimization of a learnable latent variable. We observe that attention, as the core module of MLLMs, connects text prompt tokens and visual tokens, ultimately determining the final results. Our approach involves adjusting visual tokens from the MLP output at test time, controlling the attention response to ensure text prompt tokens attend to visual tokens in referring regions. We optimize a learnable latent variable based on an energy function, enhancing the strength of referring regions in the attention map. This enables detailed region description and reasoning without the need for substantial training costs or model retraining. Our method offers a promising direction for integrating referring abilities into MLLMs, and supports referring with box, mask, scribble and point. The results demonstrate that our method exhibits out-of-domain generalization and interpretability.

Existing Large Vision-Language Models (LVLMs) exhibit insufficient visual attention, leading to hallucinations. To alleviate this problem, some previous studies adjust and amplify visual attention. These methods present a limitation that boosting attention for all visual tokens inevitably increases attention to task irrelevant tokens. To tackle this challenge, we propose a training free attentional intervention algorithm to enhance the attention of task-relevant tokens based on the argument that task-relevant tokens generally demonstrate high visual-textual similarities. Specifically, the vision-text cross-attention submatrices, which represent visual-textual correlations, are extracted to construct the reweighting matrices to reallocate attention. Besides, to enhance the contribution of visual tokens, we inject visual attention values into the beam search decoding to identify solutions with higher visual attention. Extensive experiments demonstrate that this method significantly reduces hallucinations across mainstream LVLMs, while preserving the accuracy and coherence of generated content.

In this paper, we propose a novel text promptable surgical instrument segmentation approach to overcome challenges associated with diversity and differentiation of surgical instruments in minimally invasive surgeries. We redefine the task as text promptable, thereby enabling a more nuanced comprehension of surgical instruments and adaptability to new instrument types. Inspired by recent advancements in vision-language models, we leverage pretrained image and text encoders as our model backbone and design a text promptable mask decoder consisting of attention- and convolution-based prompting schemes for surgical instrument segmentation prediction. Our model leverages multiple text prompts for each surgical instrument through a new mixture of prompts mechanism, resulting in enhanced segmentation performance. Additionally, we introduce a hard instrument area reinforcement module to improve image feature comprehension and segmentation precision. Extensive experiments on several surgical instrument segmentation datasets demonstrate our model's superior performance and promising generalization capability. To our knowledge, this is the first implementation of a promptable approach to surgical instrument segmentation, offering significant potential for practical application in the field of robotic-assisted surgery. Code is available at https://github.com/franciszzj/TP-SIS.

In this work, we introduce Libra, a prototype model with a decoupled vision system on a large language model (LLM). The decoupled vision system decouples inner-modal modeling and cross-modal interaction, yielding unique visual information modeling and effective cross-modal comprehension. Libra is trained through discrete auto-regressive modeling on both vision and language inputs. Specifically, we incorporate a routed visual expert with a cross-modal bridge module into a pretrained LLM to route the vision and language flows during attention computing to enable different attention patterns in inner-modal modeling and cross-modal interaction scenarios. Experimental results demonstrate that the dedicated design of Libra achieves a strong MLLM baseline that rivals existing works in the image-to-text scenario with merely 50 million training data, providing a new perspective for future multimodal foundation models. Code is available at https://github.com/YifanXu74/Libra.

The U-Net architecture and its variants have remained state-of-the-art (SOTA) for retinal vessel segmentation over the past decade. In this study, we introduce a Full-Scale Guided Network (FSG-Net), where a novel feature representation module using modernized convolution blocks effectively captures full-scale structural information, while a guided convolution block subsequently refines this information. Specifically, we introduce an attention-guided filter within the guided convolution block, leveraging its similarity to unsharp masking to enhance fine vascular structures. Passing full-scale information to the attention block facilitates the generation of more contextually relevant attention maps, which are then passed to the attention-guided filter, providing further refinement to the segmentation performance. The structure preceding the guided convolution block can be replaced by any U-Net variant, ensuring flexibility and scalability across various segmentation tasks. For a fair comparison, we re-implemented recent studies available in public repositories to evaluate their scalability and reproducibility. Our experiments demonstrate that, despite its compact architecture, FSG-Net delivers performance competitive with SOTA methods across multiple public datasets. Ablation studies further demonstrate that each proposed component meaningfully contributes to this competitive performance. Our code is available on https://github.com/ZombaSY/FSG-Net-pytorch.

As large language models (LLMs) continue to advance, there is increasing interest in their ability to infer human mental states and demonstrate a human-like Theory of Mind (ToM). Most existing ToM evaluations, however, are centered on text-based inputs, while scenarios relying solely on visual information receive far less attention. This leaves a gap, since real-world human-AI interaction typically requires multimodal understanding. In addition, many current methods regard the model as a black box and rarely probe how its internal attention behaves in multiple-choice question answering (QA). The impact of LLM hallucinations on such tasks is also underexplored from an interpretability perspective. To address these issues, we introduce VisionToM, a vision-oriented intervention framework designed to strengthen task-aware reasoning. The core idea is to compute intervention vectors that align visual representations with the correct semantic targets, thereby steering the model's attention through different layers of visual features. This guidance reduces the model's reliance on spurious linguistic priors, leading to more reliable multimodal language model (MLLM) outputs and better QA performance. Experiments on the EgoToM benchmark-an egocentric, real-world video dataset for ToM with three multiple-choice QA settings-demonstrate that our method substantially improves the ToM abilities of MLLMs. Furthermore, results on an additional open-ended generation task show that VisionToM enables MLLMs to produce free-form explanations that more accurately capture agents' mental states, pushing machine-human collaboration toward greater alignment.

Transformer-based methods have demonstrated impressive results in medical image restoration, attributed to the multi-head self-attention (MSA) mechanism in the spatial dimension. However, the majority of existing Transformers conduct attention within fixed and coarsely partitioned regions (e.g. the entire image or fixed patches), resulting in interference from irrelevant regions and fragmentation of continuous image content. To overcome these challenges, we introduce a novel Region Attention Transformer (RAT) that utilizes a region-based multi-head self-attention mechanism (R-MSA). The R-MSA dynamically partitions the input image into non-overlapping semantic regions using the robust Segment Anything Model (SAM) and then performs self-attention within these regions. This region partitioning is more flexible and interpretable, ensuring that only pixels from similar semantic regions complement each other, thereby eliminating interference from irrelevant regions. Moreover, we introduce a focal region loss to guide our model to adaptively focus on recovering high-difficulty regions. Extensive experiments demonstrate the effectiveness of RAT in various medical image restoration tasks, including PET image synthesis, CT image denoising, and pathological image super-resolution. Code is available at https://github.com/Yaziwel/Region-Attention-Transformer-for-Medical-Image-Restoration.git{https://github.com/RAT}.

Attention Model has now become an important concept in neural networks that has been researched within diverse application domains. This survey provides a structured and comprehensive overview of the developments in modeling attention. In particular, we propose a taxonomy which groups existing techniques into coherent categories. We review salient neural architectures in which attention has been incorporated, and discuss applications in which modeling attention has shown a significant impact. We also describe how attention has been used to improve the interpretability of neural networks. Finally, we discuss some future research directions in attention. We hope this survey will provide a succinct introduction to attention models and guide practitioners while developing approaches for their applications.

Recent advancements in Large Vision-Language Models built upon Large Language Models have established aligning visual features with LLM representations as the dominant paradigm. However, inherited LLM architectural designs introduce suboptimal characteristics for multimodal processing. First, LVLMs exhibit a bimodal distribution in attention allocation, leading to the progressive neglect of middle visual content as context expands. Second, conventional positional encoding schemes fail to preserve vital 2D structural relationships when processing dynamic high-resolution images. To address these limitations, we propose CoMemo - a dual-path architecture that combines a Context image path with an image Memory path for visual processing, effectively alleviating visual information neglect. Additionally, we introduce RoPE-DHR, a novel positional encoding mechanism that employs thumbnail-based positional aggregation to maintain 2D spatial awareness while mitigating remote decay in extended sequences. Evaluations across seven benchmarks,including long-context comprehension, multi-image reasoning, and visual question answering, demonstrate CoMemo's superior performance compared to conventional LVLM architectures. Project page is available at https://lalbj.github.io/projects/CoMemo/.

The anatomical structure segmentation of the spine and adjacent structures from computed tomography (CT) images is a key step for spinal disease diagnosis and treatment. However, the segmentation of CT images is impeded by low contrast and complex vertebral boundaries. Although advanced models such as the Segment Anything Model (SAM) have shown promise in various segmentation tasks, their performance in spinal CT imaging is limited by high annotation requirements and poor domain adaptability. To address these limitations, we propose SpinalSAM-R1, a multimodal vision-language interactive system that integrates a fine-tuned SAM with DeepSeek-R1, for spine CT image segmentation. Specifically, our SpinalSAM-R1 introduces an anatomy-guided attention mechanism to improve spine segmentation performance, and a semantics-driven interaction protocol powered by DeepSeek-R1, enabling natural language-guided refinement. The SpinalSAM-R1 is fine-tuned using Low-Rank Adaptation (LoRA) for efficient adaptation. We validate our SpinalSAM-R1 on the spine anatomical structure with CT images. Experimental results suggest that our method achieves superior segmentation performance. Meanwhile, we develop a PyQt5-based interactive software, which supports point, box, and text-based prompts. The system supports 11 clinical operations with 94.3\% parsing accuracy and sub-800 ms response times. The software is released on https://github.com/6jm233333/spinalsam-r1.

Human attention modelling has proven, in recent years, to be particularly useful not only for understanding the cognitive processes underlying visual exploration, but also for providing support to artificial intelligence models that aim to solve problems in various domains, including image and video processing, vision-and-language applications, and language modelling. This survey offers a reasoned overview of recent efforts to integrate human attention mechanisms into contemporary deep learning models and discusses future research directions and challenges. For a comprehensive overview on the ongoing research refer to our dedicated repository available at https://github.com/aimagelab/awesome-human-visual-attention.

Cross-domain few-shot object detection (CD-FSOD) aims to adapt pretrained detectors from a source domain to target domains with limited annotations, suffering from severe domain shifts and data scarcity problems. In this work, we find a previously overlooked phenomenon: models exhibit dispersed and unfocused attention in target domains, leading to imprecise localization and redundant predictions, just like a human cannot focus on visual objects. Therefore, we call it the target-domain Astigmatism problem. Analysis on attention distances across transformer layers reveals that regular fine-tuning inherently shows a trend to remedy this problem, but results are still far from satisfactory, which we aim to enhance in this paper. Biologically inspired by the human fovea-style visual system, we enhance the fine-tuning's inherent trend through a center-periphery attention refinement framework, which contains (1) a Positive Pattern Refinement module to reshape attention toward semantic objects using class-specific prototypes, simulating the visual center region; (2) a Negative Context Modulation module to enhance boundary discrimination by modeling background context, simulating the visual periphery region; and (3) a Textual Semantic Alignment module to strengthen center-periphery distinction through cross-modal cues. Our bio-inspired approach transforms astigmatic attention into focused patterns, substantially improving adaptation to target domains. Experiments on six challenging CD-FSOD benchmarks consistently demonstrate improved detection accuracy and establish new state-of-the-art results.

We introduce a new type of foundational model for parsing human anatomy in medical images that works for different modalities. It supports supervised or unsupervised training and can perform matching, registration, classification, or segmentation with or without user interaction. We achieve this by training a neural network estimator that maps query locations to atlas coordinates via regression. Efficiency is improved by sparsely sampling the input, enabling response times of less than 1 ms without additional accelerator hardware. We demonstrate the utility of the algorithm in both CT and MRI modalities.

Several medical Multimodal Large Languange Models (MLLMs) have been developed to address tasks involving visual images with textual instructions across various medical modalities, achieving impressive results. Most current medical generalist models are region-agnostic, treating the entire image as a holistic representation. However, they struggle to identify which specific regions they are focusing on when generating a sentence. To mimic the behavior of doctors, who typically begin by reviewing the entire image before concentrating on specific regions for a thorough evaluation, we aim to enhance the capability of medical MLLMs in understanding anatomical regions within entire medical scans. To achieve it, we first formulate Region-Centric tasks and construct a large-scale dataset, MedRegInstruct, to incorporate regional information into training. Combining our collected dataset with other medical multimodal corpora for training, we propose a Region-Aware medical MLLM, MedRegA, which is the first bilingual generalist medical AI system to simultaneously handle image-level and region-level medical vision-language tasks across a broad range of modalities. Our MedRegA not only enables three region-centric tasks, but also achieves the best performance for visual question answering, report generation and medical image classification over 8 modalities, showcasing significant versatility. Experiments demonstrate that our model can not only accomplish powerful performance across various medical vision-language tasks in bilingual settings, but also recognize and detect structures in multimodal medical scans, boosting the interpretability and user interactivity of medical MLLMs. Our project page is https://medrega.github.io.

Medical visual question answering (Med-VQA) aims to answer clinically relevant questions grounded in medical images. However, existing multimodal large language models (MLLMs) often exhibit shortcut answering, producing plausible responses by exploiting language priors or dataset biases while insufficiently attending to visual evidence. This behavior undermines clinical reliability, especially when subtle imaging findings are decisive. We propose a lightweight plug-in framework, termed Intent-aware Visual Cues (InViC), to explicitly enhance image-based answer generation in medical VQA. InViC introduces a Cue Tokens Extraction (CTE) module that distills dense visual tokens into a compact set of K question-conditioned cue tokens, which serve as structured visual intermediaries injected into the LLM decoder to promote intent-aligned visual evidence. To discourage bypassing of visual information, we further design a two-stage fine-tuning strategy with a cue-bottleneck attention mask. In Stage I, we employ an attention mask to block the LLM's direct view of raw visual features, thereby funneling all visual evidence through the cue pathway. In Stage II, standard causal attention is restored to train the LLM to jointly exploit the visual and cue tokens. We evaluate InViC on three public Med-VQA benchmarks (VQA-RAD, SLAKE, and ImageCLEF VQA-Med 2019) across multiple representative MLLMs. InViC consistently improves over zero-shot inference and standard LoRA fine-tuning, demonstrating that intent-aware visual cues with bottlenecked training is a practical and effective strategy for improving trustworthy Med-VQA.

We prove under practical assumptions that Rotary Positional Embedding (RoPE) introduces an intrinsic distance-dependent bias in attention scores that limits RoPE's ability to model long-context. RoPE extension methods may alleviate this issue, but they typically require post-hoc adjustments after pretraining, such as rescaling or hyperparameters retuning. This paper introduces Token-Aware Phase Attention (TAPA), a new positional encoding method that incorporates a learnable phase function into the attention mechanism. TAPA preserves token interactions over long range, extends to longer contexts with direct and light fine-tuning, extrapolates to unseen lengths, and attains significantly lower perplexity on long-context than RoPE families.

Visual search is important in our daily life. The efficient allocation of visual attention is critical to effectively complete visual search tasks. Prior research has predominantly modelled the spatial allocation of visual attention in images at the pixel level, e.g. using a saliency map. However, emerging evidence shows that visual attention is guided by objects rather than pixel intensities. This paper introduces the Object-level Attention Transformer (OAT), which predicts human scanpaths as they search for a target object within a cluttered scene of distractors. OAT uses an encoder-decoder architecture. The encoder captures information about the position and appearance of the objects within an image and about the target. The decoder predicts the gaze scanpath as a sequence of object fixations, by integrating output features from both the encoder and decoder. We also propose a new positional encoding that better reflects spatial relationships between objects. We evaluated OAT on the Amazon book cover dataset and a new dataset for visual search that we collected. OAT's predicted gaze scanpaths align more closely with human gaze patterns, compared to predictions by algorithms based on spatial attention on both established metrics and a novel behavioural-based metric. Our results demonstrate the generalization ability of OAT, as it accurately predicts human scanpaths for unseen layouts and target objects.

Accurate recognition of anatomical structures is essential for safe and effective minimally invasive surgery (MIS), yet it remains underexplored in surgical computer vision due to limited annotated data and methods tailored primarily to natural scenes. In this work, we present a combined dataset and model framework to advance anatomy-aware perception in MIS. First, we introduce ATLAS-120k, a large-scale clip-level semantic segmentation dataset comprising over 120,000 annotated frames from 100 surgical videos spanning 14 procedures and multiple modalities, including laparoscopic and robot-assisted surgery. The dataset captures substantial procedural variability and was created using a scalable annotation pipeline that integrates expert manual labeling, automated propagation, iterative refinement, and surgeon verification to ensure high-quality annotations. Second, we propose ATLAS (Anatomy Recognition with Context Learning using Foundation Representations), a video semantic segmentation model specifically designed for surgical anatomy recognition. Unlike conventional approaches that emphasize object tracking, ATLAS leverages foundation-model embeddings together with lightweight temporal reasoning to incorporate contextual cues such as procedure type, surgical phase, and short-term visual memory. This design enables temporally consistent and accurate predictions while maintaining real-time feasibility. Together, the dataset and model establish a practical foundation for robust surgical scene understanding and support the development of clinically applicable guidance systems for minimally invasive surgery. The models, dataset annotations and annotation platform are publicly available at: https://github.com/TimJaspers0801/ATLAS.

Understanding how attention varies across individuals has significant scientific and societal impacts. However, existing visual scanpath models treat attention uniformly, neglecting individual differences. To bridge this gap, this paper focuses on individualized scanpath prediction (ISP), a new attention modeling task that aims to accurately predict how different individuals shift their attention in diverse visual tasks. It proposes an ISP method featuring three novel technical components: (1) an observer encoder to characterize and integrate an observer's unique attention traits, (2) an observer-centric feature integration approach that holistically combines visual features, task guidance, and observer-specific characteristics, and (3) an adaptive fixation prioritization mechanism that refines scanpath predictions by dynamically prioritizing semantic feature maps based on individual observers' attention traits. These novel components allow scanpath models to effectively address the attention variations across different observers. Our method is generally applicable to different datasets, model architectures, and visual tasks, offering a comprehensive tool for transforming general scanpath models into individualized ones. Comprehensive evaluations using value-based and ranking-based metrics verify the method's effectiveness and generalizability.

We present MindEye, a novel fMRI-to-image approach to retrieve and reconstruct viewed images from brain activity. Our model comprises two parallel submodules that are specialized for retrieval (using contrastive learning) and reconstruction (using a diffusion prior). MindEye can map fMRI brain activity to any high dimensional multimodal latent space, like CLIP image space, enabling image reconstruction using generative models that accept embeddings from this latent space. We comprehensively compare our approach with other existing methods, using both qualitative side-by-side comparisons and quantitative evaluations, and show that MindEye achieves state-of-the-art performance in both reconstruction and retrieval tasks. In particular, MindEye can retrieve the exact original image even among highly similar candidates indicating that its brain embeddings retain fine-grained image-specific information. This allows us to accurately retrieve images even from large-scale databases like LAION-5B. We demonstrate through ablations that MindEye's performance improvements over previous methods result from specialized submodules for retrieval and reconstruction, improved training techniques, and training models with orders of magnitude more parameters. Furthermore, we show that MindEye can better preserve low-level image features in the reconstructions by using img2img, with outputs from a separate autoencoder. All code is available on GitHub.

Multimodal large language models (MLLMs) generate responses autoregressively, integrating visual and linguistic information in an evolving context. Prior work on interpretability has focused on individual layers and circuits (where), leaving the token-level dynamics of multimodal computation during generation (when) underexplored. We address this gap and study attention shifts as per semantic role; tracking model attention to image, text, instruction, and previously generated tokens, One Token at a Time (OTaT). We introduce multimodal tasks that require explicit switching between visual and textual context within a single response. Across two mainstream model families and four open-weight MLLMs of varying sizes, we establish consistent patterns: attention to image peaks at tokens requiring image-derived information, instruction tokens are revisited during task transitions, and attention to previously generated tokens increases as the generation progresses. Causal attention blocking interventions validate the functional role of these trends. We profile model behavior under disrupted attention and observe responses falling back to language priors, or exhibiting cross-modal leakage, denial, or recovery. Finally, informed of the attention dynamics through our novel analysis, we propose a simple test-time intervention to boost attention to the relevant modality at the right time, significantly improving multimodal task performance.

Esophageal cancer is among the most common types of cancer worldwide. It is traditionally treated using open esophagectomy, but in recent years, robot-assisted minimally invasive esophagectomy (RAMIE) has emerged as a promising alternative. However, robot-assisted surgery can be challenging for novice surgeons, as they often suffer from a loss of spatial orientation. Computer-aided anatomy recognition holds promise for improving surgical navigation, but research in this area remains limited. In this study, we developed a comprehensive dataset for semantic segmentation in RAMIE, featuring the largest collection of vital anatomical structures and surgical instruments to date. Handling this diverse set of classes presents challenges, including class imbalance and the recognition of complex structures such as nerves. This study aims to understand the challenges and limitations of current state-of-the-art algorithms on this novel dataset and problem. Therefore, we benchmarked eight real-time deep learning models using two pretraining datasets. We assessed both traditional and attention-based networks, hypothesizing that attention-based networks better capture global patterns and address challenges such as occlusion caused by blood or other tissues. The benchmark includes our RAMIE dataset and the publicly available CholecSeg8k dataset, enabling a thorough assessment of surgical segmentation tasks. Our findings indicate that pretraining on ADE20k, a dataset for semantic segmentation, is more effective than pretraining on ImageNet. Furthermore, attention-based models outperform traditional convolutional neural networks, with SegNeXt and Mask2Former achieving higher Dice scores, and Mask2Former additionally excelling in average symmetric surface distance.

Teaching machines to recognize a new category based on few training samples especially only one remains challenging owing to the incomprehensive understanding of the novel category caused by the lack of data. However, human can learn new classes quickly even given few samples since human can tell what discriminative features should be focused on about each category based on both the visual and semantic prior knowledge. To better utilize those prior knowledge, we propose the SEmantic Guided Attention (SEGA) mechanism where the semantic knowledge is used to guide the visual perception in a top-down manner about what visual features should be paid attention to when distinguishing a category from the others. As a result, the embedding of the novel class even with few samples can be more discriminative. Concretely, a feature extractor is trained to embed few images of each novel class into a visual prototype with the help of transferring visual prior knowledge from base classes. Then we learn a network that maps semantic knowledge to category-specific attention vectors which will be used to perform feature selection to enhance the visual prototypes. Extensive experiments on miniImageNet, tieredImageNet, CIFAR-FS, and CUB indicate that our semantic guided attention realizes anticipated function and outperforms state-of-the-art results.

Vision-language models are increasingly integrated into clinical workflows. However, existing benchmarks primarily assess performance on common anatomical presentations and fail to capture the challenges posed by rare variants. To address this gap, we introduce AdversarialAnatomyBench, the first benchmark comprising naturally occurring rare anatomical variants across diverse imaging modalities and anatomical regions. We call such variants that violate learned priors about "typical" human anatomy natural adversarial anatomy. Benchmarking 22 state-of-the-art VLMs with AdversarialAnatomyBench yielded three key insights. First, when queried with basic medical perception tasks, mean accuracy dropped from 74% on typical to 29% on atypical anatomy. Even the best-performing models, GPT-5, Gemini 2.5 Pro, and Llama 4 Maverick, showed performance drops of 41-51%. Second, model errors closely mirrored expected anatomical biases. Third, neither model scaling nor interventions, including bias-aware prompting and test-time reasoning, resolved these issues. These findings highlight a critical and previously unquantified limitation in current VLM: their poor generalization to rare anatomical presentations. AdversarialAnatomyBench provides a foundation for systematically measuring and mitigating anatomical bias in multimodal medical AI systems.

Different medical imaging modalities capture diagnostic information at varying spatial resolutions, from coarse global patterns to fine-grained localized structures. However, most existing vision-language frameworks in the medical domain apply a uniform strategy for local feature extraction, overlooking the modality-specific demands. In this work, we present MedMoE, a modular and extensible vision-language processing framework that dynamically adapts visual representation based on the diagnostic context. MedMoE incorporates a Mixture-of-Experts (MoE) module conditioned on the report type, which routes multi-scale image features through specialized expert branches trained to capture modality-specific visual semantics. These experts operate over feature pyramids derived from a Swin Transformer backbone, enabling spatially adaptive attention to clinically relevant regions. This framework produces localized visual representations aligned with textual descriptions, without requiring modality-specific supervision at inference. Empirical results on diverse medical benchmarks demonstrate that MedMoE improves alignment and retrieval performance across imaging modalities, underscoring the value of modality-specialized visual representations in clinical vision-language systems.

Effectively representing medical images, especially retinal images, presents a considerable challenge due to variations in appearance, size, and contextual information of pathological signs called lesions. Precise discrimination of these lesions is crucial for diagnosing vision-threatening issues such as diabetic retinopathy. While visual attention-based neural networks have been introduced to learn spatial context and channel correlations from retinal images, they often fall short in capturing localized lesion context. Addressing this limitation, we propose a novel attention mechanism called Guided Context Gating, an unique approach that integrates Context Formulation, Channel Correlation, and Guided Gating to learn global context, spatial correlations, and localized lesion context. Our qualitative evaluation against existing attention mechanisms emphasize the superiority of Guided Context Gating in terms of explainability. Notably, experiments on the Zenodo-DR-7 dataset reveal a substantial 2.63% accuracy boost over advanced attention mechanisms & an impressive 6.53% improvement over the state-of-the-art Vision Transformer for assessing the severity grade of retinopathy, even with imbalanced and limited training samples for each class.

Human visual reasoning is governed by active vision, a process where metacognitive control drives top-down goal-directed attention, dynamically routing foveal focus toward task-relevant details while maintaining peripheral awareness of the global scene. In contrast, modern Vision-Language Models (VLMs) process visual information passively, relying on the static accumulation of massive token contexts that dilute spatial reasoning and induce linguistic hallucinations. Here we propose the following paradigm shift: GazeVLM, a multimodal architecture that internalizes this metacognitive oversight over its deployment of attention resources directly into the reasoning loop. By empowering the VLM to autonomously generate gaze tokens (<LOOK>), GazeVLM establishes a top-down control mechanism over its own causal attention mask. The model dynamically dictates its focal intent, triggering a continuous suppression bias that dampens irrelevant visual features, implementing spatial selective attention and simulating foveal fixation. Once local reasoning concludes, the bias lifts, seamlessly restoring the global view. This architecture enables the model to fluidly transition between global spatial awareness and localized focal reasoning without relying on external agentic contraptions like cropping tools, or inflating the context window with additional visual tokens derived from localized visual patches. Trained with a bespoke Group Relative Policy Optimization (GRPO) procedure that rewards valid grounding, our 4B-parameter GazeVLM delivers strong high-resolution multimodal reasoning performance, surpassing state-of-the-art VLMs in its parameter class by nearly 4% and agentic multimodal pipelines built around thinking with images by more than 5% on HRBench-4k and HRBench-8k.

Recognizing and localizing events in videos is a fundamental task for video understanding. Since events may occur in auditory and visual modalities, multimodal detailed perception is essential for complete scene comprehension. Most previous works attempted to analyze videos from a holistic perspective. However, they do not consider semantic information at multiple scales, which makes the model difficult to localize events in different lengths. In this paper, we present a Multimodal Pyramid Attentional Network (MM-Pyramid) for event localization. Specifically, we first propose the attentive feature pyramid module. This module captures temporal pyramid features via several stacking pyramid units, each of them is composed of a fixed-size attention block and dilated convolution block. We also design an adaptive semantic fusion module, which leverages a unit-level attention block and a selective fusion block to integrate pyramid features interactively. Extensive experiments on audio-visual event localization and weakly-supervised audio-visual video parsing tasks verify the effectiveness of our approach.

Attention is a powerful and ubiquitous mechanism for allowing neural models to focus on particular salient pieces of information by taking their weighted average when making predictions. In particular, multi-headed attention is a driving force behind many recent state-of-the-art NLP models such as Transformer-based MT models and BERT. These models apply multiple attention mechanisms in parallel, with each attention "head" potentially focusing on different parts of the input, which makes it possible to express sophisticated functions beyond the simple weighted average. In this paper we make the surprising observation that even if models have been trained using multiple heads, in practice, a large percentage of attention heads can be removed at test time without significantly impacting performance. In fact, some layers can even be reduced to a single head. We further examine greedy algorithms for pruning down models, and the potential speed, memory efficiency, and accuracy improvements obtainable therefrom. Finally, we analyze the results with respect to which parts of the model are more reliant on having multiple heads, and provide precursory evidence that training dynamics play a role in the gains provided by multi-head attention.

A major goal of neuroscience is to understand brain computations during visual processing in naturalistic settings. A dominant approach is to use image-computable deep neural networks trained with different task objectives as a basis for linear encoding models. However, in addition to requiring tuning a large number of parameters, the linear encoding approach ignores the structure of the feature maps both in the brain and the models. Recently proposed alternatives have focused on decomposing the linear mapping to spatial and feature components but focus on finding static receptive fields for units that are applicable only in early visual areas. In this work, we employ the attention mechanism used in the transformer architecture to study how retinotopic visual features can be dynamically routed to category-selective areas in high-level visual processing. We show that this computational motif is significantly more powerful than alternative methods in predicting brain activity during natural scene viewing, across different feature basis models and modalities. We also show that this approach is inherently more interpretable, without the need to create importance maps, by interpreting the attention routing signal for different high-level categorical areas. Our approach proposes a mechanistic model of how visual information from retinotopic maps can be routed based on the relevance of the input content to different category-selective regions.

Most models of visual attention aim at predicting either top-down or bottom-up control, as studied using different visual search and free-viewing tasks. In this paper we propose the Human Attention Transformer (HAT), a single model that predicts both forms of attention control. HAT uses a novel transformer-based architecture and a simplified foveated retina that collectively create a spatio-temporal awareness akin to the dynamic visual working memory of humans. HAT not only establishes a new state-of-the-art in predicting the scanpath of fixations made during target-present and target-absent visual search and ``taskless'' free viewing, but also makes human gaze behavior interpretable. Unlike previous methods that rely on a coarse grid of fixation cells and experience information loss due to fixation discretization, HAT features a sequential dense prediction architecture and outputs a dense heatmap for each fixation, thus avoiding discretizing fixations. HAT sets a new standard in computational attention, which emphasizes effectiveness, generality, and interpretability. HAT's demonstrated scope and applicability will likely inspire the development of new attention models that can better predict human behavior in various attention-demanding scenarios. Code is available at https://github.com/cvlab-stonybrook/HAT.

Image customization, a crucial technique for industrial media production, aims to generate content that is consistent with reference images. However, current approaches conventionally separate image customization into position-aware and position-free customization paradigms and lack a universal framework for diverse customization, limiting their applications across various scenarios. To overcome these limitations, we propose IC-Custom, a unified framework that seamlessly integrates position-aware and position-free image customization through in-context learning. IC-Custom concatenates reference images with target images to a polyptych, leveraging DiT's multi-modal attention mechanism for fine-grained token-level interactions. We introduce the In-context Multi-Modal Attention (ICMA) mechanism with learnable task-oriented register tokens and boundary-aware positional embeddings to enable the model to correctly handle different task types and distinguish various inputs in polyptych configurations. To bridge the data gap, we carefully curated a high-quality dataset of 12k identity-consistent samples with 8k from real-world sources and 4k from high-quality synthetic data, avoiding the overly glossy and over-saturated synthetic appearance. IC-Custom supports various industrial applications, including try-on, accessory placement, furniture arrangement, and creative IP customization. Extensive evaluations on our proposed ProductBench and the publicly available DreamBench demonstrate that IC-Custom significantly outperforms community workflows, closed-source models, and state-of-the-art open-source approaches. IC-Custom achieves approximately 73% higher human preference across identity consistency, harmonicity, and text alignment metrics, while training only 0.4% of the original model parameters. Project page: https://liyaowei-stu.github.io/project/IC_Custom

Text-conditioned generative models for volumetric medical imaging provide semantic control but lack explicit anatomical guidance, often resulting in outputs that are spatially ambiguous or anatomically inconsistent. In contrast, structure-driven methods ensure strong anatomical consistency but typically assume access to ground-truth annotations, which are unavailable when the target image is to be synthesized. We propose a retrieval-augmented approach for Text-to-CT generation that integrates semantic and anatomical information under a realistic inference setting. Given a radiology report, our method retrieves a semantically related clinical case using a 3D vision-language encoder and leverages its associated anatomical annotation as a structural proxy. This proxy is injected into a text-conditioned latent diffusion model via a ControlNet branch, providing coarse anatomical guidance while maintaining semantic flexibility. Experiments on the CT-RATE dataset show that retrieval-augmented generation improves image fidelity and clinical consistency compared to text-only baselines, while additionally enabling explicit spatial controllability, a capability inherently absent in such approaches. Further analysis highlights the importance of retrieval quality, with semantically aligned proxies yielding consistent gains across all evaluation axes. This work introduces a principled and scalable mechanism to bridge semantic conditioning and anatomical plausibility in volumetric medical image synthesis. Code will be released.

Attention mechanisms are ubiquitous components in neural architectures applied to natural language processing. In addition to yielding gains in predictive accuracy, attention weights are often claimed to confer interpretability, purportedly useful both for providing insights to practitioners and for explaining why a model makes its decisions to stakeholders. We call the latter use of attention mechanisms into question by demonstrating a simple method for training models to produce deceptive attention masks. Our method diminishes the total weight assigned to designated impermissible tokens, even when the models can be shown to nevertheless rely on these features to drive predictions. Across multiple models and tasks, our approach manipulates attention weights while paying surprisingly little cost in accuracy. Through a human study, we show that our manipulated attention-based explanations deceive people into thinking that predictions from a model biased against gender minorities do not rely on the gender. Consequently, our results cast doubt on attention's reliability as a tool for auditing algorithms in the context of fairness and accountability.

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.

An attentional mechanism has lately been used to improve neural machine translation (NMT) by selectively focusing on parts of the source sentence during translation. However, there has been little work exploring useful architectures for attention-based NMT. This paper examines two simple and effective classes of attentional mechanism: a global approach which always attends to all source words and a local one that only looks at a subset of source words at a time. We demonstrate the effectiveness of both approaches over the WMT translation tasks between English and German in both directions. With local attention, we achieve a significant gain of 5.0 BLEU points over non-attentional systems which already incorporate known techniques such as dropout. Our ensemble model using different attention architectures has established a new state-of-the-art result in the WMT'15 English to German translation task with 25.9 BLEU points, an improvement of 1.0 BLEU points over the existing best system backed by NMT and an n-gram reranker.

Understanding the functional organization of higher visual cortex is a central focus in neuroscience. Past studies have primarily mapped the visual and semantic selectivity of neural populations using hand-selected stimuli, which may potentially bias results towards pre-existing hypotheses of visual cortex functionality. Moving beyond conventional approaches, we introduce a data-driven method that generates natural language descriptions for images predicted to maximally activate individual voxels of interest. Our method -- Semantic Captioning Using Brain Alignments ("BrainSCUBA") -- builds upon the rich embedding space learned by a contrastive vision-language model and utilizes a pre-trained large language model to generate interpretable captions. We validate our method through fine-grained voxel-level captioning across higher-order visual regions. We further perform text-conditioned image synthesis with the captions, and show that our images are semantically coherent and yield high predicted activations. Finally, to demonstrate how our method enables scientific discovery, we perform exploratory investigations on the distribution of "person" representations in the brain, and discover fine-grained semantic selectivity in body-selective areas. Unlike earlier studies that decode text, our method derives voxel-wise captions of semantic selectivity. Our results show that BrainSCUBA is a promising means for understanding functional preferences in the brain, and provides motivation for further hypothesis-driven investigation of visual cortex.

Large language models (LLMs) are increasingly integrated into high-stakes decision-making. Inspired by the theory of inattentional blindness in human cognition, we investigate whether LLMs, trained on human-preferred corpora that embed attentional biases, exhibit a similar limitation: failing to attend to subtle yet important contextual cues under explicit task instructions. To evaluate this, we introduce the task of explicit-implicit reasoning and present MixRea, a benchmark of 2,246 multiple-choice questions across 9 reasoning types with varying distributions of explicit and implicit information. Evaluation of 21 advanced LLMs shows that even the best-performing reasoning model (Gemini 2.5 Pro) achieves only 42.8\% consistency, revealing widespread inattentional blindness. To mitigate this, we propose Potential Relation Completion Prompting (PRCP), a prompting method that improves reasoning by recovering overlooked causal relations. Further analysis shows that this limitation persists across diverse multi-source reasoning tasks, highlighting the need for more cognitively aligned models.

Vision-Language Models (VLMs) have recently demonstrated remarkable capabilities in comprehending complex visual content. However, the mechanisms underlying how VLMs process visual information remain largely unexplored. In this paper, we conduct a thorough empirical analysis, focusing on attention modules across layers. We reveal several key insights about how these models process visual data: (i) the internal representation of the query tokens (e.g., representations of "describe the image"), is utilized by VLMs to store global image information; we demonstrate that these models generate surprisingly descriptive responses solely from these tokens, without direct access to image tokens. (ii) Cross-modal information flow is predominantly influenced by the middle layers (approximately 25% of all layers), while early and late layers contribute only marginally.(iii) Fine-grained visual attributes and object details are directly extracted from image tokens in a spatially localized manner, i.e., the generated tokens associated with a specific object or attribute attend strongly to their corresponding regions in the image. We propose novel quantitative evaluation to validate our observations, leveraging real-world complex visual scenes. Finally, we demonstrate the potential of our findings in facilitating efficient visual processing in state-of-the-art VLMs.

Although Visual-Language Models (VLMs) have shown impressive capabilities in tasks like visual question answering and image captioning, they still struggle with hallucinations. Analysis of attention distribution in these models shows that VLMs tend to processing textual tokens rather than visual tokens. This imbalance of attention distribution causes VLMs to favor textual knowledge in the case of multimodal knowledge conflicts, resulting in differences from the image information. In this paper, we propose Re-Balancing Contrastive Decoding (RBD) method, which employs textual and visual branches to recalibrate attention distribution in VLMs. Specifically, the textual branch injects image noise to stimulate the model's dependency on text, thereby reducing textual bias. Concurrently, the visual branch focuses on the selection of significant tokens, refining the attention mechanism to highlight the primary subject. This dual-branch strategy enables the RBD method to diminish textual bias while enhancing visual information. Experimental results demonstrate that our method, RBD, outperforms the existing methods by the CHAIR and POPE metrics, mitigate hallucinations without reducing the model's general capabilities.

Automated fetal head segmentation in ultrasound images is critical for accurate biometric measurements in prenatal care. While existing deep learning approaches have achieved a reasonable performance, they struggle with issues like low contrast, noise, and complex anatomical boundaries which are inherent to ultrasound imaging. This paper presents Attention-ResUNet. It is a novel architecture that synergistically combines residual learning with multi-scale attention mechanisms in order to achieve enhanced fetal head segmentation. Our approach integrates attention gates at four decoder levels to focus selectively on anatomically relevant regions while suppressing the background noise, and complemented by residual connections which facilitates gradient flow and feature reuse. Extensive evaluation on the HC18 Challenge dataset where n = 200 demonstrates that Attention ResUNet achieves a superior performance with a mean Dice score of 99.30 +/- 0.14% against similar architectures. It significantly outperforms five baseline architectures including ResUNet (99.26%), Attention U-Net (98.79%), Swin U-Net (98.60%), Standard U-Net (98.58%), and U-Net++ (97.46%). Through statistical analysis we confirm highly significant improvements (p < 0.001) with effect sizes that range from 0.230 to 13.159 (Cohen's d). Using Saliency map analysis, we reveal that our architecture produces highly concentrated, anatomically consistent activation patterns, which demonstrate an enhanced interpretability which is crucial for clinical deployment. The proposed method establishes a new state of the art performance for automated fetal head segmentation whilst maintaining computational efficiency with 14.7M parameters and a 45 GFLOPs inference cost. Code repository: https://github.com/Ammar-ss

Scaling pre-trained language models has resulted in large performance gains in various natural language processing tasks but comes with a large cost in memory requirements. Inspired by the position embeddings in transformers, we aim to simplify and reduce the memory footprint of the multi-head attention (MHA) mechanism. We propose an alternative module that uses only a single shared projection matrix and multiple head embeddings (MHE), i.e. one per head. We empirically demonstrate that our MHE attention is substantially more memory efficient compared to alternative attention mechanisms while achieving high predictive performance retention ratio to vanilla MHA on several downstream tasks. MHE attention only requires a negligible fraction of additional parameters (3nd, where n is the number of attention heads and d the size of the head embeddings) compared to a single-head attention, while MHA requires (3n^2-3n)d^2-3nd additional parameters.

The objective of this study is to investigate the application of various channel attention mechanisms within the domain of brain-computer interface (BCI) for motor imagery decoding. Channel attention mechanisms can be seen as a powerful evolution of spatial filters traditionally used for motor imagery decoding. This study systematically compares such mechanisms by integrating them into a lightweight architecture framework to evaluate their impact. We carefully construct a straightforward and lightweight baseline architecture designed to seamlessly integrate different channel attention mechanisms. This approach is contrary to previous works which only investigate one attention mechanism and usually build a very complex, sometimes nested architecture. Our framework allows us to evaluate and compare the impact of different attention mechanisms under the same circumstances. The easy integration of different channel attention mechanisms as well as the low computational complexity enables us to conduct a wide range of experiments on four datasets to thoroughly assess the effectiveness of the baseline model and the attention mechanisms. Our experiments demonstrate the strength and generalizability of our architecture framework as well as how channel attention mechanisms can improve the performance while maintaining the small memory footprint and low computational complexity of our baseline architecture. Our architecture emphasizes simplicity, offering easy integration of channel attention mechanisms, while maintaining a high degree of generalizability across datasets, making it a versatile and efficient solution for EEG motor imagery decoding within brain-computer interfaces.

Recently, State Space Models (SSMs), with Mamba as a prime example, have shown great promise for long-range dependency modeling with linear complexity. Then, Vision Mamba and the subsequent architectures are presented successively, and they perform well on visual tasks. The crucial step of applying Mamba to visual tasks is to construct 2D visual features in sequential manners. To effectively organize and construct visual features within the 2D image space through 1D selective scan, we propose a novel Multi-Head Scan (MHS) module. The embeddings extracted from the preceding layer are projected into multiple lower-dimensional subspaces. Subsequently, within each subspace, the selective scan is performed along distinct scan routes. The resulting sub-embeddings, obtained from the multi-head scan process, are then integrated and ultimately projected back into the high-dimensional space. Moreover, we incorporate a Scan Route Attention (SRA) mechanism to enhance the module's capability to discern complex structures. To validate the efficacy of our module, we exclusively substitute the 2D-Selective-Scan (SS2D) block in VM-UNet with our proposed module, and we train our models from scratch without using any pre-trained weights. The results indicate a significant improvement in performance while reducing the parameters of the original VM-UNet. The code for this study is publicly available at https://github.com/PixDeep/MHS-VM.

Understanding how the brain represents visual information is a fundamental challenge in neuroscience and artificial intelligence. While AI-driven decoding of neural data has provided insights into the human visual system, integrating multimodal neuroimaging signals, such as EEG, MEG, and fMRI, remains a critical hurdle due to their inherent spatiotemporal misalignment. Current approaches often analyze these modalities in isolation, limiting a holistic view of neural representation. In this study, we introduce BrainFLORA, a unified framework for integrating cross-modal neuroimaging data to construct a shared neural representation. Our approach leverages multimodal large language models (MLLMs) augmented with modality-specific adapters and task decoders, achieving state-of-the-art performance in joint-subject visual retrieval task and has the potential to extend multitasking. Combining neuroimaging analysis methods, we further reveal how visual concept representations align across neural modalities and with real world object perception. We demonstrate that the brain's structured visual concept representations exhibit an implicit mapping to physical-world stimuli, bridging neuroscience and machine learning from different modalities of neural imaging. Beyond methodological advancements, BrainFLORA offers novel implications for cognitive neuroscience and brain-computer interfaces (BCIs). Our code is available at https://github.com/ncclab-sustech/BrainFLORA.

In some medical imaging tasks and other settings where only small parts of the image are informative for the classification task, traditional CNNs can sometimes struggle to generalise. Manually annotated Regions of Interest (ROI) are sometimes used to isolate the most informative parts of the image. However, these are expensive to collect and may vary significantly across annotators. To overcome these issues, we propose a framework that employs saliency maps to obtain soft spatial attention masks that modulate the image features at different scales. We refer to our method as Adversarial Counterfactual Attention (ACAT). ACAT increases the baseline classification accuracy of lesions in brain CT scans from 71.39% to 72.55% and of COVID-19 related findings in lung CT scans from 67.71% to 70.84% and exceeds the performance of competing methods. We investigate the best way to generate the saliency maps employed in our architecture and propose a way to obtain them from adversarially generated counterfactual images. They are able to isolate the area of interest in brain and lung CT scans without using any manual annotations. In the task of localising the lesion location out of 6 possible regions, they obtain a score of 65.05% on brain CT scans, improving the score of 61.29% obtained with the best competing method.

In this work, we propose an architecture of LLM Modules that enables the transfer of knowledge from a large pre-trained model to a smaller model using an Enhanced Cross-Attention mechanism. In the proposed scheme, the Qwen2-1.5B model is frozen and its representations are passed through specially designed attention layers to the GPT-Neo-125M model, which is trained on limited computational resources. Experimental results on the Bespoke-Stratos-17k dataset demonstrate that after 15 epochs of training, the combined model generates responses comparable in quality to those obtained by distillation. We discuss the advantages of the modular approach, provide examples of input queries and comparative analysis, and outline prospects for further extension of the method.

Visual prompting techniques are widely used to efficiently fine-tune pretrained Vision Transformers (ViT) by learning a small set of shared prompts for all tokens. However, existing methods overlook the unique roles of different tokens in conveying discriminative information and interact with all tokens using the same prompts, thereby limiting the representational capacity of ViT. This often leads to indistinguishable and biased prompt-extracted features, hindering performance. To address this issue, we propose a plug-and-play Token Coordinated Prompt Attention (TCPA) module, which assigns specific coordinated prompts to different tokens for attention-based interactions. Firstly, recognizing the distinct functions of CLS and image tokens-global information aggregation and local feature extraction, we disentangle the prompts into CLS Prompts and Image Prompts, which interact exclusively with CLS tokens and image tokens through attention mechanisms. This enhances their respective discriminative abilities. Furthermore, as different image tokens correspond to distinct image patches and contain diverse information, we employ a matching function to automatically assign coordinated prompts to individual tokens. This enables more precise attention interactions, improving the diversity and representational capacity of the extracted features. Extensive experiments across various benchmarks demonstrate that TCPA significantly enhances the diversity and discriminative power of the extracted features. The code is available at https://github.com/zhoujiahuan1991/ICML2025-TCPA.

Diffusion Transformers (DiTs) have exhibited robust capabilities in image generation tasks. However, accurate text-guided image editing for multimodal DiTs (MM-DiTs) still poses a significant challenge. Unlike UNet-based structures that could utilize self/cross-attention maps for semantic editing, MM-DiTs inherently lack support for explicit and consistent incorporated text guidance, resulting in semantic misalignment between the edited results and texts. In this study, we disclose the sensitivity of different attention heads to different image semantics within MM-DiTs and introduce HeadRouter, a training-free image editing framework that edits the source image by adaptively routing the text guidance to different attention heads in MM-DiTs. Furthermore, we present a dual-token refinement module to refine text/image token representations for precise semantic guidance and accurate region expression. Experimental results on multiple benchmarks demonstrate HeadRouter's performance in terms of editing fidelity and image quality.

Recent advancements in Multimodal Large Language Models (MLLMs) have demonstrated remarkable progress in visual understanding. This impressive leap raises a compelling question: how can language models, initially trained solely on linguistic data, effectively interpret and process visual content? This paper aims to address this question with systematic investigation across 4 model families and 4 model scales, uncovering a unique class of attention heads that focus specifically on visual content. Our analysis reveals a strong correlation between the behavior of these attention heads, the distribution of attention weights, and their concentration on visual tokens within the input. These findings enhance our understanding of how LLMs adapt to multimodal tasks, demonstrating their potential to bridge the gap between textual and visual understanding. This work paves the way for the development of AI systems capable of engaging with diverse modalities.

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.

Image-text retrieval has developed rapidly in recent years. However, it is still a challenge in remote sensing due to visual-semantic imbalance, which leads to incorrect matching of non-semantic visual and textual features. To solve this problem, we propose a novel Direction-Oriented Visual-semantic Embedding Model (DOVE) to mine the relationship between vision and language. Our highlight is to conduct visual and textual representations in latent space, directing them as close as possible to a redundancy-free regional visual representation. Concretely, a Regional-Oriented Attention Module (ROAM) adaptively adjusts the distance between the final visual and textual embeddings in the latent semantic space, oriented by regional visual features. Meanwhile, a lightweight Digging Text Genome Assistant (DTGA) is designed to expand the range of tractable textual representation and enhance global word-level semantic connections using less attention operations. Ultimately, we exploit a global visual-semantic constraint to reduce single visual dependency and serve as an external constraint for the final visual and textual representations. The effectiveness and superiority of our method are verified by extensive experiments including parameter evaluation, quantitative comparison, ablation studies and visual analysis, on two benchmark datasets, RSICD and RSITMD.

Object binding, the brain's ability to bind the many features that collectively represent an object into a coherent whole, is central to human cognition. It groups low-level perceptual features into high-level object representations, stores those objects efficiently and compositionally in memory, and supports human reasoning about individual object instances. While prior work often imposes object-centric attention (e.g., Slot Attention) explicitly to probe these benefits, it remains unclear whether this ability naturally emerges in pre-trained Vision Transformers (ViTs). Intuitively, they could: recognizing which patches belong to the same object should be useful for downstream prediction and thus guide attention. Motivated by the quadratic nature of self-attention, we hypothesize that ViTs represent whether two patches belong to the same object, a property we term IsSameObject. We decode IsSameObject from patch embeddings across ViT layers using a similarity probe, which reaches over 90% accuracy. Crucially, this object-binding capability emerges reliably in self-supervised ViTs (DINO, MAE, CLIP), but markedly weaker in ImageNet-supervised models, suggesting that binding is not a trivial architectural artifact, but an ability acquired through specific pretraining objectives. We further discover that IsSameObject is encoded in a low-dimensional subspace on top of object features, and that this signal actively guides attention. Ablating IsSameObject from model activations degrades downstream performance and works against the learning objective, implying that emergent object binding naturally serves the pretraining objective. Our findings challenge the view that ViTs lack object binding and highlight how symbolic knowledge of "which parts belong together" emerges naturally in a connectionist system.

Large multimodal models (LMMs) "see" images by leveraging the attention mechanism between text and visual tokens in the transformer decoder. Ideally, these models should focus on key visual information relevant to the text token. However, recent findings indicate that LMMs have an extraordinary tendency to consistently allocate high attention weights to specific visual tokens, even when these tokens are irrelevant to the corresponding text. In this study, we investigate the property behind the appearance of these irrelevant visual tokens and examine their characteristics. Our findings show that this behavior arises due to the massive activation of certain hidden state dimensions, which resembles the attention sink found in language models. Hence, we refer to this phenomenon as the visual attention sink. In particular, our analysis reveals that removing the irrelevant visual sink tokens does not impact model performance, despite receiving high attention weights. Consequently, we recycle the attention to these tokens as surplus resources, redistributing the attention budget to enhance focus on the image. To achieve this, we introduce Visual Attention Redistribution (VAR), a method that redistributes attention in image-centric heads, which we identify as innately focusing on visual information. VAR can be seamlessly applied across different LMMs to improve performance on a wide range of tasks, including general vision-language tasks, visual hallucination tasks, and vision-centric tasks, all without the need for additional training, models, or inference steps. Experimental results demonstrate that VAR enables LMMs to process visual information more effectively by adjusting their internal attention mechanisms, offering a new direction to enhancing the multimodal capabilities of LMMs.

Automatic radiology report generation is booming due to its huge application potential for the healthcare industry. However, existing computer vision and natural language processing approaches to tackle this problem are limited in two aspects. First, when extracting image features, most of them neglect multi-view reasoning in vision and model single-view structure of medical images, such as space-view or channel-view. However, clinicians rely on multi-view imaging information for comprehensive judgment in daily clinical diagnosis. Second, when generating reports, they overlook context reasoning with multi-modal information and focus on pure textual optimization utilizing retrieval-based methods. We aim to address these two issues by proposing a model that better simulates clinicians' perspectives and generates more accurate reports. Given the above limitation in feature extraction, we propose a Globally-intensive Attention (GIA) module in the medical image encoder to simulate and integrate multi-view vision perception. GIA aims to learn three types of vision perception: depth view, space view, and pixel view. On the other hand, to address the above problem in report generation, we explore how to involve multi-modal signals to generate precisely matched reports, i.e., how to integrate previously predicted words with region-aware visual content in next word prediction. Specifically, we design a Visual Knowledge-guided Decoder (VKGD), which can adaptively consider how much the model needs to rely on visual information and previously predicted text to assist next word prediction. Hence, our final Intensive Vision-guided Network (IVGN) framework includes a GIA-guided Visual Encoder and the VKGD. Experiments on two commonly-used datasets IU X-Ray and MIMIC-CXR demonstrate the superior ability of our method compared with other state-of-the-art approaches.

Efficiently capturing multi-scale information and building long-range dependencies among pixels are essential for medical image segmentation because of the various sizes and shapes of the lesion regions or organs. In this paper, we present Multi-scale Cross-axis Attention (MCA) to solve the above challenging issues based on the efficient axial attention. Instead of simply connecting axial attention along the horizontal and vertical directions sequentially, we propose to calculate dual cross attentions between two parallel axial attentions to capture global information better. To process the significant variations of lesion regions or organs in individual sizes and shapes, we also use multiple convolutions of strip-shape kernels with different kernel sizes in each axial attention path to improve the efficiency of the proposed MCA in encoding spatial information. We build the proposed MCA upon the MSCAN backbone, yielding our network, termed MCANet. Our MCANet with only 4M+ parameters performs even better than most previous works with heavy backbones (e.g., Swin Transformer) on four challenging tasks, including skin lesion segmentation, nuclei segmentation, abdominal multi-organ segmentation, and polyp segmentation. Code is available at https://github.com/haoshao-nku/medical_seg.

Large vision-language models (LVLMs) have made substantial progress in integrating large language models (LLMs) with visual inputs, enabling advanced multimodal reasoning. Despite their success, a persistent challenge is hallucination-where generated text fails to accurately reflect visual content-undermining both accuracy and reliability. Existing methods focus on alignment training or decoding refinements but primarily address symptoms at the generation stage without probing the underlying causes. In this work, we investigate the internal mechanisms driving hallucination in LVLMs, with an emphasis on the multi-head attention module. Specifically, we introduce Vision-aware Head Divergence (VHD), a metric that quantifies the sensitivity of attention head outputs to visual context. Based on this, our findings reveal the presence of vision-aware attention heads that are more attuned to visual information; however, the model's overreliance on its prior language patterns is closely related to hallucinations. Building on these insights, we propose Vision-aware Head Reinforcement (VHR), a training-free approach to mitigate hallucination by enhancing the role of vision-aware attention heads. Extensive experiments demonstrate that our method achieves superior performance compared to state-of-the-art approaches in mitigating hallucinations, while maintaining high efficiency with negligible additional time overhead.

Recent progress in brain-guided image generation has improved the quality of fMRI-based reconstructions; however, fundamental challenges remain in preserving object-level structure and semantic fidelity. Many existing approaches overlook the spatial arrangement of salient objects, leading to conceptually inconsistent outputs. We propose a saliency-driven decoding framework that employs graph-informed saliency priors to translate structural cues from brain signals into spatial masks. These masks, together with semantic information extracted from embeddings, condition a diffusion model to guide image regeneration, helping preserve object conformity while maintaining natural scene composition. In contrast to pipelines that invoke multiple diffusion stages, our approach relies on a single frozen model, offering a more lightweight yet effective design. Experiments show that this strategy improves both conceptual alignment and structural similarity to the original stimuli, while also introducing a new direction for efficient, interpretable, and structurally grounded brain decoding.

Length extrapolation algorithms based on Rotary position embedding (RoPE) have shown promising results in extending the context length of language models. However, understanding how position embedding can capture longer-range contextual information remains elusive. Based on the intuition that different dimensions correspond to different frequency of changes in RoPE encoding, we conducted a dimension-level analysis to investigate the correlation between a hidden dimension of an attention head and its contribution to capturing long-distance dependencies. Using our correlation metric, we identified a particular type of attention heads, which we named Positional Heads, from various length-extrapolated models. These heads exhibit a strong focus on long-range information interaction and play a pivotal role in long input processing, as evidence by our ablation. We further demonstrate the correlation between the efficiency of length extrapolation and the extension of the high-dimensional attention allocation of these heads. The identification of Positional Heads provides insights for future research in long-text comprehension.

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.

Recent advances in sparse voxel representations have significantly improved the quality of 3D content generation, enabling high-resolution modeling with fine-grained geometry. However, existing frameworks suffer from severe computational inefficiencies due to the quadratic complexity of attention mechanisms in their two-stage diffusion pipelines. In this work, we propose Ultra3D, an efficient 3D generation framework that significantly accelerates sparse voxel modeling without compromising quality. Our method leverages the compact VecSet representation to efficiently generate a coarse object layout in the first stage, reducing token count and accelerating voxel coordinate prediction. To refine per-voxel latent features in the second stage, we introduce Part Attention, a geometry-aware localized attention mechanism that restricts attention computation within semantically consistent part regions. This design preserves structural continuity while avoiding unnecessary global attention, achieving up to 6.7x speed-up in latent generation. To support this mechanism, we construct a scalable part annotation pipeline that converts raw meshes into part-labeled sparse voxels. Extensive experiments demonstrate that Ultra3D supports high-resolution 3D generation at 1024 resolution and achieves state-of-the-art performance in both visual fidelity and user preference.

Effectively utilizing multi-sensory data is important for robots to generalize across diverse tasks. However, the heterogeneous nature of these modalities makes fusion challenging. Existing methods propose strategies to obtain comprehensively fused features but often ignore the fact that each modality requires different levels of attention at different manipulation stages. To address this, we propose a force-guided attention fusion module that adaptively adjusts the weights of visual and tactile features without human labeling. We also introduce a self-supervised future force prediction auxiliary task to reinforce the tactile modality, improve data imbalance, and encourage proper adjustment. Our method achieves an average success rate of 93% across three fine-grained, contactrich tasks in real-world experiments. Further analysis shows that our policy appropriately adjusts attention to each modality at different manipulation stages. The videos can be viewed at https://adaptac-dex.github.io/.

Recent Multimodal Large Language Models (MLLMs) have demonstrated significant progress in perceiving and reasoning over multimodal inquiries, ushering in a new research era for foundation models. However, vision-language misalignment in MLLMs has emerged as a critical challenge, where the textual responses generated by these models are not factually aligned with the given text-image inputs. Existing efforts to address vision-language misalignment have focused on developing specialized vision-language connectors or leveraging visual instruction tuning from diverse domains. In this paper, we tackle this issue from a fundamental yet unexplored perspective by revisiting the core architecture of MLLMs. Most MLLMs are typically built on decoder-only LLMs consisting of a causal attention mechanism, which limits the ability of earlier modalities (e.g., images) to incorporate information from later modalities (e.g., text). To address this problem, we propose AKI, a novel MLLM that unlocks causal attention into modality-mutual attention (MMA) to enable image tokens to attend to text tokens. This simple yet effective design allows AKI to achieve superior performance in 12 multimodal understanding benchmarks (+7.2% on average) without introducing additional parameters and increasing training time. Our MMA design is intended to be generic, allowing for application across various modalities, and scalable to accommodate diverse multimodal scenarios. The code is publicly available at https://github.com/sony/aki, and we will release our AKI-4B model to encourage further advancements in MLLMs across various directions.

Vision-and-language pretraining (VLP) in the medical field utilizes contrastive learning on image-text pairs to achieve effective transfer across tasks. Yet, current VLP approaches with the masked modeling strategy face two challenges when applied to the medical domain. First, current models struggle to accurately reconstruct key pathological features due to the scarcity of medical data. Second, most methods only adopt either paired image-text or image-only data, failing to exploit the combination of both paired and unpaired data. To this end, this paper proposes the MMCLIP (Masked Medical Contrastive Language-Image Pre-Training) framework to enhance pathological learning and feature learning via unpaired data. First, we introduce the attention-masked image modeling (AttMIM) and entity-driven masked language modeling module (EntMLM), which learns to reconstruct pathological visual and textual tokens via multi-modal feature interaction, thus improving medical-enhanced features. The AttMIM module masks a portion of the image features that are highly responsive to textual features. This allows MMCLIP to improve the reconstruction of highly similar image data in medicine efficiency. Second, our MMCLIP capitalizes unpaired data to enhance multimodal learning by introducing disease-kind prompts. The experimental results show that MMCLIP achieves SOTA for zero-shot and fine-tuning classification performance on five datasets. Our code will be available at https://github.com/AIGeeksGroup/MMCLIP.

As large language models evolve, there is growing anticipation that they will emulate human-like Theory of Mind (ToM) to assist with routine tasks. However, existing methods for evaluating machine ToM focus primarily on unimodal models and largely treat these models as black boxes, lacking an interpretative exploration of their internal mechanisms. In response, this study adopts an approach based on internal mechanisms to provide an interpretability-driven assessment of ToM in multimodal large language models (MLLMs). Specifically, we first construct a multimodal ToM test dataset, GridToM, which incorporates diverse belief testing tasks and perceptual information from multiple perspectives. Next, our analysis shows that attention heads in multimodal large models can distinguish cognitive information across perspectives, providing evidence of ToM capabilities. Furthermore, we present a lightweight, training-free approach that significantly enhances the model's exhibited ToM by adjusting in the direction of the attention head.

Attention mechanisms have seen wide adoption in neural NLP models. In addition to improving predictive performance, these are often touted as affording transparency: models equipped with attention provide a distribution over attended-to input units, and this is often presented (at least implicitly) as communicating the relative importance of inputs. However, it is unclear what relationship exists between attention weights and model outputs. In this work, we perform extensive experiments across a variety of NLP tasks that aim to assess the degree to which attention weights provide meaningful `explanations' for predictions. We find that they largely do not. For example, learned attention weights are frequently uncorrelated with gradient-based measures of feature importance, and one can identify very different attention distributions that nonetheless yield equivalent predictions. Our findings show that standard attention modules do not provide meaningful explanations and should not be treated as though they do. Code for all experiments is available at https://github.com/successar/AttentionExplanation.

We propose a novel attention mechanism, named Cog Attention, that enables attention weights to be negative for enhanced expressiveness, which stems from two key factors: (1) Cog Attention can shift the token deletion and copying function from a static OV matrix to dynamic QK inner products, with the OV matrix now focusing more on refinement or modification. The attention head can simultaneously delete, copy, or retain tokens by assigning them negative, positive, or minimal attention weights, respectively. As a result, a single attention head becomes more flexible and expressive. (2) Cog Attention improves the model's robustness against representational collapse, which can occur when earlier tokens are over-squashed into later positions, leading to homogeneous representations. Negative weights reduce effective information paths from earlier to later tokens, helping to mitigate this issue. We develop Transformer-like models which use Cog Attention as attention modules, including decoder-only models for language modeling and U-ViT diffusion models for image generation. Experiments show that models using Cog Attention exhibit superior performance compared to those employing traditional softmax attention modules. Our approach suggests a promising research direction for rethinking and breaking the entrenched constraints of traditional softmax attention, such as the requirement for non-negative weights.

Recent self-supervised learning (SSL) models trained on human-like egocentric visual inputs substantially underperform on image recognition tasks compared to humans. These models train on raw, uniform visual inputs collected from head-mounted cameras. This is different from humans, as the anatomical structure of the retina and visual cortex relatively amplifies the central visual information, i.e. around humans' gaze location. This selective amplification in humans likely aids in forming object-centered visual representations. Here, we investigate whether focusing on central visual information boosts egocentric visual object learning. We simulate 5-months of egocentric visual experience using the large-scale Ego4D dataset and generate gaze locations with a human gaze prediction model. To account for the importance of central vision in humans, we crop the visual area around the gaze location. Finally, we train a time-based SSL model on these modified inputs. Our experiments demonstrate that focusing on central vision leads to better object-centered representations. Our analysis shows that the SSL model leverages the temporal dynamics of the gaze movements to build stronger visual representations. Overall, our work marks a significant step toward bio-inspired learning of visual representations.

Mamba has recently garnered attention as an effective backbone for vision tasks. However, its underlying mechanism in visual domains remains poorly understood. In this work, we systematically investigate Mamba's representational properties and make three primary contributions. First, we theoretically analyze Mamba's relationship to Softmax and Linear Attention, confirming that it can be viewed as a low-rank approximation of Softmax Attention and thereby bridging the representational gap between Softmax and Linear forms. Second, we introduce a novel binary segmentation metric for activation map evaluation, extending qualitative assessments to a quantitative measure that demonstrates Mamba's capacity to model long-range dependencies. Third, by leveraging DINO for self-supervised pretraining, we obtain clearer activation maps than those produced by standard supervised approaches, highlighting Mamba's potential for interpretability. Notably, our model also achieves a 78.5 percent linear probing accuracy on ImageNet, underscoring its strong performance. We hope this work can provide valuable insights for future investigations of Mamba-based vision architectures.

Automated radiology report generation from 3D computed tomography (CT) volumes is challenging due to extreme sequence lengths, severe class imbalance, and the tendency of large language models (LLMs) to ignore visual tokens in favor of linguistic priors. We present Ker-VLJEPA-3B, a four-phase curriculum learning framework for free-text report generation from thoracic CT volumes. A phased training curriculum progressively adapts a Llama 3.2 3B decoder to ground its output in visual features from a frozen, self-supervised encoder. Our visual backbone (LeJEPA ViT-Large) is trained via self-supervised joint-embedding prediction on unlabeled CTs, without text supervision. Unlike contrastive models (CLIP, BiomedCLIP), this language-free backbone yields modality-pure representations. Vision-language alignment is deferred to the curriculum's bridge and generation phases. This modality-agnostic design can integrate any self-supervised encoder into an LLM without paired text during foundation training. Methodological innovations include: (1) zone-constrained cross-attention compressing slice embeddings into 32 spatially-grounded visual tokens; (2) PCA whitening of anisotropic LLM embeddings; (3) a positive-findings-only strategy eliminating posterior collapse; (4) warm bridge initialization transferring projection weights; and (5) selective cross-attention freezing with elastic weight consolidation to prevent catastrophic forgetting. Evaluated on the CT-RATE benchmark (2,984 validation volumes, 18 classes), Ker-VLJEPA-3B achieves a macro F1 of 0.429, surpassing the state-of-the-art (U-VLM, macro F1 = 0.414) by 3.6%, and reaching 0.448 (+8.2%) with threshold optimization. Ablation studies confirm 56.6% of generation quality derives from patient-specific visual content. Code and weights are available.

Learning object-centric representations of complex scenes is a promising step towards enabling efficient abstract reasoning from low-level perceptual features. Yet, most deep learning approaches learn distributed representations that do not capture the compositional properties of natural scenes. In this paper, we present the Slot Attention module, an architectural component that interfaces with perceptual representations such as the output of a convolutional neural network and produces a set of task-dependent abstract representations which we call slots. These slots are exchangeable and can bind to any object in the input by specializing through a competitive procedure over multiple rounds of attention. We empirically demonstrate that Slot Attention can extract object-centric representations that enable generalization to unseen compositions when trained on unsupervised object discovery and supervised property prediction tasks.

We present a simple mathematical model for the mammalian low visual pathway, taking into account its key elements: retina, lateral geniculate nucleus (LGN), primary visual cortex (V1). The analogies between the cortical level of the visual system and the structure of popular CNNs, used in image classification tasks, suggests the introduction of an additional preliminary convolutional module inspired to precortical neuronal circuits to improve robustness with respect to global light intensity and contrast variations in the input images. We validate our hypothesis on the popular databases MNIST, FashionMNIST and SVHN, obtaining significantly more robust CNNs with respect to these variations, once such extra module is added.

Free-text promptable 3D medical image segmentation offers an intuitive and clinically flexible interaction paradigm. However, current methods are highly sensitive to linguistic variability: minor changes in phrasing can cause substantial performance degradation despite identical clinical intent. Existing approaches attempt to improve robustness through stronger vision-language fusion or larger vocabularies, yet they lack mechanisms to consistently align ambiguous free-form expressions with anatomically grounded representations. We propose Skill-Evolving grounded Reasoning (SEER), a novel framework for free-text promptable 3D medical image segmentation that explicitly bridges linguistic variability and anatomical precision through a reasoning-driven design. First, we curate the SEER-Trace dataset, which pairs raw clinical requests with image-grounded, skill-tagged reasoning traces, establishing a reproducible benchmark. Second, SEER constructs an evidence-aligned target representation via a vision-language reasoning chain that verifies clinical intent against image-derived anatomical evidence, thereby enforcing semantic consistency before voxel-level decoding. Third, we introduce SEER-Loop, a dynamic skill-evolving strategy that distills high-reward reasoning trajectories into reusable skill artifacts and progressively integrates them into subsequent inference, enabling structured self-refinement and improved robustness to diverse linguistic expressions. Extensive experiments demonstrate superior performance of SEER over state-of-the-art baselines. Under linguistic perturbations, SEER reduces performance variance by 81.94% and improves worst-case Dice by 18.60%.

Reconstructing human dynamic vision from brain activity is a challenging task with great scientific significance. The difficulty stems from two primary issues: (1) vision-processing mechanisms in the brain are highly intricate and not fully revealed, making it challenging to directly learn a mapping between fMRI and video; (2) the temporal resolution of fMRI is significantly lower than that of natural videos. To overcome these issues, this paper propose a two-stage model named Mind-Animator, which achieves state-of-the-art performance on three public datasets. Specifically, during the fMRI-to-feature stage, we decouple semantic, structural, and motion features from fMRI through fMRI-vision-language tri-modal contrastive learning and sparse causal attention. In the feature-to-video stage, these features are merged to videos by an inflated Stable Diffusion. We substantiate that the reconstructed video dynamics are indeed derived from fMRI, rather than hallucinations of the generative model, through permutation tests. Additionally, the visualization of voxel-wise and ROI-wise importance maps confirms the neurobiological interpretability of our model.

Multimodal language models (MLMs) show promise for clinical decision support and diagnostic reasoning, raising the prospect of end-to-end automated medical image interpretation. However, clinicians are highly selective in adopting AI tools; a model that makes errors on seemingly simple perception tasks such as determining image orientation or identifying whether a CT scan is contrast-enhance are unlikely to be adopted for clinical tasks. We introduce Medblink, a benchmark designed to probe these models for such perceptual abilities. Medblink spans eight clinically meaningful tasks across multiple imaging modalities and anatomical regions, totaling 1,429 multiple-choice questions over 1,605 images. We evaluate 19 state-of-the-art MLMs, including general purpose (GPT4o, Claude 3.5 Sonnet) and domain specific (Med Flamingo, LLaVA Med, RadFM) models. While human annotators achieve 96.4% accuracy, the best-performing model reaches only 65%. These results show that current MLMs frequently fail at routine perceptual checks, suggesting the need to strengthen their visual grounding to support clinical adoption. Data is available on our project page.

Understanding human visual attention on a scene over time has applications in domains such as interface design and inferring cognitive states. Modeling visual scanpaths has historically relied on specialized architectures with hand-crafted priors. While these architectures can model fixation sequences, their rigid structural biases restrict easy extendability and flexible conditioning. For instance, integrating task-specific instructions or adapting to distinct viewer identities requires custom, disjoint architectural additions. We frame scanpath prediction purely as a discrete sequence modeling task. By mapping coordinates into a text vocabulary, we leverage the pretrained representations of Vision-Language Models. This framing absorbs diverse factors of variation: simple prompting allows for global conditioning, such as providing viewer identities to capture personalized biases, or task-specific objectives like visual search. The framework can also integrate per-fixation attributes, such as individual fixation durations, alongside spatial locations. The autoregressive alignment enables the scalable, exact computation of per-fixation log-likelihoods, directly equivalent to the commonly used Information Gain (IG) metric. Our model, DeepGaze3.5-VL, establishes a new state-of-the-art across multiple datasets, achieving 2.18 bits of IG on MIT1003, a 46% improvement over DeepGaze III. This advantage persists even when baselines use identical high-capacity vision encoders. Beyond predictive performance, our generative framework serves as a powerful computational tool for direct behavioral interventions, allowing for controlled in-silico simulations that would be experimentally difficult or impossible to conduct in vivo. We demonstrate this ability by performing controlled interventions on the durations of pre-saccadic fixations, recovering known oculomotor phenomena purely from data.

Attention-based mechanisms are widely used in machine learning, most prominently in transformers. However, hyperparameters such as the rank of the attention matrices and the number of heads are scaled nearly the same way in all realizations of this architecture, without theoretical justification. In this work we show that there are dramatic trade-offs between the rank and number of heads of the attention mechanism. Specifically, we present a simple and natural target function that can be represented using a single full-rank attention head for any context length, but that cannot be approximated by low-rank attention unless the number of heads is exponential in the embedding dimension, even for short context lengths. Moreover, we prove that, for short context lengths, adding depth allows the target to be approximated by low-rank attention. For long contexts, we conjecture that full-rank attention is necessary. Finally, we present experiments with off-the-shelf transformers that validate our theoretical findings.

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/.

Many papers have shown that attention heads work in conjunction with each other to perform complex tasks. It's frequently assumed that communication between attention heads is via the addition of specific features to token residuals. In this work we seek to isolate and identify the features used to effect communication and coordination among attention heads in GPT-2 small. Our key leverage on the problem is to show that these features are very often sparsely coded in the singular vectors of attention head matrices. We characterize the dimensionality and occurrence of these signals across the attention heads in GPT-2 small when used for the Indirect Object Identification (IOI) task. The sparse encoding of signals, as provided by attention head singular vectors, allows for efficient separation of signals from the residual background and straightforward identification of communication paths between attention heads. We explore the effectiveness of this approach by tracing portions of the circuits used in the IOI task. Our traces reveal considerable detail not present in previous studies, shedding light on the nature of redundant paths present in GPT-2. And our traces go beyond previous work by identifying features used to communicate between attention heads when performing IOI.

Modality following serves as the capacity of multimodal large language models (MLLMs) to selectively utilize multimodal contexts based on user instructions. It is fundamental to ensuring safety and reliability in real-world deployments. However, the underlying mechanisms governing this decision-making process remain poorly understood. In this paper, we investigate its working mechanism through an information flow lens. Our findings reveal that instruction tokens function as structural anchors for modality arbitration: Shallow attention layers perform non-selective information transfer, routing multimodal cues to these anchors as a latent buffer; Modality competition is resolved within deep attention layers guided by the instruction intent, while MLP layers exhibit semantic inertia, acting as an adversarial force. Furthermore, we identify a sparse set of specialized attention heads that drive this arbitration. Causal interventions demonstrate that manipulating a mere 5% of these critical heads can decrease the modality-following ratio by 60% through blocking, or increase it by 60% through targeted amplification of failed samples. Our work provides a substantial step toward model transparency and offers a principled framework for the orchestration of multimodal information in MLLMs.

Objective: To enable context-aware computer assistance in the operating room of the future, cognitive systems need to understand automatically which surgical phase is being performed by the medical team. The primary source of information for surgical phase recognition is typically video, which presents two challenges: extracting meaningful features from the video stream and effectively modeling temporal information in the sequence of visual features. Methods: For temporal modeling, attention mechanisms have gained popularity due to their ability to capture long-range dependencies. In this paper, we explore design choices for attention in existing temporal models for surgical phase recognition and propose a novel approach that uses attention more effectively and does not require hand-crafted constraints: TUNeS, an efficient and simple temporal model that incorporates self-attention at the core of a convolutional U-Net structure. In addition, we propose to train the feature extractor, a standard CNN, together with an LSTM on preferably long video segments, i.e., with long temporal context. Results: In our experiments, almost all temporal models performed better on top of feature extractors that were trained with longer temporal context. On these contextualized features, TUNeS achieves state-of-the-art results on the Cholec80 dataset. Conclusion: This study offers new insights on how to use attention mechanisms to build accurate and efficient temporal models for surgical phase recognition. Significance: Implementing automatic surgical phase recognition is essential to automate the analysis and optimization of surgical workflows and to enable context-aware computer assistance during surgery, thus ultimately improving patient care.

Scene Text Recognition (STR) remains challenging due to real-world complexities, where decoupled visual-linguistic optimization in existing frameworks amplifies error propagation through cross-modal misalignment. Visual encoders exhibit attention bias toward background distractors, while decoders suffer from spatial misalignment when parsing geometrically deformed text-collectively degrading recognition accuracy for irregular patterns. Inspired by the hierarchical cognitive processes in human visual perception, we propose OTSNet, a novel three-stage network embodying a neurocognitive-inspired Observation-Thinking-Spelling pipeline for unified STR modeling. The architecture comprises three core components: (1) a Dual Attention Macaron Encoder (DAME) that refines visual features through differential attention maps to suppress irrelevant regions and enhance discriminative focus; (2) a Position-Aware Module (PAM) and Semantic Quantizer (SQ) that jointly integrate spatial context with glyph-level semantic abstraction via adaptive sampling; and (3) a Multi-Modal Collaborative Verifier (MMCV) that enforces self-correction through cross-modal fusion of visual, semantic, and character-level features. Extensive experiments demonstrate that OTSNet achieves state-of-the-art performance, attaining 83.5% average accuracy on the challenging Union14M-L benchmark and 79.1% on the heavily occluded OST dataset-establishing new records across 9 out of 14 evaluation scenarios.

We introduce an attention-based method that uses learned binary attention masks to ensure that only attended image regions influence the prediction. Context can strongly affect object perception, sometimes leading to biased representations, particularly when objects appear in out-of-distribution backgrounds. At the same time, many image-level object-centric tasks require identifying relevant regions, often requiring context. To address this conundrum, we propose a two-stage framework: stage 1 processes the full image to discover object parts and identify task-relevant regions, while stage 2 leverages input attention masking to restrict its receptive field to these regions, enabling a focused analysis while filtering out potentially spurious information. Both stages are trained jointly, allowing stage 2 to refine stage 1. Extensive experiments across diverse benchmarks demonstrate that our approach significantly improves robustness against spurious correlations and out-of-distribution backgrounds.

Medical image segmentation remains particularly challenging for complex and low-contrast anatomical structures. In this paper, we introduce the U-Transformer network, which combines a U-shaped architecture for image segmentation with self- and cross-attention from Transformers. U-Transformer overcomes the inability of U-Nets to model long-range contextual interactions and spatial dependencies, which are arguably crucial for accurate segmentation in challenging contexts. To this end, attention mechanisms are incorporated at two main levels: a self-attention module leverages global interactions between encoder features, while cross-attention in the skip connections allows a fine spatial recovery in the U-Net decoder by filtering out non-semantic features. Experiments on two abdominal CT-image datasets show the large performance gain brought out by U-Transformer compared to U-Net and local Attention U-Nets. We also highlight the importance of using both self- and cross-attention, and the nice interpretability features brought out by U-Transformer.

Medical imaging is widely used in clinical practice for diagnosis and treatment. Report-writing can be error-prone for unexperienced physicians, and time- consuming and tedious for experienced physicians. To address these issues, we study the automatic generation of medical imaging reports. This task presents several challenges. First, a complete report contains multiple heterogeneous forms of information, including findings and tags. Second, abnormal regions in medical images are difficult to identify. Third, the re- ports are typically long, containing multiple sentences. To cope with these challenges, we (1) build a multi-task learning framework which jointly performs the pre- diction of tags and the generation of para- graphs, (2) propose a co-attention mechanism to localize regions containing abnormalities and generate narrations for them, (3) develop a hierarchical LSTM model to generate long paragraphs. We demonstrate the effectiveness of the proposed methods on two publicly available datasets.

Language and vision-language models have shown impressive performance across a wide range of tasks, but their internal mechanisms remain only partly understood. In this work, we study how individual attention heads in text-generative models specialize in specific semantic or visual attributes. Building on an established interpretability method, we reinterpret the practice of probing intermediate activations with the final decoding layer through the lens of signal processing. This lets us analyze multiple samples in a principled way and rank attention heads based on their relevance to target concepts. Our results show consistent patterns of specialization at the head level across both unimodal and multimodal transformers. Remarkably, we find that editing as few as 1% of the heads, selected using our method, can reliably suppress or enhance targeted concepts in the model output. We validate our approach on language tasks such as question answering and toxicity mitigation, as well as vision-language tasks including image classification and captioning. Our findings highlight an interpretable and controllable structure within attention layers, offering simple tools for understanding and editing large-scale generative models.

Transformer-based pre-training techniques of text and layout have proven effective in a number of document understanding tasks. Despite this success, multimodal pre-training models suffer from very high computational and memory costs. Motivated by human reading strategies, this paper presents Skim-Attention, a new attention mechanism that takes advantage of the structure of the document and its layout. Skim-Attention only attends to the 2-dimensional position of the words in a document. Our experiments show that Skim-Attention obtains a lower perplexity than prior works, while being more computationally efficient. Skim-Attention can be further combined with long-range Transformers to efficiently process long documents. We also show how Skim-Attention can be used off-the-shelf as a mask for any Pre-trained Language Model, allowing to improve their performance while restricting attention. Finally, we show the emergence of a document structure representation in Skim-Attention.

Transformer-based Large Language Models (LLMs) are the state-of-the-art for natural language tasks. Recent work has attempted to decode, by reverse engineering the role of linear layers, the internal mechanisms by which LLMs arrive at their final predictions for text completion tasks. Yet little is known about the specific role of attention heads in producing the final token prediction. We propose Attention Lens, a tool that enables researchers to translate the outputs of attention heads into vocabulary tokens via learned attention-head-specific transformations called lenses. Preliminary findings from our trained lenses indicate that attention heads play highly specialized roles in language models. The code for Attention Lens is available at github.com/msakarvadia/AttentionLens.

Recent approaches to multi-task learning (MTL) have focused on modelling connections between tasks at the decoder level. This leads to a tight coupling between tasks, which need retraining if a new task is inserted or removed. We argue that MTL is a stepping stone towards universal feature learning (UFL), which is the ability to learn generic features that can be applied to new tasks without retraining. We propose Medusa to realize this goal, designing task heads with dual attention mechanisms. The shared feature attention masks relevant backbone features for each task, allowing it to learn a generic representation. Meanwhile, a novel Multi-Scale Attention head allows the network to better combine per-task features from different scales when making the final prediction. We show the effectiveness of Medusa in UFL (+13.18% improvement), while maintaining MTL performance and being 25% more efficient than previous approaches.

Foundation models have transformed vision and language by learning general-purpose representations from large-scale unlabeled data, yet 3D medical imaging lacks analogous approaches. Existing self-supervised methods rely on low-level reconstruction or contrastive objectives that fail to capture the anatomical semantics critical for medical image analysis, limiting transfer to downstream tasks. We present MASS (MAsk-guided Self-Supervised learning), which treats in-context segmentation as the pretext task for learning general-purpose medical imaging representations. MASS's key insight is that automatically generated class-agnostic masks provide sufficient structural supervision for learning semantically rich representations. By training on thousands of diverse mask proposals spanning anatomical structures and pathological findings, MASS learns what semantically defines medical structures: the holistic combination of appearance, shape, spatial context, and anatomical relationships. We demonstrate effectiveness across data regimes: from small-scale pretraining on individual datasets (20-200 scans) to large-scale multi-modal pretraining on 5K CT, MRI, and PET volumes, all without annotations. MASS demonstrates: (i) few-shot segmentation on novel structures, (ii) matching full supervision with only 20-40\% labeled data while outperforming self-supervised baselines by over 20 in Dice score in low-data regimes, and (iii) frozen-encoder classification on unseen pathologies that matches full supervised training with thousands of samples. Mask-guided self-supervised pretraining captures broadly generalizable knowledge, opening a path toward 3D medical imaging foundation models without expert annotations. Code is available: https://github.com/Stanford-AIMI/MASS.

Identifying which brain regions represent a visual concept in the human brain is a central challenge in neuroscience. Existing approaches have localized coarse functional regions (e.g., faces, places) through activation maximization, identifying regions that activate strongly for a target concept relative to other concepts. Yet strong activation alone does not establish that a region represents the concept itself, as responses may instead be driven by correlated visual or semantic cues. We introduce BrainCause, an automated framework that combines generative and brain models to synthesize controlled stimuli and validate neural representations through targeted causal testing. Given a query specifying a concept of interest, our framework constructs targeted stimulus sets comprising concept images, counterfactual edits that remove the target concept while preserving other image content, and images with candidate correlated distractors. It then uses an image-to-fMRI encoding model to predict brain responses and searches for representations that respond specifically to the target concept over correlated alternatives. BrainCause returns validated candidate representations and proposes follow-up fMRI experiments to further test or extend its discoveries. Our approach successfully recovers known functional localizations and identifies new candidate representations across dozens of concepts, validated on both predicted and measured fMRI data. Critically, we show that without causal validation, a large fraction of localizations would be false positives, confirming that activation alone is insufficient evidence of representation.

Vision-Language Models (VLMs) face a bottleneck of prohibitive computational costs arising from massive visual token sequences during inference. Existing vision token reduction methods alleviate this burden, but they unintentionally preserve the isolated visual subject strictly aligned with the user's query, which fails to substantially explore salient subjects and their contextual relationships. In this paper, we propose SPpruner, a subject-centric progressive reduction paradigm that emulates the Focus-then-Context mechanism of the human visual perception system. Specifically, we first construct a focus identification module to explicitly model the interplay between visual saliency and semantic relevance. Herein, it can excavate the comprehensive visual subject spectrum to ensure a high-fidelity representation of visual input. Subsequently, a context-aware structural scanning module is developed to aggregate contextual cues from neighboring regions. As such, it can effectively restore global relational dependencies to uphold the structural integrity of the preserved subjects. Extensive experiments demonstrate that our paradigm consistently outperforms SOTA methods, achieving up to 2.53 times speedup with only 22.2% of visual tokens retained in Qwen2.5-VL and a 67% FLOPs reduction on LLaVA with a negligible 0.6% accuracy drop.

Attention sink (AS) is a consistent pattern in transformer attention maps where certain tokens (often special tokens or positional anchors) disproportionately attract attention from other tokens. We show that in transformers, AS is not an architectural artifact, but it is the manifestation of a fundamental geometric principle: the establishment of reference frames that anchor representational spaces. We analyze several architectures and identify three distinct reference frame types, centralized, distributed, and bidirectional, that correlate with the attention sink phenomenon. We show that they emerge during the earliest stages of training as optimal solutions to the problem of establishing stable coordinate systems in high-dimensional spaces. We show the influence of architecture components, particularly position encoding implementations, on the specific type of reference frame. This perspective transforms our understanding of transformer attention mechanisms and provides insights for both architecture design and the relationship with AS.

Understanding the hidden mechanisms behind human's visual perception is a fundamental question in neuroscience. To that end, investigating into the neural responses of human mind activities, such as functional Magnetic Resonance Imaging (fMRI), has been a significant research vehicle. However, analyzing fMRI signals is challenging, costly, daunting, and demanding for professional training. Despite remarkable progress in fMRI analysis, existing approaches are limited to generating 2D images and far away from being biologically meaningful and practically useful. Under this insight, we propose to generate visually plausible and functionally more comprehensive 3D outputs decoded from brain signals, enabling more sophisticated modeling of fMRI data. Conceptually, we reformulate this task as a {\em fMRI conditioned 3D object generation} problem. We design a novel 3D object representation learning method, Brain3D, that takes as input the fMRI data of a subject who was presented with a 2D image, and yields as output the corresponding 3D object images. The key capabilities of this model include tackling the noises with high-level semantic signals and a two-stage architecture design for progressive high-level information integration. Extensive experiments validate the superior capability of our model over previous state-of-the-art 3D object generation methods. Importantly, we show that our model captures the distinct functionalities of each region of human vision system as well as their intricate interplay relationships, aligning remarkably with the established discoveries in neuroscience. Further, preliminary evaluations indicate that Brain3D can successfully identify the disordered brain regions in simulated scenarios, such as V1, V2, V3, V4, and the medial temporal lobe (MTL) within the human visual system. Our data and code will be available at https://brain-3d.github.io/.

Medical image segmentation is a critical component of clinical workflows, enabling accurate diagnosis, treatment planning, and disease monitoring. However, despite the superior performance of transformer-based models over convolutional architectures, their limited interpretability remains a major obstacle to clinical trust and deployment. Existing explainable artificial intelligence (XAI) techniques, including gradient-based saliency methods and perturbation-based approaches, are often computationally expensive, require numerous forward passes, and frequently produce noisy or anatomically irrelevant explanations. To address these limitations, we propose XAI-CLIP, an ROI-guided perturbation framework that leverages multimodal vision-language model embeddings to localize clinically meaningful anatomical regions and guide the explanation process. By integrating language-informed region localization with medical image segmentation and applying targeted, region-aware perturbations, the proposed method generates clearer, boundary-aware saliency maps while substantially reducing computational overhead. Experiments conducted on the FLARE22 and CHAOS datasets demonstrate that XAI-CLIP achieves up to a 60\% reduction in runtime, a 44.6\% improvement in dice score, and a 96.7\% increase in Intersection-over-Union for occlusion-based explanations compared to conventional perturbation methods. Qualitative results further confirm cleaner and more anatomically consistent attribution maps with fewer artifacts, highlighting that the incorporation of multimodal vision-language representations into perturbation-based XAI frameworks significantly enhances both interpretability and efficiency, thereby enabling transparent and clinically deployable medical image segmentation systems.

In this work, we upgrade the multi-head attention mechanism, the core of the Transformer model, to improve efficiency while maintaining or surpassing the previous accuracy level. We show that multi-head attention can be expressed in the summation form. Drawing on the insight that not all attention heads hold equal significance, we propose Mixture-of-Head attention (MoH), a new architecture that treats attention heads as experts in the Mixture-of-Experts (MoE) mechanism. MoH has two significant advantages: First, MoH enables each token to select the appropriate attention heads, enhancing inference efficiency without compromising accuracy or increasing the number of parameters. Second, MoH replaces the standard summation in multi-head attention with a weighted summation, introducing flexibility to the attention mechanism and unlocking extra performance potential. Extensive experiments on ViT, DiT, and LLMs demonstrate that MoH outperforms multi-head attention by using only 50%-90% of the attention heads. Moreover, we demonstrate that pre-trained multi-head attention models, such as LLaMA3-8B, can be further continue-tuned into our MoH models. Notably, MoH-LLaMA3-8B achieves an average accuracy of 64.0% across 14 benchmarks, outperforming LLaMA3-8B by 2.4% by utilizing only 75% of the attention heads. We believe the proposed MoH is a promising alternative to multi-head attention and provides a strong foundation for developing advanced and efficient attention-based models.